Tuesday:
I watched a Michael Mosley show last night (I'm doing his Blood Sugar Diet atm), the first episode of "Trust Me I'm a Doctor" where they look at widely held beliefs about health. They covered a few topics but the main one was about how to lower cholesterol and therefore heart disease. They talked to experts and did an experiment where they split some people with high cholesterol into three groups: one reduced saturated fats (animal fat, cheese, butter), one added oats every day, one added almonds every day. And Michael Mosley himself did all three! I think it was for three weeks. It was to see if diet was as effective as statins. The group reducing saturated fats and the group adding oats both had major improvements, cholesterol down around 9-13%. The almonds on average appeared to do nothing, but when they looked at individuals some had a big improvement but some got worse. So that one seemed to depend on the person. And MMs cholesterol was down by about 30% - so it seemed the three strategies stacked benefits! Pretty sure his at least was as effective as the statins he had been taking. Interesting that he has high cholesterol even though he is not at all overweight and presumably follows his own healthy Mediterranean diet plan.
There are online forums for the BSD diet I'm doing and some people (who have stuck to it better than I have) have had amazing results. Weight loss, but also reversing diabetes which is what the diet is designed to do. The received wisdom was that you can't reverse diabetes once you get past the pre-diabetes stage, and maybe that is true in the sense that if they went back to their old eating habits they would have the same high blood sugar problems, but on this diet they have normal blood sugars WITHOUT all the medication they had to take before. Diet is enough, if it's the right diet. Yet the authorities still tell diabetics and prediabetics to eat plenty of carbs, spread throughout the day, to keep blood sugar levels steady! And that diabetes is progressive and you'll have to go on more and more medications eventually. Well yes, if you keep eating lots of carbs! When I've stuck to the diet a bit longer and lost some more weight I'll have my blood sugar tested and see if it's helped me. I don't think that any diet is perfect for everyone, and I tend to be happier with some carbs in my diet, but so many people have improved their blood sugars I am trying to stick with it for the duration.
Another day of clean eating under my belt.
B: roast beef, cucumber, tea.
L: chicken, grapes.
S: Apple.
D: bolognaise with zoodles.
S: cashews.
Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts
Tuesday, May 3, 2016
Tuesday, July 28, 2015
No appropriate title springs to mind
Tuesday:
I have a pimple on my nose. I need to learn to say, "No, I do not want that sugary food" in Natalie-speak!
After washing my CPAP yesterday it did that thing again last night where it wasn't expelling my outward breaths. This is not a trivial matter, it cannot be used in that state as I'd be re-inhaling my own breath and wouldn't be getting much oxygen. I'd say it was dangerous, except there is no way I wouldn't notice and rip it off. It feels like I'm suffocating straight away when it is doing that. I tried to clean the vents and make sure everything was dry and fiddled with it for a while but couldn't get it working so I gave up. And had a nasty headache this morning. I need to get this sleep thing sorted!
I finished that exercise motivation book "No Sweat". I felt like a lot of it doesn't apply to me, I don't need strategies to find time in the day or give myself permission to put myself first occasionally - although I do look after my family I already have a lot of discretionary time - and I am not trying to force myself to do kinds of exercise I hate - I already know several forms I enjoy if only I can get myself to do them.
But I did get something from it. Mainly that if I keep telling myself I should exercise for various (very valid) reasons then I'm going to resist doing it. It's like being nagged by myself, and nagging never makes you want to do something! The book's suggestion is encouraging myself to exercise because it will be immediately pleasurable. Exercise is not a chore, it is a gift I'm giving myself. Although this is true, it is hard to let go of all the should.
I drove to the library this morning (I had a huge pile of books to return, too many to carry to walk there) then walked along the lake a bit - for pleasure (or so I tried to tell myself). I did enjoy the first 30 minutes. It was bitterly cold earlier, but I had waited long enough that it wasn't too bad as long as I stayed in the sun. I listened to Katy Perry roar, and saw some ducks.
I walked for 45 minutes altogether and the last 15 to get back to the car wasn't so pleasurable, I was a bit tired and very thirsty, but overall it was a nice walk. The main thing I enjoyed was my body moving in harmony with itself.
I've been trying to reduce starchy foods lately (um, apparently except for cake. And potatoes. And some bread) but exercise is supposed to help glucose tolerance so I decided my nice walk meant I could have some pasta for lunch. I made a lovely boscaiola and ate a reasonable amount. I also had three squares of chocolate. Two hours later I tested my blood glucose. 12.8 mmol/L (230 mg/dl in the US). This is totally unacceptable, into the diabetes range. Half an hour later I checked again to see if it had gone down. 14.1 mmol/L (254 mg/dl). Even worse! That is doing my body damage. I think that is the highest I've ever seen it. Another hour later, so three and a half hours after eating, it was down to 8.7 mmol/L which is still not down into normal person range.
It's only a short time since my last official diabetes test and the doctor said to wait two years before doing another one because "you don't have diabetes" - I was 0.2 mmol/L under the official cut-off. But I am going to be more vigilant testing at home and review that decision if it seems appropriate.
Report card:
Diet: I thought good, but blood glucose results say otherwise.
Exercise: Great.
Water: Good.
Sleep: Terrible.
Mental health: Good.
I have a pimple on my nose. I need to learn to say, "No, I do not want that sugary food" in Natalie-speak!
After washing my CPAP yesterday it did that thing again last night where it wasn't expelling my outward breaths. This is not a trivial matter, it cannot be used in that state as I'd be re-inhaling my own breath and wouldn't be getting much oxygen. I'd say it was dangerous, except there is no way I wouldn't notice and rip it off. It feels like I'm suffocating straight away when it is doing that. I tried to clean the vents and make sure everything was dry and fiddled with it for a while but couldn't get it working so I gave up. And had a nasty headache this morning. I need to get this sleep thing sorted!
I finished that exercise motivation book "No Sweat". I felt like a lot of it doesn't apply to me, I don't need strategies to find time in the day or give myself permission to put myself first occasionally - although I do look after my family I already have a lot of discretionary time - and I am not trying to force myself to do kinds of exercise I hate - I already know several forms I enjoy if only I can get myself to do them.
But I did get something from it. Mainly that if I keep telling myself I should exercise for various (very valid) reasons then I'm going to resist doing it. It's like being nagged by myself, and nagging never makes you want to do something! The book's suggestion is encouraging myself to exercise because it will be immediately pleasurable. Exercise is not a chore, it is a gift I'm giving myself. Although this is true, it is hard to let go of all the should.
I drove to the library this morning (I had a huge pile of books to return, too many to carry to walk there) then walked along the lake a bit - for pleasure (or so I tried to tell myself). I did enjoy the first 30 minutes. It was bitterly cold earlier, but I had waited long enough that it wasn't too bad as long as I stayed in the sun. I listened to Katy Perry roar, and saw some ducks.
I've been trying to reduce starchy foods lately (um, apparently except for cake. And potatoes. And some bread) but exercise is supposed to help glucose tolerance so I decided my nice walk meant I could have some pasta for lunch. I made a lovely boscaiola and ate a reasonable amount. I also had three squares of chocolate. Two hours later I tested my blood glucose. 12.8 mmol/L (230 mg/dl in the US). This is totally unacceptable, into the diabetes range. Half an hour later I checked again to see if it had gone down. 14.1 mmol/L (254 mg/dl). Even worse! That is doing my body damage. I think that is the highest I've ever seen it. Another hour later, so three and a half hours after eating, it was down to 8.7 mmol/L which is still not down into normal person range.
It's only a short time since my last official diabetes test and the doctor said to wait two years before doing another one because "you don't have diabetes" - I was 0.2 mmol/L under the official cut-off. But I am going to be more vigilant testing at home and review that decision if it seems appropriate.
Report card:
Diet: I thought good, but blood glucose results say otherwise.
Exercise: Great.
Water: Good.
Sleep: Terrible.
Mental health: Good.
Sunday, June 28, 2015
Health issues - the results
Monday:
I saw my doctor and the sleep clinic today and got a lot of results back, good and bad. I'm going to list them all here, mainly for my own records.
Firstly I saw the technician at the sleep clinic. I'd had the borrowed CPAP brain for two weeks to get some more readings on how I'm sleeping. The result is that my tiredness doesn't seem to have anything to do with my sleep apnoea. The machine is working well, I'm using it correctly, I'm having a sleep apnoea "event" on average 0.1 times per hour (that is about once every second night), which is negligible. They have now increased the air pressure to eliminate even that occasional event, but it's not really going to make any difference. So, that was not the problem.
Then I saw my GP (general practitioner, my family doctor) to get the results of my glucose tolerance (diabetes) test and all the other blood readings. That was interesting and a bit scary.
Four years ago, when I was first flagged as having pre-diabetes / glucose intolerance, my blood glucose was 10.0 mmol/L. Normal is 7.7, diabetes is 11.0. So it wasn't good. I worked on it. Two years ago it was down to 8.2, nearly normal. Great work Natalie. Today it was up to 10.8 mmol/L. That is not good at all. It's 0.2 from a diagnosis of diabetes. Doubly bad, with my father recently dying of (probably) diabetes complications. I have gained weight back over the past couple of years, I was down to 78 kg for a while, I desperately need to lose it again, and more. This morning I was at my highest for a long time: 84.8 kg. That is a couple of kilograms (5 pounds) in less than two weeks. I was hoping the weight gain was partly a monthly fluctuation, but apparently not.
