Diabetes education - VA style

[Bonnie OFS]

I just got an e-mail from the VA about how to manage my diabetes. They're still pushing high carb, low fat, & eating often. :nono:

Good thing I don't listen to them. My fbs is now below 100, my after meal numbers are lower than they've ever been, I'm losing weight (finally!), and I have tons more energy then ever. Now that I'm seeing some success, I'm a whole lot happier with this WOE! :D

[GRB5111]

Sad to think about how many are following this flawed advice.

[maycan]

I was told today during my yearly physical that my bg should be under 180 at 2 hours after a meal. That is not what I have been reading here and at other diabetes management websites. Jenny at phlaunt.com says 140 is when organ damage begins.

[Bonnie OFS]

Maycan - I like your goal - it's my goal, too. 140 is NOT normal. I've tested my "normal" husband after meals & his is never much over 100, it that. I really want his metabolism, but he won't share. ;)

This past week & a half my after meal bg hasn't been over 120, but mostly under 110. I'm praying I can keep this up.

[Mycie14]

My doctors and pharmacist are all faculty at a med school / pharmacy school. None of them recommend a low carb diet, it's all standard ADA stuff. They don't try to disuade me from what I'm doing, because my results speak for themselves, but sad that they are educating the next generation of medical professionals with the old food pardigm.

I have had a pharmacy resident who knew about a ketogenic diet and was interested in what I was doing, but she was the only one. FYI, I have to go to "education" classes with the pharmacist/pharmacy resident 2-3 times a year to have the co-pays waived for all of my diabetes meds and testing supplies. Usually I educate them. :lol: or it that :cry:

[JuliaR]

How long can this go on? They are killing people with this horrible protocol!

[myrt4930]

Julia....So how many carbs do you eat per day? I was diagnosed 2 weeks ago. I'm on metforman ER and am trying to stay under 60 carbs. That might not be low enough. The medicine sure makes me feel pukey. Please help.

[calgal98]

Titrate your met slowly. I started with the smallest dose possible and when tolerated move up again. I'm at max dose and no problems at all

[JuliaR]

Julia....So how many carbs do you eat per day? I was diagnosed 2 weeks ago. I'm on metforman ER and am trying to stay under 60 carbs. That might not be low enough. The medicine sure makes me feel pukey. Please help.

I'm sorry the met is making you feel sick. I have been verrrry lucky in that metformin never bothered me (other meds have, blech!). Did you doctor tell you what time of day to take it? You might consider taking it at nighttime if the stomach upset is mild and you'll sleep through it.

I typically eat 15-25g carbs per day, not subtracting fiber. Some can tolerate more, others less. I "eat to my meter" - testing new foods to make sure they don't cause a spike: I take my BG right before I eat; 45-60 minutes after the first bite it generally the highest reading, and at two hours after the first bite my BG should be back to where it was when I started. If the spike is high or it stays high for too long then I know either that food is not going to be for me, or I should try again with a smaller quantity of it.

Some low carbs foods spike me, and some higher carbs foods are okay for me. Everyone is different. Every time I try something new I go through the testing above to make sure it's safe to keep eating that food. It's a pain but now I have a great big list of yummy foods that are good, and good for me! :yum:

I'm sorry you are going through this. Stick around the D board, read all you can from the excellent resources here and ask lots and lots of questions. You can do this!

[JEY100]

Julia....So how many carbs do you eat per day? I was diagnosed 2 weeks ago. I'm on metforman ER and am trying to stay under 60 carbs. That might not be low enough. The medicine sure makes me feel pukey. Please help.

Welcome, there are many threads on how to find the level of carbs that is right for you, with links to good resources. Read back through the threads here http://forum.lowcarber.org/forumdisplay.php?f=45. and check some websites, one I like is LowCarbRN. Some start to slowly cut down on carbs until BG is consistently in a good range, but Dr Westman, Hallberg, Bernstein etc. take the opposite approach...start with a program of 20-30 grams total carbs, and then when you reach weight and BG goals, add back foods and test, test until you find a carb level that works for you. Consider joining the DietDoctor membership (free first month) and watch Dr Westman's talk and mock class on diabetes. Since you were recently diagnosed, you may be able to reverse diabetes with diet alone quickly and stop the metformin. All the best,

[Bonnie OFS]

There is also the Reversing Diabetes facebook - https://www.facebook.com/groups/reversingdiabetes/

I've gotten some very good advice there about lchf diabetes management. It was there I learned that protein can raise bg. Now that I've lowered the amount of protein I eat, my fasting blood sugars are finally below 100.

