Type 2 Diabetic

[Donald]

New Type 2 diabetic. Anybody have any experience with these bloodless glucose monitoring devices? I hate pricking my fingers.

Do you take insulin? The insurance companies don't seem to want to pay unless you take insulin. But there are discounts. You can get the Dexcom G7 for under $200/month.

I would watch & read information by Dr Ben Bikman. You want to get yourself insulin sensitive by changing your lifestyle.

Are you taking Metformin?

I am in on the border of pre-diabetic to diabetic and am determined to become insulin sensitive. I not only want my blood sugar level down, I want fasting insulin level below 5.

 

[Donald]

They may eat high fat, in a way. But wrong fats, for sure.

Point being people fear fats and they get FAT on carb replacements.

I actually upped my fats. Don't be afraid of fat. Be afraid of simple carbs.

Cook with & eat "fruit fat' like olive and avocado and avoid fat from seed oils like corn oil. Avocado oil has a higher temp at which it burns than olive oil so you can use when you are using high heat to cook.

You need protein with 6 amino acids. Hard from plant protein but easy from animal protein. I think egg also.

 

[Pablo]

Cook with & eat "fruit fat' like olive and avocado and avoid fat from seed oils like corn oil. Avocado oil has a higher temp at which it burns than olive oil so you can use when you are using high heat to cook.

You need protein with 6 amino acids. Hard from plant protein but easy from animal protein. I think egg also.

The nice thing about upping fats at first when getting off all the nasty carbs is threefold, fat makes you full and satisfied, fat doesn't raise blood sugar (much) and it's easier to back off fat than it is carbs.

For me (NOT EVERYONE) - I just stopped eating sleazy carbs (and the bad oils and processed foods), I upped the green leafy/stemmy type veggies, protein and fats. That went on for a good while. I dropped weight, firmed up. I was doing various exercises. My BG came down a little, good but then I plateaued. I made some other changes, two meals a day, etc. Really helped my BG, weight stayed about the same but still plateaued. This is over many months. Then I backed off the fats a little, adjusted my supplements and increased my weight training. My BG readings finally started popping below 100. Even after a healthy meal, I can get a 10-20 pt rise, which is good for ME. If I cheat a little (no one is perfect) I can spike up to 150-160 (used to spike 190-200!) but I drop back rapidly, within an hour. My insulin does respond and seems like my body is dealing with sugar properly.

But I still don't know my fasting insulin level.

Tuesday is my first official blood draw since August. Appointment a week after. I have requested and OK'd for insulin level and full lipid panel along with A1c.

 

[Donald]

The nice thing about upping fats at first when getting off all the nasty carbs is threefold, fat makes you full and satisfied, fat doesn't raise blood sugar (much) and it's easier to back off fat than it is carbs.

For me (NOT EVERYONE) - I just stopped eating sleazy carbs (and the bad oils and processed foods), I upped the green leafy/stemmy type veggies, protein and fats. That went on for a good while. I dropped weight, firmed up. I was doing various exercises. My BG came down a little, good but then I plateaued. I made some other changes, two meals a day, etc. Really helped my BG, weight stayed about the same but still plateaued. This is over many months. Then I backed off the fats a little, adjusted my supplements and increased my weight training. My BG readings finally started popping below 100. Even after a healthy meal, I can get a 10-20 pt rise, which is good for ME. If I cheat a little (no one is perfect) I can spike up to 150-160 (used to spike 190-200!) but I drop back rapidly, within an hour. My insulin does respond and seems like my body is dealing with sugar properly.

But I still don't know my fasting insulin level.

Tuesday is my first official blood draw since August. Appointment a week after. I have requested and OK'd for insulin level and full lipid panel along with A1c.

I talked to the pharmacist while picking up the prescription for Dexcom G7. She is a type 1. Not sure she knew about Dr Bikman but was right on the money about why aren't they testing fasting insulin levels so they can pick up problem year before you see your blood glucose level rise.

Blood insulin is not a blood tested ordered routinely and I had the blood pulled at a DE hospital satellite but the test was sent to LabCorp who did it out of state. The hospital satellite does most of the blood tests onsite.

