How quickly should my HBA1C go down?

STARRYNIGHTS

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Hello!
It's my first post here.

I had my 5th baby 5 months ago.
I had a panel of blood tests one month post partum and was shocked when the doctor gave me the results showing I had become pre-diabetic, with a reading of 42, so just in the range.
That was the kick up the pants I needed, so i changed my diet that very day.

In 3 months I lost 15.4 lbs, eating about 1800-2000 cals per day, and with no exercise yet, as I had a Diastasis Recti of over 3 cm and was told not to exercise until it had closed suficiently by the physio I was referred to.
When I got my blood tests redone, my HBA1C reading was 35 (5.4%) so out of the danger zone and the doctor was happy with that and said he will erase the pre-diabetes diagnosis of my records.

My question was , how quickly should it go down, and what is an ideal healthy level for a hba1c to be at, if I continue eating well?
Did I get a good result in 3 mths with no exercise?
 
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TheBigNewt

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It might not go down much if any because it wasn't high to start with. But yours looks like it did. You didn't mention if you had gestational diabetes in the 5 pregnancies or not. Remember you can send the same blood sample through the lab a second time and it could drop from 42 to maybe 38. That's REALLY fast dieting results right?
 

STARRYNIGHTS

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Don't have diabetes
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It might not go down much if any because it wasn't high to start with. But yours looks like it did. You didn't mention if you had gestational diabetes in the 5 pregnancies or not. Remember you can send the same blood sample through the lab a second time and it could drop from 42 to maybe 38. That's REALLY fast dieting results right?

I had the glucose test in pregnancy and passed it.
It was the one where you drink a sugary solution and then have to sit there and wait for a few hours before being tested again.
They didn't tell me what the level was and I wished I got a print out of the test as it would be interesting to have a look now... but I do know that I had pee test strips at home and used to do them every now and then, out of interest and never showed glucose when the midwife tested, but one day, after I ate a 200 gram box of chocolate orange jellies for lunch as I was too tired to make a meal, I tested with a strip and threw a ++++ glucose reading on the strip- dark brown! :0
That freaked me out, and I didn't binge again like that, but the midwife just said that the kidneys can leak a bit of glucose and protein when pregnant and not to eat silly things like that again. :/

What should I hope to see my HBA1C come down to in another 3 months if eating really healthy?
I am not sure what to aim for, as from the reading i have done, 35 is not in a danger zone, but still not ideal?
I also read that often while losing weight, your glucose can go UP as can your cholesterol readings, as the blood stream is flooded with the fatty acids that are being metabolised, and often don't settle until your weight has been stable for over 4 weeks?

I am currently 63.5 kg and need to get back down to 50 kg again, and I have been told i can start exercising now, so hope the next blood test will be even better, but don't know what number to hope for...
 

Bluetit1802

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Hi and welcome to the forum,

Very well done on your latest HbA1c. It is perfect and ideal. Why would you want it to come down?

Exercise is good for general health, but is not obligatory in diabetes control. Your food choices are the key, but of course if you relax your eating plan too much you may end up where you started ... or worse. Whatever you have been doing has worked. Now you can exercise again this will help your general health, and sometimes just a brisk walk is all you need.

Do you have your own blood glucose meter? If not, I suggest you buy one. This will keep you on track, and will guide you in your food choices. Without one you are working blind. I don't think the pee sticks are at all reliable.

You can still ask for the print outs from your pregnancy glucose test (called an oral glucose tolerance test) and of course from your more recent tests.
 
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LittleGreyCat

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Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
Congratulations on your 5th child! :)

I imagine that exercise will be a part of your daily life for a long time to come.

Well done, and keep up the good work. Getting back to your target weight will be a good thing to do and may help to keep your BG at your current excellent level.

See https://www.diabetes.co.uk/what-is-hba1c.html for an idea of what a good HbA1c is.
 

STARRYNIGHTS

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Don't have diabetes
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Diet only
I suppose what i was wondering is what would be the hba1c of a healthy person?
For instance, one person could eat some sweets and their body deals with the glucose quickly without major spikes, while the other, with impaired glucose processing would react quite differently to the same food with big spikes...so I was wondering , if i get it to a lower level, away from heading back up to the pre-diabetic numbers, that surely means my body is functioning better as it is processing the glucose better...Does that make sense???

