Are fruits good for breakfast?

I may have said this earlier but its worth repeating. In my experience, fruits were not quite neutral to my sugar control when I had them for breakfast. And I experimented with quite a few of them.

First, let's take citrus. Orange, grapefruit, tangerine, etc.. will cause blood sugar to rise significantly. In fact, one of the first things Atkins dieters cut out is orange juice at breakfast. Doesn't matter if the juice is Tropicana or Florida's Own "Not from concentrate" or the frozen, canned Minute Maid "Mix your own juice" kinds. I even had a juicer so that I could squeeze juice out of oranges myself. Didn't work.

Bad news? In a way. Orange juice is a staple for breakfast. But in my case, a no-no. So I stay away from O.J. or grapefruit juice or any other kind of citrus fruit juice.

Next came berries. There is a little bit of good news here. Based on the glycemic index, berries are better. And strawberries are the best among them.

For a while I ate blueberries in the morning. Not so good for the glucometer reading after breakfast. Then I switched to strawberries. Better numbers on the glucometer but still not quite the containment I was looking for. My goal was to not exceed 30-35 mg/dl in the increase after breakfast.

And here was another critical metric. It turned out that my A1C number decreased when I stopped eating strawberries. Then I found out that the sugar contained in fruits, which is called fructose, is more impactful on blood than other sugars. And not in a good way. Apparently, fructose binds to the red blood cells for longer times than any other kind of sugar. Which is what leads to higher A1C.

Didn't matter to me what the science was. All I knew was that my A1C was lower without strawberries. So I gave it up as a regular breakfast item. Once in a while, I eat them when the mood hits me. But only sparingly.

Breakfast of Champions with Diabetes.

To reiterate a previous point, as a Type 2 managing the diabetes with diet and exercise, it is critically important to keep the glucose rise after breakfast to no more than 30-35 mg/dl over the fasting blood sugar reading.

Furthermore, the body for many different reasons, reacts more to carbs in the first meal of the day than to any other. My personal experience confirms this fact.

To meet the above goal, one has to experiment with the right mix of proteins and carbs and balance that mix with taste and flavor to settle on a meal that is sustainable over the long haul. I have managed to have basically the same breakfast ever since I found that this combo consistently delivered on my goal of 30-35 mg/dl maximum increase after breakfast.

I start out with 8-9 almonds that I soak in water when I first come down to the kitchen. These almonds are not snack almonds.....they are raw, untreated, pristine almonds that I buy in bulk. That is the first thing I consume as I start my early morning "feast".

I had said before that bread is an old time favorite for me. I really struggled with not being able to eat bread for breakfast until I discovered my solution.

Early on, I used to eat bran crispbreads. The brand name is GG Bran Crispbreads and I ordered them online. They used to come from some Scandinavian country. Frankly, they taste like cardboard. And look like it too. But they are a diabetic's best friend. They have very little carbs because they are mostly fiber in content. Tough to digest and tough to swallow but easy on the blood sugar.

Anyways, I found the Healthy Life brand of whole wheat bread in the bread aisle of Dominick's one day and have not looked back ever since. One slice of this bread contains 5 grams of net carbs. Compare that to the regular variety where one slice gives you as much as 25 grams of carbohydrates.

This bread is a life-saver for me. I apply a generous portion of good butter on a single slice of the Healthy Life bread and I am good to go.

To balance the carb content of the bread and almonds, I fry one egg in olive oil and eat it with relish. The feeling of relish....not the condiment.

So there you have it. My breakfast. I have 1 egg, 1 buttered slice of Healthy Life Whole Wheat bread and 9 almonds. I top this meal off with my cup of tea sweetened with Equal tablets and Whipping Cream.

This works for me day in and day out.

How to decide on a Type 2 breakfast?

Now that we have established what to do about the beverage part of breakfast in terms of sweetening and whitening it, let us turn to the meal itself.

First of all, breakfast is the most difficult meal to manage when it comes to the post-meal blood sugar increase. Meaning it is very easy to get a large increase if one is not careful.

My approach is very simple. I want to keep my after-breakfast glucose rise to less than 30-35 mg/dl. In other words, if my fasting blood glucose upon rising was 85, which it happened to be today, ideally I want my peak to be 115-120 afer I have eaten my breakfast.

Many trials and errors later, I have managed to come up with my ideal breakfast combo, which I have been having pretty much without change for the last nearly 3 years. I will share that with you momentarily.

