Questions

Question and answers………..01/03/2014

Lots of new Diabetics here recently so I thought I would help steer you in the right direction with a bit of questions and answers:

Do I need a glucose meter to control my diabetes:  Absolutely, trying to control your glucose without a meter is like driving at night with no head lights.

How many carbohydrates do I need to eat:  The actual answer to this is zero, carbohydrates are a non-essential nutrient.  In other words your body would make glucose from the proteins you ate for its daily needs for glucose.  I am not advocating zero carb diets, just trying to make a point.  Everyone’s ability to consume carbohydrates will vary depending on the amount of insulin you have available.  Use your meter, it will tell you all of the answers you are asking.  If you decide to eat a serving of oatmeal and you then check your glucose at one hour and it is above 140 or 7.8 you need to rethink your meal plan.

What medications should I take:  Work on diet first?  See if you can reduce your medications through diet alone.  Trying to maintain a diet that requires medication just doesn’t make sense.  Give up your battle to eat your favorite foods your body will love you for it.  Learn to love what you can eat and let go of what you loved to eat.  It is that simple.  The longer you wage the war between trying to maintain your old lifestyle habits and learning new lifestyle habits will only elongate the healing process.

Do I need insulin:  If after you have adjusted your diet to a point where you feel there is no further adjusting can be made and your glucose levels are still above normal insulin maybe necessary.  Do not fear insulin, it can be a very useful tool to control your glucose levels. 

Do I need to take a statin for my cholesterol:  Most T2 diabetics have high cholesterol because they have had high glucose / insulin circulating around their body causing inflammation.  The cholesterol is there to repair this inflammation.  If you reduce the inflammation by reducing your insulin and glucose your cholesterol will naturally go down.

If you have specific questions please visit our website I would be more than happy to assist you.

www.t2dcoaching.com

Taking Control

Taking Control………………………….01/03/14

What does it mean to take control of your life, health, physical well-being? When first diagnosed with diabetes it is of utmost importance to learn everything you can about your disease, read, think, read some more.  Put into practice what you have read.  Use your meter as often as you feel necessary, more importantly than just taking your glucose levels is using the information to better control yourself.  Doesn’t matter who you see for your diabetes, the doctor, the nutritionist, diabetic educator, the Endocrinologist, it is your diabetes not theirs.  You need to educate yourself to the point where you can make informed decisive decisions about how you are going to treat your diabetes.  Listen to the professionals but question everything they say, and then make a decision.  Do not let them decide for you what you are going to take to treat your diabetes.  You have to own this disease, control it to the best of your ability.  If you’re taking medication and your glucose levels are still out of control, change your diet first not your medication.  Diet and exercise is the true key to controlling this disease. All Carbohydrates will have an impact on your blood glucose levels, some faster than others but all will have an impact.  If that impact drives your glucose levels beyond your set goal you need to rethink what you are eating. If at some point you can no longer refine your diet in your quest to achieve normal glucose levels than adding more medication makes sense but you have to decide what medication you want to take.  Taking the latest and greatest medication is not always the best route to take.   Do you have a goal in mind or are you going by what your doctor told you are acceptable levels.  What are acceptable levels by most organizations and what will help eliminate future complications are usually two different goals entirely.  Learn what normal glucose levels are; decide what you want your goals to be, then strive to obtain those goals. 

We can help you make these decisions.  www.t2dcoaching.com

Resistant Starch……………………12/30/13

 

There seems to be a Lot of interest out there for resistant starch (RS). 

