Blood Sugar - Advice on weight and tummy reduction.

[TRULYSPEAKING]

My wife is on either of insulin Apidra/Regular/Lispro 16 Units 15 to 30 minutes before B/F, lunch & dinner, Insulin Glargin 42 Units at 10pm, Vildagliptin 50 mg BD and Metformin 500 mg BD. She’s putting on weight (70kg, ht 160cm, age 68) & her tummy is coming out. HbA1C last was 7. Need advice on weight & tummy reduction.

[sandybrown]

You need to list food intake for all three meals and in between to get a satisfactory answer.

[TRULYSPEAKING]

Ok and thanks.

1. Two glasses of warm water in winters and normal water in summers immediately after getting up.

2. After one hour of above - two cups of tea without sugar but with sugar-free tablets and milk powder with two Marie biscuits or two rusks. (Now no Sugar-Free tablets).

3. B/F - kernels of one and a half walnut and kernels of ten almonds (soaked in water the previous night and skin of almond kernels peeled of before eating), half apple, half pears, some seasonal fruits (total five fruits of different types and colours), mixture of Moong sprouts, cucumber, tomatoes, carrot (half cup say 100 gms.

4. One cup tea at 11 am or about.

5. Lunch - coarse grain chapati - one, daal - one katori (cup), seasonal vegetable say about 100 gm. Occasionally curd 50 to 100 gm.

6. One cup tea at 5.00 pm.

7. Dinner - the same as lunch or one piece of chicken (grilled) and mixed boiled seasonal vegetables about 100 gm.

Now since the past 10 days she has discontinued Apidra 16 units before lunch as post lunch her glucose used to go down to 80.

Her fasting sugar is around 160. But throughout the day it remains around 120. High fasting sugar level is perhaps due to “Dawn Effect”. PP Sugar level is 120 to 130.

If there is any other information desired please do ask.

[sandybrown in reply to TRULYSPEAKING]

Thank you. You need to look at some of the food intake.

Cut out number 2 and drink Fenugreek soaked water.

Add soaked Fenugreek to breakfast. You may also cut out some of the fruits to a small breakfast.

Lunch and dinner consider chick peas, sweet potatoes, green leaf veg, including (methi) cooked in butter or olive, small portion. Eat dinner before 7 PM.

Give up breakfast for few weeks and check the weight and waist!!

Check the waist to height ratio, Google to check the chart. Also Google menopause.

Regular exercise and smaller portions of food can help. Keep a food diary.

Give it a try and post the results after 4 weeks.

[TRULYSPEAKING in reply to sandybrown]

Will do. Thanks.

[Praveen55 Moderator]

TRULYSPEAKING

One of the side effects of insulin is weight gain. That is what is happening here. High level of insulin in the blood promotes fat storage.

As such the diet that your wife is following seems to be okay except few things. The key here is to follow a diet which should require less insulin to regulate the blood sugar. Being non-vegetarian makes things easier also.

Looking at the diet, it seems to me you are every careful about fat. For example, you use boiled vegetable without the use of any fat. Please remember, fat is not bad as long as it is healthy fat.

I suggest the following:

1. Use lots of non-starchy vegetables and salad. When cooking vegetables, use generously butter/ghee/coconut oil. In salad , use olive oil as dressing.

2.Remove all fruits except berries ( e.g. blue berries, straw berries etc) in moderation.

3. Reduce or eliminate consuming grains like chapati and dal. One can eat fatty fish during lunch. Or a large bowl of salad and paneer fried in butter. There are many options.

4. In dinner one can eat cauliflower rice with chicken curry. No need for rice and chapati or dal.

5. Use fresh cream, sour cream, full fat curd if hungry.

In fact if one eats properly, one may not need more than two meals plus some snacks like nuts and seeds. Below is a link for one day diet for guidance only. This kind of diet reduces the insulin requirement and one may lose weight also. Please remember, she does not have to follow in the exact way, one has to modify as per individual requirements like quantity and frequency of eating.

One can consider intermittent fasting also along with low carb meals.

healthunlocked.com/diabetes...

[TRULYSPEAKING in reply to Praveen55]

I feel very grateful for your response and advice. The only thing is that in my Country (India) berries are not commonly available. Strawberries are available only for about a month in April-May. Is Papaya ok?

We too felt that heavy insulin was perhaps largely responsible for weight gain.

Thanks once again.

[Praveen55 Moderator in reply to TRULYSPEAKING]

Yes, papaya is good. I forgot to include that because that is not easily available here.

Apart from that, locally grown non-starchy vegetables ( the ones that grow above ground) are good to meet the requirements of essential vitamins and minerals.

[TRULYSPEAKING in reply to Praveen55]

Sorry to bother you again. Apart from papaya what other fruits, amongst the following that are easily available in India, would you suggest:

1. Peaches 🍑.

2. Apricots.

3. Mausambis.

4. Guavas.

[Praveen55 Moderator in reply to TRULYSPEAKING]

TRULYSPEAKING

It all depends on your goals and priorities. All the above 4 fruits have more or less same amount of sugar per 100 gm. It is 9 gm. Guavas has highest amount of dietary fibre and therefore a preferred choice.

A diabetic can not process carbohydrate as efficiently as a non-diabetic and therefore it is better to reduce overall consumption of carbohydrate including sugar. Particularly in your wife's case of T2D and on insulin means her pancreas is already not making enough insulin to regulate the blood sugar. If she can reduce the dietary carb intake, she would require less insulin to regulate the blood sugar. I understand quitting something as simple item as a fruit may sound little strange but sugar is sugar. Please consider this carefully.

I would suggest to limit total carb intake in a day to about 50 gm if practical. Work towards getting rid of external insulin injection.

Otherwise, you adjust the insulin dose as per requirement of carb intake.

[sandybrown in reply to TRULYSPEAKING]

What fruits are available in your area in India?

[TRULYSPEAKING in reply to sandybrown]

Summers:

1. Water melons 🍉.

2. Water melons 🍈.

3. Apricots.

4. Peaches 🍑.

5. Mangoes.

6. Strawberries 🍓 (only for about a month in April-May)

7. Raspberries (only for about a month in April-May).

8. Gooseberry (only for a moment month in April-May).

9. Jamuns (Indian blackberry or Jambul).

10. Kiwis 🥝.

11. Mausambies. (It is from tad orange family but skin is green in colour)

Winters:

1. Oranges.

2. Apples.

3. Pears.

All around the year:

1. Papaya.

2. Bananas.

(All fruits are available around the year but kept in cold stores)

[sandybrown in reply to TRULYSPEAKING]

I had a look at fruits for diabetes, there are many. The list fruits that given are in the list of fruits for diabetes!, enjoy one life.