But first let's clear up some misconceptions.

Foremost, no cereal is appropriate for us Type 2s who are trying to control our diabetes with diet and exercise alone. Grape Nuts is one brand that I tried after I had read somewhere in a diabetes management book that it was okay to eat that. Results were disastrous. No offense, but this cereal tastes like birdseed. And looks like it too. Most importantly, it was affecting my sugar readings. So I abandoned it quickly.

There is a lot of mention about oatmeal, specially, steel cut oatmeal - that its alright for diabetics to eat them. Maybe. But not for this diabetic. Again, it had an unfavorable effect on blood sugar. So no dice with oatmeal for breakfast.

Fruits are a complete no-no. Here again though, there is a lot to talk about ...fruits I mean... which I will do in later posts. For now, let me say that I experimented with eating a small amount of strawberries each morning because they are one of the lowest glycemic index berries around.

Glycemic index is a measure of how quickly and how much, a specific food item will cause a rise in blood sugar.

Strawberries worked for a while but I found that my A1C was lower without the steady consumption of strawberries and higher when I ate it. So I decided to forgo it.

I thought maybe yogurt would do the trick. But no..it didn't.

One of my most favorite breakfast items is bread and I needed to have bread come hell or high water. How did I do it and what breakfast combo finally worked for me are what I will talk about in my next post.

Powdered Coffee Creamer, anyone?

Everyone has seen the powdered coffee creamer in those plastic bottles. They are everywhere. Specially in office buildings. Right next to the coffee maker and maybe a box of fresh donuts.

Coffee-Mate I believe is the leading brand. I say that because that is the creamer I see most often in public places. Years ago it used to be Cremora. But I haven't seen them in a long time.

I travel on business quite frequently. On most major airlines I ask for milk with my tea. And I generally carry my own Equal tablets in their dispenser. So there is no problem with sweetening my tea. I use as little milk as possible in my tea when I am flying because it is most commonly either skim milk or the 2 per cent kind ....yes, the kind that is higher in carb content.

On shorter flights, when United or American Airlines uses sub-contractors, like Colgan Air or Shuttle America, there is never any milk on board. Those are the times I have my tea black or I don't have any tea at all. Its tough because I take very early flights quite a lot and tea is the best waker upper for me.

So what is my beef with Coffee-Mate powdered creamer or for that matter, any other kind of coffee creamers?

Here is a list of ingredients for Coffee-mate Powder, Hazelnut, Sugar-Free. I took it from the Amazon website.

Vegetable Oil (Partially Hydrogenated Coconut or Palm Kernel and Canola, Hydrogenated Palm, Soybean, Cottonseed and/or Safflower), Corn Syrup Solids, Sodium Caseinate (A Milk Derivative), Dipotassium Phosphate (Moderates Coffee Acidity), Natural and Artificial Flavors, Monoglycerides (Prevents Oil Separation), Salt, Sodium Aluminosilicate, Sucralose, Datem, Acesulfame Potassium (Non-nutritive Sweetener), Yeast.

Pretty much the entire list has objectionable items for us diabetics.

But the worst offender is Corn Syrup Solids. Which can spike our blood sugars very fast. And yet this Coffee-mate powder is sold to us as being Sugar-Free. Amazing, isn't it?

What do you need to know about milk and yogurt?

I had never thought of this before. Milk contains varying amounts of carbohydrate depending on its fat content. Skim milk has the highest number of carb grams. Followed by 1 per cent milk and next by 2 per cent milk. Lowest amount of carbs is in whole milk. In other words, the higher the fat content, the lower the number of carb grams. Next time you are in a grocery store, just check the labels.

I personally don't drink cow's milk or goat's milk. Milk by definition is lactose. Which sounds too darned close to glucose. So I stay away from it. Type 2 folks like us, who are trying to minimize the number of carbohydrates we consume need to be aware of many of these little nuances so that we can be as miserly as possible with the intake of carb grams.

For a while I was drinking soy milk more frequently than i do now. Here too, one has to be very careful. There are many different kinds and brands available in the stores. However, a quick glance at their labels will tell you that they all contain carbs and in many instances, sugar.