The facebook format can be a bit confusing for me. There's a new reversing diabetes forum - http://rd-community.freeforums.net/ - but it's not very active.

[JEY100]

Mike may have a VA doctor? New success story on DietDoctor about diabetes patient ignoring doctor.

“‘You Can’t Do That,’ He Said. I Did It Anyway”

http://www.dietdoctor.com/cant-said-anyway

[myrt4930]

Janet---I read that article---You Can't...I Did it Anyway ... and that's the way for me to go I think.
The doctor tried me on 4 medicines and the last one was Janeva. I had such diarrhea and cramps that I would have needed a diaper to leave home LOL. But at the time it wasn't funny.
Now I'm doing lower carb...between 20 and 30...because I have no medicine so I'm being more careful with the carbs. I will get rid of this without needing insulin.
I'll keep reading, increasing my exercise and looking for hidden carbs and I think I can do this.
My doctor wants me to go to the Endrocrenologist because she says the diabetes is what is making me sick but I don't think so. When I quit Janeva the diarrhea was gone in 2 days. One thing I do notice is that I'm way more tired than I should be. myrt

[JEY100]

Good to know that you are trying to reverse your diabetes with diet alone. Have you also read all the tips for reducing any side effects of a VLC diet? Enough water, more salt and fat, usually cure the "tired" feeling. Sometimes it hard after years of the Low fat mantra to understand that if you remove carbs, your energy must come from FAT. http://www.dietdoctor.com/low-carb/side-effects
You don't need to lose weight and your "on-board pantry" is empty :lol: so add fat. Look into those "fat bomb" recipes.

I love that website...they just added the movie "Fixing Dad" for free. It is about reversing Dad's diabetes with real food. The Two Week Challenge diet is the same Duke Clinic diet I follow (but now with more LC vegetables...you can roast vegetables in olive oil, drizzle with more oil or butter if needed).
Have you watched Dr Westman's talk on Diabetes recommended in my previous post. He has great studies on his slides, many the same used in this Review Paper you can share with your doctor. 12 points of Evidence why Dietary Carbohydrate Restriction should be the first treatment for Diabetes.

http://www.sciencedirect.com/science/article/pii/S0899900714003323

Agree with Bonnie that the Reversing Diabetes FB can also be helpful. They too follow Dr Westman's strict LC diet, with a good "toolkit" pinned at top you can read after joining. Posts are tightly monitored, questions or recipes that are too lenient in carbs don't last long. ;)

[JEY100]

Think how much the VA could save by following the advice in this article on DietDoctor today:


Big Pharma is Doubling the price of Insulin

In the last few years, big pharma has doubled or tripled the already high price of insulin in the US. This price increase has no match in the rest of the world. The result is a situation where many patients have a hard time affording their medications.

Monatana Standard: Insulin Price Spike Leaves Diabetes Patients in Crisis
Reuters: Insulin cost in U.S. more than doubles between 2002-2013
STAT: Insulin prices have skyrocketed, putting drug makers on the defensive
Fortunately there’s a surprisingly simple solution, that can allow patients to get the last laugh.

If Big Pharma makes big dollars by overcharging on insulin, patients can reply by going low carb and perhaps also doing intermittent fasting. This can well reduce their need for insulin by around 30 to 70% (type 1 diabetes) or possibly even (type 2) allow them to stop needing insulin completely!

It can also reduce the need for many other chronic medications, like other diabetes or hypertension drugs. There’s a lot of money to be saved.

[Bonnie OFS]

This makes me feel virtuous & patriotic - I'm saving taxpayers money by not being on diabetic meds. :D

[RobLL]

Over the years I have had 4 PCPs with the VA. They have all been willing to support my normal BGs and A1Cs. In our region they generally don't Rx the extra rapid insulins so I get those via Medicare D.

I don't think there has ever been a discussion about diet. If asked I would just say I eat low carb.