Testing blood 2hrs after meals and carbs - confused.

[Karen.G.]

Hi all

I was told by my Diabetes Nurse not to bother checking my bloods 2hrs after meals, however, I note that a lot of people do.

Also, people are counting carbs and I don't really understand it at all. My Dietician said that I should be having carbs with every meal - but to be honest I stay away from carbs anyway.

To say I'm confused is an understatement.

:roll:

 

[CollieBoy]

Karen, ask yourself : Who will suffer the complications if you fail to control your BGs? Not your so called "diabetes nurse", she clocks off and goes home at the end of the shift. Likewise your dietician, she just parrots what she was told in class.
Short answer: YOU need to take care of yourself and learn the "Tricks of the trade" like BGs, and carb control. It it hard at first but it will become easier with practice :thumbup: :thumbup:

 

[MaryJ]

Hi Karen,

Not surprising you're confused.

Have a look at Daisy's post to new members.

In my opinion to not monitor your BG is just asking for problems and to include a carb in your meal when you don't know how it affects you would be madness. Let me give you a real example of the NHS advice.

When I was diagnosed, thankfully I found this forum. I set about testing my BG after 2 hours and kept a diary of what I ate and the reads I got. I started with 'healthy' foods.

Porridge 15.4
Chicken Salad Sandwich on Brown Bread 12.5
Spaghetti Bolognese made from scratch with wholemeal pasta 11.9

Now imagine I'd listened to the doctors. This diet would have been seen as 'excellent' I wouldn't have known any different as I wouldn't have been testing. Now lets fast forward to my imaginary 3 month review -

"But Mary, you haven't lost any weight, your HBA1c has actually gone up and your blood pressure is no better, you mustn't have been following my advice, I gave you the chance to try to control this with diet alone but sorry it's medication for you, you've only yourself to blame, I gave you the knowledge you needed to improve, did you not read the leaflet I gave you"?

But thanks to this forum and ignoring the advice I brought my HBA1c to non-diabetic levels within the first 3 months, I have lost 3.5 stone in 9 months, I have come off BP tablets as they were making me dizzy, I have lost the aches in my hands, my nefrologist has discharged me from his clinic (not related to DB) and said my last level of HBA1c 36 was "almost too good"mmmmmm I'll let that go lol, my cholesterol has improved (wasn't bad anyway)

I would urge you to read through this forum and make your own decisions about your own diabetes.

Mary x

 

[GraceK]

Stick with the forum ... you won't go wrong.

The NHS is well behind the times when it comes to advice for diabetics so it's as well you know that now. You'll find much more up to date information on this forum, PLUS the support when you need a good old rant or to just ask a question. We all have diabetes and are living with it - not all NHS professionals know all that much in depth about it.

You've already said you tend to steer clear of carbs anyway so that suggests you're already listening to yourself and your own body so I'd take a look at - http://www.dietdoctor.com/lchf which is my second favourite website at the moment.

 

[Defren]

Hi all

I was told by my Diabetes Nurse not to bother checking my bloods 2hrs after meals, however, I note that a lot of people do.

Also, people are counting carbs and I don't really understand it at all. My Dietician said that I should be having carbs with every meal - but to be honest I stay away from carbs anyway.

To say I'm confused is an understatement.

:roll:

You're not the first and you won't be the last, told not to test. Think about this, if you don't test, how are you going to know which foods spike you? Your not. Go onto Ebay or Amazon, buy an SD codefree meter, the strips for this are the cheapest by miles, and test. This forum is packed with people who control their diabetes every day. Would you like to be like them, or perhaps go blind, lose a limb, have failing kidneys. It's a no brainer really.

Welcome to the forum - Jo

 

[xyzzy]

Welcome Karen

As Fergus says who's eyes and feet are they anyway!

