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PDF Editor FAQ

How should I lower my A1C? I'm a nineteen-year-old type 1 diabetic, but it seems impossible for me to get it down.

Being a teen with T1 diabetes is hard. Hormones and growing mess with your blood sugar. The good news is that, at 19, you are on the tail end of puberty and your body should start being more “predictable", making it a bit easier to control your blood sugar.(A quick note: I was diagnosed with T1 at age 36, and two of my daughters are also T1--one diagnosed at 4 and the other at 13. We were all diagnosed within 13 months and have been living with T1 diabetes for 17 years.)My suggestions are:Make sure your insulin doses are accurate. Work with your doctor, preferably an endocrinologist, to adjust your carb ratios and correction dose. As you probably know, your insulin needs can change quickly, so you may have to adjust your dosing repeatedly. If you are not comfortable changing your dosing, call your doctor for advice.Chart your blood glucose over a two-week period. I am the worst at keeping blood sugar logs, but I am now using a CGM (continuous glucose monitor) and it shows patterns that I hadn't noticed. If you use an insulin pump, you'll also have reports you can bring up and analyze. Seeing the data can help you adjust your insulin and food intake.Save the Skittles and sodas for when you are low. If your diet is high in quick carbs, your blood sugar is harder to keep even. If you don't eat like the average 19-year-old, then congratulations! However, there's always room for improvement. Keep track of your food intake and how it affects your blood sugar. My nemesis is pizza. About an hour after I eat (and dose for it) my bg is fine. At the 2-hour mark, my bg starts going up. I've learned to give myself part of my calculated insulin dose before I eat pizza, then the rest of my dose 1 and 1/2 hours later.Learn as much as you can about T1. It's hard to find information that doesn't focus on T2 diabetes, but the more you know about T1 the better equipped you are to make treatment decisions. I recommend Think Like a Pancreas by Gary Schreiner, MS, CDE. This book helped me SO much, and I still refer to it now and then.Keeping your blood sugar as level as you can, without lows and highs, is your goal. As you well know, that's easier said than done. For now, focus on your insulin dosing and make the changes you need. If you can get yourself in range for the majority of the day, your A1c will reflect that. Remember, though, that a low A1c isn't always good--if you are suffering from hypoglycemic episodes, you should adjust your insulin to avoid them.Also, keep in mind that T1 is your lifelong companion. There are times when you will be ultra-motivated to attend to your numbers, and times when you are on autopilot. While you absolutely cannot ignore your T1, stay compassionate with yourself. You are doing the best you can!

What are the benefits of eating fruit as breakfast?

Is it healthy to eat fruits as your breakfast?It can be. Fruit is a good source of quickly accessible energy for the body, and fruits contain a significant amount of vitamins, minerals, fibre, and water.However, the energy from fruit is quickly used, so you might find yourself hungry within just an hour or so of eating. Because fruit is high in sugar (specifically fructose), you may also find yourself struggling with a blood sugar “crash” a couple of hours after eating, if you eat only fruit for breakfast. If you have any kind of blood-glucose regulation issue (e.g., diabetes, insulin resistance), you will definitely feel tired and hungry after a breakfast of only fruit.I like to explain the macronutrient balance to my kids this way: When you build a campfire, you need tinder to start the blaze, medium-size sticks (kindling) to keep it going, and a couple of logs (fuel wood) to provide long-term light and heat. In the food world, carbohydrates are your tinder, proteins are your kindling, and fats are your fuel wood. The carbs get things going, but they burn up quickly — think of pine needles or lint used as tinder, and how fast those things burn. If you have mostly carbs in your meal, you’re going to be hungry again very soon. The fats keep things going the longest, but they require more processing to access the energy, so you can’t rely on them for instant energy. Proteins are in the middle. They take longer to “burn up” than the carbs, but not as long as fats. So they give you that middle-distance burn.If you like fruit and want to include it as part of your breakfast, I would recommend adding a source of protein and a source of fat to offset the impact of the carbohydrate (sugar) in the fruit. For example, pairing your fruit with an omelet filled with guacamole or butter-sauteed vegetables, or a nice eggs benedict, would balance out the macronutrient profile. The fat in the guacamole, butter, or hollandaise will provide both long-term energy and a satiated feeling, while the protein in the eggs provides vital nutrients and mid-range energy.It’s worth noting that it takes only a small amount of fat to do the heavy lifting. Half an avocado, a handful of pecans, a couple of tablespoons of nut butter, hollandaise, or mayo — any of those will give you sufficient fat to carry you through the morning without hunger pangs or a blood-sugar crash.

How long should you wait to see a doctor if your sugar is 600?

About zero seconds. Doc or ER for a glucose reading that high.Not a doctor; responding to A2A.Make sure you follow up with a fasting insulin level later and address the insulin resistance you very likely have.Never had a blood glucose that high but WAS diabetic for a long time.Type 2 IS reversible but takes a lot of work. The meds will NEVER reverse it.Takes a lot of work because there are many factors in play AND a lot of repair work that must be done because you’ve had an issue for some time or could not get that kind of a reading.NOT saying to not take meds at this time; you can make the dietary and other changes while on meds and then taper off UNDER physician’s supervision.You likely have major gut dysbiosis. Am sure you are not “fat-adapted” either—you run strictly on glucose I bet. Will take some serious work and time to correct those issues.Read about AIP autoimmune paleo from Sarah Ballantyne; Joseph Mercola’s Fat for Fuel; and Dale Bredesen’s The End of Alzheimer’s. Make LOTS of notes. Think about what you are willing to do. Then go work with a doctor to have a plan. Talk to him about a CGM for a while as well: Continuous Glucose Monitor. Keep a good log of what you eat, drink, take (supplements and meds and anything that is “over the counter”) and how you feel. You have your work cut out for you but unquestionably need to seriously alter your diet. The recommended diabetic diets are NOT the answer; you need to eat a healthy diet. The books I recommend are by a PhD in Biomedical Physics who did medical research; a D.O. clinician; and a research MD so you are getting an assortment of scientific and medical perspectives that are important. Most likely you need a functional medicine nutritionist to work with you. Hopefully your doctor is good with that because the official diet is BAD for diabetics: heavy on carbs, light on healthy fats; the exact opposite of what it NEEDS to be. I had been diabetic for years. Saw an endocrinologist for different issue and she was OBSESSED with wanting me on metformin or SOME drug, swore diabetes was NOT reversible and horrible things were going to happen to me. That was probably 5 or more years ago. I ignored her nonsense and continued my own research. My fasting insulin went from at one time a 47 to 5; my fasting glucose had been over 100 when on meds, now 77; my A1cs had been at least 7.6 but I think it was around 9 at one point; now routinely 5.0. My current PCP calls that a reversal; my current endo thinks of me as a FORMER diabetic. Been there, done that, happy to report that it does NOT take bariatric surgery to reverse diabetes and there are exactly ZERO diabetic reversals from meds. Avoid the artificial sugars which are everywhere. Ballantyne explains that those are endocrine disruptors and can cause other issues for folks.Good luck. Don’t get trapped into “managing” your diabetes—plan on reversing it—certainly can greatly improve your condition even if you did end up needing to use metformin for years. (Make sure to supplement B12 if on that; probably also will need CoQ10 as well. If you need folate, make sure it’s folate or folinic and avoid the folic acid—read Ben Lynch to understand why.) Best to stop eating processed foods—the “fortification” is usually a mistake; often loaded with sweeteners, tons of table salt, preservatives, colourings, and more.

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