Blood Sugar Controlled!

[MickinMD ★]

With the Freestyle Libre continuous blood glucose monitor in use for 12 days, I'm learning what I can eat and not eat with my severe type-II diabetes.

Compare the first pair of graphs below with the two on the bottom and it's obvious how much this new tool helps me.

Things like eggs, ham and bean soup, low-carb and fibrous foods are required to be more dominant and processed foods, regular pasta, egg noodles, Bisquick, etc. need to become less dominant in my diet. I need to lose weight, so cutting back a little on portion sizes and minimizing snacks fits right in.

The 24 hour periods through morning and now, my blood glucose has averaged around the mid 150's, which corresponds to an A1c of 7.0, the goal for long-term blood glucose avg.  The shaded range in the graphs below, 100-160 mg/dL is the "sweet spot" that I want to be in most of the time and I've gone from being in it less than 15% of the time to more than half the time.  The fact that the numbers are jumping toward 200 even with a good diet is a little worrisome - I may need to go on a low dose of long-lasting insulin if that doesn't settle down.

 

On some other days my sugar was awfully high as shown below - some of it from experimenting to see what I can get away with.  Then I decided I better get things stabilized and THEN experiment a little.  I the numbers stay under 240 through the weekend and I average in the mid-100's, I'll feel confident enough to do some serious walking on some low-populated trails with Golden Doodle Jake.  If my numbers go too high - around 300 - if I do a lot of exercise it can actually drive my blood sugar higher instead of using some of it up as is normal.  My last blood test was the equivalent of an avg. 278 mg/dL which resulted in stronger meds plus the continous sensor.

 

 

 

 

[ChrisL]

Good news Mick.  Often times your glucose will be elevated right after a work out. My Dr said it’s your body’s fight or flight response.  You know your running for fitness but your body’s chemistry is preparing you to be chased by a bear so is dumping glucose for energy.

Overall you are better off working out even with the spikes as  long term it will keep your glucose down. 

[Airehead]

Great work Dr. Mickin. 

[Ralphie ★]

This is a classic example of 220. 221, whatever it takes to get your blood sugar down. 

[MickinMD ★]

12 hours ago, ChrisL said:

Good news Mick.  Often times your glucose will be elevated right after a work out. My Dr said it’s your body’s fight or flight response.  You know your running for fitness but your body’s chemistry is preparing you to be chased by a bear so is dumping glucose for energy.

Overall you are better off working out even with the spikes as  long term it will keep your glucose down. 

Thanks!

I was sent for 4 1-hour classes about type-II diabetes through the U. of MD Hospital System.  Basically, we learned low-carbs, low-processed foods, no pit fruits, but also to experiment and see what works with diet.  We also learned to avoid danger from various things - including the fact that exercise does NOT usually lower sugar concentrations in type-II diabetics when they are very high to start with.

It was pointed out that if your blood glucose is in the 300's or even high 200's with type-II diabetes, your pancreas has probably put MORE insulin into your bloodstream than a non-diabetic person: but the insulin can't work as normal on your cell walls to let sugar into them - that's basically what type-II diabetes is.

So, during exercise, your cells are using up sugar, little more is getting into them even though there is lots of it in the blood, so they send a chemical signal to the liver saying, "Send me some sugar."

Then the liver converts glycogen and sometimes amino acids into glucose and sends it into the bloodstream along with a chemical signal to the pancreas to pump out more insulin.

That does two bad things:

1) it kicks up the sugar concentration in your blood, thickening it and making the heart, etc. do more work.

2) it keeps the pancreas working overtime to pump out insulin, threatening to burn out the cells that make it.

 

[Razors Edge ★]

12 hours ago, MickinMD said:

With the Freestyle Libre continuous blood glucose monitor in use for 12 days, I'm learning what I can eat and not eat with my severe type-II diabetes.

Compare the first pair of graphs below with the two on the bottom and it's obvious how much this new tool helps me.

Things like eggs, ham and bean soup, low-carb and fibrous foods are required to be more dominant and processed foods, regular pasta, egg noodles, Bisquick, etc. need to become less dominant in my diet. I need to lose weight, so cutting back a little on portion sizes and minimizing snacks fits right in.

The 24 hour periods through morning and now, my blood glucose has averaged around the mid 150's, which corresponds to an A1c of 7.0, the goal for long-term blood glucose avg.  The shaded range in the graphs below, 100-160 mg/dL is the "sweet spot" that I want to be in most of the time and I've gone from being in it less than 15% of the time to more than half the time.  The fact that the numbers are jumping toward 200 even with a good diet is a little worrisome - I may need to go on a low dose of long-lasting insulin if that doesn't settle down.