 

[Pablo]

I have a question for others and @vavavroom

A1c. The interwebs says basically it's a measure of your blood sugar (BG) average for the last 90 days.

Which basic logic says that can't be true. It may be an ESTIMATE of your BG level average, something like that.

What is A1c REALLY? It's a snapshot of your hemoglobin, and how much glucose it's been carrying??

Nuts and bolts.

 

[Donald]

The nice thing about upping fats at first when getting off all the nasty carbs is threefold, fat makes you full and satisfied, fat doesn't raise blood sugar (much) and it's easier to back off fat than it is carbs.

For me (NOT EVERYONE) - I just stopped eating sleazy carbs (and the bad oils and processed foods), I upped the green leafy/stemmy type veggies, protein and fats. That went on for a good while. I dropped weight, firmed up. I was doing various exercises. My BG came down a little, good but then I plateaued. I made some other changes, two meals a day, etc. Really helped my BG, weight stayed about the same but still plateaued. This is over many months. Then I backed off the fats a little, adjusted my supplements and increased my weight training. My BG readings finally started popping below 100. Even after a healthy meal, I can get a 10-20 pt rise, which is good for ME. If I cheat a little (no one is perfect) I can spike up to 150-160 (used to spike 190-200!) but I drop back rapidly, within an hour. My insulin does respond and seems like my body is dealing with sugar properly.

But I still don't know my fasting insulin level.

Tuesday is my first official blood draw since August. Appointment a week after. I have requested and OK'd for insulin level and full lipid panel along with A1c.

The first thing to do when you get a CGM is to do a brownie or brownie & cookie test to see how high it spikes your glucose. That may wean you off brownies.

I also need to do a ice cream test and while ice cream has sugar it also has fat so it might not spike glucose like a brownie.

Oddly when you spend (after discounts) $200 for 3 Dexcom G7 sensors you still need to buy the overpatch to keep the sensor really stuck to your arm and waterproof. It's like a round waterproof bandaid. Cost is maybe 50¢. Now they sell the overpatch in white or black or neutral or Hello Kitty or many other designs.

Each sensor lasts 10 days.

 

[vavavroom]

I have a question for others and @vavavroom

A1c. The interwebs says basically it's a measure of your blood sugar (BG) average for the last 90 days.

Which basic logic says that can't be true. It may be an ESTIMATE of your BG level average, something like that.

What is A1c REALLY? It's a snapshot of your hemoglobin, and how much glucose it's been carrying??

Nuts and bolts.

Look up glycosylated hemoglobin. Glucose molecules bond to hemoglobin (glycosylation) contained in red blood cells/erythrocytes that have a lifespan of ca 120 days. From the amount of glycosylation, the average blood sugar during the last 60-90 days can be derived. It is important to note that your erythrocytes vary in age from brand-new to reaching their EOL. The A1c has the advantage of showing what your average blood sugar was over a two to three-month period rather than an arbitrary snapshot you get from a finger stick. CGMs can usually estimate an A1c by averaging the data points.

 

[Donald]

I have a question for others and @vavavroom

A1c. The interwebs says basically it's a measure of your blood sugar (BG) average for the last 90 days.

Which basic logic says that can't be true. It may be an ESTIMATE of your BG level average, something like that.

What is A1c REALLY? It's a snapshot of your hemoglobin, and how much glucose it's been carrying??

Nuts and bolts.

Specifically, the A1C test measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated).

But beyond that A1C is a better test because it's an easier test and can't be screwed up by the patient.

Moreover, most individuals do not pay attention to the request or are not asked to consume a diet with at least 200 g carbohydrate in the days before testing glucose. Some individuals do not abstain from food in the 8 h before testing, thus arriving to the laboratory in the postabsorptive rather than fasting condition. In addition, smoking or taking certain medications can adversely affect fasting glucose.

Also how quickly the blood glucose test is analyzed in the lab makes a difference.

The net is the A1C is just an easier test to get an accurate reading from.