Obviously it's time, way past time, to get really really serious about my health.
That wasn't the only result. The next most important was my level of B12, which are very low. It seems I'm not absorbing B12 from food. And guess what, low levels of B12 make you very tired. We may well have a solution to my constant fatigue. I'm now on Vitamin B12 supplements for 2 or 3 months, then will be retested. If I still can't absorb the vitamin from the tablets, as is quite likely, I will need regular injections of it. This was completely unexpected news! Lucky I'm not scared of needles. In a way I am excited about this result, because it means I might finally get a resolution to my constant tiredness. An injection every month or so in return for normal levels of energy? Bring it on! Or maybe the pills will help, which is even better.
My cholesterol is too high. I've always had high cholesterol, but last test it was down to almost normal. This time is was up again, to 6.2. Should be 3.5--5.5. Probably tied to my obesity, and another reason to lose weight.
My blood platelets are up a little bit. High enough for my doctor to point it out, but not high enough to worry, she said. They can go up due to an infection, so if I had a cold or something (and I have had a sore throat) that can cause the reading. When I got home I looked it up and the other thing that causes increased blood platelets is cancer. Ah, the internet, so comforting. I'm trying not to worry about that at this stage. I was only a little above normal. But another thing to keep an eye on.
And finally my Vitamin D levels are low. I was put on tablets for this before, but stopped taking them (without consulting my doctor) when I started walking regularly and was getting plenty of sunlight. That fizzed out a while ago. So now I'm back on the pills.
I'll be tracking food, counting calories and carbohydrates. And exercising every day.
I saw my doctor and the sleep clinic today and got a lot of results back, good and bad. I'm going to list them all here, mainly for my own records.
Firstly I saw the technician at the sleep clinic. I'd had the borrowed CPAP brain for two weeks to get some more readings on how I'm sleeping. The result is that my tiredness doesn't seem to have anything to do with my sleep apnoea. The machine is working well, I'm using it correctly, I'm having a sleep apnoea "event" on average 0.1 times per hour (that is about once every second night), which is negligible. They have now increased the air pressure to eliminate even that occasional event, but it's not really going to make any difference. So, that was not the problem.
Then I saw my GP (general practitioner, my family doctor) to get the results of my glucose tolerance (diabetes) test and all the other blood readings. That was interesting and a bit scary.
Four years ago, when I was first flagged as having pre-diabetes / glucose intolerance, my blood glucose was 10.0 mmol/L. Normal is 7.7, diabetes is 11.0. So it wasn't good. I worked on it. Two years ago it was down to 8.2, nearly normal. Great work Natalie. Today it was up to 10.8 mmol/L. That is not good at all. It's 0.2 from a diagnosis of diabetes. Doubly bad, with my father recently dying of (probably) diabetes complications. I have gained weight back over the past couple of years, I was down to 78 kg for a while, I desperately need to lose it again, and more. This morning I was at my highest for a long time: 84.8 kg. That is a couple of kilograms (5 pounds) in less than two weeks. I was hoping the weight gain was partly a monthly fluctuation, but apparently not.
Obviously it's time, way past time, to get really really serious about my health.
That wasn't the only result. The next most important was my level of B12, which are very low. It seems I'm not absorbing B12 from food. And guess what, low levels of B12 make you very tired. We may well have a solution to my constant fatigue. I'm now on Vitamin B12 supplements for 2 or 3 months, then will be retested. If I still can't absorb the vitamin from the tablets, as is quite likely, I will need regular injections of it. This was completely unexpected news! Lucky I'm not scared of needles. In a way I am excited about this result, because it means I might finally get a resolution to my constant tiredness. An injection every month or so in return for normal levels of energy? Bring it on! Or maybe the pills will help, which is even better.
My cholesterol is too high. I've always had high cholesterol, but last test it was down to almost normal. This time is was up again, to 6.2. Should be 3.5--5.5. Probably tied to my obesity, and another reason to lose weight.
My blood platelets are up a little bit. High enough for my doctor to point it out, but not high enough to worry, she said. They can go up due to an infection, so if I had a cold or something (and I have had a sore throat) that can cause the reading. When I got home I looked it up and the other thing that causes increased blood platelets is cancer. Ah, the internet, so comforting. I'm trying not to worry about that at this stage. I was only a little above normal. But another thing to keep an eye on.
And finally my Vitamin D levels are low. I was put on tablets for this before, but stopped taking them (without consulting my doctor) when I started walking regularly and was getting plenty of sunlight. That fizzed out a while ago. So now I'm back on the pills.
I'll be tracking food, counting calories and carbohydrates. And exercising every day.
Tuesday, June 23, 2015
Glucose tolerance
Tuesday:
This morning was my biennial glucose tolerance test for diabetes. It involves drinking a revoltingly sugary drink (75g of sugar, twice as much as in a Coke) then sitting still and feeling queasy for two hours while they take tests of your blood and urine. Easy! Compared to going to the dentist yesterday, it was like a morning in a luxury resort. Results in a few days.
Home for lunch and some work trying to organise the roof being fixed (another tradie coming Friday), the TV fixed (trying to decide whether to pay the exorbitant price I've been quoted or just buy a new one), the curtains installed (in two weeks) then off to the hairdresser. I hadn't had my hair cut for a while because I am trying to grow it longer again, but it was looking really ragged and needed to be neatened up. As many women (and maybe some men) would know, that in-between stage is very tricky! It looks ok I think, I'll know better after I've washed it and done my own styling because I could never blow-dry like this again even if I wanted to.
Report card:
Diet: Ok.
Exercise: Poor.
Water: Good.
Sleep: Ok. A bit better.
Mental health: Ok.
This morning was my biennial glucose tolerance test for diabetes. It involves drinking a revoltingly sugary drink (75g of sugar, twice as much as in a Coke) then sitting still and feeling queasy for two hours while they take tests of your blood and urine. Easy! Compared to going to the dentist yesterday, it was like a morning in a luxury resort. Results in a few days.
Home for lunch and some work trying to organise the roof being fixed (another tradie coming Friday), the TV fixed (trying to decide whether to pay the exorbitant price I've been quoted or just buy a new one), the curtains installed (in two weeks) then off to the hairdresser. I hadn't had my hair cut for a while because I am trying to grow it longer again, but it was looking really ragged and needed to be neatened up. As many women (and maybe some men) would know, that in-between stage is very tricky! It looks ok I think, I'll know better after I've washed it and done my own styling because I could never blow-dry like this again even if I wanted to.
Report card:
Diet: Ok.
Exercise: Poor.
Water: Good.
Sleep: Ok. A bit better.
Mental health: Ok.
Tuesday, July 30, 2013
Good news!
Wednesday:
Awesome news! I don't have diabetes. In fact my numbers are better than last year, so I don't know what was going on with my finger-prick test that day. I walked into the test confident I was doing well and walked out sure I had diabetes. I was right the first time.
My doctor appointment wasn't until 11.30 so I spent the morning stressing. I mean, I "knew" I had diabetes but its a different thing getting it confirmed by the doctor. Then I walked to the clinic, luckily didn't have to wait long. But my doctor then referred to what we had talked about last appointment (different problem) and I brought up that I'd had the glucose test last week and I was sure I had diabetes. But she still went on about the other issue! I wanted to smack her. I was at the point of interrupting to demand my results when she finally got to it. Flicked through the numbers on her screen, yeah iron good, vitamin B fine etc etc oh cholesterol a bit high need to work on that ... no diabetes, glucose 8.2 mmol/L ...
What??
I craned around to look at her screen. 8.2. Last year I was 10.0. Normal is 7.8, diabetes is 11.1 mmol/L, pre-diabetes in-between. I was nearly down to normal!!
I felt like someone who braced so hard for a blow that when it didn't come they fall over forwards.
I had worked really hard when I was diagnosed with pre-diabetes last year, and although I slumped a bit back into my old ways I had still felt my blood glucose was better. I had been stunned by the (wrong) number I got from the finger-prick test on the day, but I convinced myself I must have slumped more than I thought. Because I am such a bad person. All my fault.
So yay.
Obviously what I have been doing for the past year, the good bits, were working. I hadn't lost any weight but I'd been pretty careful with my carbs until very recently.
I am not using this as an excuse to eat what I like and not exercise. I am not "cured". I still have pre-diabetes. I've had two big scares and I will continue with the plan to lose weight; eating more carefully and exercising regularly. I won't be quite so 100% stringent on how much carbohydrate with each meal, but still pretty careful.
Big relief though.
Awesome news! I don't have diabetes. In fact my numbers are better than last year, so I don't know what was going on with my finger-prick test that day. I walked into the test confident I was doing well and walked out sure I had diabetes. I was right the first time.
My doctor appointment wasn't until 11.30 so I spent the morning stressing. I mean, I "knew" I had diabetes but its a different thing getting it confirmed by the doctor. Then I walked to the clinic, luckily didn't have to wait long. But my doctor then referred to what we had talked about last appointment (different problem) and I brought up that I'd had the glucose test last week and I was sure I had diabetes. But she still went on about the other issue! I wanted to smack her. I was at the point of interrupting to demand my results when she finally got to it. Flicked through the numbers on her screen, yeah iron good, vitamin B fine etc etc oh cholesterol a bit high need to work on that ... no diabetes, glucose 8.2 mmol/L ...
What??
