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Tuesday, October 31, 2006

Books and Links

Get ready for information overload.

Books

The books below are well worth reading. I benefited most from Gretchen Becker's book, and Bernstein also has a wealth of good ideas although his dietary ideas may be a little strict for some. It's a smorgasbord - I take what works for me, and leave what doesn't suit me. Jenny Ruhl has just published hers; it is very readable and has a wealth of useful and practical information well supported by scientific cites.

Available from your library, good bookstore or Amazon. No - I don't get a commission.

The First Year, Type 2 Diabetes, An Essential Guide for the Newly Diagnosed. Author: Gretchen Becker. ISBN 1-56924-646-0 (buy on Amazon)

Dr. Bernstein's Diabetes Solution, Revised and Updated, by Richard K, Bernstein, M.D.,ISBN 0-316-09906-6. (buy on Amazon)

Blood Sugar 101, What They Don't Tell you about Diabetes, by Jenny Ruhl, ISBN-13: 978-0-9647116-1-7. (buy on Amazon)


Magazines and Cook Books
All the magazines I've read on diabetes were only suitable for one thing - and they were too glossy to even be much use for that. The same applies to all "Diabetes Recipes" books and magazines. If you need a recipe book, look for a low-carb recipe book, not a diabetes one.


Links

I've listed some links below, but by far the most important one is Jennifer's Advice to The Newly Diagnosed. These are all links to that:



This is not an exhaustive list, but some, like Mendosa, have links to many others. Those which require registration have never sent me a spam or promotion.

A.S.D. home page
http://www.alt-support-diabetes.org/index.php

General Diabetes Information:

The misc.health.diabetes FAQs
http://www.faqs.org/faqs/diabetes/

David Mendosa
http://www.mendosa.com/

Jenny Ruhl
http://www.phlaunt.com/diabetes

Diabetic Talk Site Map (excellent resources pages)
http://web.archive.org/web/20071229131928/www.diabetic-talk.org/sitemap.htm

Joslin
http://joslin.org/

The AACE
http://www.aace.com/index.php

The ADA
http://www.diabetes.org/home.jsp

Diabetes Australia
http://www.diabetesaustralia.com.au/en/

Diabetes UK
http://www.diabetes.org.uk/home.htm

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
http://diabetes.niddk.nih.gov/

UK Prospective Diabetes Study (Type 2)
http://www.dtu.ox.ac.uk/index.php

Diabetes Control and Complications Trial (DCCT) (Type 1)
http://diabetes.niddk.nih.gov/dm/pubs/control/

Medical Research Search Engines:

Highwire
http://highwire.stanford.edu/

Medscape (registration required)
http://www.medscape.com/medscapetoday

Google Scholar
http://scholar.google.com/advanced_scholar_search

Discussion Groups

YahooDiabetes World
http://health.groups.yahoo.com/group/diabetesworld/

The ADA Forums and Message Boards
http://connect.diabetes.org/forums/default.aspx

Diabetes Support Forum UK
http://www.diabetes-support.org.uk/


I attempt to keep them current - please let me know if any links have changed.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

Food and Recipes

Contents:

Opinions on Diet Items

Aspartame
Cinnamon, Spices, Herbs and Similar
Eggs, Carbs and Cholesterol
Are Carbs Really Necessary?
Banting's Diet
It Must Be OK - It's Sugar-Free! Wrong!
What is a Balanced Diet For a Type 2 Diabetic?
 
Comments and Tips

Cooking as a Survival Skill
Thanksgiving and other Feasts
What to Eat at First
Grazing
Eating Out
The Price of Eating Healthy
Analysis of a Day's Meals
Analysis of a Day's Meals, Day 2
Travelling With Type 2
Food, Farmers and Factories
I'm Type 2! What Should I Eat?
Catering For Different Tastes When Cooking

Kitchen Tips

Kitchen Essentials: Steamer Saucepan

Alcohol 

Red, Red Wine
Wine and Serendipity

General Recipes

Yoghurt
Vegetables
Stir-Fry and Salad Mix
Chili Crab
Psyllium, Fibre, Muesli and Nuts
Snacks
Low Carb Crustless Quiche

Breakfasts

Breakfasts
Breakfast On The Run
Stuffed Mushrooms
(also see quiche above)