 

On some other days my sugar was awfully high as shown below - some of it from experimenting to see what I can get away with.  Then I decided I better get things stabilized and THEN experiment a little.  I the numbers stay under 240 through the weekend and I average in the mid-100's, I'll feel confident enough to do some serious walking on some low-populated trails with Golden Doodle Jake.  If my numbers go too high - around 300 - if I do a lot of exercise it can actually drive my blood sugar higher instead of using some of it up as is normal.  My last blood test was the equivalent of an avg. 278 mg/dL which resulted in stronger meds plus the continous sensor.

 

 

 

 

This is like the Strava of diabetes tracking!!!  Keep on top of the data collecting, and go for some KOMs and PRs so that you are getting yourself healthier on a consistent basis.

Pretty neat stuff and I am happy you got a new tool to help you work on this problem.

[ChrisL]

46 minutes ago, MickinMD said:

Thanks!

I was sent for 4 1-hour classes about type-II diabetes through the U. of MD Hospital System.  Basically, we learned low-carbs, low-processed foods, no pit fruits, but also to experiment and see what works with diet.  We also learned to avoid danger from various things - including the fact that exercise does NOT usually lower sugar concentrations in type-II diabetics when they are very high to start with.

It was pointed out that if your blood glucose is in the 300's or even high 200's with type-II diabetes, your pancreas has probably put MORE insulin into your bloodstream than a non-diabetic person: but the insulin can't work as normal on your cell walls to let sugar into them - that's basically what type-II diabetes is.

So, during exercise, your cells are using up sugar, little more is getting into them even though there is lots of it in the blood, so they send a chemical signal to the liver saying, "Send me some sugar."

Then the liver converts glycogen and sometimes amino acids into glucose and sends it into the bloodstream along with a chemical signal to the pancreas to pump out more insulin.

That does two bad things:

1) it kicks up the sugar concentration in your blood, thickening it and making the heart, etc. do more work.

2) it keeps the pancreas working overtime to pump out insulin, threatening to burn out the cells that make it.

 

Huh...   That makes sense though.  So what is the recommendation for people with blood glucose values in the high 200’s & above on working out? Should it be controlled with diet & meds first?  I can see the concern with someone with thickened blood working out.

[Razors Edge ★]

7 minutes ago, ChrisL said:

Huh...   That makes sense though.  So what is the recommendation for people with blood glucose values in the high 200’s & above on working out? Should it be controlled with diet & meds first?  I can see the concern with someone with thickened blood working out.

Lots of water and low amounts of sodium during exercise and throughout the pre and post workout periods would definitely seem important to keep blood from being too thick. 

I can't imagine a "normal" scenario for a diabetic (or non diabetic) where exercise coupled with weight loss weren't a large part of the solution to controlling diabetes - especially with a goal of diminished reliance on pharmaceuticals to regulate things.  Getting to the point where exercise and weight loss are safe to ramp up - more and more - might just be a bit like "warming up a car" before starting to race. 

[ChrisL]

1 minute ago, Razors Edge said:

Lots of water and low amounts of sodium during exercise and throughout the pre and post workout periods would definitely seem important to keep blood from being too thick. 

I can't imagine a "normal" scenario for a diabetic (or non diabetic) where exercise coupled with weight loss weren't a large part of the solution to controlling diabetes - especially with a goal of diminished reliance on pharmaceuticals to regulate things.  Getting to the point where exercise and weight loss are safe to ramp up - more and more - might just be a bit like "warming up a car" before starting to race. 

True but Mick is referring to those with dangerously high levels of blood glucose and I’m thinking if your numbers are ranging around 300 or higher, overall health & fitness is poor. As a comparison a bad reading for me is high 100 range, like 190 but my range is 120-160. So get the glucose under control first and then incorporate exercise.  

Having an obese out of shape person with glucose in the 300 range with thickened blood could present other issues. Remember all those Dutch & Belgian cyclists that died of heart attacks due to EPO use due to blood like maple syrup due to EPO use.  I can see a similar concern here.  I’m not sure fluids & minerals would help much.

