RE: Postprandial readings, cholesterol testing and more

[Guest guest]

I sort of eat Vegetarian as I try to avoid meat, especially beef.

My dietician said there are a couple of nutrients that vegetarians

need to be sure they get. I take a multi-vitamin for seniors without

iron and twice a week I take one with iron. I am 62 and have had

Diabetes Type II for a little over a year and am doing well with

exercise and diet.

The diabetes classes I took were invaluable and I attend a diabetes

support group once a month. My insurance paid for most of the fee and

I received lots of handouts and information to refer back to later

along with recipes. We were taught how to check our blood and when.

Also advised to keep a food diary along with the record of our bg

levels. Then if you are having a problem with your bg being high,

the dietician can see if it is what you are eating and help you

change your diet. She can also help you plan so that you can eat

perhaps small amounts of a favorite no no food!

I was eating some Sugarfree candy my daughter brought me and also

those sugarfree cookies. Not a lot at a time. Anyway I was having

tremendous amounts of gas and couldn't figure it out. The dietician

said it was the sugar alcohol in the candy. I now use Beano when

I eat stuff with sugar alcohol and it really helps.

I asked the same question you did a few weeks ago on this list about

how many people were keeping or had kept in the past, their bg in

control with diet and exercise and I think I only got one answer

so most of the people here must be on meds. There was a lady who

spoke at our diabetes group that had it for 5 years. Her A1c was

4.8. She worked out at the gym, lost a lot of weight and wrote

down everything she ate. She had tablets with everything she

had eaten in the last 5 years. She said she bought diabetes

cookbooks but didn't use them. That she learned to eat regular

food like everyone else but controlled her serving sizes.

I eat a lot of soy products instead of meat. Sausage links and patties,

bacon, chix nuggets, hot wings (can't think of the name), beef-like patties,

etc. I like some of the Go-Lean cereals. The Go-Lean crunch makes a nice

snack you can carry with you.

I carry Glucerna meal and snack bars or fruit with me all the time. It is

important to eat at regular times.

My doctor, like yours, told me to keep my bg below 140. It went over 180

when I had pneumonia. If it goes over 200 I am to take a pill that I keep

in my purse only after I try exercising first.

We learned at the diabetes classes and meetings that your home glucose

meters can be as much as 10% wrong in either direction.

What did you eat at the Health Fair before your test of over 180?

How long was it between the food at the Health Fair and your last

meal or snack and what was that?

[Guest guest]

window199 wrote:

>Here are my questions:

>

>1.I have seen some publications that suggest that a postprandial

>reading of less than 180 for a diabetic is acceptable. As I said my

>doctors have always told me to aim for 100 – 140, but I am just

>curious ………… ..does anybody know what the average postprandial (1 and

>2 hours) readings are for a non-diabetic?

>

http://www.joslin.harvard.edu/education/library/wbggoal.shtml

or http://tinyurl.com/2dmg3

The above link will take you to the Joslin Clinic's web page where they

show non-diabetic levels. The Joslin Diabetes Clinic is a leading, well

respected diabetes clinic and research facility and is associated with

Harvard University.

Until about a year ago, you could easily find standards for 1-hour

postprandial bgs. But since then, a study came out linking death by

heart attack to the 2-hour postprandial reading. Since then the emphasis

for our self-care has shifted to the 2-hour reading. The 1-hour reading

isn't given much weight any more. However, it's still possible to find

older, obsolete advice on the Internet which were written before. Those

of us who have been hard-core diabetics for longer than one year, tend

to strive for 1-hour readings which are better than 180. Perhaps it's

not necessary. Perhaps we do it from force of habit. Perhaps we're

untrusting of lax medical advice, since medical advice keeps changing.

Yesterday's cutting edge medical advice is today's charming, ignorant

medicine. Leeches, anyone?

