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Musings for the Sweetly Bemused: A Diabetes Blog

A Diabetes Diagnosis: Taking Control


Musings for the Sweetly Bemused: A Diabetes Blog
By: lizmariposa

My name is Lizmari Collazo.

I am a Puerto Rican, living in Iowa. A lover of white picket fences, black cats, Winter, and photography. I am a 35 year old who was diagnosed with Type 2 Diabetes two years ago, on November 17th, 2009, with an A1C of 10.5%.

Those are the numbers that "define" me, but they do not tell my story in full. The journey toward my diagnosis was a rocky, and complicated one, and it is my goal that others would learn, and grow from my experiences.

I am not a doctor, nor a medical professional of any kind, so please do not take my musings as a "diagnosis" or as a treatment for any medical condition, at any time. If you should have any concerns regarding any health problems you may be experiencing, please contact your medical team, or a qualified medical professional in your area, as soon as possible. 


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 Blog Entries
A Diabetes Diagnosis: Finding the Motivation - Mar 22
My faithful readers might be missing some of my posts, as of late, and I dully apologize. Sometimes, life throws us much more than diabetes to handle. :) Close to a ...
more
A Diabetes Diagnosis: Taking Control - Feb 25
Last week, we discussed how allowing baby steps into our diabetes management plan can help us overcome some of the fogginess, and the fear, that a diabetes diagnosis can ...
more
A Diabetes Diagnosis: Now What? - Feb 16
It's a place of shock, bewilderment, desperation, sadness, fear, or sometimes, misplaced relief or joy. It's a diabetes diagnosis. Sometimes, it might come at us in ...
more
The Uncommon Diagnosis Story IS the Common Diagnosis Story - Feb 11
Hello to all, in the Diabetes1 world out there! :) This is my very first blog post, in this community... and I'd like to take a moment to just introduce myself. I'm sure ...
more
Posted: Feb 25, 2012 14:28
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  • A Diabetes Diagnosis: Taking Control
    Last week, we discussed how allowing baby steps into our diabetes management plan can help us overcome some of the fogginess, and the fear, that a diabetes diagnosis can bring. We even went ahead and took our first baby step by discussing "What is Diabetes?" This week, I'd like to visit a few of the steps that we can take with all the knowledge and information that we gained by simply knowing what diabetes is, and learning about the basic problems and challenges that it can present.

    If my readers might recall, we went into a little bit of detail about the basic concept of glucose. Glucose, is a type of sugar in which the body turns ALL the food that we eat (and not just sugary foods); it is the body's main source of energy. Nearly all (about 98%) of all the carbohydrates we consume will get turned into glucose, compared to 58% of proteins, and around a 10% of fats. 

    This basic piece of information is the most powerful weapon we have against controlling high blood glucose levels. 

    Because carbohydrates are the biggest contributors, by far, to our blood glucose levels and needs, it is paramount that we manage, and control their consumption with some care. By controlling our carbohydrate consumption levels, we are essentially, controlling our blood glucose levels.

    Now, carbohydrates and starches may bring some confusion to persons trying to manage diabetes, and often... for the wrong reasons. Dietitians, nutritionists, and TV personalities love to focus on the roles of "good" and "bad" carbohydrates in our diets, and will always outline that we, as diabetics, need to focus on consuming good carbohydrates, instead of "bad ones..." and that's not a bad thing, in and of itself. (If we consume too many "fast burning", so called "bad" carbohydrates, we'll be left unfulfilled, and hungry, and often, with roller-coasting blood glucose levels.) But something folks always fail to mention is that, at the end of the day, it is not so much the quality of the carbohydrates we are consuming, but the AMOUNT of them.

    Most Americans consume a seriously disproportionate amount of carbohydrates in their diets, and while some might argue that the average person needs to consume a diet that consists of 60% carbohydrates, the average American consumes much, much more than this. If, for example, we are consuming double the amount of recommended carbohydrates, and replaced all of those with supposed "good carbohydrates" (which we will discuss later), it won't negate that we were still consuming double the amount of recommended carbohydrates! We will still have high blood sugar... even if those carbohydrates were slower burning.   

    So, how do we know how to make proper carbohydrate meal choices? What are our best alternatives? 

    The truth of the mater is that there is NO diabetes diet out there. There is no real truth set in stone that says you have to follow any one person's plan to the letter; even a dietitian's plan. Your best guides in making meal planning decisions will ALWAYS be your glucose meter, moderation, and your own body. 

    Which brings us to our second baby step: Using Our Glucose Meters.