I craned around to look at her screen. 8.2. Last year I was 10.0. Normal is 7.8, diabetes is 11.1 mmol/L, pre-diabetes in-between. I was nearly down to normal!!
I felt like someone who braced so hard for a blow that when it didn't come they fall over forwards.
I had worked really hard when I was diagnosed with pre-diabetes last year, and although I slumped a bit back into my old ways I had still felt my blood glucose was better. I had been stunned by the (wrong) number I got from the finger-prick test on the day, but I convinced myself I must have slumped more than I thought. Because I am such a bad person. All my fault.
So yay.
Obviously what I have been doing for the past year, the good bits, were working. I hadn't lost any weight but I'd been pretty careful with my carbs until very recently.
I am not using this as an excuse to eat what I like and not exercise. I am not "cured". I still have pre-diabetes. I've had two big scares and I will continue with the plan to lose weight; eating more carefully and exercising regularly. I won't be quite so 100% stringent on how much carbohydrate with each meal, but still pretty careful.
Big relief though.
Saturday, July 27, 2013
In the groove
Sunday:
Things are going well. I've exercised every day, an hour of moderate-level (dancing with the Xbox) and this morning I did an hour and three quarters. I was tired but just kept going anyway. And it took a couple of days but I've got my diet to where I want it.
Yesterday I had three serves of (full fat) dairy, two fruits, lots and lots of vegetables of various kinds, appropriate amounts of chicken at lunch and salmon at dinner, and some healthy carbs (high fibre bread, Ryvita whole grain crackers, potato). No sugar. Around 30g of fibre! And all within my calorie limit of 1340. I will actually allow myself a bit more than that on days of extra exercise, like today, if I am hungry. Only slight failing was only five glasses of water, but still pretty good. I sometimes feel a little bloated with all the bulk of vegetables and extra fibre, and there is a certain "something" missing when I can't snack mindlessly at night, but I'll get past that.
I've been refreshing my memory on all the diabetics stuff, not that I really need it but I do like reading about it, and I found a book at the library that I really loved. Because it reaffirmed what I was already starting to do! I'd started trying to lose weight and exercising, of course, but also started increasing fibre, taking my calcium/vitamin D tables which my doctor had recommended ages ago and I'd taken one bottle but hadn't bothered to buy any more until this week, and taking krill oil tablets because my mum said they'd helped her with her joint problems.
So, I get this book, The Diabetes DTour Diet (Barbara Quinn and the editors of Prevention magazine, 2009, Rodale Inc), from the library yesterday. It has a detailed diabetic-specific diet to help you lose weight and balance glucose levels which involves the main points:
*Exercise regularly (tick)
*Eat at least 25g fibre per day (tick)
*1200mg of calcium per day (tick, part diet part tablets)
*1000 IU of vitamin D per day (tick, combo of diet, sunlight and tablets)
*1100mg if omega-3s per day (I think so, not sure how much omega 3 in krill oil but I also had salmon. The book doesn't actually recommend fish oil tablets but there is no way I am eating that much fish)
It was very affirming to be told I was doing something right. I'm not going to follow their exact diet plan but I like the guidelines.
I weighed myself yesterday and I'd already lost that carb-loading weight plus a bit more in a couple of days, so that was reassuring too.
In a good mindset.
Things are going well. I've exercised every day, an hour of moderate-level (dancing with the Xbox) and this morning I did an hour and three quarters. I was tired but just kept going anyway. And it took a couple of days but I've got my diet to where I want it.
Yesterday I had three serves of (full fat) dairy, two fruits, lots and lots of vegetables of various kinds, appropriate amounts of chicken at lunch and salmon at dinner, and some healthy carbs (high fibre bread, Ryvita whole grain crackers, potato). No sugar. Around 30g of fibre! And all within my calorie limit of 1340. I will actually allow myself a bit more than that on days of extra exercise, like today, if I am hungry. Only slight failing was only five glasses of water, but still pretty good. I sometimes feel a little bloated with all the bulk of vegetables and extra fibre, and there is a certain "something" missing when I can't snack mindlessly at night, but I'll get past that.
I've been refreshing my memory on all the diabetics stuff, not that I really need it but I do like reading about it, and I found a book at the library that I really loved. Because it reaffirmed what I was already starting to do! I'd started trying to lose weight and exercising, of course, but also started increasing fibre, taking my calcium/vitamin D tables which my doctor had recommended ages ago and I'd taken one bottle but hadn't bothered to buy any more until this week, and taking krill oil tablets because my mum said they'd helped her with her joint problems.
So, I get this book, The Diabetes DTour Diet (Barbara Quinn and the editors of Prevention magazine, 2009, Rodale Inc), from the library yesterday. It has a detailed diabetic-specific diet to help you lose weight and balance glucose levels which involves the main points:
*Exercise regularly (tick)
*Eat at least 25g fibre per day (tick)
*1200mg of calcium per day (tick, part diet part tablets)
*1000 IU of vitamin D per day (tick, combo of diet, sunlight and tablets)
*1100mg if omega-3s per day (I think so, not sure how much omega 3 in krill oil but I also had salmon. The book doesn't actually recommend fish oil tablets but there is no way I am eating that much fish)
It was very affirming to be told I was doing something right. I'm not going to follow their exact diet plan but I like the guidelines.
I weighed myself yesterday and I'd already lost that carb-loading weight plus a bit more in a couple of days, so that was reassuring too.
In a good mindset.
Thursday, July 25, 2013
Putting on my determined face
Friday:
The last 22 hours or so I've been feeling denial, anger, guilt, fear, sadness and determination. Whether I've got diabetes or "just" pre-diabetes that is getting worse, I've let this happen and I need to do something about it. When I was diagnosed with pre-diabetes last year I was very proactive for a little while but then slumped back into my old ways. I can't let that happen again.
Different authorities give conflicting advice about how much carbohydrate diabetics should eat (Australian diabetic diet guidelines are fairly high in carbs but ONLY low GI, the US doesn't seem as into the whole GI thing and suggests smaller amounts of carbs) but everyone agrees that I need to:
1) lose weight
2) exercise regularly (not just to help lose weight, exercise has other benefits for diabetics)
As a tertiary issue I need to spread carbs throughout the day. I will be going with a slightly lower-carb version of my dietician's advice and having small amounts of low GI carbs with every meal and snack. And drink a lot more water. And take my vitamin D tablets like my doctor says.
I have already cleared six months (nearly a month of that has already gone) to write a novel, which I can only work on for a couple of hours a day due to my RSI. My only other commitments within school hours are doing a bit of housework and getting the shopping done etc -- all in my own time. I have the most available time of anyone you know to fit in regular exercise. So I have the least excuse of anyone you have ever met to not exercise. I don't have to get up before dawn, or go to the gym after work, or squeeze in a run at lunchtime like many people. So I will just do it!
I can't completely shed the guilt, denial etc (yet) but I am working on building up the determination. I can absolutely do this. Lose 20 kg, get rid of the dangerous abdominal fat, get into a regular rhythm of exercise for the rest of my life, which will be long and healthy. The only thing stopping me is inertia. It is easier to sit around than get into my exercise gear and start moving. The wheels are stuck in the mud. But I've just had a huge shove to help me get going.
I felt so ill most of the day after that glucose test. And I got up four times in the night to pee like a racehorse as my body tried to get rid of all the sugar. For the next few days in particular I am going to work on being gentle to my pancreas. Regular small doses of healthy carbs that won't stress the poor thing. It's been through enough lately.
The last 22 hours or so I've been feeling denial, anger, guilt, fear, sadness and determination. Whether I've got diabetes or "just" pre-diabetes that is getting worse, I've let this happen and I need to do something about it. When I was diagnosed with pre-diabetes last year I was very proactive for a little while but then slumped back into my old ways. I can't let that happen again.
Different authorities give conflicting advice about how much carbohydrate diabetics should eat (Australian diabetic diet guidelines are fairly high in carbs but ONLY low GI, the US doesn't seem as into the whole GI thing and suggests smaller amounts of carbs) but everyone agrees that I need to:
1) lose weight
2) exercise regularly (not just to help lose weight, exercise has other benefits for diabetics)
As a tertiary issue I need to spread carbs throughout the day. I will be going with a slightly lower-carb version of my dietician's advice and having small amounts of low GI carbs with every meal and snack. And drink a lot more water. And take my vitamin D tablets like my doctor says.
I have already cleared six months (nearly a month of that has already gone) to write a novel, which I can only work on for a couple of hours a day due to my RSI. My only other commitments within school hours are doing a bit of housework and getting the shopping done etc -- all in my own time. I have the most available time of anyone you know to fit in regular exercise. So I have the least excuse of anyone you have ever met to not exercise. I don't have to get up before dawn, or go to the gym after work, or squeeze in a run at lunchtime like many people. So I will just do it!
I can't completely shed the guilt, denial etc (yet) but I am working on building up the determination. I can absolutely do this. Lose 20 kg, get rid of the dangerous abdominal fat, get into a regular rhythm of exercise for the rest of my life, which will be long and healthy. The only thing stopping me is inertia. It is easier to sit around than get into my exercise gear and start moving. The wheels are stuck in the mud. But I've just had a huge shove to help me get going.
I felt so ill most of the day after that glucose test. And I got up four times in the night to pee like a racehorse as my body tried to get rid of all the sugar. For the next few days in particular I am going to work on being gentle to my pancreas. Regular small doses of healthy carbs that won't stress the poor thing. It's been through enough lately.
