The only sensible way to put together a diet that suits your diabetes is to actually see how things affect it and make decisions based upon that. Any other way is stupid actually, just as stupid as neglecting your diabetes by not paying attention to your diet.
People do differ in the amount of carbohydrates they can tolerate, and some require a very low carb diet, while others may choose one just because it improves their blood sugar. There are many diabetics who follow a ketogenic diet which is not only very low carb, it’s also fairly low protein as well, and extremely high in fat. While this may not be for everyone, for reasons I’ll get into in a later article, this, plus the studies that have been done on this, have shown that we don’t need anywhere near the 200 grams of carbohydrate conventional thinking claims we do.
We do need some, but a lot of people do just great on just 20 grams of carbs or even less. I’m certainly not here promoting that but I will talk about it more as we go on because some people might want to try this, and I know of a few diabetics personally who swear by this and think everyone should be on it, for what that’s worth.
What I feel is correct though is for people to at least be checking this and then taking this information they get from testing various foods, and then taking that information into account when they decide what they should be eating.
People are going to have different preferences though as far as what kind of control they are looking to achieve, both from their diet and overall, as well as having various eating preferences that are going to factor into this.
As far as the desired control goes, this isn’t really cut and dried, a lot of people think it is, but when you look at this issue more closely you will see that we’re talking about risk management and risk preferences, as well as competing preferences, as well as other factors that play into this, and the whole thing is actually pretty complicated, and deserves an article of its own, several probably, which I’ll get to later.
We do need to talk about this a little here though for the purposes of this article, and it’s better to actually look at what sort of A1C we want to shoot for here, rather than looking at how high we want to go, and then look to translate that to PP readings, post prandial, in other words after meal highs.
So the ADA and the medical community generally set the meaning of good control as an A1C below 7. 6.5 is where a diagnosis of diabetes is confirmed, and if you look at all the data we have correlating A1C with risk of diabetic damage, we do see that the risk only really starts to climb significantly at 6.5, and below that it’s pretty insignificant.
This doesn’t mean that there aren’t people who shoot for lower than that, there are people who aren’t happy with anything less than normal blood sugar, but they think we should all only be happy with that, and they get real confused here because this really is a matter of balancing risk tolerance with a bunch of other things.
The endocrinologist society has come out with a lower recommendation of 6.5 and under indicating good control, and I do tend to agree with that one more, based upon the science we have, but there’s not really that much difference in risk between 6.5 an 7 anyway, and the 7 seems to be a pretty good standard as well, although a lot of diabetics online paint the ADA as the devil for setting the bar so high.
Anyway, let’s say that you don’t want to have diabetic blood sugar anymore and therefore want your A1C to below this threshold, which is 6.5. So what kind of PP readings should you be shooting for? The endocrinologists say 140 and below, but an A1C actually works out to closer to 160 and below, with an A1C of 6.5 that works out to an average blood sugar of 140, so obviously if you never go above that you’re going to end up with quite a bit better A1C than this, in the 5’s probably.
So let’s say you shoot for that and therefore use the 160 here, in other words we’ve chosen this A1C and then we want to achieve it, and we start testing. The first thing we need to realize is that we may not be below 160 even before we start depending on what our between meal blood sugar is, especially in the early stages of treatment, while you are first trying to figure out the diet you want to try to get yourself down to more reasonable levels.
So when we first start out here, we may not even be able to worry about going over any number, we instead may just be limited to testing how much we go up with certain foods, and this is something we want to be doing regardless, since it gives us a relative comparison between different foods, which is very important when deciding what to eat and what not to eat.
So you test, you eat something and you test again 2 hours later, and you see how a certain food may be raising your blood sugar. It’s generally a good idea to test a food a few times, if it’s close that is, if it’s way out there then that might be enough evidence right there, but there are other things that affect our PP readings besides the food, so more testing may be needed.
So you do that with the things you eat and you see how everything affects you, you give up the stuff that hurts you too much, you keep the stuff that doesn’t, you try new things and see how they affect you, and you end up with a plan that is tailored to you, which is what you definitely need.