    Yes, that's right. We learn all of the information we need, and much more, one meal at a time, and one event at a time, with our glucose meters. 
    • By testing before, and 1 - 2 hours after a meal;
    • Before going to bed, and at rising;
    • Before, and during, or after exercising;
    • Throughout the day when we are ill, stressed out, or feeling unwell;
    • And as needed, when symptoms present which may indicate hypo or hyperglycemia (low, or high blood glucose.) 
    I will note now that this is a lot more testing than the 1-2 strips a doctor, or insurance company, may allow for you, if you have Type 2 Diabetes. This is an expensive disease, and one in which you might have to invest in some extra, out of pocket, testing strips in order to help you make future confident decisions about your management, particularly, if you are not under any medications. Don't despair, though, bargain department stores often have some affordable, and generic, meters and strips. (By FDA standards, ALL meters must be within the same percentages of accuracy, regardless of brand, so they are no less reliable than more expensive ones... though this might be a topic of argument for many.) 

    Set a Blood Glucose Goal

    Most American and worldwide diabetic guideline organizations, including the American Association of Clinical Endocrinologists, recommend that diabetic patients keep their blood glucose levels at below 140 mg/dL (7.69 mmol/L) or less, 2 hours after meals, and below 110 mg/dL (6.04 mmol/L), fasting. These guidelines might be different for you, if you are pregnant, or if you have other health issues or complications that might make it risky to reach for these levels. When in doubt, always consult with your Endocrinologist, or your medical team.

    Make meal decisions that help you reach these goals

    • Keep a journal, or a spreadsheet, that helps you keep track of what you ate, and how much of it you ate -- particularly, the TOTAL carbohydrate serving size in your meals. Research the nutritional information label of your foods, or meals, or look up foods on sites like NutritionData, or CalorieKing, for the necessary information. Some of these sites even have "recipe analyzers" which will allow you to get more precise information when meal planning. Always note the serving size, and adjust your total carbohydrate counts accordingly. 
     
    • Test your blood glucose levels before any meals, and 1-2 hours after meals. Write down these numbers on your spreadsheet, and note the amount of points your blood glucose levels "spiked" after you ate. If your levels rose more than 50 points, or they surpassed your blood glucose level goals, it might be time to cut back on the total amount of carbohydrates that you had for that meal, by either reducing your portions, or cutting out an item altogether. 
    • Make better food choices: By far, the best sources of fiber are non-starchy vegetables, and leafy greens. NOT starchy alternatives, like whole wheat breads, sweet potatoes, pastas, or grains and rices. While it is OKAY to enjoy some of these foods, in moderation, ALWAYS compliment them with non-starchy, fiber-rich, vegetables, and leafy greens. They will greatly slow down the absorption of glucose in your system, and help you attain control with more ease... as well as keep you full. If you allow your meals to consist of at least 50% non-starchy veggies, or leafy greens, you'll have an easier time at attaining control.
    • Rotate your testing: Never assume your evening numbers will translate to your morning numbers. Diabetics are the most insulin resistant in the mornings, and therefore, the most carbohydrate intolerant at those times. Consider making meals more centered around protein rich foods, like eggs, instead of cereals, breads, or starches. If you want to include some of these in your morning, be prepared to incorporate exercise into your routine. (Oatmeal might be good for Wilford Brimley, but it sure as heck is NOT good for me.) Never Assume - ALWAYS TEST. Test, test, test. I cannot stress this enough. Every diabetic is DIFFERENT. 
    • There are no good, or bad carbohydrates. Aside from outright junk foods, ie, foods that aren't even really foods, like ho-hos, or twinkies, there are NO good or bad carbohydrates. All carbohydrates have their proper place, in our diets. Use your meter to determine that place, the best. If you are exercising intensely, it is OKAY to pair a fast acting carbohydrate with a protein, and a fat, for strong, extended release. If you are experiencing a low blood glucose event, always consume a FAST acting carbohydrate, or simple carbohydrate -- ie, something made up of pure sugar or glucose -- BY ITSELF. Do *not* consume something that is slow, and complex, as it's digestion might not be fast enough to raise your blood glucose levels to a safe zone. In any other situation, simple carbohydrates are TREATS; and thus, they are meant to be consumed sparingly, and in moderation. They are not meant as "nutritional powerhouses." At meal times, strive to consume more complex, or slow burning carbohydrates. Try juggling, and spacing out your daily carbohydrate consumption, if you want to accommodate an occasional treat, such as ½ cup of ice cream, or a small cookie. Consider this: Often, a ½ cup of ice cream may have 17-20 grams of carbohydrate, but 1 serving of pasta may have well over 40 grams of carbohydrate. In this case, that pasta is more likely to spike you than that ice cream! (Perhaps, avoid having a starch at dinner, if you are planning for a dessert.)

    Data is Power.

    We have just examined a few of the baby steps that we can take to help us attain proper DATA, to make powerful decisions in our daily diabetes management routines. (Of course, this information is very basic, and it does not account for the impact that your medications, or insulin regimen, might have. If you are learning to manage insulin, it might be advisable to make an appointment with a Certified Diabetes Educator, or CDE, as well as investing in the book "Think like a Pancreas," by Gary Scheiner.) 

    Try applying some of this knowledge, perhaps with just ONE MEAL a day. Visualize it! 



     What baby step will we discuss next week? Stay tuned to find out! 






     
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