Confused about minimum amount of carbs

[PNWkayaker]

A couple of months ago, my blood test showed me to be prediabetic (glucose 115; a1c 5.8). Since then, after following a very low carb diet, exercising my butt off (generally about 5 hours of vigorous cardio and 2 days of weightlifting per week), and losing about 20 pounds, my a1c has come down to 5.2. However, as of a few weeks ago, I found myself waking in the middle of the night with anxious thoughts, sweaty, and unable to get back to sleep. About this time I had obtained a glucose meter and found out my morning fasting glucose was still in the range of 100-115! My doc told me I wasn't getting enough healthy, low GI, carbs, and as a result, around the middle of the night my body thinks it's starving and signals my liver to start manufacturing glucose. That explanation seems logical and when I eat more carbs, I no longer have this nighttime thing. [Per Doc's suggestion, I stopped measuring my glucose, since he said it was unnecessary and (accurately) just stressing me out.]

The problem is: after increasing my carb consumption (mostly from oatmeal, quinoa, millet, beans, hummus, brown rice, etc), my weight loss abruptly halted! Doc says I need to get a minimum of 120 grams of healthy carbs per day (so, about 40g per meal). Ever seen how big a serving of quinoa or oatmeal you need to get 40 grams of carbs? It's HUGE! Beans aren't so voluminous, but I can't just eat beans!

Questions:
-- Is 120 g per day of carbs really necessary to avoid this low nighttime blood sugar/followed by high blood sugar rebound phenomenon?

-- The doc was frustratingly brief in answering my questions, so my understanding of the nighttime blood sugar thing may not be complete or totally accurate. If anyone has any other insights to offer, they would be very much appreciated!

-- If we really do need 120g of carbs per day, how do people manage to consume the 120g, plus protein (I aim for 80-100 grams per day to prevent muscle loss from the exercise) and still lose weight? (I'd like to lose another 15-20 pounds to get close to my ideal BMI).

Thanks in advance!

[Wifezilla]

I hope some of the smart people stop by to help. Until then, there's me! LOL

120g of carb is not necessary, but you will need to make changes to avoid that morning problem.

Your doctor sounds like he is spouting the standard crap that makes diabetics stay sick and die early.

[LarryAJ]

exercising my butt off My first reaction is, "Are you eating ENOUGH protein?" Using your profile weight and height, a good approximation of the protein you need per meal is 34 grams, or 102 grams each day.

Next, you say very low-carb, but then you are exercising a bunch. That is going to require energy from some source. Since you are not eating carbs, then it has to come from some place. If it is not coming from your eating, no wonder your body may think you are starving it. It seems that a general rule is that you need to replace the carbs you are not eating with fat. Now it sometimes does not work for some people, so you need to test carefully to see how well it will work for you.

My suggestion, FWIW, is to check your protein consumption and get it up to 90 to 140 grams per day. I gave you a range because I do not want you to become overly obsessive about getting the EXACT amount. It is over the period of weeks that it needs to average out close to the 102 grams/day figure - though you might need more to make up for the exercise.

Then, over the period of at least a week, and three would probably be better, add in fat to make up the loss from the carbohydrates that you cut out. Obviously, you need to use GOOD fats, like butter, coconut oil, olive oil, bacon grease, etc. Check the forums, there are lots of posts about the use of fats and which ones are good. Remember that fat has 9 calories per gram but carbohydrate only has 4 calories per gram. So for every 9 grams of carbohydrate you stop eating you only need to eat 4 grams of fat to make up the energy loss.

Morning "bounce" is going to take some experimentation to get it under control. But you can do it if you are careful and you keep good records of what you eat and what it does to your blood glucose. There are plenty of ladies here that have direct experience with this, and they will chime in soon.

[PNWkayaker]

Wifezilla -- Yes, although I generally have liked my doc, he does seem to adhere to the party line for the most part (although he's willing to recommend supplements and chiropractors). I have to admit, though, that I do feel better after increasing my carbs. Perhaps I just don't need to go the full 120 grams.

LarryAJ -- I suspect you are right on the money -- that energy has got to come from somewhere! And my worst morning glucose was after my hardest exercise (like when combining an hour of cardio followed by weightlifting). Since then, I've started taking leucine after lifting weights (to hopefully reduce muscle breakdown), plus a protein drink, plus some complex carbs to refuel. Although I've been trying to increase my protein, I'll try to keep a closer watch on it. I hadn't thought about increasing fats. Currently, I take a tablespoon each of cod liver oil, ground flax seed, and lecithin (<-- mostly fat), plus 4 of these gigantic fish oil capsules; plus whatever fat I get from a standard serving of either salmon or chicken -- and that's about all the fat in my diet.