Most of the medical advice you find is based on the recommendations of

the American Diabetes Association (ADA), which sets diabetes policy in

medical circles. The sort of person who joins mailing lists like this

tend to be the high strivers. Much of the diabetic advice issued by the

ADA seems to be directed to low striving diabetics, diabetics who don't

receive adequate training from their doctors or on their own. The ADA,

it appears to many of us, tends to set the bar low so as not to frighten

off these diabetics. Most of these diabetics just want to pop a pill and

not worry about anything else. If they don't meet standards, they tend

to just give up rather than try harder. The ADA wants them to at least

make minimal efforts to control their diabetes rather than give up

entirely. Thus you have 1-hour postprandial recommendations of 180. In

some places, I've seen recommendations of under 200. Unfortunately, you

won't find a single, consistently recommended set of goal numbers in

your searches.

If you're looking for a 1-hour postprandial recommendation, mine is 160.

Some recommend 140.

The Joslin standards for non-diabetics show maximum readings. Most

non-diabetics run numbers which are considerable lower. Joslin tells us

that the maximum 2-hour postprandial for a non-diabetic is 140, but many

run around 80 or 90.

>2.From my research I have gathered that T2 diabetes is a progressive

>disease, and even if I manage to use diet/exercise alone to manage my

>diabetes there will come a time again when I will require oral

>medication and/or insulin. Is anyone aware any research on T2

>diabetics who manage their disease through diet and exercise?

>

Perhaps some exists, but I'm not aware of any such research. Here's

another issue: Most research you read will tell you than one terrible

health calamity or another will befall " diabetics. " I really haven't

seen much, if any, research that distinguishes between well controlled

diabetics and poorly controlled diabetics. Most diabetics are poorly

controlled. The few bits of research which estimated A1c's for groups of

diabetics usually city A1c's of 7 or 8 and average. The DCCT and the

UKPDS both showed that complications develop at dramatically lower rates

in well controlled diabetics, but other research doesn't seem to make

that distinction.

It may be no more than an article of faith, but most list members tend

to believe that good control will slow or, if we're lucky, stop

progression. High glucose levels are toxic to beta cells. Perhaps being

uncontrolled hastens progression. No one really knows, so the best bet

seems to be good control.

As for postponing the use of medications, it's a controversial topic.

Today, there are different kinds of oral medications. The oldest

medication is the sulfonylurea family of drugs, which stimulate the

pancreas to produce insulin. Many diabetics tend to believe that making

the pancreas work harder may " burn out " beta cells and hasten

progression, but there's no clear research that backs that idea up. In

fact the UKPDS, showed that Type 2's on sulfs didn't progress any faster

than those who were not. But many people take a " better safe than sorry "

tack, and try to avoid sulfs. Two other drugs, Starlix and Prandin,

stimulate the pancreas, but for a much shorter amount time, so perhaps

they don't hasten progression, or don't hasten it as much as the sulfs.

Glucophage doesn't stimulate insulin production. It improves insulin

resistance and inhibits the liver from releasing as much stored glucose.

There has been on-going research to learn whether pre-diabetics may

postpone diagnosis by taking Glucophage. I believe the issue here is

insulin resistance. So perhaps taking Glucophage may be a good thing.

Actos and Avandia work by improving insulin resistance as well.

And there is even a bit of research which found that progression is much

slower in new diabetics who are started on insulin immediately. The

though here is that injected insulin actually " rests " the pancreas. So

perhaps started insulin right away is the best way to preserve your

pancreas function.

Nevertheless, many people prefer not to take medication of any kind. So

the best of luck to you.

>3. I had a total, non-fasting (I had eaten 1 hour and 45 minutes

>before the testing) cholesterol testing at a health fair yesterday.

>It came back with a total cholesterol of 184. That was higher than I

>expected. I am just curious if anybody knows how reliable these

>tests are? I am not due for another cholesterol test with the lab

>for another month.

>

I've heard the tests at health fairs don't tend to be terribly accurate.

But who knows, perhaps the tests have improved. One issue I've heard is

that tests only give total cholesterol. Knowing the LDL and HDL is

important, and the health fair tests don't give you that.

>4.Lastly are there any T2 diabetics on the list who are following a

>vegetarian diet?

>

I'm not. Many diabetic find they do best on low carb diets. I understand

a vegetarian diet is more challenging for a diabetic since veggies tend

to have lots of carbs, nevertheless, there are vegetarian diabetics. If

you haven't already, you might do a Google search for vegetarian

diabetes diet. I've seen sites out there.

>Oh by the way please everyone wish me luck as I try to embark on the

>managing this disease through diet and exercise.