Soup

Hearty Vegetable Soup
Simple Low Carb Soups I - Mushroom
Simple Low Carb Soups II - Asparagus

Dips

Cheesy Guacamole Dip

Casseroles and Stews

Breakfast Stew, Low Carb
Beef Burgundy
Sweet Curry
Ki Si Ming
Serendipitous Cajun Chicken

Pasta and Sauces

Napoli Sauce
Lasagna
Pizza with Minimal Carbs
Konjac and Shiritaki Noodles


Desserts

Small New York Baked Low Carb Cheesecake
Large New York Baked Low Carb Cheesecake




Check back regularly - the list will gradually grow.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

Opinions

I tend to be fairly strong in my opinions on some aspects of diabetes treatment, various national diabetes authorities, internet spammers and scammers and some other things. So This page will act as a "Contents" page, with links to other pages as I post them.

General

Teeth, Gums, Diabetes and Death November 06, 2006
Test, Test, Test April 17, 2009
Good Advice, Bad Advice - Nicky's Experience 24 September 2007
Motivation, Likes and Dislikes 28 February 2008
Money, Medications and Motives June 10, 2008
Past, Present and Future July 21, 2008
Miracles and Wonders November 25, 2008
The Diabetes Diet Wars November 27, 2008
Smoking and Diabetes December 17, 2008
Diabetes and Dental health January 03, 2009
Health Care Funding By Governments June 12, 2009
Swine Flu, Diabetes and Good Sense August 13, 2009
To Medicate - Or Not? September 23, 2010
Celebrating An Anniversary Saturday, April 30, 2011
The Discovery of Insulin Thursday, October 20, 2011
Taxes For Our Own Good  Monday, July 23, 2012
What's In a Name? Am I a Diabetic or A Person With Diabetes? Tuesday, April 02, 2013
Type 2 Diabetes and the Shame Game Friday, May 03, 2013 
Stress and Blood Glucose Levels. Saturday, September 21, 2013
I Ate Nothing! Why Are My BGs high? February 16, 2009
Are Diabetes Complications Inevitable? Not necessarily... Friday, May 01, 2015


Medical Authorities, Research and Guidelines

Diabetes Authorities and Diet 02 Nov 2006
Self-Testing and Type 2 Management 01 July 2007
The Diabetes Revolution? 09 December 2007
The Other Side of the Revolution 09 December 2007
ACCORD, Foxes and Grapes 10 February 2008
The Quality of ADA Dietary Advice 29 February 2008
Is Testing Worthwhile? 30 April 2008
ADVANCE and ACCORD June 07, 2008
Experts November 16, 2008
ADA Accomplishments in 2008 January 09, 2009
Choices, Consequences and Responsibility June 22, 2009
Good Targets, Bad Methods February 03, 2010
SMBG Research, Or The Lack Of It February 16, 2010
Should Detectives, Not Just Academics, Review Drug Research? February 26, 2010
SMBG - A Doctor Who Understands March 14, 2010
Tight Control. When Will They Ever Learn? July 15, 2011
The 600 Calorie Diet for Type 2 Diabetes July 28, 2011
ADA Standards of Medical Care in Diabetes 2012, February 3, 2012
Do Doctors Matter? Saturday, May 10, 2014


On Blood Glucose Testing
When To Test? 08 Nov 2006
Blood Glucose Targets 02 Dec 2006
Blood Glucose Targets 2015 01 August 2015
Testing Etiquette 09 Dec 2006
How Often Should We Test? July 30, 2008
I'm a New Type 2. Do I Really Have to Test so Much?  January 05, 2013
For UK Type 2s: A Petition to Make Test Strips Available to People With Type 2 Friday, July 26, 2013
Must I test Before Meals Too? Tuesday, April 22, 2014
I Think I May Have Diabetes... Friday, September 18, 2015


