Eating like a diabetic

[Tobin S.]

It's not as difficult as I had suspected. My wife was recently diagnosed as having diabetes. We went to a class for diabetics to learn how to manage the disease. We still have three more classes to go, but I've already learned a lot.

I have decided to eat like my wife does in support of her and to make things easier for her. I'm allowed a little more because I'm male, but it's the same thing in principle. We mainly count carbohydrates, eat three meals a day and space them out 5 to 6 hours apart. We each have a carbohydrate allowance for each meal. If we want a snack between meals, we have to subtract the carbs allowed for the meals it's between and time-wise it has to be roughly mid way between meals. Because we both want to lose weight, we are also counting our calories.

For example, I'm allowed 60 carbs per meal and 1800 calories a day for a moderately active man to lose weight, assuming I had diabetes, and I am even though I don't. If I want a snack after dinner, it can be up to 15 carbs and I have to subtract that from my meal. So 45 carbs for my meal for a 15 carb snack later.

I'm sure there is going to be a lot more to managing the illness than that, but that's the basics on how we need to eat. Since being diagnosed and starting medication and eating right, my wife's blood sugar has come down from the mid 200s to the mid 100s. We are just learning how to eat so we may be able to make more adjustments there to help control the illness. The pharmacist also said that the medication my wife is taking has been prescribed at a lower dosage and may be increased when my wife goes back to the doctor here in a few weeks.

She is doing really good, though, and I couldn't be more proud of her for tackling this problem and working through it. There are other people in the class who have been diabetics for longer and a few who haven't taken very good care of themselves. One woman there has partially lost her eyesight and lost her job because of it. She also has trouble with her feet and has a hard time walking. We're going to do what we can to keep that from happening.

I am very overweight, but surprisingly there is nothing wrong with me that is associated with being heavy aside from possible sleep apnea. I'm going for a sleep study late next month. My wife has told me for a while now that I snore and sometimes stop breathing for a few seconds in my sleep. I was told by one of the women conducting the diabetes class that untreated sleep apnea can have severe long term effects...like dying before your time.

So by my wife getting treatment it has also helped me to get serious about my health. The one bad thing in all of this? No more 6 packs on Saturday night. A regular twelve ounce beer has 15 carbs. I've always been one of those guys who has to have at least 3 or 4 if I'm going to drink at all. So, adios brewskis!

[Ptah]

1. You and your wife's approach to health is a joy to read, Tobin.

Thanks for another top-notch post.

[Tobin S.]

6. Thanks, hoss.

Good to see you this evening.

[adirondacker]

2. That is terrific Tobin. I was emailed an excellent article from Harvard...

http://www.hsph.harvard.edu/nutritionsource/fats-full-story/

I have high triglycerides / low ldl which requires a similar diet, and also plenty of Exercise

When I stick to a decent routine, I feel Much better and don't get into the highs and lows associated with excess sugars. I also have been able to stave off having to take statins as well.

Best Wishes!

[Tobin S.]

7. Thanks for the link.

My wife has taken to walking a lot. It probably wouldn't hurt me to do the same, but I have a fairly physical job so I'm not really sedentary.

[Wounded Bear]

3. Good job!

The meds for diabetes can take a few tries to get right. I did. They start low and ramp it up as necessary to lower the blood sugars.

Diet is very important, but hey, reward yourself from time to time with a treat. Take a long term approach. If she's taking daily readings, don't make adjustments on one day's numbers. Look at it long term. Your doctor will see you periodically and take an A1C reading. That's really the gold standard. The daily readings you take are indicators, at best. I'm not sure they're that well calibrated, but you do get useful trends from them.

I never actually counted anything, but I lost 40 pounds and brought my blood sugar down from 250+ to where most days I'm under 135 or so. Diet and medications mostly. I don't get enough excercise, but nobody's perfect. On the diet side, I took a general approach to increase veggies and decrease red meat. Cutting out the brewskis will help a lot.

A lot of doctors will not distinguish carbs from one another, but I do. I love carbs, but....I go for low glycemic stuff-whole grains and I watch my fiber. You can get good fiber from green veggies, of course, but I like to get them from breads. I buy the more expensive ones when I can and shoot for 3 grams/slice of fiber if I can get it. No fluffy white bread. Pastas can actually be not as bad as you might think, as they typically have no yeasts and can be quite low glycemic. But watch out for the sugars in the sauces.

It's been an interesting journey for me. Best of luck for both of you.

[Tobin S.]

8. Thank you. She's taking Metformin 1000 mg a day.

500 mg in the morning and 500 in the evening. The pharmacist said it was a very good drug. It's not too pricey, either.

[Wounded Bear]

11. That's the standard....

Because I'm not that good at watching what I eat (yeah, it's my fault I take 2000mg Metformin and 10mg Glipizide, split into two doses daily.

