Diabetes Survival Guide!

You've been told you have Type 2 Diabetes.  Your A1c is something higher that 6.5.  So, now what?  You have three basic tools to control Type 2 Diabetes: medication, exercise and diet.  Using all three, you can control and manage the disease.  But, what in the world is diabetes?

(I have used survival guides most of my professional life.  A survival guide gives you just enough information to 'get your work done' if everything is normal and is a reference resource until you gain experience.  And, I probably should have written this a while back, but it just occurred to me that it might be needed.  Plus, it also helps that I have a number of the pieces in place to which to refer.  Could it be seredipity?)

Your doctor has told you that you will probably have to take some medication to lower your A1c.  No surprise.  The doctor wants to get your A1c down ASAP - think of it as getting the poison out of your system.  So, meds are a very normal route.  In fact, they might start you on metformin, one of the most widely prescribed drugs fo diabetics.

Dr. K has written about metformin, and you should read it to understand the drug and  how it works.

But, what if you don't want to take a medication?  Well, there are those who decide they want to control diabetes through diet and exercise - and some are successful!  Some control and beat back the disease through the diet and exercise route.  But, the number who are successful is limited - very limited.

The first goal is to get your A1c down as soon as you can.  You can always stop taking meds if you see your numbers dropping and getting an A1c under 5.5; there is no rule that states you have to take them forever.  This is a decision you should make after talking with your doctor.  So, think about taking the medication.

For me, it was a no brainer.  I knew diabetes could cause serious damage and could lead to death.  I chose to take the meds to get myself back to 'normal.'  Diabetes normal is not good enough for me.  Normal is normal is normal, even if it's done with the aid of medication!

Regardless if you are taking medication, or not, you should start to exercise.  Read about my post on exercise to get a beginning point.  I still just walk, but a lot faster than I did at the beginning.  If you are going depend on exercise to gain more control, you will need to use cardio exercise and resistance training (aka weightlifting).  And, plan to spend about an hour a day, five or six days a week of exercise time if you have the weights at home.  If you go to a gym during a busy period, figure at least two hours a day.

You are going to have to start glucose testing at least twice per day.  Most of the instruction I have seen is either incomplete, or really cause pain.  For complete instructions on how to get a good reading without pain, read this.

And, you are going to examine your diet. Chances are it will change.  Mine did - a lot.  I started a lower carb diet and over the course of nine months I lost about 60 pounds between diet and exercise.  Diet is so very, very important as you work to control diabetes.

And, to bring it all together, I have strongly recommeded a food diary.  Keeping one was so helpful in the beginning as I was lowering my A1c - it told me what I could and could not eat if I paid attention to my meter readings.  The food diary continues to be a tool for success and something I go back to when I see my numbers creeping up.  You can read about it here and then download it by following the instructions in the post.

Just so you know, I started my diabetes journey with an A1c of 13 - that's pretty high.  My most recent test gave me a 6.1.  Blood pressure 114/80.  Weight seven pounds up over a year's time, which I am losing - I got a bit cocky when I had a test result of 5.9!  I lose the weight, keep up with my diet and meds, and I should be at about a 5.8 or lower when tested again.  I mention all of that just so you know I have first hand knowledge of what you are facing - and KNOW you can be successful!

As always, thank you for reading.  God Bless and know you can beat the enemy; you CAN control diabetes.

Please feel free to send me your comments.

Tale of Two People (with apologies to Dickens)

It was the best of times.  It was the worst of times.  And, so the story starts.  For so many faced with the diagnoses of Diabetes or Prediabetes it is the worst of times.  I know the feeling.  And, I know the very real fear.

What happens as a result of the diagnoses is in your hands; it's your choice.  It's all in how you react and what you do, or action you take.  Let me tell you about Dave and John.

I learned about them during the same day last week and since I am not a big believer in coincidence, I thought I'd share their stories with you.  I learned about David when he left a comment and then sent me an email and will let him tell his story in his own words...