Wednesday, July 24, 2013
Probably bad news
Thursday:
I had my oral glucose tolerance test today after three days of eating lots of carbohydrates and then overnight fasting. I think it is going to be bad news. I felt so shaky and horrible (but not nauseated this time) by the two hour point that the blood-test guy wouldn't let me leave the room until he'd watched me eat my banana and made sure I'd stopped trembling. And more telling, I tested my blood with my own little kit in the bathroom just before that and it was 11.2 mmol/L. Last year, when I was diagnosed with pre-diabetes, it was 10.0. Diabetes starts at 11.1 mmol/L.
I have an appointment with my doctor next Wednesday for the official and more accurate results, but whether I am "officially" diabetic or not I am worse than last year. They have to draw a line on the continuum somewhere, but 11.0 not being diabetes and 11.1 being diabetes is a bit arbitrary anyway. So even if the more accurate test results show I am 11.0, it is just as much of a worry as if I am 0.2 over that.
It was well below freezing this morning, the kids were amazed at all the frost on the grass as I dropped them off at school a bit early, worried about them being out in the cold for 10 mins before school started. I drove to the pathology clinic, parked a couple of blocks away and walked through the numbing cold to find I had forgotten my referral! Arg! And I needed to give a urine sample, too, so I was uncomfortably holding that in, but they wouldn't take it without the referral. I had to go to the bathroom anyway, then back to my car, drove home and got the referral (which had been sitting right under my handbag but I'd forgotten it anyway), drove back and found parking again, back through the frost. Tried to give a urine sample but had almost nothing to give. Just enough, apparently. Phew.
Then I had to sit for half an hour to relax before they started the glucose test. They took blood then I had to drink a bottle of water with 75 grams of glucose in it. Disgustingly, gaggingly sweet. Read a magazine for an hour then another vial of blood. I was starting to feel really cold and a bit trembly but dismissed it because in the past I have felt nauseated if I was reacting badly to the glucose. Another hour, then I secretly tested myself (the number really shocked me, not what I was expecting) and then had the final vial of blood taken. Really shaky by now. The guy made me stay sitting, wouldn't let me bend down even to get my bag, got my banana for me and watched me eat it. That was kind of awkward! He waited with me until I felt a bit better then I could finally leave.
I went to the library nearby and grabbed some books on diabetes and some recipes for diabetic-friendly meals then drove home and made a big salad with some lamb for lunch. I still feel weak and a bit unwell. I suppose a salad doesn't have much carbohydrate, I was trying to be really healthy, but maybe I need some carbs (more than just the banana). I'll have a couple of crackers.
Big big priority to manage this and to lose the weight. Weight loss and regular exercise and both very important for diabetes management.
I put on half a kilo with the three days of carb loading, so my starting point is 80.5kg.
I had my oral glucose tolerance test today after three days of eating lots of carbohydrates and then overnight fasting. I think it is going to be bad news. I felt so shaky and horrible (but not nauseated this time) by the two hour point that the blood-test guy wouldn't let me leave the room until he'd watched me eat my banana and made sure I'd stopped trembling. And more telling, I tested my blood with my own little kit in the bathroom just before that and it was 11.2 mmol/L. Last year, when I was diagnosed with pre-diabetes, it was 10.0. Diabetes starts at 11.1 mmol/L.
I have an appointment with my doctor next Wednesday for the official and more accurate results, but whether I am "officially" diabetic or not I am worse than last year. They have to draw a line on the continuum somewhere, but 11.0 not being diabetes and 11.1 being diabetes is a bit arbitrary anyway. So even if the more accurate test results show I am 11.0, it is just as much of a worry as if I am 0.2 over that.
It was well below freezing this morning, the kids were amazed at all the frost on the grass as I dropped them off at school a bit early, worried about them being out in the cold for 10 mins before school started. I drove to the pathology clinic, parked a couple of blocks away and walked through the numbing cold to find I had forgotten my referral! Arg! And I needed to give a urine sample, too, so I was uncomfortably holding that in, but they wouldn't take it without the referral. I had to go to the bathroom anyway, then back to my car, drove home and got the referral (which had been sitting right under my handbag but I'd forgotten it anyway), drove back and found parking again, back through the frost. Tried to give a urine sample but had almost nothing to give. Just enough, apparently. Phew.
Then I had to sit for half an hour to relax before they started the glucose test. They took blood then I had to drink a bottle of water with 75 grams of glucose in it. Disgustingly, gaggingly sweet. Read a magazine for an hour then another vial of blood. I was starting to feel really cold and a bit trembly but dismissed it because in the past I have felt nauseated if I was reacting badly to the glucose. Another hour, then I secretly tested myself (the number really shocked me, not what I was expecting) and then had the final vial of blood taken. Really shaky by now. The guy made me stay sitting, wouldn't let me bend down even to get my bag, got my banana for me and watched me eat it. That was kind of awkward! He waited with me until I felt a bit better then I could finally leave.
I went to the library nearby and grabbed some books on diabetes and some recipes for diabetic-friendly meals then drove home and made a big salad with some lamb for lunch. I still feel weak and a bit unwell. I suppose a salad doesn't have much carbohydrate, I was trying to be really healthy, but maybe I need some carbs (more than just the banana). I'll have a couple of crackers.
Big big priority to manage this and to lose the weight. Weight loss and regular exercise and both very important for diabetes management.
I put on half a kilo with the three days of carb loading, so my starting point is 80.5kg.
Saturday, March 30, 2013
Easter
Sunday:
Happy Easter!
When we got to my mum's house late on Thursday and decided to stay even though she was sick, I was only worried about inconveniencing her and the difficulties of finding a motel. Not germs. When I told her not to get up and cook us breakfast, but she did anyway, I was only thinking about how she wasn't feeling well. Not germs. Now my eyes have been watering for two days and are sore and burning, my body aches a bit, I'm so tired I fell asleep slumped in my armchair this afternoon, and my throat is starting to hurt. Maybe I should have thought about the germs a bit more.
We had a nice Easter egg hunt around the house this morning and as we don't allow the children to eat much at a time their stash will probably last them months. Even though we made them eat breakfast before any chocolate, and then moderated their intake, by late morning they were both in tears and fighting. Usually they play beautifully together. Much better after a blood-sugar-moderating lunch.
We had pancakes for afternoon tea; Jasmine & I had nutella on ours (chocolate spread, very Eastery), Aiden had plain, Tim had honey. About 30 grams of carbohydrate each for the pancakes, plus toppings -- so at the most 45g which is not excessive even for a diabetic but the problem is the form it came in. I just thought to test our blood sugar. It's been about a hour and a half since, so not an official time for testing blood sugar but still indicative of issues. Mine was 7.8 which is the top of the normal range and quite satisfactory -- I haven't had any really bad numbers for a while. I feel that I am gradually getting better. Tim's was 12.5. Terrible. In actual diabetic (not just pre-diabetic) range. I will test him again at the two hour point, but that is a bad number, worse than either of us have ever had.
He went to the doctor recently but she only sent him for a fasting blood test (results not back yet) which probably won't tell him anything as I think he has impaired glucose tolerance, not necessarily imparied fasting glucose. He needs a proper test. That will be next.
The fact that our children had an obvious behavioural change after a relatively small amount of sugar worries me too. It was probably exacerbated by a couple of days of junk food and poor sleep, but still. Or are they coming down sick too? I've actually noticed this change in my daughter before specifically at Easter.
I'm going back on low carb tomorrow. My huge chocolate bunny will have to be spread out over a long time.
Happy Easter!
When we got to my mum's house late on Thursday and decided to stay even though she was sick, I was only worried about inconveniencing her and the difficulties of finding a motel. Not germs. When I told her not to get up and cook us breakfast, but she did anyway, I was only thinking about how she wasn't feeling well. Not germs. Now my eyes have been watering for two days and are sore and burning, my body aches a bit, I'm so tired I fell asleep slumped in my armchair this afternoon, and my throat is starting to hurt. Maybe I should have thought about the germs a bit more.
We had a nice Easter egg hunt around the house this morning and as we don't allow the children to eat much at a time their stash will probably last them months. Even though we made them eat breakfast before any chocolate, and then moderated their intake, by late morning they were both in tears and fighting. Usually they play beautifully together. Much better after a blood-sugar-moderating lunch.
We had pancakes for afternoon tea; Jasmine & I had nutella on ours (chocolate spread, very Eastery), Aiden had plain, Tim had honey. About 30 grams of carbohydrate each for the pancakes, plus toppings -- so at the most 45g which is not excessive even for a diabetic but the problem is the form it came in. I just thought to test our blood sugar. It's been about a hour and a half since, so not an official time for testing blood sugar but still indicative of issues. Mine was 7.8 which is the top of the normal range and quite satisfactory -- I haven't had any really bad numbers for a while. I feel that I am gradually getting better. Tim's was 12.5. Terrible. In actual diabetic (not just pre-diabetic) range. I will test him again at the two hour point, but that is a bad number, worse than either of us have ever had.
He went to the doctor recently but she only sent him for a fasting blood test (results not back yet) which probably won't tell him anything as I think he has impaired glucose tolerance, not necessarily imparied fasting glucose. He needs a proper test. That will be next.
The fact that our children had an obvious behavioural change after a relatively small amount of sugar worries me too. It was probably exacerbated by a couple of days of junk food and poor sleep, but still. Or are they coming down sick too? I've actually noticed this change in my daughter before specifically at Easter.