Resistant starch is exactly what the name implies resistant to digestion.  It is in the fiber category but is not a true fiber as your body can ferment the substance in your large intestine.  RS will not digest in your stomach or small intestine but travels on to your large intestine where bacteria ferment it into useful by products, mainly short chain fatty acids (SFA’s).  Your body can use these SFA’s as a fuel source so in theory it becomes less interested in maintaining a glucose supply.  RS if ingested properly should not raise your glucose or your insulin levels.  The old saying you are what you eat applies to what bacteria you have growing in your large intestine.  A high carb standard American diet (SAD) will lend itself to harboring a certain type of bacterial flora one that is predisposed to acquiring as much glucose from the food you eat as it can.  The bacteria associated with RS are bacteria that only want to ferment the RS into SFA’s and other useful by products your body can use. You can change the bacterial flora in your gut by ingesting RS daily.  I used the high maize 260 or corn starch.  I choose this RS because it was easily separated from the starch that would raise my glucose levels, (soluble starch). I placed 40 grams of the RS in a glass of water, stirred, then refrigerated until the RS sunk to the bottom. What was left on the bottom was pure RS and what was dissolved in solution was the soluble starch.  I would then slowly and gently pour off the water then add additional water and drink it down.  I did this twice a day for a month.  Now I will tell you this didn’t come without side effects.  I took these side effects as a positive note that I didn’t have the proper bacteria to handle this new food source.  I had to map out where I was going and identify all of the available rest rooms; I knew I would be visiting them soon.  After the first couple weeks the side effects wore off dramatically, by the beginning of the second month I had no side effects at all.  The lack of side effects indicated to me that I was developing the proper bacteria and could reduce my intake to 40 grams a day, down from the 80 grams I was ingesting.  RS has no effect on your body; it is the bacteria that develop from the RS that provides all of the benefits.  RS will improve most digestive issues in most people.  My overall blood glucose average went down significantly as did my morning fasting glucose levels.  I was diagnosed with an A1C in the teens and a fasting glucose in the upper 300’s.  I started the RS about a month after being diagnosed, my 3 month A1C was 5.6, then a couple of months later I was down to 4.8.  The RS was one of the supplements that had a large impact on regaining my health.  One other benefit is the reduction in abdominal fat; I swear I could see my stomach shrink on a daily basis.  I went from a waist size of nearly 42 to a 36 inch waist now and I weigh 225 pounds. 

http://ajcn.nutrition.org/content/82/3/559.abstract

Come visit us at www.t2dcoaching.com we can help answer your questions and provide motivation.

Cholesterol……………..12/17/2013

First thing most doctors want to do when your diagnosed with diabetes is to put you on a cholesterol drug (statin) and an ACE inhibitor (blood pressure) as a precaution to protect your kidneys.  The ACE inhibitor is really not a bad idea in my mind if you can tolerate the side effects; I take a small dose of Lisinopril daily by choice.

Statins on the other hand do more harm than good.  Reducing your Cholesterol through chemical alteration rather than changing the root cause for your cholesterol leads to a false sense of security about what foods you can consume.  Why is cholesterol there, what is its purpose.  Cholesterol is there to protect the lining of your arteries from inflammation caused by high insulin and high glucose values.  If you reduce the inflammation you reduce your body’s need for cholesterol.  You reduce the inflammation by keeping your circulating insulin as low as possible through eating a low carb diet.  You can’t blame cholesterol for doing its job; it would be like blaming the firefighters for the fire.  When you reduce your insulin usage you will reduce your inflammation and along with that will come weight loss.  Your body will now start to mobilize fats stores this will be evident if you get a cholesterol test while your body is in weight loss mode.  Once you reach your goal weight your cholesterol will drop into a normal range.  My total cholesterol is now in the 150’s and my triglycerides are in the 30’s.  This is all due to reducing my carbohydrate intake and exercise. 

It is far more important to test for particle size than testing for total cholesterol.  Particle size can be done with a VAP test or a NMR LipoProtein test.  Either will yield more information than a total cholesterol test will.

Here is but one article about what is the true cause of heart disease.

http://myscienceacademy.org/2012/08/19/world-renown-heart-surgeon-speaks-out-on-what-really-causes-heart-disease/

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Holidays and keeping Blood Glucose under Control

Holidays are especially difficult if you are newly diagnosed. What should I eat, what can I eat, how much should I eat of this or that, all questions you will ask yourself before you go to that party or have friends and relatives over for dinner. My strategy for going to a party where I know nothing of what is being served is to eat something at home right before I leave. It is a lot easier to turn down tempting food when you are not hungry and makes it easier to be highly selective when dinner is served. Stick to your plan, meat and vegetables. Watch out for hidden carbohydrates in gravies and sauces.