The only one on the market that I know of that will not affect blood sugar readings is the Westsoy Unsweetened Soy Milk. It comes in 3 flavors if I remember correctly - Plain, Almond and Vanilla. This is the only milk I will drink. With tons of flavored sugar-free DaVinci Gourmet syrup stirred into this milk. Pineapple or Chocolate or Strawberry flavored DaVinci syrup have turned a cold glass of soy milk into a dessert for me on many a nights after dinner.

The Westsoy Unsweetened soy milk is not cheap. Neither is the sugar free DaVinci Gourmet syrup. But hey....think of all the money you are saving not eating donuts, cakes, sweet rolls, candy,etc..

Let's talk about yogurt. Try a simple experiment. Next time you are in the milk and dairy aisle in your favorite grocery store, take a look at the carb content of Plain Dannon yogurt, Lowfat Dannon yogurt and Fat Free Dannon yogurt. You will see the Whole milk yogurt has the least amount of carbs, 12 grams to be exact in the larger tub. That is the one you want. Remember every little bit counts.

Going back to the question of what to add to tea or coffee, i.e. milk or half-and-half or what have you, the same logic applies. There are fewer carbs in half-and-half than there are in whole milk and there are fewer carbs in Cream....yes, Table Cream or Whipping Cream or Heavy Whipping Cream than in half-and-half. The choice is obvious.

One teaspoon or at most one tablespoon of cream will whiten the blackest tea in my experience. So that is what I use. Heavy Whipping Cream with Equal tablets in a freshly steeped cup of tea. And I continue to have 4 such cups of sweet-tasting, almond-colored tea every day with no effect on my blood sugar.

Choosing an artificial sweetener.

As I was saying, I was used to drinking at least 3 cups of tea every day with lots of sugar and a good bit of half-and-half. And when you have done that for half a century, give or take a few years, its pretty difficult to give it up.

In fact, one ethnic variation, the Indian spiced tea involves boiling the tea in equal parts of water and milk and adding sugar and cardamom to it, thereby giving it a dessert-like quality. Sugar was the main ingredient in the tea for me. It provided the perfect capper for me after dinner or lunch.

So I was pretty bummed out. Equal and Sweet'N Low powder in packets did not have a good feel and had an aftertaste. Splenda was the least offensive of them all.

It was not until later that I found out a very critical factoid about the artificial sweeteners. All the powdered packet kind contain one very nasty ingredient. Maltodextrin. Believe it or not, maltodextrin causes blood sugar to rise fast.

Yeah.. how do you like that? The artificial sweetener that you are picking as a substitute for sugar and thus aiming to avoid a sugar spike......well, the sweetener itself causes a spike because of the maltodextrin in it. The reason why manufacturers of the sweeteners add maltodextrin is to give bulk to the sweeteners. So that these synthetic powders will look and feel like sugar.

And the marketing campaigns launched by these brands can make the claim that these artificial sweeteners are just like sugar. In fact, as their commercials emphasize the "just like sugar" theme. " You can use 1 teaspoonful of Splenda instead of one teaspoonful of sugar in your cooking and your recipe will not be affected at all", they tout.

Plus the bulking agent, maltodextrin costs less and adds more weight to the sweetener so that the companies can get more revenues per ounce from them.

Another interesting point of fact is that all the powdered sweeteners can claim zero carbohydrates as long as they contain less than 1 gram of carbohydrate - that is the federal law. So even though you might be expecting no impact on your blood sugars from Splenda, Equal or Sweet'N Low,in actuality, if you add 3 to 4 packets to a large Starbucks size coffee container you are consuming almost 3-4 grams of carbs. If you have 4 such mugs in a day, you may be racking up a goodly number of carb grams without even thinking about it.

So what is the solution?

After doing a great deal of research, I homed in on Equal tablets. Not the Equal powder, Huge difference between the powder and the tablets. The Equal tablets do not contain any maltodextrin. They are sold in a Pez dispenser like box for $2.99. 100 tablets in each dispenser.

Unfortunately, Jewel and Dominick's in the Chicago area do not carry them. Only Treasure Island does. After I started using them, I tested my blood sugars to confirm that they did not have any effect. And they did not. In a few days, I became used to the taste.

The Equal tablets took care of my need to sweeten tea. But they were not good for much more than that. I did make cheesecake using crushed Equal tablets a few times and that worked fine.

I was not done with sweeteners though. I still had more work to do.