I'm going back on low carb tomorrow. My huge chocolate bunny will have to be spread out over a long time.
Sunday, September 2, 2012
Brief review of some books about diabetes
I have read quite a few books but have returned some of them to the library already, this is not meant as a comprehensive review of the literature. Just some thoughts.
Prediabetes for Dummies (already returned so I don't have publishing details handy)
I hate hate hate the title of this book -- part of a big franchise of "for Dummies" books -- and would never have bought it just because of that. But it didn't seem to be geared to dummies at all. It had plenty of comprehensive information about prediabetes and in fact was one of the very few I could find that was about prediabetes rather than diabetes. Written by a medical professional and strongly pushing the "lose weight and exercise" message, it also went into detail about what is happening in the prediabetic body. Recommended.
Various CSIRO books about Diabetes (already returned)
CSIRO stands for ... um ... something or other, anyway they are Australian science boffins. I tried their diet last year or the year before (it was a best seller) and wrote about it here in the blog. The books with the word "diabetes" on the cover had some information about diabetes but mainly just pushed their diet. Lots of recipes and glossy pictures of happy healthy people. An attractive couple of books but didn't have any depth of information so not really what I was looking for.
The First Year: Type 2 Diabetes by Gretchen Becker
Marlowe & Company: 2004
This book is written by someone with diabetes rather than a doctor or scientist, and I loved it. A very easy to read, chatty and informal style from someone who has been through it all; but with lots of detailed information too. As well as the physical aspects, she talks about emotional aspects like depression and having to watch other people eat cake. There were some "facts" there that I hadn't seen elsewhere (therefore unsubstantiated and under suspicion but still interesting). It had its faults, in particular she talks about lots of different studies but doesn't reference them in the text, so you don't know which of the studies in the Resources chapter she is referring to. On the other hand, she seems to give a very balanced approach to different arguments, saying that no one size fits all and every situation is different. Recommended.
Prediabetes for Dummies (already returned so I don't have publishing details handy)
I hate hate hate the title of this book -- part of a big franchise of "for Dummies" books -- and would never have bought it just because of that. But it didn't seem to be geared to dummies at all. It had plenty of comprehensive information about prediabetes and in fact was one of the very few I could find that was about prediabetes rather than diabetes. Written by a medical professional and strongly pushing the "lose weight and exercise" message, it also went into detail about what is happening in the prediabetic body. Recommended.
Various CSIRO books about Diabetes (already returned)
CSIRO stands for ... um ... something or other, anyway they are Australian science boffins. I tried their diet last year or the year before (it was a best seller) and wrote about it here in the blog. The books with the word "diabetes" on the cover had some information about diabetes but mainly just pushed their diet. Lots of recipes and glossy pictures of happy healthy people. An attractive couple of books but didn't have any depth of information so not really what I was looking for.
The First Year: Type 2 Diabetes by Gretchen Becker
Marlowe & Company: 2004
This book is written by someone with diabetes rather than a doctor or scientist, and I loved it. A very easy to read, chatty and informal style from someone who has been through it all; but with lots of detailed information too. As well as the physical aspects, she talks about emotional aspects like depression and having to watch other people eat cake. There were some "facts" there that I hadn't seen elsewhere (therefore unsubstantiated and under suspicion but still interesting). It had its faults, in particular she talks about lots of different studies but doesn't reference them in the text, so you don't know which of the studies in the Resources chapter she is referring to. On the other hand, she seems to give a very balanced approach to different arguments, saying that no one size fits all and every situation is different. Recommended.
Monday, August 20, 2012
What I have learned about Prediabetes
Tuesday:
Over the past week I have been reading numerous websites like Diabetes Australia and the equivalent US and UK sites, World Health Organization (WHO), National Diabetes Information Clearinghouse (NDIC), various other health sites, books borrowed from the library, and the handouts I was given when I had gestational diabetes. I've got information from the sheet that had my blood test results and even from an obesity special of "Embarassing Bodies". What follows is my summary of all that information. I'm afraid it isn't referenced, and as figures varied slightly from source to source they might not always be what your favourite source gives. Also, most of the world measures blood sugar in mmol/L, any Americans reading will have to multiply by 18 to get mg/dl. Sorry if I've made any mistakes, but this is what I have learned about prediabetes.
What is Prediabetes?
Blood glucose (sugar) is managed by the pancreas. The human body likes a level of 4--6 mmol/L (millimoles per liter), and to achieve this the pancreas secretes several different hormones. When you haven't eaten for a while it secretes glucagon to increase your blood glucose level, when you eat it releases insulin which opens the cells of the body to let glucose in so you can use it. If you have type 2 diabetes, or to a lesser extent prediabetes; your muscles, fat, and liver don't respond properly to the insulin (insulin resistance). The pancreas releases more but eventually can't keep up, and excess glucose builds up in the blood and can do a lot of damage. The thirst and frequent urination that go with diabetes are caused by the kidneys trying to flush out all that extra glucose. (Type 1 diabetes is quite different, it occurs when the pancreas makes little or no insulin at all.)
A normal fasting level of glucose is less than 5.6 mmol/L. A reading of 5.6--6.9 is considered impaired fasting glucose. A reading of 7.0 of over is considered diabetes.
Two hours after drinking 75 grams of glucose, a normal reading is less than 7.8 mmol/L. A reading of 7.8--11.1 shows impaired glucose tolerance, a reading of over 11.1 is diabetes.
Both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are now called prediabetes. IGT carries a worse risk of developing into full-blown diabetes. People with prediabetes are ten times more likely to get diabetes, generally within ten years. One site suggested the average was three years. Prediabetes is almost completely preventable and reversable.
Who gets Prediabetes?
The risk assessment factors include:
# Age -- older people have a higher risk
# Gender -- men are more likely to get it
# BMI (body mass index) -- fatter people have a higher risk, in particular visceral fat* is a major contributor.
# Family history -- it has a genetic factor
# Heart rate -- high is bad
# Blood pressure -- high is bad
# A history of gestational diabetes or having given birth to a large baby
# A history of polycystic ovary syndrome
Obviously not all of these are preventable, but a lifestyle that includes a healthy diet and exercise can have a huge effect of BMI, heart rate, and blood pressure.
Visceral fat
Visceral fat is the fat that surrounds the abdominal organs, as opposed to subcutaneous fat which sits under the skin all over the body. An apple-shaped body is a good indicator of too much visceral fat. Visceral fat is associated with a much higher risk of prediabetes, diabetes, heart disease, metabolic syndrome, breast cancer, high blood pressure, gall bladder disease, and cancer of the colon and rectum. It causes a decrease in blood flow, and releases hormones into the blood that contribute to insulin resistance. Visceral fat is very, very bad; but fortunately it is the first to go when you lose weight. Even exercise without a restricted diet will reduce visceral fat.
What is so bad about Prediabetes?
Not only does it quickly lead to diabetes, if not treated, but risk factors for various problems are already increasing.
# Heart attack and stroke -- risk is double for prediabetic, double that again for a diabetic
# Damage to the blood vessels in the eyes can lead to blindness
# Alzheimer's risk doubles with diabetes
# Diabetes leads to kidney disease and possible kidney failure
# Nerve disease can lead to foot amputation
# A diabetic can expect a lot more sick days
# Sexual disfunction is common
# I have seen mentions of links to shoulder problems and periodontal disease as well
How do you prevent/reverse Prediabetes?
A weight reduction of only 5-7% can cause a 60% reduction in the incidence of diabetes. Compare this to a 31% reduced risk given by the diabetes drug metformin. A healthy weight, or even a healthier weight, is extremely important.
Exercise is vital, not only because it helps you to lose weight, but because exercise makes your cells more sensitive to insulin -- opposing insulin resistance. It also helps reduce some of the other diabetic risk factors like high blood pressure.
Frequent high glucose levels are doing damage to your pancreas and your vascular (blood) system, which is very dangerous. Damage to blood vessels in the brain can lead to a stroke, damage to blood vessels in the eyes can lead to blindness etc. Limit your intake of sugar and highly processed carbohydrates, and check your blood glucose levels to make sure they are within acceptable limits.
The Glucose Index is a way of measuring how quickly carbohydrates in food are converted to glucose in the blood. For diabetics and prediabetics, low GI foods are better because their blood glucose level rises more slowly and over a longer period rather than a quick spike.
So:
# Lose weight
# Exercise
# Manage your carbohydrate intake, spreading them throughout the day. Aim for low GI foods.
Other issues
I have discussed topics that have seemed important to me in my particular circumstances. I haven't talked about medication or bariatric surgery for instance. So you might want to do some more research if you think you needhelp getting your prediabetes under control.
Over the past week I have been reading numerous websites like Diabetes Australia and the equivalent US and UK sites, World Health Organization (WHO), National Diabetes Information Clearinghouse (NDIC), various other health sites, books borrowed from the library, and the handouts I was given when I had gestational diabetes. I've got information from the sheet that had my blood test results and even from an obesity special of "Embarassing Bodies". What follows is my summary of all that information. I'm afraid it isn't referenced, and as figures varied slightly from source to source they might not always be what your favourite source gives. Also, most of the world measures blood sugar in mmol/L, any Americans reading will have to multiply by 18 to get mg/dl. Sorry if I've made any mistakes, but this is what I have learned about prediabetes.
What is Prediabetes?
