HELP!!! Carb Confused!!!
I am post op VSG 5 months. I am a Diabetic Type 2 and highly carb sensitive. I was on Novolog Insulin, Lantus Insulin, Glypizide and Metformin (Long Release) Pre-op. My highest weight was 270lbs (A1C 11.2), I lost 45lbs Pre-op, surgery weight was 225lbs (A1C 6.8 off all insulin) and now I am 190lbs (A1C increased to 7.8) I am on 750mg per day of Metformin.
Pre-op my previous doctor placed me on 20-30grams of carbs per day, I worked out 3-4 times per week but this made me very sick and I went Hypoglycemic 4 times with a Glucose reading of 28,35,31 and 30. I fainted 3 times. My nutritionist said 80-100g per day for my body to function pre-op.
Now I am going on to my 7th week stalling at 190lbs, I have increased my exercise, water and getting in my protein, I am on 900cals per day and my average carb intake is 70g per day. My new Endocrinlogist said between 80-100g of carbs per day is good, BUT my nutrtionist said I should never be eating that many carbs. I drink skim milk, low fat dairy, flax seed products, no pasta, rice and very rarely I will have starchy vegetables, but everything has carbs in it and it all adds up.
I would love to hear from some of the post-opers with Diabetes who could give me your opinion and experience with carbs post-op and how many carbs you were having 5 months out. Between my nut and endocrinologist I am so confused. I need my A1C to get down to under 6.0!
Pre-op my previous doctor placed me on 20-30grams of carbs per day, I worked out 3-4 times per week but this made me very sick and I went Hypoglycemic 4 times with a Glucose reading of 28,35,31 and 30. I fainted 3 times. My nutritionist said 80-100g per day for my body to function pre-op.
Now I am going on to my 7th week stalling at 190lbs, I have increased my exercise, water and getting in my protein, I am on 900cals per day and my average carb intake is 70g per day. My new Endocrinlogist said between 80-100g of carbs per day is good, BUT my nutrtionist said I should never be eating that many carbs. I drink skim milk, low fat dairy, flax seed products, no pasta, rice and very rarely I will have starchy vegetables, but everything has carbs in it and it all adds up.
I would love to hear from some of the post-opers with Diabetes who could give me your opinion and experience with carbs post-op and how many carbs you were having 5 months out. Between my nut and endocrinologist I am so confused. I need my A1C to get down to under 6.0!
I am type 1.5 and 8 months post op RNY. Because I am more type 1 than type 2, I have and will always need insulin. I use Lantus, Novolog and Metformin also, but am off a lot of type 2 drugs that I took pre surgery. I've been diabetic for almost 26 years.
I've recently started working with an excellent diabetic educator to get tighter control of my blood sugars. I'm also carb counting much more agressively. I tend to eat about 10-15 carbs per meal, but the diabetic educator is encouraging me to eat closer to 30 per meal. I test my blood sugar before every meal and then use a formula that has a ratio of units of insulin to grams of carbs. I also add in a correction dose based on my blood sugar.
Anyway, I think you need to work carefully with both an RD and a diabetic educator/endocrinologist who can help you get the right combination of nutrition, carbs, medication for weight loss. Sometimes these things conflict with one another, so I can totally understand your frustration!! For example, the RD at the surgeon is always telling me to snack. And, when I tell them I really CAN'T snack because it screws up all my insulin dosing, they look confused. When I tell the CDE (certified diabetic educator) that I have to emphasize protein since I am post-op, he looks a little confused too.
You are the best source of information about your body and how it responds. I would suggest that you get to a CDE and have them help you get more precise about your dosing, so that YOU can control the amount of medication to the amount of carbs you eat. That way you have the tools to vary your dosage to match what you think your body needs to maintain your health and your weight loss.
The CDE I work with consults with people all over the country via Skype and phone conferences. If you would like that info, please message me and I will share it with you.
Good luck!
I've recently started working with an excellent diabetic educator to get tighter control of my blood sugars. I'm also carb counting much more agressively. I tend to eat about 10-15 carbs per meal, but the diabetic educator is encouraging me to eat closer to 30 per meal. I test my blood sugar before every meal and then use a formula that has a ratio of units of insulin to grams of carbs. I also add in a correction dose based on my blood sugar.