I began my search for a sugar-free syrup that I could use to create impromptu desserts with. Again, after a lot of looking, I chose DaVinci Gourmet syrups. These are made with Splenda but not the retail Splenda powder which contains maltodextrin.

Merisant Company, Splenda's manufacturer sells non-maltodextrin added Splenda to commercial accounts such as DaVinci. These sugar-free syrups are sold in wine bottles and come in many different flavors. I get them online either from DaVinci directly or from a third party for about $7.99 per bottle plus shipping.

Sometimes, Marshalls or T.J. Maxx stores have them on their shelves. But only a handful of flavors. Their price is fantastic though. Only $5.99 per bottle.

One simple and convenient dessert I came up with and use every other day is to add Raspberry or Strawberry flavored DaVinci Gourmet sugar-free syrup to full fat plain yogurt. Just mix it well and it is ready to be had. Satisfies my sweet tooth every time.

Now you might ask why full fat yogurt? Why not lowfat or nonfat yogurt in keeping with the overall theme of healthfulness. That will be the subject of my next post. This applies to choice of milk as well.

Are Skittles allowed?

Recently diagnosed Type 2 asked if it was okay to continue to eat Skittles. Here is how I answered this question in another forum.

I can see you have a strong fondness for Skittles since you are using it as your nickname.

But the bad news is that a sugar by any other name is still sugar. And that is how our body sees all candy. Including Skittles.

Once you start testing your blood sugar levels, you will be able to see what one Skittle can do to your glucose reading. It causes the blood sugar to spike up very fast and it maximizes the magnitude of the increase as well. So that is double jeopardy.

Does a fasting glucose of 112 indicate prediabetes?

Here is my answer to this question posed in another forum.

The fasting blood glucose cutoff for diabetes is 125.

Normal maximum currently is 100. It used to be 125, then it was lowered to 115 and then 110. And finally to 100.

Today, a reading in the range of 100-125 is called by various names: Impaired Glucose Tolerance, Insulin Resistant, Prediabetic, etc.

For a non-diabetic, the fasting blood glucose number is generally very low. Even if the non-diabetic has eaten a lot of carbs in their last meal the previous day, the FBG in a lab will be low 100.

In my own case, as I looked at my blood test reports from physicals I had had each year for the 15 years before I was diagnosed, I saw a clear trend in the FBG creeping up ever so slowly.

You can do two things.

1. Ask for a second FBG test in a different lab, if possible. And if the reading is in the 100 - 125 range and depending on your age, blood pressure, cholestrol conditions which cause what is known as the metabolic syndrome, you may be pre-diabetic. In which case, you should take all actions required to control diabetes through diet and exercise and "cut it off at the pass" .

2. Take comfort in the fact that your post-prandial readings are so good. You have not crossed over into the realm of diabetics. This is a more telling test, in my opinion, of your current condition. Again, going from personal experience, the body's inability to process carbs efficiently and the body's cells' inability to accept glucose via insulin - both these abilities decrease gradually and when diabetic controls are compromised, the post-meal readings - the Oral Glucose Tolerance Test is a proxy for post-meal sugar control assessment - leave no doubt at all. In other words, if you were diabetic, all your OGTT readings would show that clearly. You may want to repeat this test again as well for your peace of mind.

I think you are still in good shape and can avoid the full-blown diabetes if you start learning about what you need to do and make those changes quickly.

Losing weight in the first 60 days and my initial predicament

Interestingly, I was never overweight. But I was tipping the scale at the top end of the Healthy/Normal weight range for my age, sex and height. My BMI number was also fine. So at first, it seemed like I didn't have any "weight to give" to deal with my Type 2. Thinking I was okay in the weight department, I did not focus on wight loss as a priority to get my blood sugars down or my A1C below 6. I was feeling pretty depressed. My father was never diabetic in his entire life. My mother who is in her 70s has normal readings. Both my siblings have no signs of prediabetes or insulin resistance. Which meant that I did not inherit any defective genes. Then somebody told me something which really depressed me. It may or may not be an urban myth but it did catch me at the worst time. The comment was that "diabetes skips a generation". And my paternal grandfather was diabetic. But those were olden days with imprecise diagnoses and faulty treatments. Maybe he was not, I hoped. With with no specifics about Type 1 or 2 in the "generation skip" comment, I was even more confused .