They should give here a blood pressure reliever, too. I used to get Lisinipril, but they had to take me to an HCTZ/Lisinopril blend.

[musiclawyer]

4. And avoid bad carbs

You know what they are
Learn to like Ezekiel bread, manna bread, quinoa, brown rice flour Etc

Wheat and sugar are basically poison to a lot of people

[localroger]

5. Miller Lite and Michelob Ultra

3 carbs and 2.5 carbs per can, respectively. After awhile they will seem normal, just like never eating pasta or bread.

Your doctor will complain but you can also drink mixed drinks with carb-free mixers and distilled spirits like vodka and bourbon; alcohol has calories but it isn't processed like carbohydrates and does not make your blood sugar go up. (This can be easily verified by doing a DIY test with a glucose meter in case you're dubious.) Most wines are also OK, but it's too bad US vintners don't label their wines for sugar content like the Canadians do.

Good luck with the diet, you may be amazed at how much your health improves.

[Tobin S.]

9. I guess light beer is better than no beer.

Not much, though.

I think I'm just going to swear the stuff off. I've never liked wine or liquor, including mixed drinks.

[RebelOne]

10. I am not diabetic, but all relatives on my mother's side,

plus two of my sisters, have had type II diabetes. So I have been watching my sugar intake. I had a pre-op examination for a cataract operation in February where I had a blood test, and my sugar count was normal. I was surprised because I love my wine and guzzle it at night so that I can fall asleep and was worried that would affect my sugar level.

I also love to pig out on ice cream before bed. I have discovered sugar-free ice cream, so I can indulge without guilt.

[grasswire]

12. how many carbs is your wife allowed daily?

[Tobin S.]

17. 160, that's for a moderately active diabetic woman. She walks quite a bit.

She can either have them over the course of three meals or have a few snacks in between meals as well.

45 for breakfast, 55 for lunch, and 60 for dinner.

or maybe

35 for breakfast, 15 for a snack, 50 for lunch, 45 for dinner, and 15 for a snack.

See how it works? She's not supposed to go over 160 carbs a day and everything has to be timed appropriately- meals 5-6 hours apart and snacks two or three hours after meals.

Also, and this is important, it's not like weight watchers points. You can't save them up or use them whenever you want to. If she has 35 for breakfast intending to have a 15 carb snack before lunch but doesn't get it for some reason, she loses those carbs for the day- she can't have 70 at lunch. Another example is say she only ate 35 carbs for breakfast and 50 for lunch intending to eat 15 carb snacks between her meals. She doesn't still have those 30 carbs avaiable. She can still only have 60 for supper maximum with no snack later on or 45 and 15 like before. She loses those 30 carbs.

So not only what you eat is important, but when you eat as well as far as managing blood sugar goes.

[grasswire]

18. wow

I try to limit to 60 carbs a day. Not easy. It's hard to feel full without much bread, but nuts and some cheeses help.

The celebrated authority on diabetes, Dr. Bernstein, urges that level.

[Tobin S.]

20. This is what they are telling us in class

The class is taught by two dieticians and it is certified by the American Diabetic Association. It's based on the latest research.

They've found that when you do not consume enough carbs, your liver, which stores glucose, will dump glucose into your blood because it doesn't know when your next meal will be. It sort of goes into emergency mode. That will cause your blood sugar to spike. That happened to my wife. The first week she found out she had diabetes she didn't know how to eat and ended up not eating enough one day. Her blood sugar spiked to 273 toward the end of the day. We didn't know what was going on until we talked to the dietician.

Also, this is the same reason why a lot of diabetics see their blood sugar rise or even spike overnight. They've just gone too long without eating and the liver goes into emergency mode. They recommend a snack before bed time.

[grasswire]

21. many specialists recommend eating a small meal every two hours or so.

Protein and some complex carb.

Be assured that there are many paths to stability, and new recommendations every day. The ADA does not have a lock on information, just as the American Heart Association does not have the best information regarding heart disease. (Remember, for half a century the AHA told a us to eat the low-fat, high carb diet that has resulted in so much diabetes.)

Type 2 diabetes is virtually a self help disease. Experimentation with foods and testing, combined with how the patient feels at any given moment, will dictate the adjustments. There is no one-size-fits-all. Unfortunately.

Good luck! Best wishes to both of you.

[Iris]

13. I'm glad you're getting the sleep apnea checked out.

I just lost a friend last fall due to severe, unmanaged sleep apnea.

Sounds like you've got a great new life in front of you!

[KT2000]

14. Good for you!!

My sister follows the rules very well and she has been able to get off the medication. Not everyone is able to do that even if they follow everything strictly but maybe your wife will be one of the lucky ones!
Anyway - good going!