Anyway, I think you need to work carefully with both an RD and a diabetic educator/endocrinologist who can help you get the right combination of nutrition, carbs, medication for weight loss. Sometimes these things conflict with one another, so I can totally understand your frustration!! For example, the RD at the surgeon is always telling me to snack. And, when I tell them I really CAN'T snack because it screws up all my insulin dosing, they look confused. When I tell the CDE (certified diabetic educator) that I have to emphasize protein since I am post-op, he looks a little confused too.
You are the best source of information about your body and how it responds. I would suggest that you get to a CDE and have them help you get more precise about your dosing, so that YOU can control the amount of medication to the amount of carbs you eat. That way you have the tools to vary your dosage to match what you think your body needs to maintain your health and your weight loss.
The CDE I work with consults with people all over the country via Skype and phone conferences. If you would like that info, please message me and I will share it with you.
Good luck!
IMO - the carbs you are eating - will only make things worse for you. Skim milk - maybe the the worse offender, as well as low fat - FF yogurt.
I had RNY and got RH - reactive hypoglycemia and hypoglycemia at times.
But by trial and error - i found out that I do need some carbs - but I mostly need fat and proteins then some carbs. But never "liquid " type carbs (*like milk, or juice or even thin yogurt)
I keep my fat to protein to carb ratio optimum for me. complex carbs - non -starchy veggies, virtually no fruits, or very limited - low glycemic fruits.
Fat stabilizes my BS - so much better that anything else.
you may want to check this - very interesting...
http://www.diabetes-book.com/index.shtml
also check others post people who deal with RH...
check
http://www.obesityhelp.com/forums/rny/4555953/quotTheyquot-s aid-Id-gain-it-all-back-are-quottheyquot-right/
http://www.obesityhelp.com/forums/wls_grads/3453812/Reactive -Hypoglycemia-my-trial-error-research/
http://www.obesityhelp.com/search/action,search_oh/?q=RH&cx= 000946886326336472648%3Ae-vpeg4uyxw&cof=FORID%3A9
http://www.obesityhelp.com/search/action,search_oh/?q=Reacti ve+Hypoglycemia&cx=000946886326336472648%3Ae-vpeg4uyxw&cof=F ORID%3A9
and so on... typical post op - long term RNY.
I had RNY and got RH - reactive hypoglycemia and hypoglycemia at times.
But by trial and error - i found out that I do need some carbs - but I mostly need fat and proteins then some carbs. But never "liquid " type carbs (*like milk, or juice or even thin yogurt)
I keep my fat to protein to carb ratio optimum for me. complex carbs - non -starchy veggies, virtually no fruits, or very limited - low glycemic fruits.
Fat stabilizes my BS - so much better that anything else.
you may want to check this - very interesting...
http://www.diabetes-book.com/index.shtml
also check others post people who deal with RH...
check
http://www.obesityhelp.com/forums/rny/4555953/quotTheyquot-s aid-Id-gain-it-all-back-are-quottheyquot-right/
http://www.obesityhelp.com/forums/wls_grads/3453812/Reactive -Hypoglycemia-my-trial-error-research/
http://www.obesityhelp.com/search/action,search_oh/?q=RH&cx= 000946886326336472648%3Ae-vpeg4uyxw&cof=FORID%3A9
http://www.obesityhelp.com/search/action,search_oh/?q=Reacti ve+Hypoglycemia&cx=000946886326336472648%3Ae-vpeg4uyxw&cof=F ORID%3A9
and so on... typical post op - long term RNY.
Hala. RNY 5/14/2008; Happy At Goal =HAG
"I can eat or do anything I want to - as long as I am willing to deal with the consequences"
"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."
I am T2D, diagnosed 1998. Before pre-op I was on insulin Lantus and Novolog. Insulin wasn't helping much and my blood sugars were always high. My last AIC was 9.0, which is the highest I've ever seen. I follow up with my physician to have another test next week, but I know it will be amazing. My blood sugars have been coming down since preop started 04.03.13. My blood sugars now are usually around 90 and I take no meds except my thyroid meds.
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