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I'm interested in any tips, thoughts or ideas y'all might have about simple living with diabetes. In particular, information concerning health care, medication, medical supplies and lifestyle (holidays, dining out, social situations, etc.) would be most helpful.
Thanks!
Do you have Type I or Type II diabetes?
The information I'm seeking is for people with Type 2 Diabetes who take both injectable insulin and oral medications to manage their condition.
I have type 2 and have had it for years. I was really over weight when I came down with it. I have lost about 50 lbs and my last A1C reading was 6.2 which indicates my diabetes is well under control. Metformin is the only medication I take. Keeping your weight under control is probably the most important factor in controlling your diabetes. I only eat 3 meals a day and do not snack. I watch my carb intake. Bread can be a killer. Eat lots of veges and exercise to burn the carbs. I try to walk over a mile a couple of times a week. I am just not the type of person that can go to a gym and work out. We live in the mountains and I like to go for walks/hikes.
I check my blood sugar every morning and if it is up I go over what I eat and did the day before.
Thanks for the information, freein05! I look forward to reading others' comments on Simple Living with Diabetes.
I would ignore the ADA's dietary advice, that's for sure, and start with Dr. Richard K. Bernstein's books on diabetes control. He's a type 1 who has been maintaining good numbers and robust health for decades following his own plan. I would also look into other low-carb and paleo resources http://www.ncbi.nlm.nih.gov/pubmed/19604407?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed _ResultsPanel.Pubmed_RVDocSum&ordinalpos=2 Add regular exercise and a healthy skepticism toward "common wisdom, " and you're on your way.
Good advice, JaneV2.0! It seems to me the ADA recommends a diet that is way too high in carbohydrates for most people with Type 2 Diabetes. It seems to me that it would be prudent to choose low or no saturated fat and low or no cholesterol protein sources to prevent heart disease, strokes, blood clots, vascular disease and kidney disease. I'm open to any suggestions for these. Thanks!
Eat to Live by Joel Fuhrman helped to give me the info to understand the impact of carbs and red meats especially on one's diet whether diabetic or not. I am not but found it so helpful and readable.
Sometimes, one has to understand the thought behind the changes before one can make the changes needed. If it doesn't make sense due to a lack of knowledge or understanding, it can seem like deprivation. If one chooses to make the changes and feels that they are right for one, it is so much easier to accept. It is a lifestyle change one is choosing, not a temporary thing to do.
The ADA guidelines are all about choice as I understand it so one would then choose the source of carbs differently. Legumes, for example, provide both protein and carb equally and a dietitian would help to sort this out. Getting one's mind around the idea of choosing differently for better health and as Free mentioned including appropriate exercise is key.
Thanks, razz. I agree the ADA guidelines are all about choice, but the ADA recommendations for servings (exchanges) of carbohydrates are simply too high for many people living with Type 2 Diabetes, who experience elevated blood glucose levels from that amount of carbohydrates in their diet.
It seems some people are more carb-sensitive than others and a one-size-fits-all approach to diet for all people living with Type 2 Diabetes, to me, seems irresponsible. All starches are not created equal(ly), so it makes sense for many with Type 2 Diabetes to choose lower Glycemic Index carbohydrates and to eat them in smaller quantities and/or less frequently. All people with Type 2 Diabetes are not created equal(ly), either, so it makes sense for them to use their glucose monitor to test the effects of various carbohydrates on their blood glucose levels and to monitor their progress with dietary changes with regular blood tests.
Does anyone have tips for living simply with respect to health care, medications, medical supplies, holidays, dining out and social situations?
I'm also interested in finding recipes for low carbohydrate, high protein meals that are low in cholesterol, sodium, saturated fat and trans fat, yet full of flavor. Yes, I know...I'm asking for a lot.
Thanks, razz. I agree the ADA guidelines are all about choice, but the ADA recommendations for servings (exchanges) of carbohydrates are simply too high for many people living with Type 2 Diabetes, who experience elevated blood glucose levels from that amount of carbohydrates in their diet.