Blood glucose (sugar) is managed by the pancreas. The human body likes a level of 4--6 mmol/L (millimoles per liter), and to achieve this the pancreas secretes several different hormones. When you haven't eaten for a while it secretes glucagon to increase your blood glucose level, when you eat it releases insulin which opens the cells of the body to let glucose in so you can use it. If you have type 2 diabetes, or to a lesser extent prediabetes; your muscles, fat, and liver don't respond properly to the insulin (insulin resistance). The pancreas releases more but eventually can't keep up, and excess glucose builds up in the blood and can do a lot of damage. The thirst and frequent urination that go with diabetes are caused by the kidneys trying to flush out all that extra glucose. (Type 1 diabetes is quite different, it occurs when the pancreas makes little or no insulin at all.)
A normal fasting level of glucose is less than 5.6 mmol/L. A reading of 5.6--6.9 is considered impaired fasting glucose. A reading of 7.0 of over is considered diabetes.
Two hours after drinking 75 grams of glucose, a normal reading is less than 7.8 mmol/L. A reading of 7.8--11.1 shows impaired glucose tolerance, a reading of over 11.1 is diabetes.
Both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are now called prediabetes. IGT carries a worse risk of developing into full-blown diabetes. People with prediabetes are ten times more likely to get diabetes, generally within ten years. One site suggested the average was three years. Prediabetes is almost completely preventable and reversable.
Who gets Prediabetes?
The risk assessment factors include:
# Age -- older people have a higher risk
# Gender -- men are more likely to get it
# BMI (body mass index) -- fatter people have a higher risk, in particular visceral fat* is a major contributor.
# Family history -- it has a genetic factor
# Heart rate -- high is bad
# Blood pressure -- high is bad
# A history of gestational diabetes or having given birth to a large baby
# A history of polycystic ovary syndrome
Obviously not all of these are preventable, but a lifestyle that includes a healthy diet and exercise can have a huge effect of BMI, heart rate, and blood pressure.
Visceral fat
Visceral fat is the fat that surrounds the abdominal organs, as opposed to subcutaneous fat which sits under the skin all over the body. An apple-shaped body is a good indicator of too much visceral fat. Visceral fat is associated with a much higher risk of prediabetes, diabetes, heart disease, metabolic syndrome, breast cancer, high blood pressure, gall bladder disease, and cancer of the colon and rectum. It causes a decrease in blood flow, and releases hormones into the blood that contribute to insulin resistance. Visceral fat is very, very bad; but fortunately it is the first to go when you lose weight. Even exercise without a restricted diet will reduce visceral fat.
What is so bad about Prediabetes?
Not only does it quickly lead to diabetes, if not treated, but risk factors for various problems are already increasing.
# Heart attack and stroke -- risk is double for prediabetic, double that again for a diabetic
# Damage to the blood vessels in the eyes can lead to blindness
# Alzheimer's risk doubles with diabetes
# Diabetes leads to kidney disease and possible kidney failure
# Nerve disease can lead to foot amputation
# A diabetic can expect a lot more sick days
# Sexual disfunction is common
# I have seen mentions of links to shoulder problems and periodontal disease as well
How do you prevent/reverse Prediabetes?
A weight reduction of only 5-7% can cause a 60% reduction in the incidence of diabetes. Compare this to a 31% reduced risk given by the diabetes drug metformin. A healthy weight, or even a healthier weight, is extremely important.
Exercise is vital, not only because it helps you to lose weight, but because exercise makes your cells more sensitive to insulin -- opposing insulin resistance. It also helps reduce some of the other diabetic risk factors like high blood pressure.
Frequent high glucose levels are doing damage to your pancreas and your vascular (blood) system, which is very dangerous. Damage to blood vessels in the brain can lead to a stroke, damage to blood vessels in the eyes can lead to blindness etc. Limit your intake of sugar and highly processed carbohydrates, and check your blood glucose levels to make sure they are within acceptable limits.
The Glucose Index is a way of measuring how quickly carbohydrates in food are converted to glucose in the blood. For diabetics and prediabetics, low GI foods are better because their blood glucose level rises more slowly and over a longer period rather than a quick spike.
So:
# Lose weight
# Exercise
# Manage your carbohydrate intake, spreading them throughout the day. Aim for low GI foods.
Other issues
I have discussed topics that have seemed important to me in my particular circumstances. I haven't talked about medication or bariatric surgery for instance. So you might want to do some more research if you think you needhelp getting your prediabetes under control.
Thursday, August 16, 2012
It's prediabetes
Friday:
When I originally booked my glucose tolerance test the receptionist said the results would take 3-4 days so I booked a doctor appointment accordingly. But when I was getting the test done the nurse (or whatever her designation was) at the collection centre said it would take about 2 days. So this afternoon I went into my doctor's clinic and asked. Sure enough, they were there. I had been a bit paranoid about whether they would give them to me, I thought they might insist I wait until I saw a doctor. The receptionist checked her computer and said the doctor (the one who referred me for the test when I saw him about something else, not my usual doctor who is very hard to get in to see) had seen them and there was no further action. Sounded good. She asked if I would like a copy, and of course I said yes. She printed it out but then hesitated and went to check with the doctor first. Bad? Had she noticed something? I could hear him riffling through the pages (he had the first room down the corridor, and the door was ajar) but couldn't hear what he said to her. She came back, and handed the papers over with a reassuring smile.
"Fasting 4.1 (normal range 3.4 -- 6.0)
1 Hour 10.1
2 Hours 10.0 H (normal range 3.4 -- 7.7)
"The two hour glucose value is in the impaired range (7.8 -- 11.0 mmol/L). Guidelines suggest that the one hour value has the least importance in interpretation. Current criteria are based on the fasting and two hour values.
There is no evidence of diabetes mellitus.
Periodic retesting of undiagnosed diabetes mellitus is recommended by measuring fasting serum glucose each year in patients with impaired glucose tolerance."
So, I have prediabetes but they don't have any specific recommendations other than to recheck every year. Of course my doctor may have something more to say. I have cancelled my appt with the random doctor next Wednesday and booked in with my own doctor the following week, when she is available. I decided that this is a long term thing that I need a long term doctor-patient relationship for.
I fully expected this result. I've been reading a book about prediabetes that I got from the library and the more I read the more I was convinced that I had it. My home blood test figures while on the high-carb diet were pretty clear. But unlike the pathology lab recommendation, I don't intend to just wait until it turns into diabetes. There seems to be plenty I can do.
As I have been doing the past couple of days, I can manage my blood sugar levels to avoid further harm to my pancreas and other parts of my body. I can lose weight so that I don't have as much dangerous visceral fat (fat around my internal organs, different to subcutaneous fat that sits under the skin). I can exercise regularly; not just to lose weight but because it helps my body deal with glucose.
As I said, I've been reading a lot; but I obviously haven't been taking it in properly. In that last paragraph, I wasn't able to remember exactly why visceral fat is so bad for diabetes or what exercise does that is so good. I guess up until now I was reading for interest without knowing for sure that it was actually important. And I can lose weight and exercise without knowing the technical reasons why. But I'll be reading over everything again until I could give a lecture on it if I wanted to.
There are other figures in the lab results, all my numbers are normal except for cholesterol which was 5.6; normal range is 3.5 -- 5.5. Only 0.1 over normal! That is awsome for me! Last reading I remember getting was 7.1, so it is great to get it so low. Hopefully next time it should be down in the normal range.
My weight on the morning of the gtt, after three days of overeating carbs, was up to 79.1 kg. Not a nice number. But I am confident I can get it down again.
I don't feel stressed or upset about this diagnosis at all. Maybe because I was expecting it. But also it seems to be very managable and reversable. I am in control of my own destiny!
I have some challenges this weekend involving eating out several times. It will my first test of dealing with temptations and restaurant food. I have an app on my phone that tells me the carbs in things, I will probably have to guess a bit. I will also away from the gym. But that is life, I just have to deal with it and find a way.
When I originally booked my glucose tolerance test the receptionist said the results would take 3-4 days so I booked a doctor appointment accordingly. But when I was getting the test done the nurse (or whatever her designation was) at the collection centre said it would take about 2 days. So this afternoon I went into my doctor's clinic and asked. Sure enough, they were there. I had been a bit paranoid about whether they would give them to me, I thought they might insist I wait until I saw a doctor. The receptionist checked her computer and said the doctor (the one who referred me for the test when I saw him about something else, not my usual doctor who is very hard to get in to see) had seen them and there was no further action. Sounded good. She asked if I would like a copy, and of course I said yes. She printed it out but then hesitated and went to check with the doctor first. Bad? Had she noticed something? I could hear him riffling through the pages (he had the first room down the corridor, and the door was ajar) but couldn't hear what he said to her. She came back, and handed the papers over with a reassuring smile.
"Fasting 4.1 (normal range 3.4 -- 6.0)
1 Hour 10.1
2 Hours 10.0 H (normal range 3.4 -- 7.7)
"The two hour glucose value is in the impaired range (7.8 -- 11.0 mmol/L). Guidelines suggest that the one hour value has the least importance in interpretation. Current criteria are based on the fasting and two hour values.
There is no evidence of diabetes mellitus.
Periodic retesting of undiagnosed diabetes mellitus is recommended by measuring fasting serum glucose each year in patients with impaired glucose tolerance."
So, I have prediabetes but they don't have any specific recommendations other than to recheck every year. Of course my doctor may have something more to say. I have cancelled my appt with the random doctor next Wednesday and booked in with my own doctor the following week, when she is available. I decided that this is a long term thing that I need a long term doctor-patient relationship for.