The doctor didn't tell me what to aim for...
When I had the hba1c two other times, I got a reading of 41 and then a 39 a year or so apart and didn't do anything as I wasnt "in the danger zone yet" (and wanted to still enjoy blocks of chocolate at leisure) but now i know that even edging up to the glucose levels of pre-diabetes, causes damage in your body and arteries, so surely lower is better?
 

STARRYNIGHTS

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Don't have diabetes
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Congratulations on your 5th child! :)

I imagine that exercise will be a part of your daily life for a long time to come.

Well done, and keep up the good work. Getting back to your target weight will be a good thing to do and may help to keep your BG at your current excellent level.

Thanks Little grey cat

I always did exercise daily, running and working out, and only had a BMI of 18.2, but over the last 5 yrs with 3 babies in that time, got into some bad habits with eating chocolate for calories at times, when I had my handful and couldn't get myself proper food, and not exercising regularily, so by the time I got pregnant with no 5, I already weighed 64 kg which put my bmi at almost 25....I am thankful for that last bloodtest, as it knocked some sense into me that i have to get healthy again, and stop abusing my body with bad food!

Nana and my auty both had/have type 2 and my mum, who is now 75 is just pre-diabetic with a reading of 42, but she is determined it won't progress.
Nana and my Aunty ate a fair bit of "naughty food" over their life time, whereas my mum has always been moderate, and not prone to bingeing on stuff, so she probably staved it off longer.
At least now i know I wasn't getting away with it and I can turn the tide on my habits!
 

LittleGreyCat

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4,233
Type of diabetes
Type 2
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Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
I suppose what i was wondering is what would be the hba1c of a healthy person?
For instance, one person could eat some sweets and their body deals with the glucose quickly without major spikes, while the other, with impaired glucose processing would react quite differently to the same food with big spikes...so I was wondering , if i get it to a lower level, away from heading back up to the pre-diabetic numbers, that surely means my body is functioning better as it is processing the glucose better...Does that make sense???

The doctor didn't tell me what to aim for...
When I had the hba1c two other times, I got a reading of 41 and then a 39 a year or so apart and didn't do anything as I wasnt "in the danger zone yet" (and wanted to still enjoy blocks of chocolate at leisure) but now i know that even edging up to the glucose levels of pre-diabetes, causes damage in your body and arteries, so surely lower is better?

Lower is not always better.
More an issue for T1s, but going too low with your BG can also damage your body.
A bit like anorexia, lower is not always good for weight. A healthy balance is best.
 
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TheBigNewt

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Type 1
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I am currently 63.5 kg and need to get back down to 50 kg again, and I have been told i can start exercising now, so hope the next blood test will be even better, but don't know what number to hope for...
Hope it doesn't go up.
 

AloeSvea

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Hi @STARRYNIGHTS. My understanding that 'really healthy' cells are in the low 30s range, HBA1c-wise.

And HBA1c of 35, from your being in the prediabetic range of 42 is really good, as others above have said. Very well done indeed.

It wouldn't take much, in terms of not eating carby food, for you to get in the really healthy range, IMHO (just saying!).

Because of the family history, I would keep an eye on your height-waist ratio, and keep that as well below .50 as you can(ie that your waist size is below half your height), rather than watch your weight per se. Because waist size seems to be a good reflection of insulin resistance, which is where the prediabetes and diabetes is coming from, and you are prone to it. Could be a good reason to be a moderate carber and see how that goes for you? Keep your glucose levels down, so you insulin levels, therefore your cells lovely and insulin sensitive! (And therefore no prediabetes not to mention the dastardly diabetes.)

I have a girlfriend who recently got diagnosed with an HBA1c of 42, and what I just wrote is what I have said to her.
 

STARRYNIGHTS

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Don't have diabetes
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Hi @STARRYNIGHTS. My understanding that 'really healthy' cells are in the low 30s range, HBA1c-wise.

And HBA1c of 35, from your being in the prediabetic range of 42 is really good, as others above have said. Very well done indeed.

It wouldn't take much, in terms of not eating carby food, for you to get in the really healthy range, IMHO (just saying!).