If you want to learn to carb count its dead easy so just ask. In the meantime a good way to start is to get an SD Codefree meter like Jo (Defren) suggests then start to lower your carbs. What many would suggest is to try and cut out all plain sugar so sugar in tea, coffee, cakes biscuits, non diet sodas etc. but also recognize things like pure fruit juices are full of sugar too. Next and the bit most UK dietitians and DSN's won't tell you is you need to probably at least halve your starchy carb foods so that would be rice, pasta, bread, potatoes, cereals and other things made from flour. Replace with extra meat, fish, eggs, cheese and especially green veg so that you don't get hungry. No idea why in this country there is this fixation on eating starchy carbs as they raise blood levels nearly as badly as plain sugar so its rather like telling an alcoholic to go ahead and drink loads of vodka. In other countries diets that recommend reducing starchy carbohydrates are routinely recommended to T2 diabetics. On the starchy food you keep swap to brown basmati rice and brown or tri-colour pasta. The bread that most of us recommend is Burgen Soya bread that you will find at most supermarkets.

So once you've got your meter here's how to use it. Your final target which may take some weeks to achieve is to get the vast majority of reading you take two hours after eating a meal under 8. At all other times of the day or night if you take a reading it should be between 4 and 7. If you do that you are meeting the UK health guidelines and should easily meet any hBA1c target that you end up agreeing with your DSN. 8 is recognised as the level that if you exceed on a regular basis that you will start to put yourself at high risk of diabetic complications.

At the beginning you may find you have no chance of getting anywhere near an 8 on your meter, I started out in the 20's. In that case the thing to try is to take a reading before you eat, note it down and then take another reading 2 hours later. Aim to get the 2 hour figure to be roughly the same of less than the before eating figure. If you do that then gradually day by day you should see your overall scores reduce. If your two hour readings keep spiking well above your before eating reading then you'll need to adjust your carbs lower.

Hope that helps

Steve

PS recommend you read the dietdoctor site that Grace gave you it is an excellent introduction to what you need to aim to do.

 

[Karen.G.]

Thank you all so much. I'm off work today and I'm going to do some investigating/reading.

It's nice to know there is someplace to go and ask questions.

Karen

 

[Sid Bonkers]

Hi Karen, IMHO there is absolutely no need to count carbs at all unless you are a type 1 diabetic and need to work out how much insulin to inject, there is however a very real need to rest before and after eating until your bg levels are under control.

Simply put test your bg before eating to get a base bg level then eat and teat again 2 hours after finishing your meal, if your bg level is more than 1 or 2 mmol/L higher than your before meal level then you need to reduce the amount of carbs in that meal to reduce your after meal (postprandial) level, once you get all your postprandial readings no higher than 1 or 2 mmol/L than your pre meal levels all your readings will start to drop and you will start to gain good control.

It means lots of testing in the early stages as you need to test every meal combination that you eat until you can build up a picture of what portions are safe to eat.

In my opinion carb counting is pointless and confusing foe T2's on diet or diet and oral meds, just find out what portions of carbs are safe to eat through testing.

 

[borofergie]

Hi Karen, IMHO there is absolutely no need to count carbs at all unless you are a type 1 diabetic and need to work out how much insulin to inject, there is however a very real need to rest before and after eating until your bg levels are under control.

In my opinion carb counting is pointless and confusing foe T2's on diet or diet and oral meds, just find out what portions of carbs are safe to eat through testing.

:shock:

I don't doubt that your approach is successful Sid (and is a good method of control if you can hack the small portion sizes), but there are very many forum members that get control by "counting carbs" than by "portion control" (I can think of only one off the top of my head).

It amounts to pretty much the same thing anyway. You control your carbs by simply eating less food. I'd argue that counting carbs (and testing afterwards) is a more accurate way of getting to the same place.

Very many diabetics don't find counting carbohydrates "pointless or confusing", I think that it's rather silly to try and convince the newly diagnosed to not count carbs.

I'd also argue that counting carbs is very, very, easy, even for someone with basic arithmetic skills.

 

[xyzzy]

I'd also argue that counting carbs is very, very, easy, even for someone with basic arithmetic skills.