Ten years ago I was in prediabetes -- not surprising at all since my father is a diabetic and I weighed in at well over 260 pounds and seldom did any exercise. As I looked at my father and saw him deteriorating before my eyes, I decided to do something about my own health (I couldn't get him to even listen to his doctor). I took up cycling and lost over 60 pounds. I now ride around 7,000 miles a year. At my last physical my BP was 100/58, my resting pulse was 52, and my fasting blood sugar level was around 65 mg/dL.

When I took up cycling I also started the Atkins Diet -- got rid of ALL refined sugars, white bread, etc. Whole grains, lean protein and fresh fruit are the only things I eat now.

Now, I am not going to suggest that you start cycling 7,000 miles a year.  But, take a look at David's blog about his adventures and product reviews.  You might decide you want to take up cycling or bike riding as a form of exercise.

What I do want to point out is that he took action and overcame a diagnoses of Prediabetes.  What did he do?  Diet.  Exercise.  And, as a result he beat diabetes!  Good going David!

Now, John (not their real name; I could just as well have used Mary, Fred, Barney, or Lucille) faced diabetes in a different manner.  They did nothing.  Or, at the most very, very little.  What's happened?  Pretty much what you would expect.  They are in their mid-50's, on dialysis three times a week and have six to eight months to live.  They won't live to see their grandchildren or their birthdays.  Why?  Because they did not fight to control the disease.  John did not fight to win the war.

John's story did not have to end that way.  A little exercise - 30 minutes a day.  A change in diet.  Take prescribed medications.  And, who knows how long John would have lived?

I hear less dramatic stories all of the time.  But, make no mistake - Diabetes has one goal and that is to ravage your life.  If you have diabetes, your single goal should be to ravage diabetes, and you can do it!

You can control diabetes!  You can beat Prediabetes!

If you have no faith, you've lost your battle. ~Bill Cosby
You may have to fight a battle more than once to win it. ~Magaret Thatcher

Prediabetes Can Be Beat!

Yesterday I spent the day near the ocean.  It was one of those gorgeous days where the sky was crystal blue; ocean was incredible with the perfect breeze blowing.  The day was...well, I don't have the words to describe it adequately.  Then, because I love watching people, I started  watching them and noticing the food they were carrying - it was all either deep fried, sweet, or deep fried and sweet.

Late last night I was looking at yesterday's Los Angeles Times and came across an article with this headline: " Clothing lines embrace plus sizes."  People are getting bigger and need bigger clothes.  Do you think there is any correlation between what we eat, getting bigger and clothing manufacturers making larger sizes?  Nah, couldn't be...could it?

There are 75,000,000 to 80,000,000 Americans who have Prediabetes.  This is a condition where they have high blood sugar readings and will most likely be diagnosed with Diabetes sooner or later.  Take a look at what the American Diabetes Association says about Prediabetes.

Let me tell you - you do not want to be a diabetic.  Your life will change if you take the disease seriously.  And, if you don't, you will pay a heavy price.  Am I scaring you a bit?  I hope so.  I wish someone had scared me when I was told I had Prediabetes.

If you are told you have Prediabetes there are steps you can take - steps that mean you probably will not get Diabetes.  What do you need to do?  Talk with your doctor.  Find out the immediate things to do.  Chances are it will be a short list (I like short lists).  You will need to educate yourself and take action.

So, what might be on your 'to do list?'

Change your diet.  You can always go to a lower carb diet as a first step.  If anyone had really told me, or if I had taken the time to find out instead of being in denial, I would have found that a lower carb diet was not a bad thing at all; in fact, it's pretty good.


I look back at how much I used to eat and I am amazed.  I ate much more than I needed to eat.  Why?  I just love the taste of food.  How it looks.  How it smells.  How it tastes.  I just love everything about it.  If a plate of pasta is good, two plates are better.  Am I right?  Well, I was wrong.  If I had made a few changes and understood that I only needed to eat the food I would need for fuel, I would be much better off today.  But, it's not easy to change how one eats until they are forced to do so.

Don't become a diabetic statistic.  Start thinking about what you eat; how much you eat and the effect it has on your body.