Something else you can do and another topic I will cover in future post is carb budget. How many carbohydrates can you eat in a 24 hour period and still remain with normal blood glucose levels. Every diabetic has a carb budget. You have to determine what your carb budget is by testing and trying out new foods, it takes time and effort and your body will love you for it, especially your pancreas. There are two forms of the same insulin with your body, phase I, and phase II insulin. Most type 2 diabetics lack a phase I insulin. Phase I insulin is stored insulin released immediately upon eating, phase II insulin is newly manufactured insulin and takes over if your phase I insulin is insufficient to normalize your blood glucose level. So if you eat below your carb budget for several days your body will once again start to store phase I insulin. This insulin will provide you with extended coverage of an upcoming meal you are planning. Come visit us, feel free to ask a question.

High Glucose/High Insulin....11/12/2013

What does it mean to be a typical Type 2 diabetic with insulin resistance? It takes several factors to become a T2 diabetic, the first is insulin resistance.  This usually occurs years in advance of someone being diagnosed with diabetes.  The second part of the equation is when your pancreas reaches a point that it can no longer produce enough insulin to overcome your demand for insulin you become a diabetic.  If diagnosed early enough most will have high circulating insulin and high levels of glucose as compared to a normal person.  The insulin is no longer allowing the glucose into the muscles to be used as energy so your body makes and stores the Insulin/Glucose mix as fat.  That's why it is so easy for a person with insulin resistance to gain weight rapidly.

Having high insulin and high glucose levels means your body is also suffering from lots of inflammation.  This inflammation is causing your body to produce more and more Cholesterol to try and repair the vascular damage that's occurring.  The Cholesterol is not the enemy, the inflammation is the enemy.

How do you reduce the inflammation?  You reduce the inflammation by eating foods that do not require large amounts of insulin to process the food into energy.  Mostly fats, proteins and low carbohydrate vegetables.  By eating low carbohydrate foods, increased natural fats and moderate proteins you reduce the inflammation.  It is important to note that natural fats are essential to overall health.  You cannot sustain a diet of low carbs, low fat, high protein; it will lead to problems later on in life.  All excess protein is converted into glucose by the liver and then stored as glycogen then fat.  The reduction in inflammation will result in reduction in your glucose levels, your body weight, cholesterol levels and some even find a reduction in their blood pressure levels.  The reduction in glucose levels will be the first thing that is noticeable.  All carbohydrates affect your blood glucose levels, some faster than others but all have an effect. Lowering your insulin levels is as important as lowering your glucose levels and the only way to do that is to reduce your intake of carbohydrates. 

What does it mean, Ketogenic Diet........11/6/2013

Ketogenic diet is a healthy, satisfying, fully nutritious diet that will help you normalize your Blood Glucose levels, Your Cholesterol Levels and your Blood Pressure levels. Ketogenic diet means your body has switched from using glucose as its main source of energy to using fats.  Human body has evolved to use both glucose and fats as a source of energy.  Using fats as an energy source will reduce your body's inflammation levels.  This in turn reduces your body's need for Cholesterol.  Cholesterol is used to repair the damage that was caused by the inflammation of having high blood glucose levels and high insulin levels.  If you reduce the inflammation you reduce your body's need to keep making more and more cholesterol.

In order for your body to become ketogenic you will have to consume less than 50 grams of carbohydrates a day and your level of natural fats will have to exceed that of your protein consumption.  A simplistic approach to a ketogenic diet would be consuming real whole foods, natural fats, moderate proteins, reduced carbohydrates.  All the carbohydrates you need will be found in the numerous low carbohydrate vegetables.

Ketones are formed in your liver when your brain determines that your incoming carbohydrates are not at a level to support your energy needs. Your muscles will then start to use stored fats or ingested fats as an energy source.  The byproducts of your muscles using fats travel to your liver where they are converted to ketones (ketosis).  The ketones are then used by your brain, your heart and all other organs that cannot use fats directly as an energy source.

Ketogenic diets are not something new; they have been employed by doctors for many years to control seizures in children and adults.  Your brain functions differently on ketones than it does on glucose.   If you're interested in this type of treatment plan for your health please come and visit us.