I started thinking about the symptoms I had heard about up to that point in time and if I had any of them.......frequent urination, lots of urinary output, occasional blurring of eyesight, sleepiness after eating, etc., etc.,

I did not have any of those symptoms. Well, all except feeling somewhat lethargic after a heavy meal. But that was due to " blood rushing to an empty stomach to deal with the food in the stomach" is what I had read and heard. So that was not too much out of the ordinary.

Then...what was the problem? Why was I diabetic?

And more importantly, what should I do first?

Where do I even begin?

I realized how totally, absolutely ignorant I was about this disease and more so about how to control it. There was literally only one actionable thing I could think of. And that was to give up everything sweet. No more sugar in tea. Which I used to have to the tune of 2-3 teaspoonfuls in a coffee mug of black tea with half-and-half. And at 3-4 times a day, that alone translated into 10 teaspoonfuls of raw sugar every day. But I can't drink unsweetened tea, I thought. So I reached for artificial sweeteners but even that poses questions of optimalness - which one is the best or shall we say least harmful to the body? Equal or Sweet-n-low or Splenda? I picked Splenda ... had heard good things about it. It tasted awful the first few times I tried it in tea.

This was only the beginning.

How often should someone test their blood sugar?

Here is how I answered this question on another forum today.

Regarding your question on how often to test your blood sugar, here are some suggestions..

Test first thing in the morning. This is your fasting blood glucose reading and should be below 100. Occasionally if it is in the low 100s its acceptable, but for 90% of the time, it should be below 100.

Test after meals. To determine the peak sugar level after the meal, measure at roughly the 90 minute mark after the first bite of food. For some people, the peak appears a little later, closer to 2 hours after the first bite. Once you know your peak, you need to test for the post-meal sugar level going back to baseline, i.e. your pre-meal level. Generally, this point comes at 3 to 3 and a half hours after the first bite. In a non-diabetic, the peak never goes above 140. You must aim for no more than 160 as your absolute highest peak. Return to baseline means the blood sugar is below 100 ideally.

Breakfast post-meal sugar is the hardest to control, followed by dinner. Lunch is the easiest of the three. Knowing this is helpful because then you can consume higher number of carbohydrates at lunchtime and the least number of carbs at breakfast.

How much you test depends on how data-driven you are. From personal experience, I can tell you that the more you test, the more you will know about your tolerance for carbohydrates in your meals. That will enable you to plan your meals for better control of post-meal spikes.

Dante

Introduction

Here is the beginning of my journey.

On May 26, 2006 I got my blood test results back based on sample collected on May 15, 2006. My fasting blood glucose was 127 and post prandial blood glucose was 255.

A week later, on May 31, 2006, I got my A1C tested and it was 6.9%. There was no doubt about my diabetes.

For those who may not know, fasting blood glucose above 125 and post meal glucose above 200 and HbA1C reading of 6% or above, places one in the diabetic camp. Not pre-diabetic and not insulin-sensitive. Full Type 2 diabetes in all its glory. I was aghast.

But I resolved to get back to a non-diabetic blood profile as quickly as possible. And started learning about what I needed to do to achieve that. I became a man possessed.

On July 26, 2006, less than 60 days after confirmation of diabetes diagnosis, I got my blood tested again. This time my fasting blood glucose was 84 and my HbA1C was 5.7%. I also got my insulin and C-peptide levels measured. And they were perfectly normal.

To confirm the blood results, my physician had me go back for another fasting blood glucose and insulin level measurement on August 2, 2006. Numbers were 80 for the fasting blood glucose and nearly the same insulin reading as the week before. I was back in the non-diabetic world again as I had planned. I felt relief and a sense of success. Hard to describe in words.

Did this mean that I was cured of this disease? Of course not. But without any medication or insulin, I had managed to reverse my diabetes. And in less than 60 days. No miracle cure. No test drugs. And nearly 3 years later, my numbers are better.

So that there is no doubt in any one's mind that I am making this up I have scanned the pages from my blood test reports and will upload them as soon as I can figure out how to add pdf files to the blog. When I tried to do it a few times, I got Error messages.

Anyways, the purpose of my blog is to share my findings with others and hopefully gain some important knowledge from others. I suppose if there is a category of diabetics that people like me belong to, it would be "people controlling Type 2 diabetes with diet and exercise". With 25 million Americans already diagnosed as diabetics and another 54 million people with prediabetes or borderline profiles, we all need to learn about this sneaky but deadly disease.

More to come........