You might need to lose a little weight.  Guess what, if you go to a lower carb diet, you will probably lose a little weight.  I know it's not easy - really.  There is no magic potion to take or a magic pill to take that will make you lose weight permanently.  It's about changing habits.  Changing eating habits.  But, if you can change that habit, you will change your life! I know I will be writing about this sometime in the future.

Change your diet...Maybe lose a little weight...anything else?  Yes, exercise.

Exercise.  You don't have to spend two hours in the gym to exercise.  You are not going to six-pack abs here.  You just want to get healthier.  All you need to do is to get 150 minutes a week of exercise.  Did you know that cleaning a house or apartment is considered exercise?  Chances are you are already do that.  Maybe you can walk for 30 minutes a night.  Just 30 minutes a night to keep track of what's going on in the neighborhood and it's exercise!

If I sound like I am begging you to take action, I am.  I would much rather hear about someone beating a Prediabetes diagnoses than progressing to full-blown diabetes.  It can be reversed and YOU can do it.

A Test You Can't Fail - Part Four - What Does it Mean?

You have done your tests and have your results.  What in the world do they mean?

First, understand that while your numbers will fluctuate, the ADA refers to ranges.  The American Diabetes Association has a good article on glucose levels.  Again, because I love simple, think in terms of the following ranges as goals to achieve:

Fasting Glucose Test - This is your first test of the day: 70 to 120 is the target range.  This range is the goal.  The Goal.  You may not be seing these numbers.  I remember my first test in the middle of the day about 30 minutes after I had lunch.  My number was over 300.  I had no clue what that meant.  Now I know it was way, way, way too high.  My first morning reading was 297.  Again, very, very, very high.  Now my morning readings are 85 - 95.  Rarely do they go above or below.

As I started my way to gaining control over diabetes, my morning readings started to come down 10 and 20 points a day.  Sometimes they went up from one day to another, but I was learning what I could eat and not eat.  But, when you look over a week's or month's time period, there was a downward trend.  These morning readings are a great indicator of where you are in your battle to control the disease.  If you are only going to test once a day, this is the one to do.

Evening/Night Test - This one was a challenge for me.  Think in terms of a range of 110 to 140.  I, again, want to stress I am not a doctor, this is just what I found to be about right when I test at night as I was gaining control.

Diabetes control is a journey - remember that.  When I first started testing at night after I started medication, I was happy to see anything around 160.  Due to eating changes, exercise and medication, that number came down pretty quickly to around 130.

I just did a test and found that I was at 91.  I ate about 2.5 hours ago - so it was low even for me.  Most of the time I my tests show 95 to 125 - there are a lot of variables such as what did I have for dinner, how long ago it was, and have I had anything to eat since dinner.

After Eating - This test is done two hours after you start eating a meal.  This is important enough to repeat - two hours after you START a meal.  For me, start means when I take my first bite.  The goal here is less than 180 for a Type 2 Diabetic.

You can control diabetes.  You really can.  I know in the beginning it might not seem so easy, but it's all about a series of choices.  The better choices lead to control and lower test numbers.  Other choices lead to higher results.  But sometimes you don't know how certain foods will effect you.  sure, there are guidelines, but we are all different.  You only learn how a food will effect your body after you eat it - and you learn through testing.  If you get a higher number, it's a food to avoid.

I started with very high numbers - VERY high.  Through diet, exercise and medication I am controlling the disease.  Do I miss apple pie, french fries and cheese cake?  Well, yeah.  But, I want control of the disease because I have respect (fear) of what it can do to me - the complications can be severe.

Remember, you cannot fail this test; you can only fail to test.  Even getting a high number provides a lesson.  If you are just starting treatment, you want your readings to trend down.  If you have been under treatment for awhile, you want fairly level readings near or in the normal range - at least that's the goal and it's one that is attainable!

Here is a good article from Diabetes Self-Management on glucose levels.

Don't let diabetes win. Battle and control it!  You can do it...I know you can.  Keep your food diary and learn from it.  If needed, lose weight.  Take your medication.  And, TEST.

Diabetes Week Two

I made it through the first week of diabetes.  My life changed in the same way you turn a light on - within a moment.  Was I still scared?  Oh, yeah.  In fact today, almost three years later I am still scared of diabetes if I was being completely honest.  I have a deep and abiding respect for what the disease can do if not managed and controlled.