Resetting your System.......10/30/13

If you are taking medication after medication and your doctor is trying to add more medication, why not go back to ground zero for a couple of months. This is not a long term thing but a tool to determine your status with your disease, a means to adjust your medication to its lowest possible denominator.

Adjust your diet, diet is the biggest tool you got in your tool box to manipulate your glucose levels, your cholesterol, your blood pressure, your inflammation. Eat real whole foods, foods that come without a label except for dairy products. Limit your carbs to those found in low carb vegetables. Avoid foods that have wheat, grains, oatmeal, potatoes, rice, pasta, beans, and flour products. Do not avoid natural fats, fats found in red meat, dark meat Chicken, or dairy products. You do not have to seek out fat but avoiding it will not allow your body to heal properly. Avoid most fruits except for a small amount of berries. This is not a long term plan but a plan to rest your pancreas. Think of it like putting a cast on a broken bone. Once you see your glucose levels fall into a normal range and become predictable try to stay at this level for a couple of months. This is Diabetic cruise control, the lowest point of ingested carbohydrates that will provide a balanced diet with all the necessary nutrients. Some will find they like it here, I do. It is easy, no counting carbs, no worrying over a glucose spike or a hypoglycemic events. You will be eating approximately 30-50 grams of carbohydrates a day at this level of diet.

Now you can choose to remain at this level or you can start to reintroduce the foods you love or thought you loved. Your cravings will change over time; you will no longer want the high carbohydrate items you were seeking before this. Most will see a drastic reduction in cravings after a couple of weeks. You will learn the difference between true hunger, and false hunger created by your previous insulin spike. You will have to test before the new food item, 1 hour after, and 2 hours after to see if it is a food you are capable of eating by comparing the numbers on your glucose meter to the goals you set for yourself. Your body will respond differently now than it did before you rested your pancreas.

While doing this you are going to have to monitor your glucose levels closely. If you are taking medications, they will need adjusting. If you are injecting insulin be sure to inform your doctor of your intentions, this will lower your glucose levels and your insulin demand. If you need help please stop in and see us.

Building Confidence.....10/29/13

As a diabetic a big fear always comes to mind, can I go hypoglycemic?  If you are on certain medications that directly impact your glucose levels there is always a possibility you can have a hypoglycemic event. Medications that fall into this group would be ones that urge your beta mass found in your pancreas to secrete insulin even when it is not desired. Injecting insulin always comes with the potential of a hypoglycemic event. Your liver is there to protect you from these events.  How do I know if my liver is working?  You can test your liver's capabilities of bringing up a low blood glucose number under a controlled situation.  This will build confidence within yourself and reduce the anxiety of thinking you will have a hypoglycemic episode.

This exercise is mainly for those just on Metformin or those that are not on any medication but still have a fear of going hypoglycemic. 

Everyone has a typical blood glucose curve for themselves.  Generally your glucose will be at its highest in the morning and gradually fall during the day except for post meal times.  I am at my lowest right before I eat dinner.  What I have done is check my blood glucose levels right before dinner.  I then restricted myself from eating anything, I wanted to see how low I would go before my liver decided to bring my blood glucose levels back up and also how high would I go afterwards.  I had food there waiting for me so I could have stopped and eat at any time.  What I found was my cut off mark was the low 60's, once I hit the low 60's my liver would bring me back up to the mid 80's.  This exercise will not only build confidence but it will also give you another marker on how well your body is healing.  We can help you understand these numbers on our website.

Observational Discoveries.....10/25/2013

Every Diabetic wants to know, how well am I doing?  There are a few basic tests a Type 2 Diabetic can perform to determine their blood glucose stability. The first and easiest test to perform is fasting in the morning.  Record your blood glucose levels immediately upon waking.  Then without eating or drinking anything but water keep recording your blood glucose levels on 30-60 minute intervals.  You want to witness when your glucose levels rises, how high it rises and at what level of blood glucose does your pancreas release insulin and you start to see your levels fall.  This simple test will yield lots of information that can be used over and over again.  The first piece of information is your peak glucose level.  The peak glucose level while fasting will provide you a number to base future food items on that you eat for breakfast.  Sometimes a morning peak is about what you didn't eat as opposed to what you did eat.  Example, you go through all of the above testing for a couple of mornings and you note that your glucose levels go to 140 or 7.8, you now have a number to base your levels on when you do eat something.  The next morning if you consume (x) grams of protein, (y) grams of natural fats and your glucose level still goes to 130-140, you now know it would have gone that high even if you didn't consume anything. Mornings are all about waking up your system, stomach, liver, pancreas, brain, all have to work in harmony to stop your morning rise.  If you repeat this test over time you may notice that your rise becomes smaller and smaller, this I feel is due to your body healing itself.  We can help you interpret these numbers here at t2dcoaching.  Next week we will talk about building confidence with your stability.