I fully expected this result. I've been reading a book about prediabetes that I got from the library and the more I read the more I was convinced that I had it. My home blood test figures while on the high-carb diet were pretty clear. But unlike the pathology lab recommendation, I don't intend to just wait until it turns into diabetes. There seems to be plenty I can do.
As I have been doing the past couple of days, I can manage my blood sugar levels to avoid further harm to my pancreas and other parts of my body. I can lose weight so that I don't have as much dangerous visceral fat (fat around my internal organs, different to subcutaneous fat that sits under the skin). I can exercise regularly; not just to lose weight but because it helps my body deal with glucose.
As I said, I've been reading a lot; but I obviously haven't been taking it in properly. In that last paragraph, I wasn't able to remember exactly why visceral fat is so bad for diabetes or what exercise does that is so good. I guess up until now I was reading for interest without knowing for sure that it was actually important. And I can lose weight and exercise without knowing the technical reasons why. But I'll be reading over everything again until I could give a lecture on it if I wanted to.
There are other figures in the lab results, all my numbers are normal except for cholesterol which was 5.6; normal range is 3.5 -- 5.5. Only 0.1 over normal! That is awsome for me! Last reading I remember getting was 7.1, so it is great to get it so low. Hopefully next time it should be down in the normal range.
My weight on the morning of the gtt, after three days of overeating carbs, was up to 79.1 kg. Not a nice number. But I am confident I can get it down again.
I don't feel stressed or upset about this diagnosis at all. Maybe because I was expecting it. But also it seems to be very managable and reversable. I am in control of my own destiny!
I have some challenges this weekend involving eating out several times. It will my first test of dealing with temptations and restaurant food. I have an app on my phone that tells me the carbs in things, I will probably have to guess a bit. I will also away from the gym. But that is life, I just have to deal with it and find a way.
Wednesday, August 15, 2012
Staying away from medication
Thursday:
My dietician friend told me that if I do have diabetes it could be months before I am able to see an endocrinologist or whatever specialist I need to see, so the doctor could put me on medication straight away without waiting for a specialist opinion. I don't think my doctor would, but I am not seeing my regular doctor. Of course I want to avoid hopefully-unnecessary medication; so for next six days, until I see the doctor, I will be managing my diet and taking regular blood glucose tests. That way, when I see the doctor next week I can prove that I can manage diabetes without medication. Or if I can't, at least I will know. And of course if I don't have diabetes (fingers crossed), managing my diet will help me avoid getting it in the future.
A "diabetes" diet is in most ways just a basic healthy diet: a balance of protein, carbs, fibre, dairy etc, not too much fat. But I need to spread my carbs out evenly throughout the day. I am currently using the handouts I got when I had gestational diabetes, and I am going to pick up some books from the library today. I am aiming for 1-2 serves of carbohydrate for each snack and 2-3 serves at each meal. One serve is 15g of carbohydrate: one slice of bread, a small apple, half a potato. Non-starchy vegetables have very little carbohydrate; meat and cheese have none.
I am also going to exercise regularly; both to stabilise blood sugar (it helps) and to lose weight.
Getting rid of my dangerous belly fat is a long-term goal.
This kind of sounds like I think I have diabetes; I don't really. I am expecting pre-diabetes or nothing. But I am in a fairly high risk category and I need to take action now to avoid getting it in five or ten years. I am using this as a motivator.
My dietician friend told me that if I do have diabetes it could be months before I am able to see an endocrinologist or whatever specialist I need to see, so the doctor could put me on medication straight away without waiting for a specialist opinion. I don't think my doctor would, but I am not seeing my regular doctor. Of course I want to avoid hopefully-unnecessary medication; so for next six days, until I see the doctor, I will be managing my diet and taking regular blood glucose tests. That way, when I see the doctor next week I can prove that I can manage diabetes without medication. Or if I can't, at least I will know. And of course if I don't have diabetes (fingers crossed), managing my diet will help me avoid getting it in the future.
A "diabetes" diet is in most ways just a basic healthy diet: a balance of protein, carbs, fibre, dairy etc, not too much fat. But I need to spread my carbs out evenly throughout the day. I am currently using the handouts I got when I had gestational diabetes, and I am going to pick up some books from the library today. I am aiming for 1-2 serves of carbohydrate for each snack and 2-3 serves at each meal. One serve is 15g of carbohydrate: one slice of bread, a small apple, half a potato. Non-starchy vegetables have very little carbohydrate; meat and cheese have none.
I am also going to exercise regularly; both to stabilise blood sugar (it helps) and to lose weight.
Getting rid of my dangerous belly fat is a long-term goal.
This kind of sounds like I think I have diabetes; I don't really. I am expecting pre-diabetes or nothing. But I am in a fairly high risk category and I need to take action now to avoid getting it in five or ten years. I am using this as a motivator.
Tuesday, August 14, 2012
Glucose tolerance test
Wednesday:
I had my glucose tolerance test for diabetes this morning. I don't see the doctor until next Wednesday, which is frustrating. I couldn't even see my usual doctor then, I would have had to wait even longer, so I'm just seeing some random doctor in the same clinic. The results might be ready on Friday, maybe I can get a look at them early. My nutritionist friend can translate them for me, she asked me to get a copy but I forgot.
By yesterday afternoon I was starting to feel a bit unwell. I don't know if it was the cold I've caught from my son, or the high levels of carbohydrates. Or both. My blood sugars were 9.8 two hours after lunch and 9.0 two hours after dinner, both pretty high. The clinic said I can still do the test while I have a cold so presumably it also wouldn't affect these figures.
I started fasting at 9.30pm. I didn't sleep well at all and felt a bit nauseated in the morning after I got up. At the clinic I gave them a wee sample then rested for a while, then they took the vial of fasting blood before I drank the horrible horrible glucose drink -- 75g of glucose in 300mL of water, that is equivalent to 15 teaspoons of sugar. I felt extremely nauseated afterwards and was quite worried about vomiting. I would have loved to lie down somewhere. I also felt very cold, and a bit weak and dizzy. But I got through it and they took blood at one hour and two hours, then I could go.
They didn't do a fingerprick test at the same time (they have in the past, when I did the test at the hospital) so I have no idea what sort of blood sugar level I had. I did think about taking my own testing kit with me, to use in the toilets if they wouldn't show me the fingerprick figures, but decided against it. I wish I had. I hate not knowing stuff.
I went and had part of a Subway sandwich on the way back to my car but still felt quite nauseated for another hour or so. I'm a lot better now (2.30pm) but still not great; but that could be more about my cold. Runny nose and headache etc.
Now I just have to wait and see. I hate waiting.
I had my glucose tolerance test for diabetes this morning. I don't see the doctor until next Wednesday, which is frustrating. I couldn't even see my usual doctor then, I would have had to wait even longer, so I'm just seeing some random doctor in the same clinic. The results might be ready on Friday, maybe I can get a look at them early. My nutritionist friend can translate them for me, she asked me to get a copy but I forgot.
By yesterday afternoon I was starting to feel a bit unwell. I don't know if it was the cold I've caught from my son, or the high levels of carbohydrates. Or both. My blood sugars were 9.8 two hours after lunch and 9.0 two hours after dinner, both pretty high. The clinic said I can still do the test while I have a cold so presumably it also wouldn't affect these figures.
I started fasting at 9.30pm. I didn't sleep well at all and felt a bit nauseated in the morning after I got up. At the clinic I gave them a wee sample then rested for a while, then they took the vial of fasting blood before I drank the horrible horrible glucose drink -- 75g of glucose in 300mL of water, that is equivalent to 15 teaspoons of sugar. I felt extremely nauseated afterwards and was quite worried about vomiting. I would have loved to lie down somewhere. I also felt very cold, and a bit weak and dizzy. But I got through it and they took blood at one hour and two hours, then I could go.
They didn't do a fingerprick test at the same time (they have in the past, when I did the test at the hospital) so I have no idea what sort of blood sugar level I had. I did think about taking my own testing kit with me, to use in the toilets if they wouldn't show me the fingerprick figures, but decided against it. I wish I had. I hate not knowing stuff.
I went and had part of a Subway sandwich on the way back to my car but still felt quite nauseated for another hour or so. I'm a lot better now (2.30pm) but still not great; but that could be more about my cold. Runny nose and headache etc.
Now I just have to wait and see. I hate waiting.
Monday, August 13, 2012
Starting to panic just a little bit
Monday:
I have nearly finished day two of carbo loading for my glucose tolerance test on Wednesday. I am starting to get quite worried about what the result will be. I had my old testing kit from when I had gestational diabetes, so I've done a few blood tests at different times of day, both before and after I started the carb loading. At first I thought the results were ok, mostly. A bit high one hour after eating; but that is ok, right, because they generally tell you to test two hours after eating when your blood sugars have stabilised a bit. Now I'm not sure if it is ok or not.
Worse, I also now think that what I was reading as "acceptable" was actually only "acceptable for a diabetic". Not "normal". I've read a lot of web-sites (yes, yes, a very dangerous thing to do. Damn you, easily accessable internet!) and I've found all the information a bit confusing. They generally only give a fasting figure for non-diabetics (mine is ok) but don't talk much about what it should be later in the day.