 

[Pablo]

Look up glycosylated hemoglobin. Glucose molecules bond to hemoglobin (glycosylation) contained in red blood cells/erythrocytes that have a lifespan of ca 120 days. From the amount of glycosylation, the average blood sugar during the last 60-90 days can be derived. It is important to note that your erythrocytes vary in age from brand-new to reaching their EOL. The A1c has the advantage of showing what your average blood sugar was over a two to three-month period rather than an arbitrary snapshot you get from a finger stick. CGMs can usually estimate an A1c by averaging the data points.

Thanks - here is a money quote from the rock solid source

"A1c is a weighted average of blood glucose levels during the life of the red blood cells (117 days for men and 106 days in women[16]). Therefore, glucose levels on days nearer to the test contribute substantially more to the level of A1c than the levels in days further from the test."

Glycated hemoglobin - Wikipedia

en.wikipedia.org

IF CGM's were more accurate, they would indeed provide a better "average". It would not matter if it was day one or day 117.

Finger stick is all I currently possess. And even if I take 12 readings per day, it's going to be a very misleading estimate of the true BG pattern. It will be quite interesting this go around.

 

[Lubener]

Very interesting comments. I am still learning about this subject. I often wonder as far as carbs go, how much in daily grams is too much even if one periodically consumes mostly complex carbs? Do artificial sweetners contribute to a higher A1C reading? I only use monk fruit and stevia sweetners.

 

[Pablo]

Very interesting comments. I am still learning about this subject. I often wonder as far as carbs go, how much in daily grams is too much even if one periodically consumes mostly complex carbs? Do artificial sweetners contribute to a higher A1C reading? I only use monk fruit and stevia sweetners.

ADA I think recommends 15g carbs per meal. Some draw the line much less than that. Some sources say 50g per day. Some 30. I have a different view, but it really depends on your goal and where you are "on your journey" (read that as health/fat person/diabetic/weight loss/muscle builder/etc spectrum)

BUTTTTTTTTTTTT as you clearly point out, and if not abundantly clear - leaf foliage, stems, REAL complex carbs don't count. NOT sure about the periodically part, but a) eating this stuff doesn't cancel out lousy carbs. And b) don't kid yourself with some of lingo usually hiding starches on the worst offenders: labels on packaging "dietary fiber" and such. Most companies really stretch that definition - for many people most of that really goes to starches and then sugars, pretty quickly. The same with most all grains, sweet potatoes, squash, etc. They can be eaten, but very small amounts. Eat a whole sweet potato and check blood sugar!

There are multiple threads on fake sweeteners. Yes most are unhealthy. Read the packages on yours, what else in with those? Some actually raise BG, some hardly much, others vary by person. Some may not cause a BG spike, but cause an insulin response. This is worse IMHO!! Type 2 we are talking hyperinsulinemia in many cases (strongly insulin resistant being the result). I mess around with some sweeteners - allulose, inulin, date sugar. The jury is still out frankly. My advice is to get off all the sweeteners, get your body right first.

Last tidbids: Learn liver and kidney healthy via whole foods. Organic beef to leafy greens. Fish to cod liver oil. ACV to lemon juice. Clean chicken and eggs. Meat salads with lots of parma cheese. Sauerkraut and cabbage.

 

[Pablo]

Look up glycosylated hemoglobin. Glucose molecules bond to hemoglobin (glycosylation) contained in red blood cells/erythrocytes that have a lifespan of ca 120 days. From the amount of glycosylation, the average blood sugar during the last 60-90 days can be derived. It is important to note that your erythrocytes vary in age from brand-new to reaching their EOL. The A1c has the advantage of showing what your average blood sugar was over a two to three-month period rather than an arbitrary snapshot you get from a finger stick. CGMs can usually estimate an A1c by averaging the data points.

OK now I searched and searched. I cannot get a clear answer: How fast does your blood glycate? Spontaneous??

