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For background info, here are my type 2 husband's previous ac1's (they were all listed on the lab report which is great because I didn't have any)

Taking Metmorfin and another medication, don't remember the name...

03 Nov 2010: 7.6
11 Feb 2011: 8.6
04 Apr 2011: 8.2
20 Jul 2011: 8.7
14 Oct 2011: 6.9 (starting McDougall diet, had lost about 10 pounds at that point)
12 Jan 2012: 5.4 (had lost 30 pounds and was taking 1000 mg metmorfin a day)
02 Apr 2012: 6.5 (had lost 42 pounds and stopped all meds Feb 1st)

Other numbers noted:

Total cholesterol: 143 LDL: 67 HDL: 58 Triglycerides: 91

It's disappointing to see that his previous ac1 was better, albeit with metmorfin. We've only started testing bg a few weeks ago and learnt to alter his diet to avoid spikes. In terms of numbers, his fasting level is usually around 115, and if eating properly will not go over 140. The question is, can we improve on his ac1 just by diet and controlling his spikes or should we consider going back on the metmorfin again? Husband is seeing his doctor tonight so I would be really grateful for your opinions.

A couple things you might find interesting:
http://forecast.diabetes.org/magazine/f ... new-number
http://borderlinediabetes.blogspot.com/ ... o-you.html

I wouldn't go back on the medication unless it were absolutely necessary, and that would probably have to include having an ac1 above 7, but I can't make that call for someone else and don't know what your husband's doc will suggest. If you continue to monitor his blood glucose you'll find what works best as far as eating goes and probably see further improvement without medication. Medications always have side effects. I say avoid them if you can. What was the doc's ac1 target number for your husband? According to Mayo clinic, ac1 of 7 percent or less is a common treatment target for someone who's been diagnosed with type 2 diabetes. In that case, your husband would be on target.

http://www.drmcdougall.com/med_diabetes.html According to this, Dr. McDougall doesn't recommend taking oral hypoglycemic drugs because they increase the risk of dying sooner.

Just my thoughts.

I've said this before: losing weight usually lowers a person's bloodsugar numbers. So after starting McD your husband lost quite a bit of weight and went from A1C 6.9 to 5.4 (results are 2-3 months average) Then he stopped the medication and didn't lose as much weight plus the metmorfin got out of his system. The result: his A1C went back up.

It will now be interesting to see if he continues to get lower readings once he has reached his ideal weight and will not be losing much more.

The official A1C recommendations are all over the place from 7 to under 5. As you know the low-carb people all clamor to be UNDER 5.

It will be interesting to see what your doctor's comfort zone is. But there is no doubt your husband is making great progress. I wish him continued success.

I'm confused. The 4/2/12 number is lower than any other number EXCEPT the 1/12/12 number, which is when he was on meds. Of COURSE it went up when he went off the meds, b/c they were keeping it artificially low. ???

What is his weight and height currently?

One thing from my experience is that between meal snacks only sent my A1c from 5.4 up to 6. I quit the snacks and it went right back down. Snacking maintains a higher baseline during the day so makes spikes absolute value higher and makes for a higher average (A1c) overall)

Thank you all for your thoughtful and informative replies.

So my husband went to see his doctor last night, and his reaction to the results was very positive. He pointed out the fact that when my husband had the 5.4 ac1 in January, he was 15 pounds heavier than now, and he thought that if he had stayed on the Metmorfin his BG might have dropped too much. He also thought that 6.5 is a good reading, (I can tell he doesn't hang around the low carb forums ) and in view of that and the excellent cholesterol and blood pressure (which was in the low range of normal) tests, we should continue on as we have been doing.

Soooo... You have to realize that this is a French family doctor in a small village not some high flying New York endo! Taking everything on board that I've learned here I've decided that I would be very happy if husband could get a 5.5 ac1. Why that number? First of all, I've been studying the eAG chart (thank you AlwaysAgnes) and based on the non-diabetic readings of myself and my healthy teenagers, I feel that if we had an ac1 done it would be around 5.5. I base this on fact is that we have resting blood sugars of around 90, and spike up to 125-130 after healthy carb meals (veggies, whole grains, legumes). If I look at the chart I think our average would be 5.5, and I don't think we could have a lower ac1 eating the way we do. I realize that a lot of high fat/low carbers go for even tighter control, but I can hardly expect him to have a lower ac1 than the non-diabetics. And as long as his overall health remains excellent, (cholesterol, blood pressure, sense of well being) I would be pleased to reach a goal of 5.5.

Now the question is, can we do it without drugs or without giving him traditional high fat foods like meat, dairy and eggs? I don't ever want him on any drugs again, I'd rather force feed him a steak first! I'm still hopeful that we can, for a few reasons. First of all, my husband's weight has dropped again, I thought he was at his set weight but apparently not. As of this morning he is now 5'9" 154 pounds (180 cm/69.9 kg), which gives him a BMI of 21.6 which isn't that low. I would like to see him at 21, which would make him really slender. He looks slim, but still has a little flab around his tummy, I can't decide if it's from 15 years of wearing a pot belly or fat. In any case, he's starting to add abdomen exercises to his workout, right now he rides a stationary bike. So we'll be testing the Barnard theory that fat increases resistance to insulin.

The other thing is that we've only started testing his blood glucose regularly a few weeks ago, and until then his daily breakfast was rolled oats with milk, which I now know spikes him to 200. I was also giving him a lot of potatos with a similar result. That won't be happening anymore. I'm confident that with the knowledge we now have, I won't have any problem keeping his bg under 140. Hopefully one day in the near future his insulin sensitivity will improve and he can join in with the rest of the family when we eat potatoes which he loves. Luckily he always hated oats so that works out well

I've also noticed in the last week that his bg between meals is getting lower, it's consistently under 100 now, where it used to be 110-120. These are still relatively early days for him, and after having basically poorly controlled diabetes for 15 years, it's not going to get back to normal in a few months. I'm an excellent cook, and there are a lot of carbs that he handles very well, so for the time being we are going to keep on testing, and keep the bad carbs away. I actually googled low-carb vegan diet and was surprised to see quite a lot of info out there on it. We are not alone!