Because of the family history, I would keep an eye on your height-waist ratio, and keep that as well below .50 as you can(ie that your waist size is below half your height), rather than watch your weight per se. Because waist size seems to be a good reflection of insulin resistance, which is where the prediabetes and diabetes is coming from, and you are prone to it. Could be a good reason to be a moderate carber and see how that goes for you? Keep your glucose levels down, so you insulin levels, therefore your cells lovely and insulin sensitive! (And therefore no prediabetes not to mention the dastardly diabetes.)

I have a girlfriend who recently got diagnosed with an HBA1c of 42, and what I just wrote is what I have said to her.


Thanks Aloe Svea!

Funnily enough, I got it down by going 80% cards/ 10% fat / 10% protein following Dr Neal Barnard's / Dr McDougall's suggestions.

So whole foods, plant based no added fats or oils.
Ofcourse I have mostly avoided bad cqrbohydrates like cakes, biscuits, sweets white bread etc for the most part, although for the fist month and a half I was having half a white naan bread (100 grams) with my Kale lentil soup for lunch each day, plus a white cinnamon raison bagel for breakfast, but that was still a good change from what I was having before, then I re-adjusted and swapped the bagel for breakfast (no marg) for Porridge with oat milk and a dash of maple syrup, had my large bowl of kale lentil soup for lunch most days, and if I do have some naan, I choose a wholemeal one (which is not nearly as yummy! :/ ) and for dinner most nights it was 5 baked potatoes,2 baked sweet potatoes, no oil, with garlic and chilli grinder on top plus a large salad with mix raw veg and mixed courgette, aubergine and asparagus chargrilled no oil on top, with 4 green olives sliced and 1/4 avocado and 1 tsp chia seed. If i didn't have potatoes and salad for dinner, which was my favorite, it would be Rice and veg, white rice for the first half and I changed to brown rice the last 6 weeks as I tried to make things healthier.
For a snack watching a movie etc, I made air popped popcorn and used a squirt or two of the fry light butter flavoured spray tossed in to flavour it, with a pinch of salt which was still very low fat at 0.1 grams a spray.
I had one whoopsie where I scoffed 6 chocolate digestives in a row one day when I was stressed and upset, but after that asked my husband to hide all the biscuits as I realised I wasn't trust worthy under pressure!
I got a (!) on my serum ALT bloodtest on the liver panel before I changed my eating, and it cam in at 35, 33 being the upper limit, and on the next test it was 23, so that moved in the right direction too!

I tracked it all in cronometer too to make sure I stuck to the 80/10/10 principle.
Mum was really interested that it had worked, as she always freaks out about potatoes etc, but that is where a large amount of my calories came from!
She has pre-diabetes too and carefully measures her blood sugars etc, but hasn't been able to shake it, so i think she is watching with interest as it is so different to what she has been trying.

I was really quite surprised after the test results that the maxium advise i got from the doctors was the receptionist ssaying to me "No more cakes, biscuits and unhealthy sweets and we'll test again in a year!"

There is no one to ask all the questions to, like, if I get rid of pre diabetes, does that mean I am normal, with a functioning pancreas again? Am I still insulin resistant, or has that disappeared now, and all that.

Thanks for the tip on the waistline.
I will measure that...
I have been skinny most of my life, but as I mentioned am just coming down in weight again after baby no 5 and am currently a sz 12 on top instead of my usual 8, and I carry my fat around my middle, not my hips, which ofcourse is the dastardly apple shape.
When slim, I have a good waist, but when i put on weight, it fills out there first.
 

AloeSvea

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I hear you @STARRYNIGHTS, on the fat being carried around your middle - absolutely me too, and is a common story of those prone to blood glucose dysregulation. (A sign of the dastardly insulin resistance-prone body type.)

The five children sounds wonderful! Now I am past all that and have adult children - I wish I had had 13. (My adult kids merely smile indulgently at that.) (But I really do think that!) (No grandchildren yet.)

I am a LCHF/Keto eater, and a big meat, poultry, fish eater, so I am amazed you were able to get so much better on a diet like the one above! But that goes to show, perhaps, how well functioning your liver and pancreas are still. I have very stubborn insulin resistance, and probably in my liver, so an 80% carb diet would have me well in the red danger zone on the HBA1c-meter displayed on this website :). But what is truly wonderful about this forum is it shows how varied the different types of ways of eatings are, and how differently different bodies/people respond to them.