[DebJ]

15. Hi Tobin! Here's some good news you might be able to get...

and some bad news you want to avoid!

My husband was 120 lbs overweight on his 6'7" frame for many decades before I met him in his mid-fifties. He had a heart attack in his forties, was diagnosed diabetic, and never learned anything except to avoid potatoes. Seriously. ( I just met him 10 years ago.) High cholesterol. His medicine bag was enormous. In addition to two diabetes meds, cholesterol meds, and aspirin, he also had to take a med to regulate his heart rhythm, and two different meds for blood pressure.. Huge doses of everything, too. Plus nitroglycerin for chest pains. Absolutely all of this was due to his food addiction and overweight. ALL of it.

Now he's down to a good BMI. We took him down the 120 lbs over 10 months. At first he lost like 8-10 a week; by the
end it was just maybe 1.5 lbs a week (which takes two weeks of weigh-ins to notice just because of water weight.)

GOOD NEWS: He was just told by his doctor he is probably not diabetic anymore, and his cholesterol is not only normal, his 'good' cholesterol is better than mine, and his blood pressure requires almost no medication at all. The last two months he took just one Tradjenta twice a week; now he's not taking any diabetic meds. (But he also just started urinating a lot at night, so we might need more tweaking or to retain the lower dose. Getting him to take his blood sugar is very difficult! I'll have to play sergeant again!) He was also able to stop his cholesterol meds. No more worries about what those meds might be doing to him long-term from side effects, yeah!

PRECAUTION: While he was losing this weight, his blood sugar was going whacko. We ended up taking it six times a day (because I insisted) and we were able to determine from that how to adjust his diet and his medicines. Turns out the 'main' diabetic medicine had to be continuously lowered as he lost weight, or his blood sugar crashed. He'd be stable a week, then crash again, in the earlier weeks, because he was losing weight so rapidly. But within four months, he was off the 'main' med altogether (i forgot the name now it's been two years), and just taking Tradjenta. Usually Tradjenta is an add-on med, but he got to the point where it was his only diabetic med.
HOPE YOU/SHE DOESN'T DO THIS: Ask the doctor to jack up the diabetic meds doseage so one can overeat and keep blood sugar in a better range. That's what my husband did. AND he thought 160/90 was a 'good' range for blood pressure. End result: his kidneys now only function at 29%. Now he's on a really restricted diet, and it's not fun. THE ONLY THING HE CAN EVER DRINK AGAIN IS WATER, PRETTY MUCH. (Or a rare glass of tea.) It was the kidney give out that forced the weight loss. He just wouldn't do it before; serious food addict.

GOOD NEWS: His sleep apnea is gone. He used to snore something awful, and do that catch-the-breath-stop-breathing thing. He only snores rarely now. The weight was the issue. Healthy weight, no more apnea. Double gift!


DIET STUFF: Because my husband is so tall, he has to have 2700 calories a day to maintain 205 lbs. He's not very active at all. 2700 calories means about 385 carbs a day. You are lucky you got a dietician who said you could do 60 carbs at a meal. We got an idiot who said no one should ever have more than 120 carbs a day, 40 carbs max per meal. What a dolt. He'd have to have been downing a tub of fat a day to make up for necessary calories. He now eats 6 times a day to spread the carbs around.

A carb is not a carb is not the same as other carbs. One woman we know... pineapple would knock her for a loop, throw her blood sugar sky high, when the same amount of carb in other fruits did not do that. Depends on the person what certain foods will do.

I put my husband on whole grain whole wheat bread and whole grain brown rice, and it helped tremendously to smooth out the carbs because of the fiber content. Also made him feel fuller. White bread is candy. Period. That's what it is, candy mush.

Someone referred to wheat as a 'bad' carb. The medical facts are that 5-10% of people have a gluten allergy, and 0.5% have a wheat allergy. So I wouldn't worry about that. The gluten thing is largely a marketing device; sell the fear!

The advice on whole grain breads is excellent advice...really helped in our household. Also, when you do the whole grain bread, Pepperidge Farm has the lowest sodium breads. Anyone who has been overweight for a period of time will likely have issues with salt, too, if not now, it's coming unless the weight comes off quickly enough. Sodium is another kidney killer / blood pressure raiser. Most Americans get the largest majority of sodium from their bread intake. Fast food breads are truly hideous. A McDonald's breakfast sandwich has an entire day's limit of sodium in it. Control the sodium in whole grain whole wheat bread that tastes really good, and it's positively painless. You can cut like 400 mg a day of sodium and never notice it.