The good news is that it can be controlled with a bit of effort which was my big "AHA!" during Week Two.

Anyway, back at Week Two.  I had begun to take my meds - Metformin twice a day 1.000 mg each time.  Pretty standard starting treatment.  And, it was just the Metformin.  I know many may have two pills to take, which for some proves to be very effective.  It's kind of like a one-two punch and when you are in a war with diabetes, you want to throw as many punches as possible to get your glucose, and subsequently your A1c, down somewhere in normal range.  If you need to see the a chart for A1c values and how they compare to your blood glucose readings, look here for a pretty easy to read chart.

Remember not to use one reading, but look at your average reading.  Even then, it depends on when you take it.  More on that at some point in the near future.

Again I got a bit side tracked.  Week Two - I had begun my walking.  Every evening for 30 minutes.  I know I have written here before I don't like exercise, but we were talking about my life here.  So, that walk became one of my best friends.  I didn't try to walk fast or go very far at first.  I used shoes that were about five or six years old and just walked.  One foot in front of another.  For 30 minutes - which seemed like forever the frist few days, but by the time Week Two started, the time seemed to go a little faster, but not much.

And, I was getting more ideas of what I could and could not eat.  Think about it, we get near immediate feedback with our glucose readings.  If it's not the right food, up it goes.  If it is the right food, it dips a little bit.  Take your readings twice a day, more often if your doctor will authorize it, so you will know what your blood sugar (glucose) is doing.  You should be on a steady downward trend.  And, keep a record of your readings as well as diet (everything you eat and when) in a food diary.  You will really learn what is working and will be able to spot trends faster.  If you spot the trend, you can make adjustments.

Me?  I just liked seeing the numbers go down.  I started with seeing glucose numbers of 300+.  It was an exciting morning when I hit 297.  During the second week I saw it get down to 275.  I was making progress!  Fear was gone because I was taking action.  I knew the meds would not make me go too low - fat chance when you are in the high 200's.  Things were beginning to work and I felt empowered; that I could get this disease under control. Hey, I even found I lost my first couple of pounds during Week Two,

What was I doing?

Meds.  Diet.  Walking.  Testing.  Recording.  If I was really bright, I'd come up with some sort of catchy acronym, but alas and alack, I am not that bright.  I am open to ideas, though.  You know what my meds were.  I was on a low carb diet.  I was walking 30 minutes a day, six days per week.  And, I kept records.  All of this really began to come together during the second week.

You can do this.  It's all about little steps that collectively make a journey.  You can take the small steps without fear - a lot of folks have gone before you.

Your Best Friends in the Kitchen

If you are at all like me, after being diagnosed with diabetes, you are kind of afraid of the ktichen.  Afterall, that is where it might have all happened.  there is no need to be afraid of the ktichen - it's one of the best rooms in the house to win the war on diabetes. 

I remember before I heard those words, "You have diabetes." I loved kitchen tools.  Why?  I had to make sure I was putting enough sugar in the cookies...and butter.  Can't forget the butter, can I?  I am not kidding.  Measuring cups were used most of the time to measure sugar.  In just about everything.  I even found out a little bit of sugar made pasta sauce better!

Well, now I have new uses for the measuring cups, spoons and even a scale - to make sure I am getting the right portions.  I know, you can eyeball what three or four ounces of meat look like without a scale (kind like a deck of cards), but if you have a scale you will know exactly.  Okay, I am going on about a scale, but to tell you the truth, I learned the visual clues on some items, which can be found here.  I am actually a bit too lazy to weigh my food.

However, I have used measuring cups from Day One for a lot of foods like berries and cereals.  Look at cereal boxes to determine what a real portion size is - or at least what they use to base the nutrition information.  I have found it to be somewhere between 1/2 and 3/4 of a cup.  Measure it out and put it in a bowl - and that's it besides a bit of milk.  You don't get to add more cereal.  Add a piece of whole wheat toast (I never, ever thought I'd be advocating whole wheat anything!), if you need to add food, or add a 1/4 cup of berries.

