How am I supposed to eat?

[MySillyEagle]

I can't get my sugar levels under control.

I'm type 2, I have recently bought a cgm as I constantly feel crap. Now I know why.

On a typical day, on waking I'll be 12. After breakfast and getting to work I'll be 15. By lunch I'll be 9. Mid afternoon 13. By dinner I'll be 6. Bed I'll be 5.

8am ish Breakfast would normally be toast or banana.
Midday ish Lunch chicken salad with fruit
8pm ish Dinner veg, meat, potato.

No dessert. No snacking. I drink black tea and lots of water. I'm on metformin, and I'm just so worn out with it all.

Please help me.

So I don't think eggs are thought to give you high cholesterol any longer.

The way my granny did it with my granddad was using the glycaemic load method. So essentially glycemic index is telling you how much simple carbohydrate something has in it per unit weight of that product, but glycaemic load then multiplies that by the amount you eat. So he ate a lot of yoghurt, nuts, and that sort of thing. Chocolate - okay but only a square or two. Mashed potato - absolutely not, because it's starchy and you eat a big portion.

She managed to reverse his diabetes so he was no longer diabetic using this alone so might be worth a try.

I think you're in a very difficult situation because you sort of can't afford Not to make the changes in terms of making sure you're there for your kids.

Even apples and pears are moderate in carbohydrate. Berries are low,.

Those test kits are pointless for T2. They go up and down all over the place all the time and do not help you at all. It is the regular HbA1c blood test that measures how you are doing over time that's the important one.

You need a low GI diet. Toast in the morning would be fine, but have brown toast with peanut butter. Don't eat so much fruit. The Diabetes UK website has really helpful nutrition guidelines for people with T2. For instance, basmati rice is better than ordinary rice. Your 'plate' at each meal should be half veg/salad, a quarter protein, and a quarter carbs. Ideally the carbs should be wholemeal, wholegrain or seeded, potatoes with the skin on etc. You also need to go easy on carbs & sugars, which includes glucose, fructose (found in fruit) and lactose (found in dairy).

My DH was diagnosed with type 2 3 years ago. He has cut bread, potatoes, rice, added sugar and fruit from his diet. His blood sugar has been completely under control this way.

Things he's found really helpful - pulses instead of carbs in meals, e.g. braised french lentils, cannellini bean salad, dhal, etc. Chickpea pasta (actual pasta is a no go, but the chickpea and lentil versions worked really well and almost taste like the real thing, enough so that sometimes we all have it). Also, keto bread. He's found a semi decent bread brand he likes that does tortillas, sliced seeded bread, bagels and burger buns. He still needs to limit amounts but he can have cheese on toast or a burger, etc. and his blood sugar stays fine. Every now and then we cut the crusts off the bagels and fry pieces for croutons, or cut the tortillas up and fry them to make tortilla chips (not often because it's still not healthy, but for the odd treat).

He's also found some good keto brand ice cream he can have from time to time and some chocolate protein bars and nice dark chocolate that don't screw up his blood sugar if he has them in moderation. Lentil crisps have filled a bit of a savoury itch too. He used to be a big Greek yoghurt and honey fan and we've recently found a sugar free honey substitute that is better than most fake sweet things. He still misses puddings, though!

He paid for CGMs for the first year or so and really tracked what worked and what didn't. Once he had things stable he cut wearing them right down. Now he only wears them from time to time to check he's still on track or if he's going somewhere he won't have much knowledge and/or control over his food.

It is hard. What works for some people doesn't work for others, so these are just some ideas. The CGM is a great investment for finding what works for you and setting up a way of eating you can enjoy and stick to.

@Ineffable23youre right. Eggs are fine for cholesterol. If you are at risk of cardiovascular disease where parameters are a bit different they say anything up to 7 eggs a week is fine.

@sherbetlemonadewholgrain, not brown bread. Brown bread is often white bread with colour. Wholegrain is the good stuff. Also sourdough has lower GI.

Well yeah primarily.

But it also works there too.

Eating vegetables at the beginning of a meal significantly reduces blood sugar spikes by slowing down carbohydrate digestion and glucose absorption.

many studies have been done about this so no it’s not nonsense

I can’t recommend fast800 blood sugar recipe book highly enough. The late great Michael Moseley created a series of diet books with one specifically designed for people with type two diabetes. I got my sugars under control with it.

I'm T2 and have been prescribed monjaro. It has really helped me to get my HBA1C back into the normal range.

NICE guidance changed in April and now recommends that all T2 diabetics (especially those having difficulty keeping blood sugars down) should add dapagliflozin to metformin - my GP practice is calling all T2s in to discuss it. I’m not keen for myself as I’m well controlled on metformin, but it sounds like it could be a good idea for you.
Im sorry you’re struggling 🥺

If you fill your plate with veg, proteins, fats and carbohydrates. Eat veg first then protein and fats and eat carbs last. Also try to have a quick 10 or 15 min walk after your meal.
If possible, avoid eating 2-3 hours before bed as that will give you up to 10 hours fasting before your next meal. Chickpeas, lentils, beans, eggs, mince, cottage cheese, Greek yogurt, chia seeds, basil seeds, kefir, all help in your protein and fibre intake. So not just focus on meats.

Also if you don’t have time to write down your meals, take a picture in your phone.

Do you definitely need to eat breakfast? I'm type 2 and wear a cgm and like you I have high morning glucose usually. I used to always eat breakfast even though I didn't want to because I believed that it was the healthy thing to do, and I tried various things like a protein breakfast but in the end I went with no breakfast, just black coffee, because that worked as well as anything else and I didn't actually want to eat breakfast anyway. I would only ever eat toast/bread or a banana if I was going a bit low (usually at about 4pm for me).