So lets say any given human is in near perfect health, fasting BG arbitrary say 85. Eat a healthy meal, BG goes to 110. Repeat for 120 days, same and same. Then said person goes sugar/starch nuts for a single meal, and eats a LOT. BG goes to 220. Then within a couple hours, walking, running, lifting, rest BG drops to 110. One time event. Next day blood draw for A1c. How fast do his/her red blood cells get glycated? How weighted is that single event?

 

[Pablo]

Here's one: Non-fat dry powdered milk WILL raise blood glucose. Accident and deduction led me to actually read the nutrition label. NOT an insignificant amount of carbohydrates.

I was adding it to my choco-espresso, either no sweetener or allulose or inulin (w/organic cacao and cream, water and 2-3 shots) and my BG would pop a bit. More than I expected.

I guess I shouldn't be surprised, so DUH to me.

 

[vavavroom]

OK now I searched and searched. I cannot get a clear answer: How fast does your blood glycate? Spontaneous??

So lets say any given human is in near perfect health, fasting BG arbitrary say 85. Eat a healthy meal, BG goes to 110. Repeat for 120 days, same and same. Then said person goes sugar/starch nuts for a single meal, and eats a LOT. BG goes to 220. Then within a couple hours, walking, running, lifting, rest BG drops to 110. One time event. Next day blood draw for A1c. How fast do his/her red blood cells get glycated? How weighted is that single event?

You'll have to ask an endocrinologist who specializes in research. Your hypothetical random high blood sugar of 220 from food is not something that would happen only to a diabetic. With a properly functioning metabolusm blood glucose levels are self-limiting to under 180.

 

[Pablo]

You'll have to ask an endocrinologist who specializes in research. Your hypothetical random high blood sugar of 220 from food is not something that would happen to a person who does not have diabetes.

Interesting!
Not sure if I can find one

I just puked up the 220, say 170-180 or whatever, same scenario

 

[vavavroom]

I don't expect one or even a few high BG occurrences will skew the A1c significantly. There could also have been low BG events that were not even detected. The A1c is not flawless. For example, it does not tell us if a person had wild swings in BG levels which are more damaging compared to more stable levels. That's where the CGM rules. It allows you to see the swings in BG levels and to act accordingly.

 

[alarmguy]

They may eat high fat, in a way. But wrong fats, for sure.

Point being people fear fats and they get FAT on carb replacements.

I actually upped my fats. Don't be afraid of fat. Be afraid of simple carbs.

I dont disagree but with heart disease it's a tight rope. One lipid that most people never have checked (though that is changing) Is Lipo Protein A
Because of family history my new Cardiologist (btw interned at Cleveland Clinic) So even though my lipids, My ENTIRE life have been great he had my Lipoprotein A checked. It's really high, it's hereditary and there is no treatment for it yet. He wanted it in my file because he feels we are on the cusp of a treatment.

I like this guy a lot, and you know much of what he said makes sense that I think you understand as well. For the time being, we discussed eating properly to keep inflammation as low as possible and in my case try to keep my LDL as close to 30 as possible. Meaning keep the lipids as low as possible because he feels it will help even though there is nothing yet to control the hereditary Lipo A
But we also discussed much of what contributes to inflammation which aligns with controlling and/or preventing diabetes.

 

[sloinker]

In my case I started seeing a new doctor last September. My prior doctor never tested for what really needed testing. I had gained a pile of wait in 2 years without a lifestyle change. The new doc tested my thyroid and it was off the charts high, which means it wasn't working. I am now on synthetic thyroxin. He also tested for A1C and I was right at the top of pre-diabetic once and diabetic the next time it was checked. I got a prescription for the Freestlye Libre 2 which I started 3 weeks ago. So far my daily average has been around 100, only going into alarm twice, low around 65. My insurance doesn't cover the CGM as my A1C is below 8 and I don't use insulin. The libre 2 costs $75 a month with a manufacturer coupon. I use my smart phone and the doctors office shares the info from my phone. I was also prescribed Mounjaro which surprisingly is covered by my insurance. Been using it 3 weks now at the lowest dose. Stepping up to the next dose next week. Needless to say, the swapping of doctors has been a real lifestyle change with results.
What do you call a medical school graduate that finished last in his class? That was my old practitioner.