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Managing bGs

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janeecee said:
The 'eat to the meter' philosophy is basically sound re finding what works, but in my experience I have not fared so well by cutting carbs because, as I explained before, it works for a week or so and then my readings jump overnight. When I cut the carbs in response, the same thing happens again. Low carbing does not work for me in some linear "cut the carbs and the BG levels will follow" way. We're all different, and what works for one won't necessarily work for another.


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Do you normally experience any DP (dawn phenomenum) effect on your normal diet? In all people diabetic or not the liver releases glucose in the period just before you wake up to give you energy for the new day. In non diabetics any excess is normally mopped up quickly by an insulin response however in T2's and those with insulin resistance that glucose can take several hours to go. It sounds like in response to reducing carbs your liver is reacting by dumping more than normal (for whatever reason) and therefore you are seeing that as an enhanced DP effect in the morning. If you are currently happy with your overall BG's on your regime then I wouldn't change what you're doing because as you say everyone is different and the knack in all of this is to find the long term sustainable regime that works for you as an individual.

If like me and many (maybe the majority) of others you where diagnosed with a significant DP problem then you look at the issue as how to get your liver to stop dumping so much glucose overnight and how to reduce the spike it gives you as quickly as possible. Most find that carb restriction (however its done) will gradually reduce DP over a period of several weeks but even now my wake up BG reading is still my highest of the day and I have learnt to just accept that will likely always be the case. At diagnosis I started using two simple rules. First like others (but not all) I've found that introducing a sharp but controlled spike in my BG's at breakfast kick starts me so that the DP effect is mopped up quicker. To do that I'll have something that contains a small amount of sugar like a few raspberries or strawberries. Secondly whenever I woke up with a FBG more than 6 I went for a brisk 5 or 10 minute walk around the local streets as the exercise will get your muscles to help soak up the excess.
 
gezzathorpe said:
xyzzy said:
gezzathorpe said:
You could have used a julienne peeler on your courgettes for a 'pseudo spaghetti'.
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Yes. You can also slice them into chunky chip shapes, coat them with Parmesan cheese and shove in the oven to make a delish replacement for chips.
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That sounds nice, but wouldn't look so good in a spaghetti sauce. :***:
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No but with a nice bit of steak they can't be beat, far nicer than boring old chips :thumbup:
 
No, I don't seem to be at the stage of dawn phenomenon. My fasting levels are usually slightly lower than my bedtime readings. If fasting is higher than bedtime its only by about +0.2 to +0.3. My breakfast readings are generally higher than fasting though occasionally about -0.2 down but usually it's anything up to +1.1 higher. I have impaired glucose tolerance, but my fasting is 'normal'. Unfortunately I do not have the luxury of going for a walk. I would hazard a guess that my problems have arisen from the physical inactivity caused by my disability, but there is very little I can do about that. Apart from age, that's my only risk factor.


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janeecee said:
No, I don't seem to be at the stage of dawn phenomenon. My fasting levels are usually slightly lower than my bedtime readings. If fasting is higher than bedtime its only by about +0.2 to +0.3. My breakfast readings are generally higher than fasting though occasionally about -0.2 down but usually it's anything up to +1.1 higher. I have impaired glucose tolerance, but my fasting is 'normal'. Unfortunately I do not have the luxury of going for a walk. I would hazard a guess that my problems have arisen from the physical inactivity caused by my disability, but there is very little I can do about that. Apart from age, that's my only risk factor.


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The rise between wake up and breakfast is pretty normal and happens in loads of people diabetic or not so I wouldn't be concerned about that. If you are generally happy with your levels and the dietary regime you're using to obtain them the I'd just keep doing it. Within reasonable limits I wouldn't be too concerned over any individual BG reading and just keep an eye out that you aren't seeing a deterioration in BG's over an extended period of several days.
 
gezzathorpe said:
janeecee said:
The 'eat to the meter' philosophy is basically sound re finding what works, but in my experience I have not fared so well by cutting carbs because, as I explained before, it works for a week or so and then my readings jump overnight. When I cut the carbs in response, the same thing happens again. Low carbing does not work for me in some linear "cut the carbs and the BG levels will follow" way. We're all different, and what works for one won't necessarily work for another.


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Whilst I remember, my DN wasn't interested at all in my +01:00 readings on my chart and focusses on the +02:00.
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Here's a comparison between my OGTT and Person X who is Very Low Carb/High Protein and is hoping to beat diabetes this year. Quite similar patterns even though diets are quite different. Person X's fasting level was probably due to increasing carbs for the three days prior to the test as per protocol.