Yes what's difficult about reading the number of grams / 100g of carbohydrates off the back of a packet then multiplying that by the amount of grams of the stuff you are about to eat and dividing that result by one hundred.

So for all of you who want to carb count if the packet says the total carbohydrate is say 25g per 100g and you weigh out 250g to eat just use the calculator on your phone, PC, pad or calculator and do 25 times 250 divided 100. The answer is 62.5 grams. Do that for everything in the meal and add all the answers together. What is so difficult about that?

I don't know, I really think those who say T2's shouldn't carb count should stop making the assumption that we are too stooopid to do simple sums its so demeaning and so classically stereotyping. Of course if portion control works for you no need to change, every one is different!

 

[borofergie]

every one is different!

Just wanted to make the point that I am not different. I am the same as everyone else.

 

[Paul_c]

Hi Karen, IMHO there is absolutely no need to count carbs at all unless you are a type 1 diabetic and need to work out how much insulin to inject, there is however a very real need to rest before and after eating until your bg levels are under control.

Simply put test your bg before eating to get a base bg level then eat and teat again 2 hours after finishing your meal, if your bg level is more than 1 or 2 mmol/L higher than your before meal level then you need to reduce the amount of carbs in that meal to reduce your after meal (postprandial) level, once you get all your postprandial readings no higher than 1 or 2 mmol/L than your pre meal levels all your readings will start to drop and you will start to gain good control.

It means lots of testing in the early stages as you need to test every meal combination that you eat until you can build up a picture of what portions are safe to eat.

In my opinion carb counting is pointless and confusing foe T2's on diet or diet and oral meds, just find out what portions of carbs are safe to eat through testing.

In effect by reducing your portion sizes, you're effectively "counting" carbs... as in, I can't have more than that much potato or bread or whatever or else I will be over...

I now count the carbs in my meal... as I know I can only tolerate 30grams total of any carb in a meal and bulk it right out with the "free" foods that are not restricted by having high carb contents

 

[Bellx15]

Welcome Karen

At the beginning you may find you have no chance of getting anywhere near an 8 on your meter, I started out in the 20's. In that case the thing to try is to take a reading before you eat, note it down and then take another reading 2 hours later. Aim to get the 2 hour figure to be roughly the same of less than the before eating figure. If you do that then gradually day by day you should see your overall scores reduce.

Great post, Steve (and the others).

I am just wanting some sort of reassurance on this point: If you manage your BG as you describe, day by day, is it really established that you will improve your overall BG levels over the longer term?

 

[borofergie]

This is for Sid:

 

[lucylocket61]

I have to count the carbs in a meal to find out how many carbs are in a portion.

eg. If i have a portion of rice which contains 40g of carbohydrate, I know the amount of carbs I have eaten. Then, when I test 2 hours later, I know the effect 40g of carbs has on my body.

I can then adjust both the portion size and its relative carbohydrate contents up or down (usually down in my case) until I find a portion with the right amount of carbs to keep my blood sugars at a safe level.

So it makes sense to count the carbs in a portion.

 

[MaryJ]

Welcome Karen

At the beginning you may find you have no chance of getting anywhere near an 8 on your meter, I started out in the 20's. In that case the thing to try is to take a reading before you eat, note it down and then take another reading 2 hours later. Aim to get the 2 hour figure to be roughly the same of less than the before eating figure. If you do that then gradually day by day you should see your overall scores reduce.

Great post, Steve (and the others).

I am just wanting some sort of reassurance on this point: If you manage your BG as you describe, day by day, is it really established that you will improve your overall BG levels over the longer term?

YES, proven time and time again. Only time will tell how long you can maintain diet only control but many have done it for years , I'm approaching yr 1 and intend to continue forever, and ever and ever and ever (you get the idea lol )

Mary x

 

[Fraddycat]

Hi Karen, I was diagnosed in March 2010 and followed conventional NHS/DUK advice for 2 years. My BGs went up as did my meds and by Feb this year I was feeling really lousy. In June 2012 I was sure there was something wrong with my diet, everything I ate made me feel rubbish, but according to the rules I was eating healthily, porridge, brown bread sandwiches, pasta etc. The Doctor and DN had nothing to say on diet except 'keep doing what you are doing'.