My experience with folks in my life who have gotten into the prediabetic zone is it has not taken them much adjustment to get out of it, and get healthier. But what I have noticed is when I strongly suggest they have once every three month HBA1c's, or once every six months - not once a year as your doctor suggested - and they do, they can go very quiet on me. I don't really know what this means, but I suspect their HBA1c has been varying a lot, depending on their diet (and to a lesser extent activity/exercise levels). (They go quiet on me I think because they know I am going to suggest they lower their carbs! As a matter of course.) (And who wants that, right?)

My mother too had a prediabetes level of 42, and I was thrilled when she got it down to 37 by upping her activity level. (She is very physically active.) It didn't take much, but I have not been able to get her (well, her doctor actually) to have more regular HBA1c's to keep an eye on that. I do not know this, but I imagine - easy go, easy come? might be the story. As in her levels could go up and down a lot. As I say though - I have no idea if this is the case or not.

Different countries have different statistics/recorded outcomes of those who get into the prediabetic zone, in terms of staying out of it, and not going on to develop fullblown diabetes. I know my own, but it might be interesting for you to find out your country's stats on it? (They must be in this website somewhere.)

If they are anything like my own country's, it might encourage you to lower your carb intake generally, to make sure you are not one of the ones who crosses over into the dark side! In my country (NZ), 70% of those who have been officially diagnosed with prediabetes go on to develop diabetes given enough time (they don't say what that is).

You are in exactly the right place to make sure you are not one of those that crosses into T2D! (As in on this forum.)
 
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STARRYNIGHTS

Active Member
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Type of diabetes
Don't have diabetes
Treatment type
Diet only
I am in the UK- I think I may be able to have a test every 3 mths, as the doctor said i can have one again in 3 mths.
I think their standard line is test once a yr, but will allow you if you ask, otherwise i will just pay for a private one, as I want to make sure that what i am doing is working.
I womder whether 70% of pre-diabetics go on eventually to full blown diabetes as they can't make the adjustment to curbing their eating/lifestyle, as I know many friends with different ailments that are preventable and just say "what the hell- its genetic/not my fault etc, " but don't do their bit to head towards wellness.
Digging their grave with their fork so to speak...
I was eating way too much fat before, and a fair bit of sugar, so I have cut both of those right down.
I will make sure to update the thread each time I get a blood test, so people can see what pattern is happening.

You might find it interesting to watch his Ted Talk, even though its different from what you do, as he explains how it works.
There is an inset video on the page here.
http://www.pcrm.org/media/experts/neal-barnard-diabetes-book

And this Blog explains it a little:
https://blogs.webmd.com/life-with-diabetes-2/2010/05/low-fat-vegan-diet-for-reversing-diabetes.html
Low-Fat Vegan Diet for Reversing Diabetes
By Michael Dansinger, MD

The WebMD Health Exchange
I have often declared that there are many good eating strategies for diabetes reversal. All eating strategies have strengths and weaknesses. In this blog entry, I’ll share my thoughts about Dr. Neal Barnard’s program for reversing diabetes.

BarnardBook.jpg

I like Dr. Barnard’s approach. He is a physician who cares deeply about fighting diabetes and getting at the root causes. He recognizes the power of lifestyle change for reversing and preventing health problems, and he has been a leader in framing type 2 diabetes as a potentially “reversible” condition. He has published several books, including the Program for Reversing Diabetes (Rodale, 2007).

Dr. Barnard points out that people with type 2 diabetes or those at risk for diabetes accumulate abnormal fat droplets inside the muscle cells, and this leads to insulin resistance. Eating a high-fat American diet can worsen the problem. He also points out that weight loss can reduce insulin resistance and reduce or eliminate the abnormal fat droplets. This reduction of insulin resistance (or increase in sensitivity to insulin) results in improvement in blood glucose and A1c levels because the available insulin can now work more effectively to usher glucose from the blood into the muscles and organs that use glucose.