On Food and Drink
Cooking as a Survival Skill 01 Nov 2006
Thanksgiving and other Feasts (Jennifer) 17 Nov 2006
Red, Red Wine 15 March 2007
Wine and Serendipity 24 April 2007
Cinnamon, Spices, Herbs and Similar 06 October 2007
Dieting for Life - What's in a Name? 24 April 2007
What to Eat Until You Get Your Meter. May 06, 2008
The Price of Eating Healthy July 16, 2008
Eggs, Carbs and Cholesterol October 02, 2008
Are Carbs Really Necessary? April 25, 2009
Aspartame May 4, 2009
Food, Farmers and Factories September 15, 2009
Cholesterol, Fats, Carbs, Statins and Exercise October 31, 2009
Banting's Diet April 14, 2010
Free Radicals and James Bond August 9, 2011
Konjac and Shiritaki Noodles October 24, 2013
Fat: The New Health Paradigm Monday, September 21, 2015
What is a Balanced Diet For a Type 2 Diabetic? Saturday, October 22, 2016


On using the Web and the Net
Miracle Cures 31st Oct 2006
Be Smart, Be Skeptical August 18, 2008
Privacy On Forums And The Web August 11, 2010

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

Monday, October 30, 2006

Miracle Cures

There are NO cures; just better ways of treatment and management. Accept it, and get on with it.

Please read this link recommending Glucobate, the latest miracle cure for diabetes. After you read the glowing reports, make sure you click on the FAQs for more details:

Glucobate

[note 15th April 2009 : Today I found that the original link shown below no longer works, so I have substituted the UK copy of the original FTC page]
http://wemarket4u.net/glucobate/index.html

I was going to write a detailed comment on my experiences on the net with scam artists, herbal cures and weirdos. I reckon the FTC has done a brilliant job with that site, so I'll leave it at that.

Remember that motto "Be Smart, Be Skeptical" every time you read advertising or testimonials where someone is trying to sell you something - especially if it's supposed to improve your health.

Test everything through the filter of your own common sense. That applies wherever you read it or hear it - including here.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

Friday, October 27, 2006

Breakfasts

See also Travelling With Type 2

For various reasons, I'm one of the many type 2's for whom breakfast is the hardest meal of the day to get right. The traditional "heart-healthy" breakfast of cereal, milk, juice and toast is a disaster for my blood glucose levels. So, after much experimentation I came up with these ideas.

Breakfasts With Minimal Carbs

1. Egg. The humble egg can be cooked in so many ways: poached, fried (minimal oil in a non-stick pan), normal omelette (beat it lightly while cooking), fluffy omelette (separate, whip the white with a spoonful of water, fold back with filling and yolk), scrambled with a little milk, frittata (sort of a heavier omelette with filling), and baked. Use fillings, cheese, fresh herbs if you can, dried if you can't.

2. Meat. Bacon, Ham, small steak, hamburger patty (watch the fat), chicken, prosciutto, hot dogs and so on. Can be fried, grilled/broiled, chopped after cooking and added to omelettes, frittata or scrambled eggs. For bacon or other fatty meats, drain on absorbent paper before serving.

3. Fish. Smoked, canned or fresh. Can be poached, fried, as a mornay (easy on the thickener), mixed in a stir-fry etc. Same for seafood.

4. Mushrooms. Small ones can be sliced and cooked with onions, herbs , garlic etc and a little oil and a smidgin of flour for a gravy. Large ones can be filled with bolognaise or napoli sauce (or whatever you like), topped with grated cheese and baked in the oven. Also another good omelette filling.

5. Casseroles and stews - beef, lamb, chicken, mince (ground beef) etc can be pre-prepared and divided into individual breakfast sized serves. Put them in small plastic containers in the freezer and zap one in the microwave for breakfast. Check the carbs in the recipe to check suitability. Beef bourgignon, Irish Stew (watch the spuds), chicken fricassee, whatever your favourite is. Always test at 1 hr the first time with casseroles - thickeners are usually the carb culprits for high BGs.

6. Leftovers - slices of roast meat, re-heated or cold, re-heated chops etc

Bon Appetit.

Alan, T2, Australia
Everything in Moderation - Except laughter

Painless Pricks


One of the common objections to testing blood glucose more frequently is a fear of pain from testing. If you are suffering pain when you test, you are doing it incorrectly.

I learned this the hard way in my first year after diagnosis. I hope it helps you.

Do not use an alcohol swab to clean the test site unless there is no other choice. Repeated use of alcohol over time for that purpose will dry out the site and may cause skin problems.