I was looking for the smiley face when you included bacon grease in your list of healthy fats! Is bacon grease really healthy???

Thanks for the comments!

[dancinbr]

A couple of months ago, my blood test showed me to be prediabetic (glucose 115; a1c 5.8). Since then, after following a very low carb diet, exercising my butt off (generally about 5 hours of vigorous cardio and 2 days of weightlifting per week), and losing about 20 pounds, my a1c has come down to 5.2. However, as of a few weeks ago, I found myself waking in the middle of the night with anxious thoughts, sweaty, and unable to get back to sleep. About this time I had obtained a glucose meter and found out my morning fasting glucose was still in the range of 100-115! My doc told me I wasn't getting enough healthy, low GI, carbs, and as a result, around the middle of the night my body thinks it's starving and signals my liver to start manufacturing glucose. That explanation seems logical and when I eat more carbs, I no longer have this nighttime thing. [Per Doc's suggestion, I stopped measuring my glucose, since he said it was unnecessary and (accurately) just stressing me out.]

The problem is: after increasing my carb consumption (mostly from oatmeal, quinoa, millet, beans, hummus, brown rice, etc), my weight loss abruptly halted! Doc says I need to get a minimum of 120 grams of healthy carbs per day (so, about 40g per meal). Ever seen how big a serving of quinoa or oatmeal you need to get 40 grams of carbs? It's HUGE! Beans aren't so voluminous, but I can't just eat beans!

Questions:
-- Is 120 g per day of carbs really necessary to avoid this low nighttime blood sugar/followed by high blood sugar rebound phenomenon?

-- The doc was frustratingly brief in answering my questions, so my understanding of the nighttime blood sugar thing may not be complete or totally accurate. If anyone has any other insights to offer, they would be very much appreciated!

-- If we really do need 120g of carbs per day, how do people manage to consume the 120g, plus protein (I aim for 80-100 grams per day to prevent muscle loss from the exercise) and still lose weight? (I'd like to lose another 15-20 pounds to get close to my ideal BMI).

Thanks in advance!

Hello,

I don't know if you have looked around enough to visit some sites and books that many of us have followed.

I have two suggestions.

First, go to Jenny's site and learn learn learn. You are experiencing dawn phenomenom.

http://www.phlaunt.com/diabetes/index.php


Secondly, I like to read Dr. Bernsteins Diabetes solution.

I use it as a good guideline.

Many people follow his recommendations closely that is keeping their carbs down to 30gm a day. But you must also have proteing. Again, Dr. Bernsteins diet book and Jenny's protein calculator will help.

Here is Dr. Bernsteins' site and book. If you don't have it I would recommend getting it.

the 120g per day is pure ADA crap!

I keep my carbs between 30-60 and I try never to go over 100gm per day.

I don't have dawn phenomenom since I use meds and insuling to prevent it.

Many others here have found other solutions to this problem as well. Eating more carbs is not the solution in most of our opinions here on this site.

Here is Dr. Bernsteins site: http://www.diabetes911.net/

I think you are beyond pre-diabetic IMHO.

So, get with it. You are doing great with the exercise and weight loss. My weight loss has stalled. I am simply not doing as well.

BUT THE MOST IMPORTANT THING YOU CAN DO IS KEEP MEASURING WITH YOUR GLUCOSE METER AT LEAST 4 TIMES A DAY.

I do 7 times a day. This is your true guide as to how you are doing in controlling your Blood Glucose levels.

Try to keep your BG below 100. I try to target 85. When you eat try to keep your BG below 120-140 after one hour and below 120 after 2 hours. Then it should head back down anyway below 100.

If you are not doing this, you are having too many carbs and too little exercise or some combination of both.

Take the time to really go through the information on Jenny's site. It is all very good.

Be informed. Most doctors are NOT believe it or not. They still follow the ADA guidelines. If the ADA guidelines were so good please explain why so many people are having complications that follow these guidelines.

Poke around more in this site.

Read my journal.

Read Cajunboys journal. Read a few others to gain other folks experience.

We support each other here.

Best wishes,

Ralph

[Nancy LC]

I think they came up with that 120g number because the brain uses around 130g or so of glucose a day. However, these dumbos don't realize you can create all the glucose your body needs from the proteins you eat. They must've slept through school.