>

By all means: good luck.

Edd

[Guest guest]

Hi, Debra...I see no one has answered your questions. I was waiting to

see if anyone did, because I just don't know the answer to #1, 3 and 4.

Re #2 -- I can only answer from my own experience and what I've learned

on the list. I'm not a type 2; I'm a type 1 on insulin. But frrom what

I've learned here - and my own experience so far - if you can keep your

BGs in the non-diabetic range, i.e. A1Cs no higher than nondiabetics --

you may be able to indefinitely postpone the progression of diabetes.

All labs are different, though, so in order to find out what your lab

normal is, be sure to get a copy of all your lab tests. Then aim for

the normal " nondiabetic " number. In my lab, it's 6 and under. I've been

diabetic for almost 7 years now and have consistently managed to keep my

A1C under 6 and I have no complications. So far, so good!

I don't know why the list is so quiet right now. I'm sure others have

had experience they can share re your other questions. You lurkers out

there -- this lady needs some input from you. Please speak up!

Vicki

Postprandial readings, cholesterol testing and

more

> Can anyone provide me with some information? When I was diagnosed

> with T2 diabetes 8 months ago I was told to take my postprandial

> reading two hours after eating. The range I was told to hit was

> between 100-140. Thank God I have had no problem staying in that

> range since losing weight. In fact I have now started taking my

> postprandial reading 1 hour after eating and my numbers average

> between 82 to 115. I am only talking 250mg of Glucophage in the

> morning. On my next visit with my doctor I am going to ask him about

> going without medication all together; as I want to see the impact on

> my numbers.

>

> Here are my questions:

>

> 1.I have seen some publications that suggest that a postprandial

> reading of less than 180 for a diabetic is acceptable. As I said my

> doctors have always told me to aim for 100 - 140, but I am just

> curious........does anybody know what the average postprandial (1 and

> 2 hours) readings are for a non-diabetic?

>

> 2.From my research I have gathered that T2 diabetes is a progressive

> disease, and even if I manage to use diet/exercise alone to manage my

> diabetes there will come a time again when I will require oral

> medication and/or insulin. Is anyone aware any research on T2

> diabetics who manage their disease through diet and exercise?

>

> 3. I had a total, non-fasting (I had eaten 1 hour and 45 minutes

> before the testing) cholesterol testing at a health fair yesterday.

> It came back with a total cholesterol of 184. That was higher than I

> expected. I am just curious if anybody knows how reliable these

> tests are? I am not due for another cholesterol test with the lab

> for another month.

>

> 4.Lastly are there any T2 diabetics on the list who are following a

> vegetarian diet?

>

> Oh by the way please everyone wish me luck as I try to embark on the

> managing this disease through diet and exercise.

>

> Regards and Good Karma,

>

> Debra

[Guest guest]

Edd,

Thank you so much for the wealth of info and the link to Joslin.

Regards,

Debra

>

> >Here are my questions:

> >

> >1.I have seen some publications that suggest that a postprandial

> >reading of less than 180 for a diabetic is acceptable. As I said

my

> >doctors have always told me to aim for 100 – 140, but I am just

> >curious ………… ..does anybody know what the average postprandial (1

and

> >2 hours) readings are for a non-diabetic?

> >

>

> http://www.joslin.harvard.edu/education/library/wbggoal.shtml

> or http://tinyurl.com/2dmg3

>

> The above link will take you to the Joslin Clinic's web page where

they

> show non-diabetic levels. The Joslin Diabetes Clinic is a leading,

well

> respected diabetes clinic and research facility and is associated

with

> Harvard University.

>

>

> Until about a year ago, you could easily find standards for 1-hour

> postprandial bgs. But since then, a study came out linking death by

> heart attack to the 2-hour postprandial reading. Since then the

emphasis

> for our self-care has shifted to the 2-hour reading. The 1-hour

reading

> isn't given much weight any more. However, it's still possible to

find

> older, obsolete advice on the Internet which were written before.

Those

> of us who have been hard-core diabetics for longer than one year,

tend

> to strive for 1-hour readings which are better than 180. Perhaps

it's

> not necessary. Perhaps we do it from force of habit. Perhaps we're

> untrusting of lax medical advice, since medical advice keeps

changing.