Continuing with the theme of strategies..10/22/2013

If you're newly diagnosed, you have to ask yourself,  what are my goals going to be?   You have to have a goal in mind; you need a stepping stone to determine your progress.  

For example if I was diagnosed with fasting blood glucose in the 400's, what can I expect a month from now, 2 months from now, etc.  No one has the answers to those questions but it helps if you make a mental picture of where you want to be in 2, 3, 4 months down the road.  This will help you form a game plan.  Ask yourself how you are going to achieve your goals and what are you willing to do to achieve them?  First, you need to find out what actually can be done to reach your goals.  This requires some research on your part.  I can guide you to the information but it is up to you to evaluate this information and decide how it may pertain to your particular circumstances.  I am here to help make sense of the information and you can use me as a sounding board for your questions that you will inevitably have.  

Hot Tubs....10/24/2013

This pertains to more than just hot tubs but it is getting to that time of year when a hot tub feels really good.  Your internal body temperature is a steady 98.6 f, 37 C.  When your core temperature begins to raise it sets of a cascade of events that may cause erratic changes in your blood glucose levels.  Some will see a rapid rise; there are a few individuals that see a drop.  This phenomenon occurs due to an adrenalin release; your body is trying to reduce your core temperature.  When you get an adrenalin release your insulin resistance goes up, your liver will secrete glucose, your heart rate climbs, and your blood vessel contract raising your blood pressure. This is in effort to get more blood to the surface of your body; blood near the surface can be cooled by the atmosphere and then recirculated back to your core.  Problem arises that the atmosphere temperature is also high (hot tub) so your body responds by sending out more adrenalin.  If you are going to use a hot tub or be outside just being aware of your body's signals, rapid heartbeat, sweating profusely, feeling ill, all will help maintain control of your blood glucose levels.

Eat to Your Meter

If you're newly diagnosed and do not have blood glucose meter it is highly advisable to get one.  Having Diabetes without a meter is like driving at night with no head lights.  Having Diabetes is a proactive disease, the less reactive you are the better off you will be.  Non Diabetic individuals will have their blood glucose levels peak between 45 minutes to approximately 90 minutes depending on the meal and the amount of fat consumed.  Fat reduces the rate of digestion, something to keep in mind; it will come in handy in the future.  Your meter is like the older 8 ball toy you had when you were a kid, ask it a question and it would tell you an answer, (showing my age here).  Your meter has the answer to what foods you should eat, reduce, or remove from your diet altogether.  After you eat a meal your blood glucose begins to rise and peaks in approximately one hour, it's up to you to find when your body peaks.  This takes time and multiple testing of your glucose levels after you eat to determine your peak time.  Once you got this information your now on your way to discovering what foods do what to your body.  The two hour reading will tell you how well your body is recovering from the meal you just ate.  This reading should be back to your premeal number or under 100mg/dl.  This way of managing your diabetes is in conjunction with having a set goal.  What do I want my glucose to be before I eat, one and two hours after I eat?  You have to have a goal for this management style to work properly.  Now that you have your goals and a plan you can test different foods and observe their effect on your blood glucose. Test your glucose levels before you eat, then at your own peak time after you eat, then again at the two hour mark.  If any of the numbers recorded are outside of your goals you will have to either reduce the amount of carbohydrates you ate, or eliminate that food altogether.  It takes time to build a working food list, (safe foods), foods that will not raise your glucose levels beyond your goals.  It is well worth the effort and your body will love you for it. 

www.t2dcoaching.com