If possible wash your hands in warm soapy water, rinse well and shake them to get the circulation going. Check your lancet-holder; it should be adjustable. Mine is a Soft-clix, made by Roche and is usually painless. That brand has an excellent reputation among the diabetics I know, but any good lancet device should do the job. I get an occasional tiny sting and it lets me know if it's getting blunt sometimes, but I tested over 5000 times in the first four years after diagnosis, before I stopped counting, without any trauma. That's from a guy who was, and is, needle-phobic.

Start with the second lowest setting (1 or 1.5), hold it firmly against your skin on the side of a finger near the tip. Don't flinch when you release the button. The button releases a spring-loaded tiny needle which makes a tiny hole in your skin and instantly retracts. Using the side of your finger-tip has two advantages: there are less nerve-ends than on the pads, and it doubles the number of test-points so you can rotate through the positions.

Massage gently (milking a cow) until a drop of blood forms sufficient to put on the test strip. If this setting doesn't provide an adequate quantity, move the lancet setting up one notch for the next one. If you got a large sample and it hurt a little, go to the lower setting.

And that's all there is to it. Sometimes it helps to shake your hands a little more, or warm them up if it's cold.

The manufacturers advise changing the lancet needle every time; I change mine when I remember or if it gets a bit blunt. I have never had an infection as a result of doing that, nor have I ever heard of it happening from the people I talk to on the web. You do what you are comfortable with, subject to doctor's orders.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

Up-dated 10th July 2009


Other's Stories

This is an index page for the stories of others that I happen across on this journey. Stories that uplift me, or I learn from, or those I just found interesting and enjoyed reading.

Maybe others will enjoy them as much as I.

xita's Story When I was diagnosed my A1c was 10.4 I finally had another test and my new A1c is 5.1 I am so happy I needed to tell someone... When I started this journey nearly 8 months ago I weighed 256 pounds. I am now 193.

Jennifer's Story Eight years ago today I was diagnosed with T2 diabetes. I was very afraid...

Good Advice, Bad Advice - Nicky's Experience My doctor is adamant that I shouldn't test, and that I should base my diet on whole grains. OTOH, I have an A1c of 5.5% ...

LuckyKat My name is Kathy and I am both a horror story and a diabetic survivor.Let me start with my family history. My mother was a Type 1.5 diabetic. My Father is a type 2 diabetic. My brother is a type 2 diabetic. Me --I am a type 2

Turning Points My story.

Inspiration nanna2six' story. When I was diagnosed in April 2008, I wasn't sure where to start. I went in for my annual exam, on a Friday, on the following Tuesday the nurse called and said I needed to repeat my glucose test because it was a "little high". I said how high? She said 289.

Lisa's Story My story begins like most of us: hearing that my fasting blood glucose (BG) reading put me over the “limit.” No prediabetes, do not pass go, go directly to full-on diabetes. No “get out of jail free” card for me. This had been on my radar for quite some time. Oddly, it still took me by surprise. 

George's Story Hi. I am George_M. What follows is my story, and why I feel so lucky to have diabetes.

Tammy's Story I will never forget that morning. It was Tuesday, May 29th, 2013 and was two days before my 42nd birthday. My doctor called to tell me I had diabetes and I needed to see my endocrinologist right away. My A1C was 10.7 and this could not wait. My heart was racing, and I really don't remember driving home. I cried all the way home in a complete state of panic. My name is Tammy and I am a registered nurse, having spent most of my career working in ICU.

Weight Loss Cooking and Eating Plan

Alan’s "Everything in Moderation " Cooking and Eating Plan

Allied Posts:
Cooking as a Survival Skill
Recipes
Dieting for Life - What's in a Name?

Weight Loss Phase

Background.

This is not so much a diet as a general guide to cooking and eating. There are no absolutes. If you find any value in my experience – terrific. However, what follows is purely my own method of dealing with my own situation. It is also a work in progress – because what I needed was a "way of eating" that I could comfortably follow for the rest of my life. Not just a short-term weight loss diet. The plan was developed over a few months after I was diagnosed with diabetes and leukemia in early 2002. It is based on a distillation of research on the internet, advice from doctors, a course with a dietitian and general reading on the subject over some years.

It is titled "weight loss phase" because I did it in stages – first I lost weight, then used my meter to modify my menu for better blood glucose numbers, then I refined the result to improve various other aspects for health and nutrition. I’ll post on that later. In April 2002, at the time I was advised I had type 2 diabetes, I weighed 117 Kg or 257 lbs. Like many fat people I was adept at not getting my photo taken so I don't have many to choose from that era.


