brittle Diabetes

Hi I am currently about five weeks Post op lapband. When i started this Journey I was on 1000mgs of metformin 2x aday. Byetta10 units 2x a day.,and a whopping 60 units Lantus twice a day. I was also taking Lotrel 5/20 2pills once a day , Crestor 1 a day, A pill for swelling once a day(forgot the name.) Nexium for reflux.Toprol Xl 50mg once a day. ...NOW I take one Lotrel , I still take the metformin in liquid form(Riomed). and I take one shot of Lantus 50 units in the evening.  I have good control of my blood sugars at this amount of insulin. I am ready to begin the real exercise my Goal is to put my diabetes in remission totally. I know i was one sick person. Can you give me any advise to help me along nutritionally, To reach my goal. I am between NUT as my Nut left the practice and the only other ones that are familiar with lap band do not have hours that I can make it due to my work schedule.

Can you first post what your blood sugars are before I respond. Everyone's version of "good control" is different. Just want to be sure we are on the same page. Sara Nejat-Bina, RD, CNSD, CDE

Hi Sara.  Thank you for responding . My fasting blood sugars are bet 70-110. Since surgery my blood sugar were only high twice after eating lunch they were once 160 and once it was 230. The 230 was after eating split pea soup( 2 hours after). Hope this helps. This has been the best it has been in years. Thank you so much in advance. Karen

Hi Karen, Blood sugars between 70-110 are totally normal. GREAT! Exercise will reduce your blood sugar as well, so it is first very important that you always carry a carbohydrate source with you when you exercise. There is a risk of low blood sugar; even more so with you since your blood sugar is already very well under control and you are taking insulin. Exercise will increase your sensitivity to insulin. When you had blood sugars out of control, you likely had a lot of insulin floating around in your blood, it was just difficult for you body to use it because of obesity. Think of it as the insulin couldn't find the sugar in your blood because it was getting lost in the extra fat. So your body produced more insulin and you had to take extra insulin to increase the chance that some of it could find the sugar. Now that you have less fat, the insulin can find the sugar easier. Exercise will improve that even more. So you do have a risk of having low blood sugar. You can experience low blood sugar during exercise or immediately after exercise. If your sugar is less than 100 prior to exercise, you must eat a snack that contains carbohydrate. Four saltine crackers or a yogurt will help. Carry some lifesavers with you (or other hard candies WITH sugar) just in case you hit a low during exercise. Sucking on 4 lifesavers will increase your sugar for you if you have a low during exercise. Generally, exercising 1-3 hours after a meal is safest. ***Check your blood sugar before and after exercise****. Be sure to wear a diabetes bracelet or something to identify you as a diabetic when you are out exercising. This should help to get you started with exercise and brittle diabetes. As you lose weight, your diabetes will continue to improve & you won't have to take as much medication - making your risk for low sugar much less. Hope that helps with exercise and diabetes. Sara Nejat-Bina, RD, CNSD, CDE eNutritionCare.com

Sarad: Thanks for the tips. Is what you discribed when i was more over weight insulin resistant.  I am going to be very careful when I exercise. I will check and keep hard candy or glucose tablets.  I am looking forward to beginning some more exercising at 6weeks out . Right now I walk alot ,but I haven't been doing it for long periods of time. I'm still so out of shape. Thanks again, Karen