Again thanks for all the feed-back, and the information. I'll keep you updated.

Are you familiar with all the info Dr. McDougall has posted re: diabetes?

http://www.drmcdougall.com/med_hot_diabetes.html

Particularly here?

http://www.drmcdougall.com/misc/2006nl/ ... ycemic.htm

And particularly this (from above link):
[emphasis mine]

It occurred to me that you (1) post a lot about how various carbs raise your husband's blood sugar (which is not the usual result on this plan), and (2) seem to eat rather high fat meals (higher fat than recommended for diabetic patients, who should really be following a diet closer to MWL, and also higher fat than the regular plan for the most part).

You might consider that it is the FAT, and not the carbs, that is raising your husband's blood sugar. That certainly seems to be what Dr. McDougall is saying.

You might want to email him for clarification: drmcdougall@drmcdougall.com

My personal experience, via my bg monitor, is that while high dietary fat and esp saturated fat definitely has an effect, already in place body fat is much more significant. Attain a lean, healthy body weight and insulin resistance generally vanishes and your body will do just fine with a bit higher fat intake (so long as it is most all unsaturated far carried in its whole plant home)

That may be true, Geoffrey. Not sure what hubby's current BMI is? I don't think she answered. But given that right now a lot (by the standards of this WOE) of fat is being served, it seems at least possible that it is the culprit, particularly if hubby is not yet at a low norma BMI.

The only diet info I saw above was until a couple weeks ago, milk in the morning and that would for sure be an issue.

Not a terrible BMI by any means. But

This could be a huge issue. About 18 months ago I got down to 105 lbs (from 120) at 5'3" and looked like an Xray but I still had the pot belly I have had for probably 10 years. I lost the weight really by accident playing with calorie density and just went to far, gone before you know it! And I still had some IR issues. Built back up 120 working out and am just now completing a water fast. Only when you fast on water, not juice, the body goes deep into ketosis and so is quite muscle sparing. This morning I weighed 103, look much more muscular than I did at 105, and my waist has gone from 32 inches to 28. That is to say, I now have a waist! Subcutaneous fat is not much harm in and of itself. Women generally carry much more of it than men do yet on average they live longer. But in most people, not in some like me!, it is a fair marker for visceral fat which is the real killer. That's the stuff that accumulates around organs and jams up the insulin receptors and all does all sorts of other mischief. I have zero evidence but suspect that my lean, fat person body is what is behind much or the diabetes that catches thinner people by surprise. I have met/known many. "How could I have diabetes? I eat healthy, I am lean and fit..."

Hi,

1. My husband has diabetes type 2 so unfortunately some whole foods will spike his blood sugar into unsafe levels, i.e. 200+. A few examples are potatoes, oats, wheat flour, and apples. Luckily there are several healthy grains he can eat without any problems, such as quinoa, brown rice, and chickpeas. We're still in the process of testing to determine safe and unsafe foods for him at this time. The only high fat food he eats regularly is tofu in his breakfast scramble, prepared with a lot of veg, and this because it does not spike his blood sugar. He does not eat any oils nor do I ever use any in my kitchen.

2. Curious about the impression that we eat a high fat diet, was it from my Easter dinner posting? That was a feast! My husband and myself follow the MWL plan, he didn't lose 42 pounds in the last 6 months on a hight fat diet. I eat at the higher end of the Mcdougall fat spectrum simply because I'm very slender, and if I don't 'bulk up' with nuts, tofu and avocados, my weight gets too low. I'm also feeding a large family of healthy teenagers who have no problem eating like me. My husband often gets a slightly modified dinner to suit his weight loss goals.



It was definitely eating too much fat which gave him diabetes type 2 in the first place, but unfortunately there are a lot of carbs which are still spiking his blood sugar to unsafe levels. It is my hope that given more time eating this diet and at a good weight, this will gradually decrease.



The milk referred to was soya milk on his oats, and we've since found out that oats will spike him to 220, so they're out of his diet for now.



Studying the information in that link I read this: Blood sugar levels, if you are taking insulin, should be controlled at 150 mg/dl to 300 mg/dl.

I wish Dr. McDdougall could explain to me how someone's blood sugar can be considered controlled at those levels, when it is well documented that nerve damage occurs as blood sugar rises above 140 mg/dL. Anyone?

I think his rationale is that IF someone is really sticking to the diet, all their numbers will go towards normal fairly quickly. In which case a short time with excursions to 300 is much less of a danger than the danger of a medication induced hypo which can even be fatal! He figures, I am sure that the high end will rapidly be reduced, within days to weeks and continue dropping until remaining in fully safe range.

As mentioned above though, from what I have seen, some people can take awhile to get really normalized blood sugar response, and the limiting factor is residual visceral fat i.e. a pot belly.

That's what I'm hoping too, as of this morning he is down another pound, it seems to be going fast now. He also exercises several hours a week and is going to start adding some abdomen exercises to his workout as per his doctor's suggestion, as he's been suffering from lower back pain for the last couple of months. That's the downside of losing weight. I've also noticed that his BG between meals is consistently under 100 now, and a few months ago it wasn't.

OK. I just see you posting recipes which contain tofu and nuts frequently (and recommending adding them to other peoples' recipes). I didn't realize that you were making 2 entirely different meals each time. If your husband is truly following MWL then he should just keep it up. It hasn't been very long, he still has weight to lose, etc.

Have you emailed him?