September 17, 2014

Eating to Your Meter

I know you have heard this or eat to your meter. Many people with diabetes refuse to do this and often wonder why their blood glucose readings are remaining elevated. Their doctor sees A1c's that are elevated also and asks what they are eating. Many just don't answer or give what they know they should be eating and the doctor has to assume that their pancreas is not producing enough insulin or that the patient is very insulin resistant.

Yes, more test strips than your insurance will often allow, but if patients are honest with their doctors, and request extra, many doctors will go the extra mile and request the insurance company to provide more for three to six months. Some insurance companies will allow this if they see the A1c's coming down, as they don't want the extra expenses involved with complications.

This is one reason I suggest food logs be maintained as well as blood glucose reading logs. This means extra work and many people with diabetes don't see the value. I say that anything that can help manage diabetes and prevent complications is worth the effort. Life should slow down and people should take the time necessary while eating or immediately after the meal. People can forget an hour later and this robs them of the information that could be of help in determining if they need to reduce the quantity or eliminate a food item from their meal plan.

If you can afford the extra test strips, use them wisely. Continue the testing as soon as your wake up (fasting blood glucose reading) to watch for trends. Then select the meal that is generally your largest meal. Always test before the meal to give you a base for the after meal readings. This is just a suggestion, but after first bite, I start testing at the one-hour mark and test every 15 minutes until the next reading is less the previous reading. I do this every day for a week and then every few months (normally three or four months) until I am comfortable that the time was staying consistent. For me this was about 90 minutes, that was until I started slowing my eating and chewing my food longer. Then the time changed to 75 minutes.

Others that I know start testing at the one-hour mark and test every 30 minutes. Most end up at or near the 85 to 100 minute mark. That is why we tell people that what works for me, may not work for you or your mileage may vary (YMMV). Some people start testing one-half an hour after last bite. The best method is being consistent with when you start testing and the testing interval.

Now, realize that you are measuring the difference between the before and the after meal tests. Most people do not want an increase of more than 40 mg/dl. There are also people that want even less of an increase. We can use this information to determine if we need to curtail the serving size of food we eat, or if this is something we need to eliminate from our food plan. Many people strive to have premeal (preprandial) levels of 80 to 90 mg/dl and post meal (postprandial) levels under 125 mg/dl.

By doing testing, you will often be surprised what can be eaten with a smaller serving size and by counting carbohydrates.

The biggest problem is balancing the nutrition to obtain the nutrients you need including vitamins and minerals. Realize that I am not referring to whole grains which we can live without as the nutrients can be found in other foods that do not spike blood glucose levels as whole grain foods do.

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