Discussion Board

It seemed like it took my body a couple of months to re-learn how to control my blood sugar. I quit the medicine after two weeks, but still had spikes north of 160 fairly often. I had spent the previous year never being below 160, so I wasn't worried about the spikes.

I check it every once in a while now, it's pretty much just a waste of strips. Always 80-120 before, after, during, fasting...Doesn't really matter anymore.

Of course my wife says I was never "really diabetic" in the first place, so that's her excuse for why it won't work for her.

If you go on the web md diabetes group they will say not to go over 140 or sometimes even 120--ever. Dr. Mirkin who has a website says anything over 140 causes sugar to stick to the cells.

Some say the area under the curve you could draw of the time after the first bite of food vs blood sugar is the important thing (does it spike and there is a narrow curve or is it a long slow decline) I do not know which they think is best.

Some say the blood sugar reading 20 minutes after first bite is the best predictor of good control, others say 1/2 hour is best, others say one hour, some say 2 hours. Which is why I don't worry.

Sometimes you can eat exactly the same meal and start out with exactly the same blood sugar reading and on different days your sugar will be different numbers post prandially.

Sometimes if I eat a whole extra lot of starches, the blood sugar might go to 180 or 200 just as it would if I ate fewer carbs. Does this mean that because of the extra carbs and the absence of fat, the insulin that is produced is taking care of the extra carbs and the blood sugar remains as it would with say, one potato instead of two.


I would be happy with a reading of 120 two hours after a starchy meal. Mine have gone up over 200. Then they come back down. My morning numbers are normal but I haven't had an A1c in a while. Don't forget, metabolic syndrome is a collection of risk factors. If you see these improving along with lower fasting sugars and lowering HbA1c then, despite the occasional highs, I would assume he is doing pretty well and showing improvement in his health.

What does it mean if he were eating fats and meat and no or few carbs and maintaining nice low numbers? It would mean that despite the numbers, his risk factors after time might increase and he could be building up more resistance to insulin.

I have asked Dr. McDougall about post prandials above 140 being dangerous and causing sugar to stick to the cells but he has not answered. ( I do not mean temporarily while coming off meds and waiting for things to adjust, but even in the long run.)

Didi

I know that. I'm asking what YOUR blood sugar is at the same time you take his.

I'm not diabetic, but I have a glucometer and have used it to test different foods. I get symptoms and feel awful when my blood sugar hits into the 150's, so for me 200 would be nuts. From what my doctor told me, no non-diabetic person should ever hit 200, unless they're in some sort of physical crisis (those can make your blood sugar shoot up), or they've just eaten, you know, ten doughnuts or something.

After a normal healthy meal, yeah, I would think 200 was high. And especially if he's diabetic, he doesn't want those spikes to happen, right?

This has been a problem for me on the diet, and is one reason why I have tried to go slowly.

For instance, all the books (Ornish, Essy, McDougall) will suggest oatmeal for breakfast, but for me just one small bowl made plain, without fruit or anything, will send my blood sugar up within 20-30 minutes, and I will get the familiar shakes and uncomfortable anxiety as it comes ratcheting down. Not fun! The recipe that Essy's wife loves, the one where you replace the liquid in your oatmeal with apple juice and then add dried fruit? The morning I tried that one was insane - I felt terrible for hours. I worked out the sugar content later and it was something like three candy bars. You really have to be careful.

Oatmeal was a disaster for husband too, one small bowl made with water and no fruit put him at 220! Of course you have to realize that non-diabetics don't have that kind of reaction. I love my oatmeal, and it doesn't do crazy things to my blood sugar thank goodness. It is a disease, after all.



Oh, sorry, I don't take it every time he does, partly because I'm a big baby with needles of any kind, and partly because it's frustrating when we have the same meal and I'm way lower than him. What was interesting is that I can have spikes of 130 or a bit more after eating, but never over 140. And in the morning I am always around 80, never over 90. Basically my blood sugar is very stable.

I used to be a big baby with needles (dangerously phobic), until I took a desensitization training course with a local university. It was so interesting, and it worked! The first thing I did was go out and get a tattoo.

