New diabetic DH please help

iVillage Member
Registered: 05-09-2005
New diabetic DH please help
9
Thu, 02-21-2008 - 2:17pm
Hi,
My husband developed a swollen knee with redness and pain last week. The internist (regular primary care MD) ordered an A1c, fasting blood glucose and uric acid (maybe the knee was gout?). Primary MD treated the knee only with NSAIDS -- it is better this week.
He also has kidney stones - 3 episodes in past 12 months -- we wanted to know if he had gout (which can cause kidney stones -- we have never been able to catch a stone to have in analyzed) -- I think the Uric acid level was between 6 and 7.
We have not seen the primary MD for follow-up (they are awful about follow-up) but the urologist today said that the A1c indicated diabetes (didn't tell us the number) and that the fasting blood glucose was 121.
I had already asked the primary md for a referral to a nutritionist -- but they didn't give us an appointment until March 26th.
Sooooooo what do I do in the meantime? Cut back on carbs in general -- find a diabetic diet -- the urologist said all white foods had to go, but that that was not his specialty.
Can you give any suggestions for what to do until we see the MD? Should I ask for a referral to a special dietician who specializes in diabetes? Should I ask for a referral to an endocrinologist.
My husband is definitely overweight -- has been for a very long time. He eats when I am not home. Height 6 feet, weight 265
History of heart disease -- had quadruple bypass surgery.
I know generally speaking being overweight has been/is a major problem.
Please help me with diet until we get some definitive guidance (if we ever get any) and questions to ask -- also about referrals.
Thanks much
Megan
iVillage Member
Registered: 04-03-2003
Thu, 02-21-2008 - 3:28pm

There is no "diabetic diet" - it's a matter of controlling carbs and portion sizes in general. White food out is a good general rule of thumb - white flour, white potato, white rice, white sugar - all hit the blood stream like a grenade. What you want is a nice gentle swell like a calm lake not a big tsunami as far as how your blood sugar changes over the day. You'll want to keep carbs at probably 30 grams at breakfast and lunch and 45 at dinner for your hubby's size until otherwise instructed. Check *every* package for the carbohydrate values. Fiber is good. Protein is good. Carbs are necessary but must be watched - try to get carbs in partnership with fiber and/or protein. So, instead of white bread and cold cuts for lunch, try whole grain bread with nut butter (real nut butter not the stuff that is mostly hydrogenated oil with some peanut added) and a spoonful of fruit jam. Better yet, find a low carb whole grain bread. South Beach diet related products are often an easy way to find low carb (but check them anyhow, some of the snack bars are still pretty high in carbs, plus they often contain maltitol or other sugar alcohols which can cause digestive upset in some people, especially if eaten a lot). With his existing cardiovascular issues, low fat/low cholesterol is even more important for him than for diabetics in general, who are at higher risk to start with.

If your hubby eats when you're not home, be sure to stock the house with foods that are okay for him to eat - lots of fresh, easy to grab veggies; whole grain pretzel sticks; unsalted nuts; etc Remove potato chips, cookies, soft drinks, and so on until he's talked with a nutritionist and had follow up work done - he'll need a blood glucose monitor to keep tabs on his blood sugar levels. That'll be how he'll know that eating one pretzel is okay but 4 is too much for him (because 4 might be okay for someone else OR 1 might be too much for someone else); it's how he'll know whether he can have 1/2 cup pasta or 3/4 cup pasta *safely*.

One thing to note is that carbs cannot be 'saved up' as calories can. While one might say "gee I know that I'm going to be going to that party this evening so I'll eat just a light dinner because there'll be snacks" (saving calories to use later), carbs are a use them or lose them proposition - you can't 'save' 20 grams of carbs from lunch and have a huge dinner. What you'll end up with is dropping your blood sugar low in the afternoon with the too small lunch and then spiking up way high with the huge dinner. You don't want peaks and valleys because both too high and too low cause damage.

--Deb

Avatar for cl_coldfingers
iVillage Member
Registered: 03-19-2003
Thu, 02-21-2008 - 6:15pm

Hi and welcome to the board?


iVillage Member
Registered: 07-10-2003
Thu, 02-21-2008 - 8:02pm

There is supposed to be a link somewhere here to a Eat to Beat Diabetes plan, somewhere around here. Hopefully Maryfrances will pop up with the link!!


Avatar for cl_maryfrances40
iVillage Member
Registered: 03-25-2003
Fri, 02-22-2008 - 11:43pm
Here is the link to the article entitled Eating to Beat Diabetes

http://health.ivillage.com/diabetesthy/di/0,,pz7h,00.html


Remember we have to have some carbs for brain health. The thing about diabetic eating is that the total amount of carbs is controlled and it is better to get his carbs from whole grains. In diabetes we have a saying "If it is white, don't bite!". Try to use white carbs sparingly. Whatie carbs are white potatoes, white flour, white rice and of course white sugar. All these carbs will raise his blood sugar as quickly as if he ate a spoonful of sugar and they will all raise it the same amount.



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iVillage Member
Registered: 05-09-2005
Sun, 02-24-2008 - 7:45pm
Hi,
Thanks for the info. We got a note from the MD yesterday (Sat) which gave us only one of the test results the A1c which was 6.8. It said "your diabetes is under intermediate control. Please see me".
But of course they won't give us an appointment for a month so I need help with this. I guess what is really upsetting is -- the MD is acting like we knew my DH had diabetes -- we were never given a referral to a dietician until I "demanded" one because of his weight. We were given no information about this, ever. No classes, nothing.
Oh well. The Joslin sites are helpful and the carb counts. Thanks so much.
Megan
Avatar for cl_coldfingers
iVillage Member
Registered: 03-19-2003
Sun, 02-24-2008 - 7:57pm

That is too bad that the dr is acting that way...


Avatar for cl_maryfrances40
iVillage Member
Registered: 03-25-2003
Sun, 02-24-2008 - 8:53pm

Megan,


You husband appears to be real lucky because his number isn't that bad. With even a modest amount of weight loss he will most likely have this number under 6.


So see his doctor again and do see the dietitian. In the meantime use the materials that you found at Joslin. Please get back to us and let us know how both of you are doing. We are here to answer questions and to hand hold at anytime.



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iVillage Member
Registered: 06-09-2000
Wed, 02-27-2008 - 11:45am
Hey Megan, I am the wife of a Type 2 Diabetic and just wanted to say hi and let you know this a great place for info and support. My DH was diagnosed last June and it was a total shocker. We never knew until he got sick and it turned out he was close to a coma when we got to ER. His sugar was over 400....talk about scared......both of us were scared for different reasons. He immediately was given a shot of insulin and after a few hours was able to come home. The doctor in ER acted like we should have known too. Luckily are family doc was wonderful and got Brian's sugar down. It took a diet and meds, but I am happy to say he is doing very well. The one big piece of advice I can give is this......Don't NAG him.......he has to do this his way and all you can do is try and keep healthy foods in the


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iVillage Member
Registered: 03-04-2008
Tue, 03-04-2008 - 7:40am

I would just like to thank you for your input. My husband was just told he has diabetes. I have been reading so many things it is making my head spin. You message helped me understand a bit especially about the carb. We have an appt. tomorrow with a nutritionists. Thanks again