> Yesterday's cutting edge medical advice is today's charming,

ignorant

> medicine. Leeches, anyone?

>

>

> Most of the medical advice you find is based on the recommendations

of

> the American Diabetes Association (ADA), which sets diabetes policy

in

> medical circles. The sort of person who joins mailing lists like

this

> tend to be the high strivers. Much of the diabetic advice issued by

the

> ADA seems to be directed to low striving diabetics, diabetics who

don't

> receive adequate training from their doctors or on their own. The

ADA,

> it appears to many of us, tends to set the bar low so as not to

frighten

> off these diabetics. Most of these diabetics just want to pop a

pill and

> not worry about anything else. If they don't meet standards, they

tend

> to just give up rather than try harder. The ADA wants them to at

least

> make minimal efforts to control their diabetes rather than give up

> entirely. Thus you have 1-hour postprandial recommendations of 180.

In

> some places, I've seen recommendations of under 200. Unfortunately,

you

> won't find a single, consistently recommended set of goal numbers

in

> your searches.

>

>

> If you're looking for a 1-hour postprandial recommendation, mine is

160.

> Some recommend 140.

>

>

> The Joslin standards for non-diabetics show maximum readings. Most

> non-diabetics run numbers which are considerable lower. Joslin

tells us

> that the maximum 2-hour postprandial for a non-diabetic is 140, but

many

> run around 80 or 90.

>

>

> >2.From my research I have gathered that T2 diabetes is a

progressive

> >disease, and even if I manage to use diet/exercise alone to manage

my

> >diabetes there will come a time again when I will require oral

> >medication and/or insulin. Is anyone aware any research on T2

> >diabetics who manage their disease through diet and exercise?

> >

>

> Perhaps some exists, but I'm not aware of any such research. Here's

> another issue: Most research you read will tell you than one

terrible

> health calamity or another will befall " diabetics. " I really

haven't

> seen much, if any, research that distinguishes between well

controlled

> diabetics and poorly controlled diabetics. Most diabetics are

poorly

> controlled. The few bits of research which estimated A1c's for

groups of

> diabetics usually city A1c's of 7 or 8 and average. The DCCT and

the

> UKPDS both showed that complications develop at dramatically lower

rates

> in well controlled diabetics, but other research doesn't seem to

make

> that distinction.

>

>

> It may be no more than an article of faith, but most list members

tend

> to believe that good control will slow or, if we're lucky, stop

> progression. High glucose levels are toxic to beta cells. Perhaps

being

> uncontrolled hastens progression. No one really knows, so the best

bet

> seems to be good control.

>

>

> As for postponing the use of medications, it's a controversial

topic.

> Today, there are different kinds of oral medications. The oldest

> medication is the sulfonylurea family of drugs, which stimulate the

> pancreas to produce insulin. Many diabetics tend to believe that

making

> the pancreas work harder may " burn out " beta cells and hasten

> progression, but there's no clear research that backs that idea up.

In

> fact the UKPDS, showed that Type 2's on sulfs didn't progress any

faster

> than those who were not. But many people take a " better safe than

sorry "

> tack, and try to avoid sulfs. Two other drugs, Starlix and Prandin,

> stimulate the pancreas, but for a much shorter amount time, so

perhaps

> they don't hasten progression, or don't hasten it as much as the

sulfs.

>

>

> Glucophage doesn't stimulate insulin production. It improves

insulin

> resistance and inhibits the liver from releasing as much stored

glucose.

> There has been on-going research to learn whether pre-diabetics may

> postpone diagnosis by taking Glucophage. I believe the issue here

is

> insulin resistance. So perhaps taking Glucophage may be a good

thing.

> Actos and Avandia work by improving insulin resistance as well.

>

>

> And there is even a bit of research which found that progression is

much

> slower in new diabetics who are started on insulin immediately. The

> though here is that injected insulin actually " rests " the pancreas.

So

> perhaps started insulin right away is the best way to preserve your

> pancreas function.

>

>

> Nevertheless, many people prefer not to take medication of any

kind. So

> the best of luck to you.