It seems some people are more carb-sensitive than others and a one-size-fits-all approach to diet for all people living with Type 2 Diabetes, to me, seems irresponsible. All starches are not created equal(ly), so it makes sense for many with Type 2 Diabetes to choose lower Glycemic Index carbohydrates and to eat them in smaller quantities and/or less frequently. All people with Type 2 Diabetes are not created equal(ly), either, so it makes sense for them to use their glucose monitor to test the effects of various carbohydrates on their blood glucose levels and to monitor their progress with dietary changes with regular blood tests.
Does anyone have tips for living simply with respect to health care, medications, medical supplies, holidays, dining out and social situations?
I'm also interested in finding recipes for low carbohydrate, high protein meals that are low in cholesterol, sodium, saturated fat and trans fat, yet full of flavor. Yes, I know...I'm asking for a lot.
The reason that I suggest a visit to a dietitian is that I was given the diabetes food group fact sheet with the neat icons that a neighbour with both diabetes and heart issues used. He was advised which carbs (meaning most grains and starch) were unsuitable for him and the alternative choices which his wife could prepare that he might enjoy. He has since passed away due to the severity of the heart issues and that is why I got to see his copy.
They did have as full active life as his health permitted including dining out but the salt intake was the major limitation not the carbs.
In Canada, a family doctor can refer someone to a health unit based dietitian for a complete health analysis and explicit diet advice. Is this a possibility for you?
In Canada, a family doctor can refer someone to a health unit based dietitian for a complete health analysis and explicit diet advice. Is this a possibility for you?
We do not have national health care in the US, so access to dietitians, Diabetes Educators and other such services is dependent upon one's ability to pay for these services and/or one's insurance coverage. I am fortunate to have health insurance coverage, but, sadly, I found the information concerning dietary recommendations from the dietitian and Diabetes Educator sorely lacking. They gave me one-size-fits-all information and handouts from the ADA and Novo Nordisk Inc. and neither was willing or able to give any explicit dietary advice.
fidgiegirl
5-29-12, 9:42pm
RCWRTR, would a paleo diet have what you are looking for? Zoebird? Help with this?
RCWRTR, would a paleo diet have what you are looking for? Zoebird? Help with this?
Maybe. Or a modified paleo. That's what I'm trying do, just to eat better and lose some weight. Poultry, lean pork, occasionally lean beef (I don't each much beef), seafood, lots of veggies, some fruit, some dairy (Greek yogurt, feta/brie/cheddar cheese, some butter, 1% milk in tea), olive oil. No soda. No bread, pasta, rice, etc. Small amounts of fruit juice. Small amounts of sweet potatoes instead of white potatoes.
Aren't the carbs from pasta, rice, potatoes, etc., the big bad things to be avoided for diabetics?
I am awaiting a consultation with a nephrologist. I am hoping to have more information regarding nutrition then. In the meantime, I'm eating a diet pretty similar to Tradd's. I appreciate the advice re: diet, but am feeling a bit overwhelmed by conflicting information at the moment concerning what to eat and what not to eat.
I started this thread because I'm specifically interested in other aspects of simple living with diabetes (see original post).
Thanks!
RC, I forgot to add something a diabetic (type 2) friend told me a while back. He used to use a lot of artificial sweeteners, drink diet soda, etc. But he said once he quit that stuff, drinking only water, plain tea/coffee, and some very occasional fruit juice, he felt much better. The food budget was in better shape since he wasn't buying all the artificial stuff, and shopping was easier, too!
Dr. Bernstein and others who successfully control their blood sugar levels would advise "Eat to your meter"--in other words, test yourself often. You'll soon learn which foods do and don't cause spikes and subsequent lows.
I'm doing just that, JaneV2.0! I test twice daily plus just before and 2 hours after each meal whenever I include any new foods in my meal plans. I have learned a lot about how my body responds to various carbohydrates.
Do you (or anyone else) have any suggestions re: dining out, social events, holidays and/or travel with Diabetes?
Eat to the meter is good advise. Also think about when you eat. I ( type 2) try to eat small meals in the evening and my large meal at noon like they do in Europe. Eating a meal with more carbs at noon gives your body more time to burn them. When you eat those same carbs in the evening your body does not have much time to burn them. My testing proves that for me. I love rice and I will eat it at noon so my body will have time to burn the carbs.