Most diabetics, or pre-diabetics, whether on low carb or not, get Dawn Phenomenon in some form or another.

[PNWkayaker]

I think you are beyond pre-diabetic IMHO.


Why would you say that, given my a1c at 5.2 and the fact that my fasting glucose has never exceeded 115? After the major anxiety I was feeling over all this, which was finally relieved when my doc said I definitely didn't have diabetes and in fact was below the prediabetic threshold, this is the last thing I need to hear!

[Cajunboy47]

Why would you say that, given my a1c at 5.2 and the fact that my fasting glucose has never exceeded 115? After the major anxiety I was feeling over all this, which was finally relieved when my doc said I definitely didn't have diabetes and in fact was below the prediabetic threshold, this is the last thing I need to hear!

If I understand your first post correctly, your concern began with your experiencing low blood sugar at night. Something in your post makes me feel you believe that as long as your BG has never gone over 115, you don't have diabetes.

Pre-diabetes usually starts with experiencing low blood sugar. Pre-diabetes is a diabetic condition. Diabetes is a progressive disease and it can come upon you with full avengence very suddenly when you've teetered on the borderline for a year or more, even years..... The one thing that bothers me is that your Doctor diagnosed you as pre-diabetic, but then you say your Doctor told you not to bother monitoring as it was stressing you out and your numbers were not that high. He must have graduated with other dummies, such as my first Doctor who originally diagnosed me then minimalized it as though I had nothing to worry about.

In my opinion, if you're going to make an error, you're better off to err on the side of caution. I'd invest in a blood glucose monitoring kit and I'd begin testing to learn what my body is doing in response to dietary intake.

As for anxiety, it stems in fear of the unknown. You'll lose the anxiety once you've made yourself fully informed about diabetes and pre-diabetes and you've tested yourself enough to know where you stand on a day to day basis. Once reaching a threshold (pre-diabetic dignosis), we only make matters worse if we don't learn all we can about what we might be facing.

The good news is that you have time on your side if you start learning all you can learn about your present health status. Another positive thing is that you can learn that diabetic or not, if you can do things to increase your metabolism, you'll benefit by easier weight loss.

Everyone gets anxiety from diabetes or just developing a fear of diabetes, be it phsyically or psychologically induced, but once a person learns that of all the diseases one could get, this is probably the easiest to control and probably the one disease that you don't have to die from it, through dealing with it, the anxiety will subside.

So, Ralph, was probably referring to your low blood sugar as a problematic sign and not the 115 number that you get on the high end....

Good luck with your health and weight loss....

Ron

[dancinbr]

Why would you say that, given my a1c at 5.2 and the fact that my fasting glucose has never exceeded 115? After the major anxiety I was feeling over all this, which was finally relieved when my doc said I definitely didn't have diabetes and in fact was below the prediabetic threshold, this is the last thing I need to hear!

I thank Cajunboy for giving more input to this as well.

Here is where I am coming from.

My Doctor did the same thing your current Doctor did. I had an A1C of 6.2 and my Fbg was just below 125.

He didn't say anything. He told me not to worry, lose some weight.

Well by the following year my A1C was up to 9.3, my average blood glucose levels were up over 300 and I was probably running around with this for well over a year.

Quite coincidentally, I decided to switch Doctors. My new Doctor called me in immediately and said you have diabetes. Lets get to work.

I studied. I found this site. I read. I learned. I didn't hide.

My A1C's are now in the 5.4-5.8 range down from 9.3. My average BG levels are between 100-110 most often below 100; all a result of my monitoring, changing my eating habits (aka much lower carbs) more exercise but not enough.

I am a full blown T2 diabetic with the same numbers you talk about.

Now, a non-diabetic a true non-diabetics A1C will be under 5.0 somewhere in the neighborhood of 4.2 to 4.6 with a FBG level of 70-85.

So, if I gave you an anxiety attack, I apologize. I am simply trying to relate my own experience to precisely where you are at this very moment.

I am not a Doctor and I do not recommend professionally any treatment.

But I also recognize the many Doctors today are so behind in terms of preventing this disease and/or treating it once you have it.

Just my opinion. You can do what you will.

But again, my recommendation to you is to become smart about this topic. Research and learn. Here everyone's experience. Just maybe you can keep this disease from advancing any further than it has already.

Just my opinion.

Be well.

Ralph