He reasons that minimizing dietary fat, especially animal fat (found in meat, eggs and dairy) can directly reduce or eliminate the fat deposits in the muscles. He has repeatedly demonstrated in published research studies (as have other researchers) that a low-fat vegan diet can reduce insulin resistance, improve insulin sensitivity and reduce elevated glucose and A1c levels. Part of the improvement is a result of the weight loss, and part of the improvement is driven by the diet itself. Add exercise to the diet and weight loss and you have a great prescription for type 2 diabetes reversal or prevention.

vegan_dinner.jpg


Vegan Dinner
Elaine Vigneault / CC BY 2.0
He frames the vegan diet according to 4 main food groups – whole grains, legumes, vegetables and fruits. He recommends steering away from refined grains and foods made from refined grains (such as white bread) as well as significant amounts of nuts, vegetable oil or high-fat vegetables and fruits. All animal products, including egg whites and non-fat dairy are out. Soy foods, if low in fat, are in.

His book provides a plethora of breakfast, lunch, dinner, and snack ideas and recipes, and a strategy for adapting to this way of eating. A one-day menu might include:

  • Veggie sausage, rye toast, oatmeal with raisins and cantaloupe for breakfast
  • Green salad, split-pea soup and hummus-cucumber-tomato sandwich on rye for lunch
  • Spinach salad, pasta with tomato mushroom sauce and broccoli for dinner
  • Fruit for snacks
In my view, this is a solid eating plan that consistently produces good results when the plan is followed carefully. Whole grains help reverse diabetes in the context of a low-fat eating strategy. Fruits, vegetables and legumes do the same. Most people like these foods and find them filling and satisfying. Unfortunately, most people with type 2 diabetes find the vegan diet challenging to start and continue without exceptional coaching.

The vegan diet is a huge leap from the typical Western diet consumed by many with type 2 diabetes. Meat, cheese and animal products are hard for people to avoid after eating such foods daily for decades. Ditto for refined starches and foods high in sugar and fat. All eating strategies require dietary sacrifices (food types and/or portions), and going vegan low-fat may be one of the most ambitious changes one can make.

The payoff is high, but the dietary change is just too extreme for most folks. This is unfortunate, and I believe well-trained lifestyle coaches can help patients/clients overcome the barriers in many cases. If we in the medical profession tried harder, we could help a lot of people go vegan and reap the health benefits.

I’m grateful for Dr. Barnard’s leadership on this issue and see him as a great role model who personally practices what he prescribes. The low-fat vegan diet is not the only way to reverse diabetes, but it is an excellent option that is seriously underrated by patients and health experts.

- Michael Dansinger, MD
 
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AloeSvea

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Yes, I think testing every three months is a really good way to go.

Alas, I am one of those folk who has not been able to reverse the blood glucose dysregulation into the healthy zone, and not for want of trying! I have not tried the Vegan/Vegetarian route, as I don't think that is for me (wrong body type! Wrong lifestyle. Wrong personal taste :)). If I am going to go 'extreme', as in more 'extreme' than what I do now in the dietary sense I would be going carnivore/zero carb, in fact, that is what I have begun experimenting with. But I am a low carb high/healthy fat/keto eater at the moment, so the next step is in that direction.

I do like Dr Barnard's work too, on going the veg route. I like Dr Mercola on this as well. It's great that you have found a way of eating that is working well for you. (That's what it is all about really, in the longterm, for keeping out of the diabetes zone.) I admire vegans for sure.
 

STARRYNIGHTS

Active Member
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Don't have diabetes
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Diet only
Yes, I think testing every three months is a really good way to go.

I have been keeping an eye on my fasting glucose for the last few weeks after buying a meter, as i am still obviously concerned that everything is ok.
I still can't have the next HBA1C for a while, but found a website where you can pay privately for one.

I had one bad day where my fasting glucose was 6.2 and after a meal i spiked to 13.6 1 hr ppd/ 11.3 2 hr ppd which scared me, but...it was a day where one of our pets was killed and it was horrible, so maybe that affected it all as i have not had anything like that any other days.

I am not sure exactly what i should be aiming for but i assume under 5.6 each morning is preferable, and better in the 4's???
I feel like after a diagnosis, we are just left to leave the office and figure it all out for ourselves, wading through all the information, self educating and experimenting on ourselves!