>

>

> >3. I had a total, non-fasting (I had eaten 1 hour and 45 minutes

> >before the testing) cholesterol testing at a health fair

yesterday.

> >It came back with a total cholesterol of 184. That was higher

than I

> >expected. I am just curious if anybody knows how reliable these

> >tests are? I am not due for another cholesterol test with the lab

> >for another month.

> >

>

> I've heard the tests at health fairs don't tend to be terribly

accurate.

> But who knows, perhaps the tests have improved. One issue I've

heard is

> that tests only give total cholesterol. Knowing the LDL and HDL is

> important, and the health fair tests don't give you that.

>

>

> >4.Lastly are there any T2 diabetics on the list who are following

a

> >vegetarian diet?

> >

>

> I'm not. Many diabetic find they do best on low carb diets. I

understand

> a vegetarian diet is more challenging for a diabetic since veggies

tend

> to have lots of carbs, nevertheless, there are vegetarian

diabetics. If

> you haven't already, you might do a Google search for vegetarian

> diabetes diet. I've seen sites out there.

>

> >Oh by the way please everyone wish me luck as I try to embark on

the

> >managing this disease through diet and exercise.

> >

>

> By all means: good luck.

>

>

> Edd

[Guest guest]

Sammie,

Thank you for responding to my posting and providing me with such

great information............about my cholesterol test: I did not eat

anything at the health fair. An 1.5 hours before taking the

cholesterol test I had eaten breakfast, which consisted of a small

bowl of oat bran cereal with 1/4 cup of soy milk, a half of a small

apple and a slice of low carb whole wheat bread with a slight drizzle

of olive oil on it. By the way my BG 1.75 hour after eating

breakfast was 114. That was also taken at the health fair.

Regards,

Debra

> I sort of eat Vegetarian as I try to avoid meat, especially beef.

> My dietician said there are a couple of nutrients that vegetarians

> need to be sure they get. I take a multi-vitamin for seniors without

> iron and twice a week I take one with iron. I am 62 and have had

> Diabetes Type II for a little over a year and am doing well with

> exercise and diet.

>

> The diabetes classes I took were invaluable and I attend a diabetes

> support group once a month. My insurance paid for most of the fee

and

> I received lots of handouts and information to refer back to later

> along with recipes. We were taught how to check our blood and when.

> Also advised to keep a food diary along with the record of our bg

> levels. Then if you are having a problem with your bg being high,

> the dietician can see if it is what you are eating and help you

> change your diet. She can also help you plan so that you can eat

> perhaps small amounts of a favorite no no food!

>

> I was eating some Sugarfree candy my daughter brought me and also

> those sugarfree cookies. Not a lot at a time. Anyway I was having

> tremendous amounts of gas and couldn't figure it out. The dietician

> said it was the sugar alcohol in the candy. I now use Beano when

> I eat stuff with sugar alcohol and it really helps.

>

> I asked the same question you did a few weeks ago on this list about

> how many people were keeping or had kept in the past, their bg in

> control with diet and exercise and I think I only got one answer

> so most of the people here must be on meds. There was a lady who

> spoke at our diabetes group that had it for 5 years. Her A1c was

> 4.8. She worked out at the gym, lost a lot of weight and wrote

> down everything she ate. She had tablets with everything she

> had eaten in the last 5 years. She said she bought diabetes

> cookbooks but didn't use them. That she learned to eat regular

> food like everyone else but controlled her serving sizes.

>

> I eat a lot of soy products instead of meat. Sausage links and

patties,

> bacon, chix nuggets, hot wings (can't think of the name), beef-like

patties,

> etc. I like some of the Go-Lean cereals. The Go-Lean crunch makes a

nice

> snack you can carry with you.

>

> I carry Glucerna meal and snack bars or fruit with me all the time.

It is

> important to eat at regular times.

>

> My doctor, like yours, told me to keep my bg below 140. It went

over 180

> when I had pneumonia. If it goes over 200 I am to take a pill that

I keep

> in my purse only after I try exercising first.

>

> We learned at the diabetes classes and meetings that your home

glucose

> meters can be as much as 10% wrong in either direction.

>

> What did you eat at the Health Fair before your test of over 180?

>

> How long was it between the food at the Health Fair and your last

> meal or snack and what was that?