PRECAUTION: How's your blood pressure, Tobin? You say nothing is wrong, but kidney disease isn't diagnosed until its too late, except in the most rare of cases. You could have lost kidney function but no one will know that yet. There are five stages, with the last stage being kidney failure, but no one gets diagnosed until stage 3, and then it's really late in the game. Because as we age, our kidneys all lose function, so when you get to age 64 like my husband and you only have 29% function to begin with, and then through age they falter more... PLEASE don't go there!
My husband's kidneys not only suffered from the erratic blood sugar for years (even with megadoses of diabetic meds) and the high blood pressure, on top of that, apparently a blood pressure med did additional damage to his kidneys. (Lipitor, helps most kidney patients, but he's in the 30% that it doesn't help or actually damages the kidneys). Meds aren't a panacea. Every med has a side effect that can sock you later. If only he had lost weight earlier in life, he wouldn't be going through this hell now, with more to come because dialysis will eventually rear its hideous head.
I now have to do my husband's diet on Excel spreadsheets. I need the sodium and potassium amounts in every single bite of every single thing that hits his stomach, plus must balance the carbs/proteins/fats ...every single thing is restricted and yet must be balanced. I had to create a database of every single thing he eats, check the labels, check the FDA website because potassium is usually not listed (but may be a requirement to list soon). It takes me 30 hours a month to produce his menu plan for the month. Then I have to make sure I have everything he needs before grocery money runs out... I can't substitute one brand for another, even. It's a nightmare. Every single bite he eats is either counted, weighed, or measured. I go through 8 sets of tbsps and tsps every day, and have 6 sets of measuring cups and a scale. I am so disgusted with what it takes to keep him fed that now I'm not eating as I should anymore. I just can't bear the kitchen, so much work, enormous piles of dishes from 6 meals a day and all the measuring stuff. PLEASE DON'T GO THERE. We are going to have a kidney disease epidemic in this country, and since most people won't go to the trouble I go to for my husband, well, a lot of people won't have to worry about Social Security....they aren't going to make it.

[Tobin S.]

19. Hi Deb

I appreciate the post. A couple of things, your husband still is a diabetic, he's just been able to manage his blood sugar through diet and weight loss. Your doctor shouldn't have told him that he was no longer a diabetic. If he goes overboard on the carbs again he'll go back to having high blood sugar. In other words, even though I'm overweight I could drink a six pack of Mountain Dew in one sitting and my blood sugar might not get over 150 because my body still produces enough insulin. While your husband, even though he is in good shape and at a healthy weight with his blood sugar controlled right now, would see a huge spike in his blood sugar if he were to do the same thing. Once your body stops producing enough insulin it never recaptures the ability to produce enough again.

As far as my health goes, I get a full panel of blood work done every six months because I take psychiatric medication and my psychiatrist needs to monitor my health. There really is nothing wrong with me at all aside from my bipolar disorder. My blood pressure is usually about 125 over 70. I just had it checked earlier this week when I went to my family doctor to schedule the sleep study. I know that stuff is unusual for a fat guy, but I really am healthy. Good genes, I guess, and luck.

[TuxedoKat]

16. Good for you and your wife

Looking for products with little to no sugar will help too. When I started drinking selzer 3-4 years ago (zero calories or sodium) it took away my desire for beer. Not that I ever drank that much but I would enjoy one a few times a week. I guess the selzer having a fizzy, non-sweet taste like beer satisfies my taste buds.

[greatlaurel]

22. Hi Tobin,

Number One thing for you to do next is to get your wife to a really good podiatrist and a really good ophthalmologist. The podiatrist is really important and usually overlooked in diabetic care for prevention of foot problems. Do not wait til she has problems with her feet. Our family doctor sent my spouse to a podiatrist as soon as diagnosed. My spouse already had diabetic neuropathy without realizing the loss of the nerve function in his feet. On top of the diabetic neuropathy, metformin causes neuropathy, as well. The podiatrist prescribed a supplement called Metanx. It is a medical food and is made up of three B vitamins. It took a long time, but the nerve function has largely returned. The podiatrist does preventive checkups every two months. Your wife may not need visits that often if she has no problems, but she should have regular foot checkups. Our podiatrist says no diabetic should ever loose a foot. He says it happens due to lack of proper preventive care. Make sure she wears slippers when she is not wearing shoes to prevent any small foot injuries, too.

Preventive eye exams are also vitally important.

You will get the hang of the diet pretty quickly. It is not too difficult.

Good luck!

[hedgehog]

23. I managed to lose 35 pounds last summer/fall using on on-line tracker

of everything I ate. I took a break over the winter due to Christmas and recovering from a car accident. I'm starting up again to finish getting to where I want to be. These on-line trackers are very useful and some link you to on-line support groups. I don't know of one aimed at diabetics, specifically, but two I know of are

http://www.loseit.com

https://www.sparkpeople.com/

Keep on doing what you're doing to keep yourselves healthy!