Post by Steve on Nov 11, 2017 17:01:42 GMT -8
Two tips for getting better! Proven by the Human Lab Rat:
No.1: Keep Good Records
It’s one thing to test your estimated average glucose (eAG) daily (and of course you do, right?) and presumably jot down your numbers in a notebook. Did I say numbers, plural? Yes, because you also want to track your blood pressure (BP) so you can see trending and work on improving things before time slips by. Not to mention having real info to show the doctor when the tech takes your BP. That shows no trend.
It is awkward to realize that my own improvements have not been the result of great medical care! Oh, I have had good care for the things that have gone wrong, after the fact, but as for help beforehand? I’m not impressed. And it took a few years to realize what was missing? And that’s what this forum is trying to fix.
Once it struck me that I was on a simple repeat loop with doctor visit, test results, come back in four months, it made me want to get past the boilerplate and same pills! I trusted the ADA 〈American Diabetes Association〉 and other sources when they advised a guidelines for carbs per meal, offering two levels: one for men, another for women. Add to that my naive belief that since doctors learn their stuff from the same books and go into practice with the same basic information on how to fix things, there must be a common approach? Oh sure, individual ideas are inevitable, but stemming from a standard template. And of course the ultimate naiveté that diabetes is so common that it must be generally well-understood! Hah! How did it take me so long to wake up?
Once I started keeping records of daily GL, BP, and meds taken, it didn’t take long before I could see where work was needed. Turned out that even when I thought my BP was good and generally stable, it wasn’t. When some nurses could see my records, I learned that my BP was putting me into the prehypertension category. A once every few months check at the doctor will almost always be higher than what you see at home. But having a list of 90+ days? Now you can see a trend. And of course daily tests for eAG will help you see where last night’s dinner may have been a little overboard. A list of morning tests is good on paper but better yet, put the numbers into the computer and easily see highs, lows, averages, etc. I made a little app that actually calculates the averages and offers a predicted A1c for a 90-day test period, clearly showing how daily variations affect the potential result.
Wait, what? It’s true. Using a formula found here, you can keep daily records and see every day what you are headed for when it's test time. Of course this is not an absolute because it only uses a few samples per day, probably done at lowest times and missing the inevitable spikes after eating. The A1c will track every hour of the days and nights for a test period. My most recent prediction was a 5.3. I just got my results: it is 5.8! Not bad.
The app I made only works on an iPhone or iPad, but realizing it should be universal, I am putting it into a spreadsheet that will work on a Mac (in Numbers) or PC (in Excel). If this interests you and you are a user of Excel and want to build your own simple tool, the formula is "A1c = (46.7 + average_blood_glucose) / 28.7”. I’ll assume you know how to format cells to average a list of 90 daily entries and then convert that number to a percentage. Otherwise, when I have polished my effort, I will post a working spreadsheet you can use with your program. Keeping numbers in a database has helped me make great progress.
No.2: Pay Attention to your Food…Generally!
No bulletin here. Of course you know your food put you here and keeps you here, but it can also be your way out with a lot more attention. Usually! You know it’s all about carbs. Go ahead and eat your steak or lamb chop. no carbs in meat. But everything else, from a carrot to an ice cream bar, is carbs. You know it’s expected that you cut down on carbs but it’s so hard! (read that with a drawn-out whiny voice like a resisting child.) Well here’s the deal: it isn’t that hard. Just remember the number 55. Now all you need to do is eat foods that have a rating of 55 on the glycemic index (GI) Usually.
By now you should know what this refers to. The glycemic index rates foods compared to pure sugar, which rates the top spot of 100. Everything else is lower, and that is the first part. Then these foods are rated according to glycemic load (GL). That is how the long-chain carbs flatten the spike: a lower high that takes longer as the complex carbs are broken down in digestion. That’s an easier hit on your diabetic body. So the foods you want to eat (usually) are rated at 55 or lower.
[To find a food's GL, multiply its GI by the number of carbohydrate grams in a serving, and then divide by 100. ]
You have heard the phrase, “Moderation in all things, including moderation!” This Human Lab Rat is able to report that I do not take potent diabetes meds, I do not consume 60g of carbs per meal, and I really don’t get any exercise. I do choose my foods from the list of 55 or lower, and I pay attention to my records. I keep my daily blood numbers near 100 for eAG and 120 or less for systolic BP. If I go higher, I know what I did that caused the bump and I correct that by the next day. Usually.