By Christmas 2002 I weighed 94 Kg or 207 lbs, a loss of 23 Kg or 50 lbs. Equally important, I was reasonably fit (apart from a few incurable diseases!), I didn’t feel hungry and I didn’t put it all back on over the Christmas/New Year feasting period. This is taken in Pisa in May 2003 on our first World Trip, the other was taken in August 2006 in Hawaii on the second trip.

I wrote the first version of this in early 2003, when some friends on the CLL list asked for a copy of my "diet". So I had to write it down for them. Since then I’ve travelled a lot, eaten out a lot, and learnt a lot. And I’ve still kept the weight off. I’ve re-written it slightly to be specific for type 2 diabetes. So I’ve worded it on the assumption that not only does the reader need to lose weight – but also wants to reduce excessive blood glucose (BG) numbers. In effect, to compress my first two phases into one. This is only the starting point. As time goes on and weight comes off the constraints on fat can be eased – but your meter will show you that the constraints on carbohydrates tend to remain.

General Guidelines.

Reduce Meat portion sizes

Start by halving, then adjust as required.

Reduce Quantity of Red meat Portions

Replace them with fish.

Increase Vegetable serves

Particularly greens and low Glycemic Load veges, to create fullness. Cabbage, celery, broccoli, spinach, silverbeet(chard) is your friend.

Increase Omega III fish meals

Salmon, sardines, tuna etc, preferably fresh rather than canned.

Minimise Milk

All types, regardless of fat content. Skim milk will actually cause bigger BG spikes. Cheese – I eat full-fat cheese, but less of it; I cannot stand "plastic"low-fat cheeses. I use low-fat cheeses like cottage, ricotta, Philadelphia in dips where I can add flavours. Take Calcium supplements if necessary to replace the loss of dairy calcium - however I added some yoghurt which helped there (see later).

Good Snacks

Fruit in moderation (use your meter to define moderation), nuts in small portions, avocado. Low-fat crackers or vegetables with dips such as hommus or guacamole etc. Slices of crisp veges (celery, carrots etc) with dips. Experiment with cottage cheeses, ricotta, lo-cal Philly, avocadoes, onions, peppers etc. Add a little plain yoghurt to your day, flavoured with fresh or frozen berries and a little artificial sweetener. If you must have a slice of bread, leave off the marg/butter and use a thin smear of the spread (not jam) of your choice. And make it a half-slice.

Lots of Variety

Vary meals and menus as much as possible to prevent boredom. Experiment by creating tasty dips etc for snacks, adding unusual spices to casseroles or marinades etc (but always have a stand-by in the freezer to allow for the occasional inedible disaster).

Guilt and Failure

I allow myself a "guilt-free" day or meal occasionally. Pizza, fish and chips (deep-fried battered fish with french fries for those people who drive on the wrong side of the road), chocolates etc. However, try to keep the portion size to a minimum or cook it at home (see tips below). Yes, I know, it’s impossible to eat one chocolate out of a full box. But try. If you allow this luxury it makes it easier to return to the plan, rather than to think "well I’ve blown it, so what the heck!".


Cooking and Preparation Tips

Saturated Fat Elimination/Reduction

Trim all fresh meats carefully to discard as much fat as possible. Do not use processed meat (e.g. all sausages, salami, bologna, chicken roll etc.) Do not eat take-away chips (fries) etc. Most are cooked in saturated fats. Substitute deli sandwiches (careful of the bread – I often discard the top piece) , salads etc for take-away. If you’re caught with a group at a take-away have salad (watch the dressing), skin-free chicken or just a very small serve. Grill (Broil?) meats when possible so that fats drain during cooking.

Other Fats

Although some other fats are good, I still try to reduce their quantity. Use cooking sprays instead of butter or spoonfuls of oil for cooking. Use a thin smear of mayo or a spread you like instead of marg/butter on sandwiches or rolls and don’t have the top half of the bun or the top slice of bread. Experiment. Cook casseroles in advance and cool in the refrigerator (or strain the liquid and cool separately before re-combining). The saturated fat will rise to the top and solidify and can be removed before re-heating or thickening. Similarly, reduced fat gravies can be made from pan juices by pouring them off into a jug and skimming. Add some ice cubes to speed up the process if the diners are waiting. They will still contain fat, but not as much.