[Razors Edge ★]

1 minute ago, ChrisL said:

True but Mick is referring to those with dangerously high levels of blood glucose and I’m thinking if your numbers are ranging around 300 or higher, overall health & fitness is poor. As a comparison a bad reading for me is high 100 range, like 190 but my range is 120-160. So get the glucose under control first and then incorporate exercise.  

Having an obese out of shape person with glucose in the 300 range with thickened blood could present other issues. Remember all those Dutch & Belgian cyclists that died of heart attacks due to EPO use due to blood like maple syrup due to EPO use.  I can see a similar concern here.  I’m not sure fluids & minerals would help much.

Yep - that's a reasonable comparison. It is sort of why I mentioned the "normal" scenario and that can't be reached until after the acute stage to drop someone out of the danger zone.  There are, by now, almost countless diabetics who have hit that danger zone and turned it around through diet, exercise, drugs, and other tools.  If Mick can get a handle & understanding of the numbers, he can then find the safe path to getting to the "normal" phase where it then becomes more of a "eat properly, exercise appropriately, treat with drugs as needed, and get healthier over time" sort of thing.  He definitely, if in that danger zone, should proceed with caution and professional medical advice to be both safe but also to actually start moving out of the red zone.

Hopefully those classes did not just point out the dangers of exercise without also pointing out the possible ways to exercise safely in that red zone and/or offer a clear plan of how to safely move out of the danger area.  Mick might have been pointing to just a small portion of what he learned in the class, but I know from talking to my mom about health issues related to obesity (but not diabetes), she hears what she wants from a conversation with doctors or nutritionists and ignores (or doesn't even process) what she doesn't want to hear.  Then, all of my conversations with her later center around why she can't do something, rather than the things she can do.  

I really think Mick is on the right path with this new tool.  His logical mind now has near real-time data to play with, and as we know, what is not measured can't be easily managed, but now he has a consistent platform for measuring his efforts.  Next steps are taking that data and putting it to good use.

[ChrisL]

24 minutes ago, Razors Edge said:

Yep - that's a reasonable comparison. It is sort of why I mentioned the "normal" scenario and that can't be reached until after the acute stage to drop someone out of the danger zone.  There are, by now, almost countless diabetics who have hit that danger zone and turned it around through diet, exercise, drugs, and other tools.  If Mick can get a handle & understanding of the numbers, he can then find the safe path to getting to the "normal" phase where it then becomes more of a "eat properly, exercise appropriately, treat with drugs as needed, and get healthier over time" sort of thing.  He definitely, if in that danger zone, should proceed with caution and professional medical advice to be both safe but also to actually start moving out of the red zone.

Hopefully those classes did not just point out the dangers of exercise without also pointing out the possible ways to exercise safely in that red zone and/or offer a clear plan of how to safely move out of the danger area.  Mick might have been pointing to just a small portion of what he learned in the class, but I know from talking to my mom about health issues related to obesity (but not diabetes), she hears what she wants from a conversation with doctors or nutritionists and ignores (or doesn't even process) what she doesn't want to hear.  Then, all of my conversations with her later center around why she can't do something, rather than the things she can do.  

I really think Mick is on the right path with this new tool.  His logical mind now has near real-time data to play with, and as we know, what is not measured can't be easily managed, but now he has a consistent platform for measuring his efforts.  Next steps are taking that data and putting it to good use.

The classes all espoused regular activity with a diet appropriate for diabetics and spend a lot of time explaining what that is.  That really was the mantra and until Mick brought it up I never heard any concerns with exercise & glucose values at that high a level.    Still curious to hear what the recommendation was from @MickinMD

 

[Reverend_Maynard]

Some info from the Mayo clinic...

Quote

250 mg/dL (13.9 mmol/L) or higher. This is a caution zone — your blood sugar may be too high to exercise safely. Before exercising, test your urine for ketones — substances made when your body breaks down fat for energy. The presence of ketones indicates that your body doesn't have enough insulin to control your blood sugar.

If you exercise when you have a high level of ketones, you risk ketoacidosis — a serious complication of diabetes that needs immediate treatment. Instead of exercising immediately, take measures to correct the high blood sugar levels and wait to exercise until your ketone test indicates an absence of ketones in your urine.

https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-and-exercise/art-20045697

[Longjohn ★]

17 hours ago, MickinMD said:

The fact that the numbers are jumping toward 200 even with a good diet is a little worrisome -

You are still learning what a good diet is. Keep working at it, you are on the right track. You couldn’t see me but I would roll my eyes when you talked about what you eat. I tried not to say anything because there were already people making suggestions and a lot of your diet is cultural. I think you grew up eating the way you do and in a lot of ways you are healthier than me. 