My new motto is Meals as Meds, Portions as Pills.
No.1: Keep Good Records
It’s one thing to test your estimated average glucose (eAG) daily (and of course you do, right?) and presumably jot down your numbers in a notebook. Did I say numbers, plural? Yes, because you also want to track your blood pressure (BP) so you can see trending and work on improving things before time slips by. Not to mention having real info to show the doctor when the tech takes your BP. That shows no trend.
It is awkward to realize that my own improvements have not been the result of great medical care! Oh, I have had good care for the things that have gone wrong, after the fact, but as for help beforehand? I’m not impressed. And it took a few years to realize what was missing? And that’s what this forum is trying to fix.
Once it struck me that I was on a simple repeat loop with doctor visit, test results, come back in four months, it made me want to get past the boilerplate and same pills! I trusted the ADA 〈American Diabetes Association〉 and other sources when they advised a guidelines for carbs per meal, offering two levels: one for men, another for women. Add to that my naive belief that since doctors learn their stuff from the same books and go into practice with the same basic information on how to fix things, there must be a common approach? Oh sure, individual ideas are inevitable, but stemming from a standard template. And of course the ultimate naiveté that diabetes is so common that it must be generally well-understood! Hah! How did it take me so long to wake up?
Once I started keeping records of daily GL, BP, and meds taken, it didn’t take long before I could see where work was needed. Turned out that even when I thought my BP was good and generally stable, it wasn’t. When some nurses could see my records, I learned that my BP was putting me into the prehypertension category. A once every few months check at the doctor will almost always be higher than what you see at home. But having a list of 90+ days? Now you can see a trend. And of course daily tests for eAG will help you see where last night’s dinner may have been a little overboard. A list of morning tests is good on paper but better yet, put the numbers into the computer and easily see highs, lows, averages, etc. I made a little app that actually calculates the averages and offers a predicted A1c for a 90-day test period, clearly showing how daily variations affect the potential result.
Wait, what? It’s true. Using a formula found here, you can keep daily records and see every day what you are headed for when it's test time. Of course this is not an absolute because it only uses a few samples per day, probably done at lowest times and missing the inevitable spikes after eating. The A1c will track every hour of the days and nights for a test period. My most recent prediction was a 5.3. I just got my results: it is 5.8! Not bad.
The app I made only works on an iPhone or iPad, but realizing it should be universal, I am putting it into a spreadsheet that will work on a Mac (in Numbers) or PC (in Excel). If this interests you and you are a user of Excel and want to build your own simple tool, the formula is "A1c = (46.7 + average_blood_glucose) / 28.7”. I’ll assume you know how to format cells to average a list of 90 daily entries and then convert that number to a percentage. Otherwise, when I have polished my effort, I will post a working spreadsheet you can use with your program. Keeping numbers in a database has helped me make great progress.
No.2: Pay Attention to your Food…Generally!
No bulletin here. Of course you know your food put you here and keeps you here, but it can also be your way out with a lot more attention. Usually! You know it’s all about carbs. Go ahead and eat your steak or lamb chop. no carbs in meat. But everything else, from a carrot to an ice cream bar, is carbs. You know it’s expected that you cut down on carbs but it’s so hard! (read that with a drawn-out whiny voice like a resisting child.) Well here’s the deal: it isn’t that hard. Just remember the number 55. Now all you need to do is eat foods that have a rating of 55 on the glycemic index (GI) Usually.
By now you should know what this refers to. The glycemic index rates foods compared to pure sugar, which rates the top spot of 100. Everything else is lower, and that is the first part. Then these foods are rated according to glycemic load (GL). That is how the long-chain carbs flatten the spike: a lower high that takes longer as the complex carbs are broken down in digestion. That’s an easier hit on your diabetic body. So the foods you want to eat (usually) are rated at 55 or lower.
[To find a food's GL, multiply its GI by the number of carbohydrate grams in a serving, and then divide by 100. ]
You have heard the phrase, “Moderation in all things, including moderation!” This Human Lab Rat is able to report that I do not take potent diabetes meds, I do not consume 60g of carbs per meal, and I really don’t get any exercise. I do choose my foods from the list of 55 or lower, and I pay attention to my records. I keep my daily blood numbers near 100 for eAG and 120 or less for systolic BP. If I go higher, I know what I did that caused the bump and I correct that by the next day. Usually.
My new motto is Meals as Meds, Portions as Pills.