You can continue to eat the things you like in moderation but maybe shift to a different time of the day when you eat them.
Don't let diabetes control your life!
Though I don't have diabetes, I eat mostly like I do--to avoid getting it and to keep my blood sugar on an even keel. To that end, I keep protein/fat snacks like pepperoni sticks in the car in lieu of a meal if I get distracted. I watch my carbohydrate intake and limit it.
My SO does have type 2, and I'm always surprised at how many people--who should know better--pressure him to eat all kinds of starchy/sugary "treats." After all, they baked it just for him! :thankyou: So I can see how it can be hard to keep your eye on the end result and ignore distractions and detours on the way to better health. I encourage you to read Dr. B. and find an on-line forum or two composed of smart, conscientious people who maintain healthy skepticism toward the diabetes establishment. After all, it has a vested interest in maintaining the status quo, which I've seen described as "carb up, then drug up."
My partner has type I. He's in amazing shape for having type I. He tests about 8 times per day, sometimes more and adjusts his eating and insulin. (Eating to the meter and frequent testing) The key to him is to keep it within a good range. Too high or too low does damage, as you know.
Because of the diabetes, his digestion is tricky, so legumes are absolutely out for him. He ended up in the hospital once from a single meal of them. How? Well, if your digestion slows or stops and you are diabetic, you are getting nothing to maintain blood sugar, so you have to be put on an IV. He didn't normally eat legumes because they bothered him, but it was a social setting where that was all that was offered so he took the risk. It's way more than just a bit of beano if your digestion is impaired. Each person is quite different in these kinds of things, as has been said. He balances fats with carbs since the fats help the carbs digest more evenly.
I know you are type II, so it's somewhat different. With social things, I just let any of my friends or family know that he's diabetic and so he may or may not eat with the rest of us. He will have some tea or coffee, or something like the green beans with few carbs. People are very understanding. Of course, his friends and family long ago adapted to this. Also, he carries snacks to all social events and may excuse himself if he needs to go eat something. Even in the middle of a church service he has gotten up to go eat something. Less disruptive than having EMT's rushing into the church service when he loses consciousness :0!. I've had to call 911 several times when he went into insulin shock and was unresponsive.
He goes to a diabetes support group and gets some good information and also emotional support there, too. You might see if there are any such groups in your area. It's through a local hospital.
He has a very good attitude toward this physical limitation. He sees the testing, snacks, etc. as a way to stay healthy and happy. He's very glad to have the meter because when he first started, they didn't have them.
Do you have a Meijer in your area? I think they are mainly in the midwest (U.S.), but not sure. Anyhow, they have a meter and test strips that are half the cost of what the major companies provide. Also other supplies at a better cost. They seem interested in helping people without insurance. Both the pharmacists at our local Meijer have some kind of training/certification in diabetes pharmaceutical care. They have been really helpful to him. They also provide low cost testing for cholesterol, liver, etc. There are a few antibiotics that they provide free of cost. So, a good choice for various services.
Good luck to you in dealing with this. If I think of anything else I'll post again.
Thanks, JaneV2.0. I've checked out Dr. Bernstein's book and Joel Furhman's book. They both seem to make more sense to me than "Carb up, then drug up."
I have found it challenging to order food in restaurants and to not offend people when refusing food they are offering. I prefer to not give my entire medical history to a server (and some dining companions) when I dine out and make specific dietary requests or when someone offers me food items I should not and/or choose not to eat. Someone suggested I tell people I have food allergies, but I do not have any food allergies. I really prefer not to lie, just so I can eat healthily.
Thanks, Sagewoman. We do not have Meijer stores in this area. I do have health insurance, so I spend approximately $65 for 200 glucose monitor test strips. Walmart, the cheapest option locally, charges $62.98 for 50 glucose monitor test strips. I pay $9.95 at CVS pharmacy for 100 lancets after insurance. So far, I have been given samples of injectable insulin and an oral Diabetes medication, but had one oral Diabetes medication prescription and one ACE-inhibitor prescription filled. The oral Diabetes medication was expensive (it met my $250 annual medication deductible and then some!), but the ACE-inhibitor cost just $8.75 after my insurance copay.