Use a non-stick pan or griddle. Most meats will not need additional oil to cook, or will only need a light spray from a cooking oil. If you must deep-fry (a rare luxury – see "guilt-free" days), use a vegetable oil (preferably peanut, not palm or coconut), wait until the oil is at the correct temperature before adding the food, don’t overcrowd the pan (this would reduce the temperature and cause the food to absorb more oil), and drain the fried food well on kitchen paper before serving. When I say it’s a luxury, I fry fish once a fortnight (two weeks) but I oven fry the chips.

Oven fry french fries – cut them large (not like thin McDonalds), throw them in boiling water until not quite cooked (still firm), spray an oven tray with cooking oil then place the "fries" on the tray and spray again lightly. Cook in the oven at about 200c (390F) until done. Use your meter to see what portion size you can handle. Mine is three chips.

Sugars

I won’t buy into the arguments about sweeteners. People say some may give you cancer. Do you think that worries a Diabetic/CLLer? Find the sweetener and lo-cal drink that you like (or that you dislike least) and consider all things flavoured with sugar as poison. If you must eat them, make it a special and rare treat.

Carbohydrates

You need carbs for energy, fibre and brain food, but steer clear of the white starches. A moderate intake of grains, cereals and legumes will keep you regular, reduce the risk of bowel cancer and provide variety in your diet without adding excess weight (provided you are sensible about portion sizes). However, once again – your meter will be your guide to your limits there. It is likely that you will be cutting back drastically on your present carb intake- add other sources of fibre, particularly leafy or green veges; I also add psyllium husk to my daily menu for extra fibre without extra kj/cals or BG spikes.

Drinks

Water, lo-cal soft drinks, tea, coffee. Nothing with a sugar content, including excessive milk (lactose). Check soy milk for fat and sugar content. No juices. Coffee is OK subject to moderation in caffeine intake – watch the milk content. Try cinnamon instead of sugar or cream.

Alcohol

Alcohol is a very personal issue, so that is one to be discussed directly with your doc. Personally, I drink 2 or 3 glasses of good red wine a day. One of the pleasant things I discovered by blood glucose testing is that a good red wine helps reduce my numbers. Unfortunately, too much of a good thing makes them go up again! I have the occasional (2 or 3 a week) scotch or rum and lo-cal mixer. This is probably more than the doctor would recommend – but (as I’ve learnt) life’s too short to give up all the good things.

Nutrition Labels – Important!

Learn to read nutrition labels on the packet. Until you start to read them you don’t realise just how much variation there is in the fat, carbohydrate and sugar content of the products you buy. Modify your purchasing habits as a result. If an article is advertised as low fat or low cal but there is no nutrition detail – it’s probably false advertising. Be very wary of "lite" or "97% fat-free"; they often compensate for the reduced fat by increasing the sugar content and can contain more kilojoules/calories than the standard product.

My Personal Diabetic Eating Rules

These apply only to me. They may or may not apply to other type 2 diabetics. Find out what does apply by testing one and two hours after every meal or snack until you know what you can eat, when you can eat it, and how much you can eat in a serve.

There are five small meals a day – breakfast, lunch, afternoon tea, dinner, supper, not more than three to four hours apart. No carbohydrates before lunch, then I gradually increase carbs at each meal until supper. I eat my cereal as my final meal (my morning regularity has significantly improved).

Minimise or eliminate serves of white starches, most fruits, all high Glycemic Index (GI) foods. Replace high GI with low, e.g. multigrain bread for white etc.

Maximise low-carb and low GI vegetables such as cabbage, celery and cauliflower.

Jams, high sugar relishes, high fat and high sugar crackers etc are poisons that other people eat. Convince your mind that these people don’t know how bad they taste. It’s a mind game, but don’t start telling your partner not to eat them unless you want a divorce.