My fastings for the last few weeks have been as follows:


10/4/18
4.8 fasting

11/4/18
6.2 fasting :/

12/4/18
fasting 5.1

14/4/18
fasting 5.5

15/4/18
Fasting 5.9

16/4/18
Fasting 5.6

17/4/18
Fasting 5.0

18/4/18
Fasting 5.4

19/4/18
Fasting 5.4

20/4/18
Fasting 4.8

21/4/18
Fasting 4.8

22/4/18
Fasting 4.9

23/4/18
5.4

24/4/18
Fasting 4.7

25/4/18
Fasting 4.4

26/4/18
5.6

27/4/18
Fasting 5.3

28/4/18
Fasting 5.3

29/4/18
Fasting 4.9

30/4/18
5.2

1/5/18
4.9

2/5/18
4.5
 
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vanillapie

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Congrats on the baby and your HbA1c results! It sounds like a case of just keep doing what you're doing. It may not necessarily go down, but staying in the healthy zone is what matters!
 

AloeSvea

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Hi again @STARRYNIGHTS.

I can but look at your gorgeous Fasting Blood Glucose results and weep! What you are doing is obviously working for you very very well.

I was listening/watching some podcast/youtube recently, can't remember which, which said one of the reasons for some folks being able to get out of prediabetes, or even diabetes, on a high carb plant based diet - is the switch to whole foods, so big reduction in all the additives and bad fats we have in processed foods, is what it takes for those folks to get out of the insulin resistance causing the blood glucose dysregulation. And all that lovely accessible nutrition in the whole foods of course - the way to go.

I would not worry about the odd 6.2er, when you are otherwise in the 4s and 5s of a morning.

And talking of that 6.2, and a high in the 13s - I am very sorry to hear about the horrible experience you had where one of your pets died! Yes, alas, stress and upset will do that for sure.

"I feel like after a diagnosis, we are just left to leave the office and figure it all out for ourselves, wading through all the information, self educating and experimenting on ourselves!"
Yes. I agree. But that is because there is a still a divide between the kind of information like we get in this forum, and the conventional medicine line and that coming from state authorities. I hope this current divide is closing - so medical professionals can talk about whole foods diets that work, or at least - direct us to specialised diabetes medical professionals with a strong interest in food as medicine for metabolic diseases. I am optimistic that this will happen eventually.

 

STARRYNIGHTS

Active Member
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Type of diabetes
Don't have diabetes
Treatment type
Diet only
My last few days have been a bit @@&%@%£!!!!

3/5/18


4.6


4//5/18


5.2


5/5/18


6.6 !!! rose to 7.7 later still fasting :/


6/5/18


6.5

Not sure what has been going on!

Well, ok, I'll be honest here :/
I have binged on some sweets!
Vegan Jelly sweets with no fat!
I know they are not health food, but I had some a few weeks ago and it made no difference, so I have a little more here and there, and the other difference is, i have as a rule been avoiding any added fats, like Avocado, nuts etc, and oils but i have had a quarter of an avocado in this or that the last week.
I have also been making banana nicecream a bit in my icecream machine which is just blended bananas and cocoa.
I bought 1% fat cocoa, but it doesn't taste nice like the 23% cocoa does so I used the good stuff instead!
I was shocked when it measured 6.6 the other morning and then a while later said 7.7 when I still hadn't eaten! :/

Anyone else would think that that all was rather healthy (well, not the sweets) but I obviously need to avoid the added fat for now.
I imagine I still have internal fat possibly in my liver etc, and eating higher fat foods (with high carbs ) is not good. It seems you either have to avoid the fats, or avoid the carbs, but the two together are bad news.
It was working so well before I got a little greedy! :/

Back to basics again!
I just want to eat stuff like everyone else and not have to think about it!
I see peoples shopping trolley filled with all sorts of ***** and none of them have a care in the world about what they're eating- they just eat it!

I will lay off any avocado, and not eat any more sweets, and then see what happens.
I was good and avoided sugar for months, but it snared me again!
 

eggs11

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Messages
638
Type of diabetes
Type 2
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Diet only
Hi @STARRYNIGHTS - I've just been catching up on this thread and found it very interesting reading indeed. I'm am fascinated by how WFPB works well for some and low carb/keto works well for others - one thing you mentioned that seems key is that no processed food and processed oils are allowed on either diet. I didn't go down the WFPB route as it seemed to close to what I was already eating and I didn't want to give up eggs and cheese, plus for me lentils spike me. But always interesting to hear of other experiences.