Whatever you do read labels, know what you are getting nutritionally and get in the habit of measuring everything until you can eyeball it.  But, beware of CREEP.  What is creep, you ask?  It's when you subconsciously make the portion sizes bigger as you eyeball portion sizes.  I found I need to check the portion sizes every couple of weeks just to make sure I am still adhering to the portion guide lines.  It's way too easy to make them bigger than they should be if you aren't using a measuring cup.

I can hear you now, "I don't have a measuring cup."  Go out and get one either at a Target or Walmart, or you can even go to your local thrift store.  Wherever you get your measuring cups and spoons, make sure you wash and sterilize them prior to using.  Yes, you will need the spoons, too.

Learn the portion sizes.  Use measuring tools in the kitchen - they will become your new best friends.  Learn visual clues to portion sizes.  Learn carb counts of the foods you eat.  Lots of learning going on, but it will pay-off very quickly as your glucose levels and weight drop.

You are in a war - make you sure have the right weapons.  Your fight starts in your kitchen.

And, if you eat out often, learn what you can eat at the places you enjoy by looking at nutritional guides that most places have easily available.

This is such an exciting time for you as you start your battle in earnest.  You can win the war and control diabetes.



Measuring cups. Measuring spoons. Maybe a scale.

Carb Revelation! It's Not Just About The Carbs

I lost about 60 pounds between diet and a bit of exercise.  My diet has been one of basic carb counting - not too difficult to understand or track.  But, and this is a revelation from yesterday during my walk - counting carbs is not enough; you have to look at the fat content!  What a concept, right?

For me, it was pretty basic diet - about 55 or 60 carbs per meal with snacks not to exceed 15 carbs.  That was it.  I just could not fully understand that diet in which you can exchange this for that to equal a number.  It just seemed a very difficult way to figure out what I could have to eat.  My carb counting was pretty easy once I knew what the carbs were and the portion size.

So, I get close to where the doctor wants me.  I had a BMI of 25.0, as I recall.  He wanted me at 24.9.  You remember about good ol' BMI's right?  Body Mass Index.  If you are above 24.9, you are overweight.  Need to check your BMI?  Look here.  And, if you want to understand more about BMI, read this article.

As I write this, I have a BMI of 25.3 - not great, but not too bad either.  And, it seems as though I have been unable to get much below 25.0.  Kind of frustrating for a guy who thinks he knows how to lose weight, right?  Well, I have to begin to learn more about fat and fat content, which I have never paid attention to in the past.

I mean, catbs turn into sugar so if I counted carbs, I would not only lose weight, but manage the diabetes.  How great is that?  And it worked for a long time.  If you are just starting out, I think carb counting is a good way to begin to manage and control diabetes.  But, if you want to make that breakthrough to getting to the right weight, you may have to look at fat.

Perfect example: I eat granola-type bars for snacks.  I found one very low carb bar - I mean it was like 9 net carbs - nice and low.  And, I sometimes use another type of bar in which the total carbs is about 18, or so.  Much, much more.  But...and this is an important but...the fat content was double in the low carb bar.  Double!  So, my current solution is to just eat about half of the higher carb, lower fat bar.  I emphasize current, because i have to look at the labels and might find a better balance.

Yes, there is a lot to think about when you have diabetes and it comes to your diet, but it soon becomes second nature.  You begin to look at the labels on all foods to find out what is good for you to eat.  I imagine I should do a food label explanation pretty soon.  That might be a good idea, huh?

So, I keep counting carbs.  But, now I am beginning to count fat - and I am sure I will come back to fat in a future blog because even I know there are different kinds of fat.  I will try to de-mystify and simplify fat when I blog about it.

I will continue to let you know about my adventures in weight loss.  By the way, when my doctor told me I had to 'lose a little weight' my BMI was 32.55.  Of course, I had no idea what a BMI was at that point, or I think I would have been discouraged.  But anyone can lose a little weight, right?  Sure glad that my doctor did not tell me I had to lose about 67 pounds, total.

As always, thank you for reading.