At lunchtime I often have some ProFusion protein bread because it has a massively high fibre content which slows digestion. I have that with some sort of protein and salad or with homemade soup (Lentil and bacon or broccoli and cheddar are my favourites). Your lunch sounds good but if it's store bought check the salad dressing as I find almost all the commercial ones too sugary. And I graze a bit in the afternoon on almonds/seeds/pecans because I like to crunch.

I don't have carb for dinner, just protein and vegetables. I missed it to start with, I used to love rice, but I got used to it and the extra veg fills me up. If I'm going in to dinnertime a bit low I will sometimes have pasta which is pre-cooked and frozen in portions which lowers the GI, I microwave it or dip it into a bowl of boiling water to heat it back up. I often have some apple/pear/strawberries after dinner, and I love it when apricots are in season as they barely spike me.

I also have some of these bars hanging around, especially in the glove box of my car. www.amazon.co.uk/Protein-Caramel-Chocolate-Calories-Snacks/dp/B0CM9WBF6W/ref=ast_sto_dp_puis?rdc=1&th=1 They are NOT food by any stretch of the imagination but if I'm hungry and not particularly low and there's nothing available that won't send my glucose sky high then these bars will fill a gap. They are high calorie but quite filling so I consider them to be sort of an emergency meal replacement rather than a snack.

Exercise is important. If you can go for a short walk within about 15 minutes of eating a meal it will use up some of the glucose. Also, if you're desk bound, there has been a lot of research recently around 'fidgeting'. Basically if you do heel lifts as you're sitting at your desk it can help balance glucose. Some of the studies had participants doing 5 minutes of seated heel lifts every hour, and other studies had them doing a couple of hours of heel lifts after each meal (which wouldn't be my choice). Both studies showed a glucose reduction in type 2 adults against a control group. It's an exercise with a very low lifestyle impact as you can do it while typing etc.

Thank you for your ongoing comments.

In no particular order....

I was prescribed the diaflap-a-thingy medication. But I'm not happy with the potential side effects. I need to get my head round that before I take it.

My lunch salad is basic, home made and half the year home grown.

Potatoes are usually small to cook in the skins.

My plate is half veg then added carb and protein.

I make my own Mayo. And salad dressings.

I don't buy prepacked food. (If it's been through a factory and put in a box I don't buy).

Same goes with ingredient lists. If I can't pronounce them, we don't buy.

I don't snack. Or eat desserts. Years back I learnt I had no off switch

My idea of anything between meals is a 4pm coffee with milk.

I drink black tea and water. No juices.

I eat breakfast, or by 11am I'm almost vomiting with hunger. That screws up the day for me.

I'm not desk bound, I'm on my feet all day.

I live simply. My idea of a takeaway, or night off cooking, is a frozen home made soup. (I have different options the kids will eat too)

We don't eat out at restaurants, - too expensive.

Reading this back, I sound so boring😁

@MySillyEagleits the potential (and relatively frequent) side effects that put me off, too. I wonder if there’s another second line alternative? What does your CGM predict your HBA1C will be?

Are there particular side effects worrying you? My DM is on it and thinks it's wonderful.

Dapagloflozin is being prescribed very widely now as it's good for diabetes, heart and kidneys in one tablet.

Or porridge without any sugar added

Don't eat toast or banana they will make your BS rocket. Greek yogurt with berries and nuts would be better.
Cut out potatoes and all refined carbs. Up your protein and try to walk or take exercise after meals. Intermittent fasting if you can manage it.
Cut out all sources of sugar.

Porridge is generally terrible for BS too. I used to have it every day until I realised.

Proper porridge is very good.

Instant or flavored oats: Avoid these when possible. They are heavily processed, digest quickly, and often contain hidden sugars that can spike blood glucose

I disagree that CGMs are not useful for T2 diabetics. They are extremely useful for showing you in real time how and why your glucose is spiking. The Hba1c is useful as an overview but not much help when you are trying to figure out what precisely is spiking you.

The Glucose Goddess is online and I find her approach very useful. Veges, then protein, then carbs.

I also disagree that your numbers are fine. They are much higher than I was told to aim for.

Oh and I cannot tolerate porridge no matter which oats are used. It's very sad .

You don’t sound boring, but from reading this I wonder if in between working full time, looking after your children, and not only cooking main meals from scratch, you are making your own basic ingredients in terms of bread, peanut butter, mayo, plus growing your own veg, you are probably absolutely exhausted. Do you ever get the chance to rest?

Does exercise make a difference to your BS? If DH is active then his BS drop the next day. I’m aware it’s a different type of diabetes he has though.

I can only speak from a gestational diabetes POV but I had that for 8 months and it reacts much the same way as T2 and is managed much stricter.

You need to live by the rule
"Never eat a naked carb"

Toast and banana are both carbs - even paired with peanut butter the balance is off (peanuts still have carbs).

Salad and chicken could be ok, but it depends on whats in the salad, & how you dress it. Apples & Pears are among the carb heavy of the fruits so you have to be careful what you've eaten them with.

I know people keep saying eat yogurt and seeds, but some greek yogurt had equal amounts of carbs to protein so keep an eye out on that.

Basically you have to learn to balance your meals, there should always be an equal amount of carbs vs protein & fat in the meal. When I had gestational diabetes I had the mantra of "if in doubt, add cheese" to up the fat content of the meal (no I didn't gain weight - except for the baby).

And if further in doubt, a walk straight after eating helps immensely by using up some of the sugar (form carbs) immediately (or a dance around the living room etc...)

P.s. Porridge would've spiked the hell out of me, not just the oats, but the milk - the lactose was a bastard.