EbwFC2IVN2dFziyXuapRjjd9y4db3N6ttZ3bqr4-HDU=w600-h400-p-no
 
janeecee said:
Just want to say thanks to xyzzy for your advice and information. Thanks for sharing.


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+1 BlindDog is a top bloke who has devoted 100's of hours and many more advising and helping people including me..I didn't even know what a carb WAS when I was diagnosed but through his and others teachings my life is transformed now..Love ya Steve!
 
Interesting, Gezzathorpe. There really is very little between the two results. Person X is slightly up on your result at 2 hours but just a little bit lower at 1 hour. I'm sure that if a different meter or even a different finger was used on the day of the test there could be anything up to 0.5-0.6 variation either way on both sets of results.

I suppose some people would say your results were better because you started with a lower FBG and you finished with a better 2 hour reading, and others would say that Person X had a better response because his spike wasn't so high as yours. I would say that they were both very similar, and if both people repeated those tests, the results would probably vary somewhat but not significantly.


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janeecee said:
Interesting, Gezzathorpe. There really is very little between the two results. Person X is slightly up on your result at 2 hours but just a little bit lower at 1 hour. I'm sure that if a different meter or even a different finger was used on the day of the test there could be anything up to 0.5-0.6 variation either way on both sets of results.

I suppose some people would say your results were better because you started with a lower FBG and you finished with a better 2 hour reading, and others would say that Person X had a better response because his spike wasn't so high as yours. I would say that they were both very similar, and if both people repeated those tests, the results would probably vary somewhat but not significantly.


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Yes. I should also mention that I have been on 250g (down from 350g) for about 5 months. I'm not sure about Person X but they were diagnosed in the first quarter of 2011. So, on the one hand, my regime hasn't had so much time to work, but on the other hand, Person Xs average weight loss is over 20 months so that weight aspect is perhaps an unrealistic comparison. The main point is, I think, the overall similarity in 'benefit' in terms of bGs and weight loss.
 
I agree that you can't really distinguish the results that closely. On the face of it, there is very little difference and you will have been using different meters .
Apart from carb intake there is a possible difference in input ie activity levels. I don't know how active you have been, I 'suspect' that Person X was very active.
 
I walk 5 miles a day but, of course, no activity during test as per protocol. My HbA1C was within 0.2 of my calculations from my meter. But point taken.

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phoenix said:
janeecee said:
How would you work out someone's activity level from the graphs?


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You can't, I just think I know who person x is.
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Person X said they were 'laid up' for the three weeks leading up to the test with an injury. So, chances are I was exercising more, don't you think?
 
? doubt if there is any real data for comparison.
When I was training for half marathon + (like person x) I needed to take less insulin . I find that if you stop exercising for a week you do notice a difference but I think it takes longer than 3 weeks to lose the advantage.
(says she who is getting back to it after 6 months of indolence; stopping has raised my levels)
 
phoenix said:
? doubt if there is any real data for comparison.
When I was training for half marathon + (like person x) I needed to take less insulin . I find that if you stop exercising for a week you do notice a difference but I think it takes longer than 3 weeks to lose the advantage.
(says she who is getting back to it after 6 months of indolence; stopping has raised my levels)
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We both followed the protocol of the test to the letter. It sounds as if you have no confidence in OGTTs? This was real data. Can I see your real data that refutes it? Wouldn't you have expected my figures to be worse if I am more sedentary?
 
Does it matter? The two sets of results look quite similar in their response to a glucose challenge. Everyone will vary anyway. There's no way of knowing whether Person X's result would be if he/she hadn't been off their feet. Guessing what it might have been is just that–a guess.


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Yes, I think that we're at cross purposes. My point is that you have similar results but different methods. You used your diet, person x used theirs which I pointed out was not just diet but included a large amount of exercise which contributes to a reduction in insulin resistance.
Both of you have managed to gain control over your glucose metabolism.
 
phoenix said:
Yes, I think that we're at cross purposes. My point is that you have similar results but different methods. You used your diet, person x used theirs which I pointed out was not just diet but included a large amount of exercise which contributes to a reduction in insulin resistance.
Both of you have managed to gain control over your glucose metabolism.
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I reckon that 35 miles a week walking is a good deal of exercise. The South Downs are not flat.
 
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