I haven't been keeping very comprehensive records yet, just a few tests here and there, but for my own records here is what I have so far (btw for Americans multiply everything by 18 to get mg/dL):
Fri 10 Aug
3.50 pm (more than two hours after a high-carb lunch) -- 6.7 mmol/L
5.00 pm (one hour after 35g carbs) -- 10.2, this is very high
6.00 pm (two hours after 35g carbs) -- 5.5
Sat 11 Aug
7.30 am (fasting) -- 4.3 mmol/L, this is normal
2.00 pm (after very high-lunch, about 60g) -- 8.4
3.00 pm (two hours after lunch) -- 6.5
Mon 13 Aug
3.20 pm (more than two hours after super-high-carb lunch, about 100g) -- 7.6 mmol/L
5.30 pm (two hours after low-carb afternoon tea* and half an hour exercise) -- 4.7
8.30 pm (two hours after pasta for dinner) -- 7.4
* I ate some of my afternoon-tea carbs at lunch, so afternoon tea was just strawberries; I probably shouldn't have done it that way.
So. If normal non-diabetic blood sugar is supposed to be 4--6 mmol/L all the time, then I am stuffed. Definitely diabetic. If it is allowed to go up to 7.8 two hours after eating and never get above 10, then I only need be a tiny bit worried. Still need to take action for my health, but not an immediate problem. If it is allowed to go up to 7.8 two hours after eating and the one hour after eating mark doesn't matter at all, then I am just fine and dandy.
I've been feeling bloated and a bit headachy and a bit sick today. I though it was all the carbs, but this evening I have a bit of a sore throat, so maybe I'm just sick. Aiden has a runny nose.
At the gym today I did my first 30 min row. I didn't go fast, just steadily, and got to 4.22 km. I didn't really have any problems rowing for that long so maybe the carbo loading is good for something.
I have nearly finished day two of carbo loading for my glucose tolerance test on Wednesday. I am starting to get quite worried about what the result will be. I had my old testing kit from when I had gestational diabetes, so I've done a few blood tests at different times of day, both before and after I started the carb loading. At first I thought the results were ok, mostly. A bit high one hour after eating; but that is ok, right, because they generally tell you to test two hours after eating when your blood sugars have stabilised a bit. Now I'm not sure if it is ok or not.
Worse, I also now think that what I was reading as "acceptable" was actually only "acceptable for a diabetic". Not "normal". I've read a lot of web-sites (yes, yes, a very dangerous thing to do. Damn you, easily accessable internet!) and I've found all the information a bit confusing. They generally only give a fasting figure for non-diabetics (mine is ok) but don't talk much about what it should be later in the day.
I haven't been keeping very comprehensive records yet, just a few tests here and there, but for my own records here is what I have so far (btw for Americans multiply everything by 18 to get mg/dL):
Fri 10 Aug
3.50 pm (more than two hours after a high-carb lunch) -- 6.7 mmol/L
5.00 pm (one hour after 35g carbs) -- 10.2, this is very high
6.00 pm (two hours after 35g carbs) -- 5.5
Sat 11 Aug
7.30 am (fasting) -- 4.3 mmol/L, this is normal
2.00 pm (after very high-lunch, about 60g) -- 8.4
3.00 pm (two hours after lunch) -- 6.5
Mon 13 Aug
3.20 pm (more than two hours after super-high-carb lunch, about 100g) -- 7.6 mmol/L
5.30 pm (two hours after low-carb afternoon tea* and half an hour exercise) -- 4.7
8.30 pm (two hours after pasta for dinner) -- 7.4
* I ate some of my afternoon-tea carbs at lunch, so afternoon tea was just strawberries; I probably shouldn't have done it that way.
So. If normal non-diabetic blood sugar is supposed to be 4--6 mmol/L all the time, then I am stuffed. Definitely diabetic. If it is allowed to go up to 7.8 two hours after eating and never get above 10, then I only need be a tiny bit worried. Still need to take action for my health, but not an immediate problem. If it is allowed to go up to 7.8 two hours after eating and the one hour after eating mark doesn't matter at all, then I am just fine and dandy.
I've been feeling bloated and a bit headachy and a bit sick today. I though it was all the carbs, but this evening I have a bit of a sore throat, so maybe I'm just sick. Aiden has a runny nose.
At the gym today I did my first 30 min row. I didn't go fast, just steadily, and got to 4.22 km. I didn't really have any problems rowing for that long so maybe the carbo loading is good for something.
Friday, August 10, 2012
Not waiting for "rock bottom"
Saturday:
My diabetes test is scheduled for next Wednesday. I have to get checked every couple of years because I had gestational diabetes, but I don't think I have it. I have no symptoms, and I've done a couple of finger-prick blood tests at home which have been normal.
Nevertheless, I am in a pretty high risk category for getting diabetes at some point. The gestational diabetes is a big warning indicator, plus I am overweight with lots of stomach fat and my dad has pre-diabetes. I have very high cholesterol, and I have always been prone to episodes of hypoglycemia (I don't know if this last is relevant, but I know that is can be a problem for diabetics).
Diabetes doesn't just mean having to inject yourself with insulin or avoiding donuts; it increases your risk of heart disease, stroke and depression, and can cause blindness and nasty circulation problems.
Why am I waiting to be diagnosed with some horrible disease to take action about my health? It isn't just about getting thin.
When I had gestational diabetes I had no difficulty managing it with careful diet, but that was for the health of my baby. I can't seem to consistently do it for myself.
I can't take action for the next few days. From tomorrow morning I will be on a three-day carb-laden diet to prepare for the glucose tolerance test. But after that, regardless of the results, I need to start looking after myself.
The best way to avoid diabetes is to act like you already have it. Regular exercise, achieving a healthy weight, a healthy diet of normal food. The only real difference is the carb counting. Carbohydrate-rich foods have to be spread out through the day in careful portions -- not too much but not too little.
I'm feeling fat and stressed and sad today. Like I need to fix my health but won't be able to. I've failed at this before.
My diabetes test is scheduled for next Wednesday. I have to get checked every couple of years because I had gestational diabetes, but I don't think I have it. I have no symptoms, and I've done a couple of finger-prick blood tests at home which have been normal.
Nevertheless, I am in a pretty high risk category for getting diabetes at some point. The gestational diabetes is a big warning indicator, plus I am overweight with lots of stomach fat and my dad has pre-diabetes. I have very high cholesterol, and I have always been prone to episodes of hypoglycemia (I don't know if this last is relevant, but I know that is can be a problem for diabetics).
Diabetes doesn't just mean having to inject yourself with insulin or avoiding donuts; it increases your risk of heart disease, stroke and depression, and can cause blindness and nasty circulation problems.
Why am I waiting to be diagnosed with some horrible disease to take action about my health? It isn't just about getting thin.
When I had gestational diabetes I had no difficulty managing it with careful diet, but that was for the health of my baby. I can't seem to consistently do it for myself.
I can't take action for the next few days. From tomorrow morning I will be on a three-day carb-laden diet to prepare for the glucose tolerance test. But after that, regardless of the results, I need to start looking after myself.
The best way to avoid diabetes is to act like you already have it. Regular exercise, achieving a healthy weight, a healthy diet of normal food. The only real difference is the carb counting. Carbohydrate-rich foods have to be spread out through the day in careful portions -- not too much but not too little.
I'm feeling fat and stressed and sad today. Like I need to fix my health but won't be able to. I've failed at this before.
Thursday, July 26, 2012
More rowing
All muscle soreness was gone today and so was most of the uncontrollable hunger. I was pretty tired from all the exercise and a couple of unsettled nights where the kids kept waking up, but at least I wasn't eating all day! Well ... not quite all day.
I had a doctor appointment today to get a prescription repeat, and in the waiting room I was reading a women's health magazine. They suggested eating protein at afternoon tea time to get you through the afternoon. Try 100g of almonds, they said. Really? 100g of nuts as a little snack? I calculate that to be 600 calories, about half the daily allowance of a woman watching her calorie intake. The magazine was a few months old, I wonder if anyone had ever pointed out the mistake, and if they had bothered to correct it in a later issue.
The doctor took my blood pressure (good, as always) and put me on the scales -- 78 kg, the same as this morning at home. He wasn't my usual doctor so talked about my family history a bit; and because my dad is now borderline diabetic and I had gestational diabetes during my second pregnancy, he wants me to have a test every two years. I had one a couple of years after Aiden was born but he is 5 1/2 now. So I need to organise that. I don't think I have any symptoms, but I am in a high risk category. When I did the test when pregnant (you fast and then drink a bottle of high-sugar liquid) I reacted very strongly and had to lie down through most of the two hour monitoring period -- and I had diabetes. The next time I did the test, when I was back to normal, I felt fine the whole time. So I might know the result before the doctors do.
I took the kids to Gecko in the afternoon but -- oh horror -- both the good rowing machines were taken! There are two on the upper floor, next to windows overlooking the pool. They are also closest to where the kids are having their exercise class so I would be more easily found if needed. There are two more downstairs with exciting views of the sweaty behinds of people on the treadmills. So I got on a treadmill for 5 minutes and happily one of the upstairs rowing machines was free by then. I had planned to do 21 mins again and try for a better distance than yesterday, so I went out hard. And was exhausted within minutes. Whether it was rowing fatigue, general tiredness, or just that I was pushing myself harder, I don't know. But I only made it to 12 minutes; 1.93 km which I think is a bit better than last time. I finished off with a cooldown on the treadmill. Overall, today was unintentionally a bit of a rest day for my body.
photo by Shelby PDX. I remembered!
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