I really appreciate your tips on how to handle some social situations and good wishes. There is a support group at an area hospital, but it is part of a program that is not covered by my insurance. I asked my Diabetes Educator to look for additional support resources and plan to continue doing so myself, as I think having a support system is very important. I am participating in an online Diabetes support forum and read posts in a second online Diabetes support forum. I am also subscribed to DiabetesPro SmartBrief, as I am a healthcare professional and find the information it provides to be helpful. It is amazing what big business Diabetes is.
Thanks, Tradd. I try to limit artificial sweeteners. I use food products made with Splenda sparingly and do not drink diet soda. I prefer to eat fruit rather than drink it and stick with water, skim milk, an occasional flavored zero carb beverage made with Splenda and decaffeinated coffees, decaffeinated teas and herbal teas. Your friend is correct that avoiding artificial sweeteners saves money and makes shopping easier.
My brother-in-law has had type 1 diabetes since the age of 6 (he's 52 now). In social settings, he just eats what everyone else is eating, except for dessert (or anything especially sugary). If asked, he says that he's never really cared for sweets.
Something he has commented on is how the dietary advice has changed since he was a kid. He was in the hospital after a wreck and asked for the diabetic dinner and was told by the nutritionist that the current advice is "to eat what you like, but make up for it with insulin". He felt miserable eating the high carb/low fat foods in the hospital and went back to his 1960s methods as soon as he was released.
Thanks, daisy. I've not heard that advice, but I have heard of some Type 1 Diabetes "pumpers" (people who use insulin pumps) adjusting their insulin dose to match their dietary intake. From what I've read so far, it seems like a low carbohydrate diet and "eating to your meter" seem to work best for most people with Type 2 Diabetes, as it helps to avoid dangerous highs and lows and extreme fluctuations in glucose levels.
My Diabetes Educator indicated my goal should be to not have an increase of more than 40 points from pre-meal glucose monitor reading to 2 hrs. post-meal glucose monitor reading, keeping my fasting blood glucose level between 70mg/dL and 100mg/dL and never going above 140mg/dL with HbA1c level at or below 6.5. I have read some sources that indicate that the ADA's guideline for HbA1c levels to be below 7.0 is too high and many of these same sources recommend HbA1c levels at or below 6.5 or 6.0 to prevent many longterm potential Diabetes complications.
I am old and just tell people I am diabetic when they offer me food mainly sweets I don't want to eat. The first doctor I had when I was diagnosed with diabetes used the A1C reading of 7 as a guide line. I did not think he was aggressive enough so I changed doctors. My current doctor wants my A1C to be in the low 6s.
I don't blame you, freein05. Everything I keep reading suggests that your current doctor has your best interests at heart when setting such A1c goals for you.
If pressed, I might cite "blood sugar issues" as I politely decline. "Doctor's orders" works for some. Your health trumps social conventions like "just this once."
I think the original quote I saw was "Carb up, then shoot up," which is certainly punchier, but doesn't apply to the oral medication crowd. Even if you're started out on insulin as a type 2, with the right dietary/exercise approach many people are able to manage without it--and even without any drugs at all. But that requires consistency and commitment. Speaking of Metformin, if I were to take any diabetes medication, it would be the most tried and true one, with the fewest side effects. The newest drugs for whatever ailment are routinely tested on patients now, often with disastrous effects. (See Avandia, Actos, Rezulin, etc.)
I discussed the possibility of reducing or eliminating injectable insulin and possibly discontinuing the DPP-4 inhibitor and/or adding Metformin or Metformin XR or Metformin ER with my former primary care physician. I plan to discuss this further with my new primary care physician and my nephrologist at my next appointments. I was able to achieve very good glucose control with diet, exercise and medication in just 2 weeks from date of diagnosis and was told that injectable insulin was necessary, at least initially, to get my blood glucose levels under control at the time of diagnosis.
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