[sheep_herder ★]

20 hours ago, ChrisL said:

Good news Mick.  Often times your glucose will be elevated right after a work out. My Dr said it’s your body’s fight or flight response.  You know your running for fitness but your body’s chemistry is preparing you to be chased by a bear so is dumping glucose for energy.

Overall you are better off working out even with the spikes as  long term it will keep your glucose down. 

In the early days, I always thought my early morning highs were due to the 'wild' dreams I had the night before. Some general rules apply, but we must not forget that diabetes is a very 'individual' disease.

[MickinMD ★]

8 hours ago, ChrisL said:

Huh...   That makes sense though.  So what is the recommendation for people with blood glucose values in the high 200’s & above on working out? Should it be controlled with diet & meds first?  I can see the concern with someone with thickened blood working out.

The University of Maryland Hospital System Nutritionists who taught the classes said do NOT do serious exercise if you blood glucose is in the high 200's or more because the glucose level and thickness of the blood might increase dramatically.  Get the glucose down first by watching what you eat plus your meds.

We've had excellent Indian Summer weather this week but I've been afraid to do 2-3 mile walks with doggie Jake until I'm sure my blood's ok. Next week I expect to do so.

Right now, if I make a semi-bad choice of food, the sugar is going a little over 200 at maximum.  I can live with that for now.  For the first week plus using the Freestyle Libre sensor, I struggling to get my AVERAGE down to 200.

[ChrisL]

5 minutes ago, MickinMD said:

The University of Maryland Hospital System Nutritionists who taught the classes said do NOT do serious exercise if you blood glucose is in the high 200's or more because the glucose level and thickness of the blood might increase dramatically.  Get the glucose down first by watching what you eat plus your meds.

We've had excellent Indian Summer weather this week but I've been afraid to do 2-3 mile walks with doggie Jake until I'm sure my blood's ok. Next week I expect to do so.

Right now, if I make a semi-bad choice of food, the sugar is going a little over 200 at maximum.  I can live with that for now.  For the first week plus using the Freestyle Libre sensor, I struggling to get my AVERAGE down to 200.

Thanks Mick I learned something new today.  Keep us posted on your progress & improvement of your numbers.

 

[sheep_herder ★]

18 hours ago, MickinMD said:

The University of Maryland Hospital System Nutritionists who taught the classes said do NOT do serious exercise if you blood glucose is in the high 200's or more because the glucose level and thickness of the blood might increase dramatically.  Get the glucose down first by watching what you eat plus your meds.

We've had excellent Indian Summer weather this week but I've been afraid to do 2-3 mile walks with doggie Jake until I'm sure my blood's ok. Next week I expect to do so.

Right now, if I make a semi-bad choice of food, the sugar is going a little over 200 at maximum.  I can live with that for now.  For the first week plus using the Freestyle Libre sensor, I struggling to get my AVERAGE down to 200.

I am glad you included 'serious exercise' because I find just getting up off my ass and walking around can greatly reduce the amount of short acting insulin that I have to shoot in a day. I take my Victoza, long-acting insulin, and short acting insulin in the morning after breakfast and before doing chores. My short-acting insulin dose is regulated by my bgl before breakfast and what I eat for breakfast. Sometimes I miss and bgl gets low before I finish chores, thus, I may have to eat a tube of Smarties to keep going. All I am trying to say, is that it is important to get up and get moving in addition to watching what you eat can have tremendous benefits in regulating bgl. I am glad your meter is working well for you. As I mentioned earlier, I have not started using my deacon g6, as testing 4 times per day is working well for me and fits my lifestyle. Best of luck with regulating your bgl.

[BuffJim]

I lost my test kit. Mick’s earlier post about the Libre inspired me to get another kit. When I test often, I eat better. Took my first test today and it was too high. Gotta buckle down. 

[BR46]

17 hours ago, BuffJim said:

I lost my test kit. Mick’s earlier post about the Libre inspired me to get another kit. When I test often, I eat better. Took my first test today and it was too high. Gotta buckle down. 

I have been watching the numbers a lot lately. My last doctor visit was not bad he did threaten to up my medication. 

[BuffJim]

Just now, BR46 said:

I have been watching the numbers a lot lately. My last doctor visit was not bad he did threaten to up my medication. 

I’m still in the 100’s. But in the wrong part of the hundreds.