Discipline

Set a healthy target in consultation with your medics, then set smaller targets (say 2.5 Kg or 5lb) on the way to your goal and celebrate in some way each time you reach the target. Involve those you care about so that they can encourage you. It won’t work if you quit, and you will quit if you don’t get results. Weigh yourself regularly and record the results. Don’t get dejected if the waistline or weight doesn’t go down every day – the body seems to take time to adjust to the changes. In my case I lost 3 Kg (6 ½ lbs) in the first week, but this stabilised to an average of about a kilo (2 lbs) per week and later to half a kilo. There were some weeks or months when I seemed to hover or even go up, but then I would lose a lot in the next week.

Postscript and Restaurant Eating


PS. Aug 2003. After writing the original cooking and eating plan we spent five months travelling the world. I didn’t gain weight but we left a reputation behind us as Aussie cheapskates because, wherever we went, we would order one main course and a spare plate for the two of us. It took some cheek, but we didn’t put the weight back on (and also saved some cash :-) Where it wasn’t possible because of language or embarrassment of others, we would order a main course and a side salad or starter – just to get the plate – then mix between the two. This allowed me to leave the high GI or high carb items for my non-diabetic wife.

We often found that we still left food on the plate, even when we shared. Because the food is actually the smallest cost in running most restaurants many provide enormous serves to attract customers. If you are eating alone in a restaurant it takes more discipline to leave over half the food when you know you are paying for it. But if you eat it, you will pay much more eventually. Specify that you absolutely, definitely do NOT want chips/fries. Many restaurants add them automatically.

Cheers, Alan, T2, Australia.

Everything in Moderation - Except Laughter

Test, Review, Adjust


When I was first diagnosed, the doc told me to "lose 8% of my body weight" (117Kg, 257lbs at that time) and test my blood glucose before breakfast and before the evening meal. My HbA1c was 8.2%. 8% of 117Kg was 9.4Kg or a little over 20lbs.

So, I did that after designing my own way of doing it using my Weight Loss Cooking and Eating Plan and decided to just keep going after I passed the 8%. In the initial plan I tried to follow the diet guidelines on the pamphlets from Diabetes Australia (DA) - which are much the same as those from the American Diabetes Association (ADA) but I also included tricks and tips from many past diets. The final version is now significantly different.

My A1c only dropped to 7.5% despite losing the weight, so during that period I decided to attend a dietician’s presentation at the local support group meeting. Later, in another post I’ll chat more about dieticians, DA and the ADA. To put it briefly – the high-carbohydrate low-fat guidelines were a disaster for me.

There are interminable arguments these days about "low-fat" versus "low-carb". To be honest - I'm not interested in those definitions. What I was looking for is the "low-BG spike, excellent nutrition" menu that suited Alan. As to the "low-BG spike, excellent nutrition" menu that will suit you - you'll have to test to find your own. Here's how I did that.

I found misc.health.diabetes on usenet and eventually I was directed to Jennifer’s famous Test, Test, Test advice. I’ve also provided a link on the side-bar. Jennifer is not a doctor either – just another type 2 diabetic. But that advice works. And it’s free.

I started following her advice and the results, in a very short time, were quite dramatic. My fasting blood glucose and A1c started going down, my after-eating (post-prandial) numbers dropped rapidly, the occasions when I suffered "lows" with the shakes and nausea a couple of hours after meals disappeared, and my weight loss re-commenced after being stalled for a few weeks.

Take the time, right now, to read it and print it out. Then come on back.

One of the reasons it works so well is that it allows us to discover what works for us as individuals – and what doesn’t. Over time I modified that advice to suit myself. Eventually I had tested often enough at one-hour and two-hours after meals to know the peak blood glucose (BG) spike timing. Once I knew that, I found I only needed to test at the peak unless the number was too high and needed a further check an hour later.

I tested a lot in those first few weeks, but the high volume of testing reduced quickly as I learned and results became predictable. If the thought of a lot of testing worries you, see how to test without pain in my post on Painless Pricks

These days I still test more than most diabetics – but nothing like those early fact-finding days. Then, as I cut or reduced the "danger foods" I reviewed the resulting menu regularly to see if I was missing anything important; over time I added, and tested, lots of new things – especially vegetables and fish – as a result. More on that in a later post.

I added some supplements, but very few. I only add a supplement if I cannot find a way to meet the need from my menu. Thus, I added Psyllium husk for fibre and calcium to compensate for a drop in dairy consumption.

To summarise, it’s as simple as this:

Start with whatever you eat now.