Day Seven

It's the end of the first week.  It's been kind of a long week for me.  I had changed just about everything from what I ate; how much I ate; when I ate; and, I was walking - not far, but walking for 30 minutes each day.  A lot of changes, but I was going on the attack against diabetes, and I just couldn't see doing it any other way.

I don't want to give anyone the impression it was easy.  Every meal was an act of will not to eat more.  Every time I got hungry, I played a little game (which I will still play today) that if I just made it 30 minutes, I could have something to eat.  Then when it go close to 30 minutes, I'd push it to an hour.  I figured that every extra minute I got without eating got me close to the time when I could eat.  I know, it sounds a bit silly, but it worked (and continues to work) for me.

And...I was taking my meds!  My blood sugar did not fall too far - which I was afraid of.  I was afraid that the meds would take me too low too fast.  I had seen people go into diabetic tremors from blood sugar being too low, and I was afraid of that.  But, you know what, it didn't happen.  The world continued to turn and I continued to function well.

What else did Day Seven bring?  Lost weight.  Not much.  I had to look twice and make sure the scale was adjusted right, but there was a loss of two pounds.  Two whole pounds!  I was headed in the right direction.

Oh, yes, my morning glucose readings were going down, too.

So, after a week lived in fear, I had a little victory.  Everything seemed to be working just like it was supposed to work.  I remember that I almost cried I was so happy.

I tell you about this because it can be you.  You can fight and win the battle.  It will take a touch of discipline and dedication, but you know what?  It becomes almost second nature after awhile and your stomach does shrink, but not as fast as some would have you believe.  But it does get smaller if you eat less.

You have to start, please.  Take the first step.  Take your meds as prescribed.  Watch what you eat.  Exercise a bit.  And you will win the war.  I know it sounds a bit corny, but I am already excited about your victories - the little ones because they add up to big ones.

And, thank you for reading.

"Perseverance is not a long race; it is many short races one after another." ~Walter Elliott

"It's not so important who starts the game but who finishes it." ~John Wooden 

Today

I just wrote about perseverance.  That each meal and each day is a decision point.  It really is.

Remember, I think I have told you that I lost about 60 pounds.  I was really happy with that.  All of my numbers were very good.  And, then I stopped being so disciplined in my approach.  If I wanted chips (I love chips - any kind of chips), I ate them and as many as I wanted.  If I wanted a cookie, I had one.  It was too dark to walk, I told myself.  Maybe a little too cold.  (Okay, go ahead ans laugh, but cold in California is 60 degrees.  I found reasons not to exercise, where before I exercised no matter what.

What happened?  I gained 7 pounds over three months.  All of my numbers went up a bit.  Still weren't terrible, but they went up - not the direction I wanted.  But, even thought I did not want the higher numbers, I did not want to lose the weight.  I knew the work it would take.

My doctor was not pleased with me.  I was not pleased with me.

So, after six months, I made the decision to lose the weight.  I knew that meant a bit extra exercise.  Not eating what I wanted, but what I should eat.  And, yes, it meant that I would be hungry sometimes.  But, I wanted to control and manage diabetes successfully more than I wanted food.  So, after fighting the decision, I made it.

I had to lose the weight and then some.

Right now, as I write this, I have lost five pounds - I think.  My scale at home is not entirely accurate.  (A piece of advice - get an accurate scale!!)  I know I have lost weight.  How much will reamin a mystery until I see the doctor next month.

What did it take?  Big surprise - less food and dedicated exercise.  I had to persevere.  I had to stick to it.  I have to control diabetes.  And, right now, my morning readings are looking pretty good and my weight is coming off.

The reason I write about this is that today's decisions regarding diet and exercise will be reflected in, on or around your body sooner than you think.  Please, please make good decisions so you can manage your diabetes.

I am not eating chips.  I am not eating cookies or ice cream.  I stay away from any sweet.  I limit carbohydrates.  Drink plenty of water.  And, I exercise.  ALTHOUGH - I do have one small (emphasis on SMALL) celebratory meal each week.  It's a small breakfast meal but I let myself have a few extra carbs knowing I will exercise a bit more so they won't have an adverse effect.

Don't forget to reward yourself for victories - I want you to have a lot of them!