Tuesday, August 19, 2008

Visit with my diabetes educator

Had a pleasant visit with my certified diabetes educator (CDE) at Mills Peninsula. The overall blood glucose numbers are looking good and are dropping.

last 60 days: 149 average
last 30 days: 145 average
last 14 days: 142 average
last 7 days: 141 average

Considering that my a1c was 9.5 when diagnosed (which means around 255 average), this is a great trend. She said that the trend should continue and that it's looking really good; I have high hopes for getting those morning fasting numbers knocked down. She did say to try not to get too frustrated with the blood glucose monitor; like the scale and the measuring tape, it's a tool, not something to get obsessed with. We're moving my metformin to p.m. instead of a.m. My CDE said that insulin resistance can increase at night while our bodies are sedentary. Exercise, exercise, exercise!

On the other hand, when I told her that my numbers had gone up after a particularly intense workout, she noted that harder isn't always better when you've got diabetes. Longer is good, as is exercising frequently (5 days/week minimum), but higher intensity can increase stress, which can increase the blood glucose immediately after. However, the activity generally makes for better numbers during the day.

Regarding weight loss, she was impressed with my progress. (Here's what the nutritionist showed me last time I visited, after I got off her scale. Revolting, no? I'll have to get a photo of me with it next time I'm there!) She asked a good question: "This might not happen, but are you prepared for how you'll feel if you don't see a loss?" Gulp. I was getting a little anxious about not seeing as much of a loss as I would have liked, never mind no loss or (gulp again) a gain. I'll have to think about that one.

We discussed the shortage of certified diabetes educators in general, and my dismay that there are so many people on the online discussion boards who are newly diagnosed yet are not given much information on how to take care of themselves or referrals to diabetes educators or nutritionists. I did find a really good online resource on the Diabetes Mine blog: a link to free online education hosted by University of California San Francisco called "Diabetes Education Online". The diet information follows the ADA diabetic exchanges program; and it explains diabetic exchanges and food planning very well and offers sample information, such as how many exchanges/day for given numbers of calories. It's general sensible eating but not low carb, so one's mileage may vary on the nutrition info if one is taking the low carb route.

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