Eat, then test after eating at your spike time and if BG’s are too high then review what you ate and change the menu next time. Then do that again, and again, and again until what you eat doesn’t spike you. You will get some surprises, particularly at breakfast time. The so-called "heart-healthy" Breakfasts are NOT for most type 2's. Similarly, you will find variations through the day - the same thing will have different effects at breakfast, lunch, dinner and supper. But I can't say how they will affect others - only how it affected me - which is why we all need to test ourselves.

As you gradually improve your blood glucose levels, review the resulting way of eating to ensure adequate nutrition, fibre etc are included and adjust accordingly.

Then test again.

Test, review, adjust, always towards better and better blood glucose levels.

And no - you won't have to test so intensively for the rest of your life. As time goes on and you build your knowledge you won't need to test as often because many of your results will become predictable as your numbers improve. You will be building your own personal Glycemic Load database. As that happens you can reduce the intensive testing to "maintenance" levels. I still do two or three fasting tests and several one-hour post-prandial tests randomly each week. Just to be sure that things aren't changing. I may do a few more if I am adding a new dish to the menu or trying a new restaurant. But I no longer need to test after every meal or snack.

Finally – add at least 30 minutes of exercise to your day – but that’s another post.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

Getting Started

Diagnosis Day

I had two options here. A chat about my own D-day, or some ideas for people reading here who just got the news.

I’ll leave the chat for some other time.

So, you’ve just found out you have type 2 diabetes? Or Impaired Glucose Tolerance? Or Pre-diabetes? Or the doctor said "you’ve got a touch of sugar" or something similar?

And you’re in shock?

Why me?

Well, I don’t really have an answer for that. To me it seemed bloody unfair. Why me? And I railed against the world for a while – but then I decided to get on with it. Because I can’t change the past, and how do I correct the mistake of choosing the wrong grand-parents? Particularly as I liked mine:-)

So my first suggestion to any newly diagnosed person reading this is the most important one of all:

It’s NOT your fault. Take a deep breath, sit back, and relax.

Forget the hype and the TV ads about obesity (10-15% of type 2’s are normal or underweight at diagnosis), lifestyle, whatever – that’s in the past, even if it was relevant, and there’s not a damn thing you can do about it.

OK – so you’ve got a flawed glucose/insulin system. I don’t care what label they put on it, or what stage you’re at – what matters is what you intend to do about it. So first, the good news. Unless you’ve been diagnosed at a very late stage, this is a slow-moving disease – you have time to learn, time to correct things, and time to improve your health for a long-term future. And there is more good news: nearly every person I’ve met who used this diagnosis as a kick-start to get fitter and healthier has improved all sorts of other aspects of their health at the same time.

What to do next? I’ll give some detailed ideas based on what I did in the next post. But there are some general points first. In everything I say, I assume that anyone reading here will always be seeing their doctor on a regular basis, be taking the medicines prescribed by their doctors, and checking any suggestions here with their doctors.

However, never forget that the person who will be most affected by poor advice from any source will be you – not me, not your doctor, but you. In my opinion, more than nearly any other condition, the success of management of diabetes depends on the diabetic. So, while your medics can advise and prescribe – it’s your decisions and your actions that will decide your future.

In broad terms, this is the plan, in addition to anything the docs prescribe:

1. If you are overweight – lose it. I’ve posted some ideas on what I did as my Weight Loss Cooking and Eating Plan

2. Obtain a blood glucose test meter. Until you do, here are some tips on What to Eat Until You Get Your Meter.

3. Learn how to test your blood glucose (BG). I’ve posted some hints on painless testing methods as Painless Pricks

4. Use those tests to adjust your menu to get those blood glucose numbers into the non-diabetic range. I've given some ideas on how to do that in the next post titled Test, Review, Adjust

5. Add at least half an hour of moderate exercise to your day. That’s a minimum, not a maximum. If that’s a new activity for you, start easy and work up slowly – but do it.

6. Later, as your diet for optimum weight and optimum BG’s starts to work, review it and adjust to ensure you aren’t missing anything vital.

There’s more – but that’s enough to start with. So stop reading, go and have a glass of wine or a diet soda and think about something else for a while:-)

And remember my sig:

Alan, T2, Australia

Everything in Moderation - Except laughter