Wow, that's a neat idea! I'm not that bad, but I can't look and my hands start to sweat when I know the prick is imminent

your wife may be right..looks like you lost (and are still losing) a lot of weight which tends to correct some people's blood sugar. Doesn't necessarily work for skinny people like me.

I wrote on this board and asked Dr. McDougall about numbers going over 140 and he never answered. It appears lots of us would like an answer. I am talking after an adjustment period to using a starch based diet.

If Dr. McDougall says for diabetics to avoid flour products and the reason is that blood sugars go too high, then I would have to avoid my morning oatmeal and banana and potatoes because my blood sugar can also go well above 140 with those.

Nordgirl, I see that you made a tofu scramble. So it looks to me like you are leaning towards low carb and away from starches because of fear of high blood sugars.

Speaking for myself, I do not worry about numbers around 200. Three hundred after a meal would worry me. My fasting sugars average between 75 and 85 and are often lower. More exercise makes them lower yet and if I don't exercise for a few days they will go higher. I have not had an HbA1c done for a couple of years, but if your husband continues to eat healthfully and has an HbA1c and it is heading downward without meds then I think that is a very good sign despite what the low carbers say about numbers always remaining under 140. (So many of them struggle to get these numbers, yet take meds and are on insulin. And their answer is to go even lower carb).

If I eat a potato at night and my blood sugar climbs, I usually find that in the morning my blood sugar is nice and low. Possibly eating that starch causes the insulin to go to work but prevents the liver from pouring out too much sugar overnight if the blood sugar goes very low due to too little carbs. I don't know.

Isn't the HbA1c a measure of how much sugar has stuck to the cells? It seems to me that if your HbA1c is in the normal range then those numbers post prandially over 140 have not done any damage. Maybe someone else can address this.

Didi

Didi I too wish Dr. McDougall would address your question and settle this once and for all. You’ve asked it many times.

And regarding your last question “Isn't the HbA1c a measure of how much sugar has stuck to the cells? It seems to me that if your HbA1c is in the normal range then those numbers post prandially over 140 have not done any damage”, I’ve done quite a bit of searching about that and found that as long as the blood sugar is short term and not lingering in the 200, 300 or higher range for days as it does for some diabetics it’s ok. But maybe Jeff N. could give us some research links on that.

And yes, the low-carb people are obsessed with keeping their BS numbers low (many below 120 at all times and A1C under 5 – no matter by what means, whether almost no carbs, medication, or insulin or all of it. The number is all that's important to them.

We DO know that true non diabetics keep a very narrow channel - something like 80-120 but definitely not much above 140 occasionally – no matter what they eat.

I’m wondering if there is any research on what the life expectancy is of people who keep a very tight control of their BS with low-carbing and medication or insulin (and what diseases they will likely get in the end) compared to say a McDougaller who has these frequent spikes for years.

This hour-long video by Dr. McDougall may answer your questions about tightly controlling blood sugars. http://vimeo.com/30473854

In the new book, The Starch Solution, there is a chapter entitled "Salt and Sugar: The Scapegoats of the Western Diet". Keep in mind my copy of the book is a review copy, so everything I'm quoting might change or be removed entirely from the published version coming out in a few weeks.

Anyway, on page 174, under the heading, The Glycemic Index: Not Ready for Prime Time, he talks about the normal increase in blood sugar after meal, and how this raise is so maligned as putting a person at risk for diabetes, thus the frequent advice to avoid foods like potatoes and white rice.

He goes on to say that this fear is unwarranted, that high starch foods have that blood sugar rise because it helps with satiety signaling; it cues you to stop eating.

The interesting part here is the graph, which I'll try to describe:

The left side is blood sugar level, from 0-150. Along the bottom is minutes after intake. It shows two foods, glucose (described as High GI Food) and beans (described as Low GI Food), and charts how the rise in bs happens.

The beans peak at about 100 minutes after intake, causing a rise of blood sugar that appears to hit about 100-105.

The straight glucose, on the other hands, peaks at approximately 40-50 minutes, and raises blood sugar to just about 140 (maybe a little under).

The assumption here is that the graph is for a person of normal health, not a diabetic, and the graph isn't referenced in the text but seems merely to illustrate high versus low GI food effects on blood sugar.