In early July I found this forum and I can really say, its changed my life. I have switched to LCHF diet and in just over 3 months have reduced my BGs from 7.6 to 6.3 (I am aiming lower but its a journey not a race). I have also had my Metformin dose reduced which I am really pleased about. So this new way of eating really can make a difference to BG.

I will say that if a person's BG has been uncontrolled/high for many years there may be a limit to how much BG can be improved by a change in diet. But there is nothing to lose, I love eating this new way, and feel liberated after years of 'dieting' that I can eat cheese and bacon and all those things that I have been told are bad for me. There are hundreds of great recipes on here for when you are craving something. The 3 minute chocolate cake is my current fave.

 

[Bellx15]

I have to count the carbs in a meal to find out how many carbs are in a portion.

eg. If i have a portion of rice which contains 40g of carbohydrate, I know the amount of carbs I have eaten. Then, when I test 2 hours later, I know the effect 40g of carbs has on my body.

I can then adjust both the portion size and its relative carbohydrate contents up or down (usually down in my case) until I find a portion with the right amount of carbs to keep my blood sugars at a safe level.

So it makes sense to count the carbs in a portion.

Or, I suppose you could get the same result by just measuring the portion size, eating it, and then testing.

(From what I've read, each type of food can produce different results, even with the same carb content).

 

[Sid Bonkers]

OK it seems I have somehow confused some of you.

As we all know some of us can eat certain foods in portions that others cant so why stick to a set number of carbs, surly you are better off testing every type of carbohydrate in every combination of food that you regularly eat so that you know that maybe you can eat two slices of Burgen that doesnt mean that you can happily eat 24g of any other carb /food does it?

I would find my levels rise if I ate 24g (in carbs) of pasta but I can happily eat two slices of bread.

So counting carbs tells me nothing, only by finding out what I can eat as an individual tells me what is safe for me to eat.

Its called eating to your meter, an old idea that was taught to me when I joined this site before people started to say only eat x number of carbs a day, an idea I find way too restrictive even though I did do it for nearly a year when I was on insulin, but then I needed to know roughly what carbs I was eating, not as exactly as a T1 would have to know but near enough.

And that is why I dont count carbs any more, nor do I count calories or fat or sheep to get to sleep, my life is so much easier now, I just know what a safe portion of carbs looks like and thats what I eat. Oh, and when I test now which is very infrequently I rarely get any surprises.

If you only eat the same amount of carbs every day, be it 50g 100g or under 20g why do you test? You must know after a year or so what levels you are going to read, I know I do, I stay between high 4's and low to mid 6's after after meals, with few exceptions.

When you are newly diagnosed my advice ids test as often as you can do and find out what is safe for you once you find out why test so regularly? There is hope at the end of the T2 tunnel as long as you dont get bogged down in the details, like counting carbs.

So there, that is exactly what I meant and if you want to count carbs or eat a certain amount of carbs a day that is entirely your prerogative, just as it is mine to eat my way and have my opinion. So posting sarcastic cartoons says more about the poster tan the method I use.

ps thanks for pm'ing the cartoon to me too Stephen, much appreciated.

 

[Sid Bonkers]

I have to count the carbs in a meal to find out how many carbs are in a portion.

eg. If i have a portion of rice which contains 40g of carbohydrate, I know the amount of carbs I have eaten. Then, when I test 2 hours later, I know the effect 40g of carbs has on my body.

I can then adjust both the portion size and its relative carbohydrate contents up or down (usually down in my case) until I find a portion with the right amount of carbs to keep my blood sugars at a safe level.

So it makes sense to count the carbs in a portion.

Or, I suppose you could get the same result by just measuring the portion size, eating it, and then testing.

(From what I've read, each type of food can produce different results, even with the same carb content).

My point in a nutshell Bellx15