I find it interesting that straight glucose, the example of a "high GI food", only goes up to barely 140, when a simple bowl of cooked (not instant) oatmeal with nothing on it, cooked only with water, sends me to 160-170, and I am regularly tested and do not have diabetes.

I too wish that this would be further addressed. It's certainly frustrating for me, wanting to start the diet yet having mornings like the one I described earlier, where one breakfast had me feeling horrible for hours. When my blood sugar rises and falls quickly like that, I become shaky, anxious, panicky, have difficulty concentrating, nauseous, and headachy, and these symptoms will continue on for quite some time after the blood sugar has gone down.

Right now the breakfast I eat isn't strictly McDougall (though it is vegan and low-fat). It's a protein smoothie, and it's the only thing I've found that I can have (besides animal protein like eggs, which of course I am now trying to avoid) that won't cause these sensations.

@purpleKale
Thank you for the additional information. What you said pretty much confirms what I have found out re spikes. Most 'normal' people will NOT spike above 140 but if they do it comes down rather quickly. How long and how high would do damage to tissues? There is already science suggesting that anything above 140 WILL do some damage. Also, people with or without diabetes will react differently to the same foods. And this is where Dr. McDougall could calm our fears by explaining where HE draws the line and why.

At the very least maybe he would address it in an upcoming newsletter. But the best thing would be to start a separate Forum for Diabetes to concencrate the information in one area ---as was recently suggested.

@talkingmountain - thanks for the link i'll be watching it later on

I have requested that Dr. McDougall address "spikes" but my question has gone unanswered. In one video he says he was criticized for allowing patients' blood sugars to rise to 250 or 350 but it wasn't clear whether or not that was after just going off meds or after a few weeks.

Those on the low carb diabetes support group insist that anything above 140 will cause complications. That is why despite their low carb diet many use meds and insulin to keep those spikes under 140.

Over the years, I have read the most accurate reading of your postprandials is--either--1 hour, 2 hours, and one said the most accurate was with 1/2 hour of taking the first bite. If you are eating fat with starches, your rise in blood sugar will be delayed to three or four hours at its peak. So take your choice.

Everyone is different and I hesitate to give advice, especially since I have not had an HbA1c for a few years. My morning fasting levels are on average between 75 and 85. Often lower, and sometimes higher in the 90's but as I continue to lose weight this is very rare. I have never worried about post prandial numbers and I have been testing for 20 years--no meds. I have no overt complications such as painful neuropathy or any eye problems whatsoever. Any other problems like kidney or liver or disordered lipids I cannot tell because it has been quite a while since I had a blood panel. I really should find a doctor but I hesitate because I do not want to argue about mammograms and colonoscopies and any other procedures which cost money and I am not convinced do any good.

I had oatmeal and a banana for breakfast and four hours later a gigantic salad of spinach, romaine, cucumbers and red peppers. It is 1/2 hour until my third of my usual four daily meals and my blood sugar is 80.

For those who say that spikes over 140 and up to 200 or a bit more are dangerous, I would like to see some references to original published studies which show they are dangerous and provoke complications. Not just someone's opinion. This might be hard to find since, dollars to donuts, any such study would most likely be on those who are taking meds. And who knows what monkey wrench the meds might throw into the mix. And if someone is low carbing and eating meats and fats, then who knows if a 140 or above post prandial for that person is more dangerous than one for someone following low fat, higher carb (and no meat)?

Although I do not worry about post prandials, I do not belly up to the trough and eat all the potatoes or rice or corn or bread that I could probably eat. Some meals I just feel like a huge salad and that fills me up enough till the next meal four hours away. Sometimes I eat a potato with a meal or some other starch but do not go overboard. On rare occasions I might eat just three potatoes and if this is at my evening meal, my morning blood sugars will be in the 70's. I think this is because the higher carb meal prevents the liver from pouring out glucose because sugar goes too low at night during the overnight fast.

If the diet that keeps people healthy is one of starches with the meal then is this the same diet that will keep someone like a diabetic with a metabolic disorder healthy? If it is then why worry about spikes. If not then we have to go back to the drawing board.

Until Dr. McDougall or Jeff answers these questions about the danger of complications from spikes over 140 with valid evidence from the research, we will just be batting this around without any definitive answers--just speculation.

Didi