The final destination of a journey is not, after all, the last item on the agenda, but rather some understanding, however simple or provisional, of what one has seen. In these modern times, with the plethora of blood-sugar-related diseases, we need tools like GI and GL to help us understand ways to control blood sugar.
The self-testing, graphic approach to food testing developed in the balance of the newsletter is a less scientific but a more dynamic way to explore postprandial (post-meal) blood glucose levels (BGLs). GI measures the blood glucose impact of foods eaten in isolation, yet we rarely consume foods this way.
GI readings vary with the individual—blood sugar and insulin reactions are more extreme for diabetics, for example (See Charts 2A and 2B). GIs are calculated in the science lab as the day’s first meal after a 12-hour fast and using a fixed serving that includes 50 grams of carbohydrate.  Most of our daily calories, however, are consumed in combination and throughout the day, when our blood sugar is affected by other foods that we have eaten earlier, as well as by our level of activity.
Of the following numbered charts, the first three are based upon scientific research journal articles (Charts 1, 2A, 2B), while the last four (Charts 3-6) are constructed from my own self-testing of foods4 using a simple blood glucose monitor. Chart 1:  Blood Sugar Curves of White Bread Compared to Bread with Added Fiber, Sourdough, and Vinegar. Chart 3:  Instant Oatmeal, Whole Oats (Soaked and Not Soaked), and Whole Oats Combined with a Protein and Fat.
To fully appreciate the impact of two back-to-back carbohydrate breakfasts please notice that the scale used for Chart 6 is twice that of Charts 3-5. Resetting the Table–to Control Blood Sugar (For a discussion of other strategies, see April 2011). Ramekins filled with condiments like nuts and seeds (GI=0).  Nuts and seeds provide healthy fats, fiber, vitamins, minerals, and antioxidants, while they slow digestion and curb blood sugar.
Sourdough bread or whole-grain bread with whole kernels; butter from grass-fed cows and organic nut and seed butters such as tahini and pumpkin seed butter. A pitcher of water and glasses for all—sometimes we mistake hunger for what is in fact thirst.  You might flavor the water with a little lemon juice or other flavoring. Because 12-hour fasting, pre-meal blood sugar reading can vary, all data points at time zero prior to the first morning meal were indexed to zero in order to illustrate the change from a neutral starting point. I use the label “traditional” carbohydrates, just as we call unrefined fats, “traditional” fats. The amounts should also be put on a blood sugar levels chart were they can be compared with other days and are a record for your doctor. Find out what your blood sugar levels after eating should be and talk to you doctor about improving your diet. There are two different tests your doctor can use to measure your blood glucose to determine if you have pre-diabetes or diabetes: the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). The FPG test is a blood test that determines the amount of glucose (sugar) in the blood after an overnight fast (not eating for at least 8 hours). With the OGTT test, a person's blood glucose level is measured after fasting and then 2 hours after drinking a glucose-rich beverage. See the chart below for the ranges of blood sugar levels and how they are used to diagnose pre-diabetes and diabetes. The Accu-Chek Academy contains information specifically for healthcare professionals that have a keen interest in diabetes management.
Join now to receive information on diabetes related news, tools to enable structured self-monitoring of blood glucose, exclusive offers, and more!
This section is for under 18's and contains a great interactive tool to help you and your family learn more about diabetes. Register now and receive additional benefits from Accu-Chek, including news, information, updates and more. The Accu-Chek Structured Self-Monitoring blood glucose Diary is designed to help people with diabetes and health care professionals focus on achieving quality results in their diabetes management1.The Accu-Chek blood glucose diary guides you to record your blood glucose in a structured manner helping you understand and manage your diabetes. Watch the video series for more information on how structured self-monitoring can help guide you and your healthcare team to adjust the many parts of your therapy.
Your blood glucose changes throughout the day depending on different factors, such as eating, exercise, medication or illness.
The diary has fields so you can record your blood glucose, insulin units, meal size and activity awareness.
By recording something like a meal size, it may assist you in understanding what caused a sudden rise or drop in your blood glucose levels. Step 5: Circle the number you think is right for the amount of physical activity you had been doing. Step 6: Finally, in the comments column you can record any dietary changes, illness, type of hypos and note any significant changes to your body, your routine or the way you feel. In the second section of the Accu-Chek blood glucose diary, you have the opportunity to complete the Accu-Chek 360 View 3-day profile.


Testing before you eat will tell you about the effect your medication has on your blood glucose, while testing 2 hours after you eat tells you about the effect of your meal. To complete the Accu-Chek 360 View 3 day profile tool, it is very similar to the front section in the diary.
Step 8: Graph your blood glucose level (from Step 3) by placing an X in the corresponding row of the chart. By self-monitoring your blood glucose you can measure how your body handles different types of food, exercise, medication, stress and illness.
Watch the video series to see how the results of self-monitoring can help guide you and your healthcare team to adjust the many parts of your therapy.
This website contains information on products which are targeted to a wide range of audiences and could contain product details or information otherwise not accessible or valid in your country. The second factor—the postwar shift from traditional to refined carbohydrates—is largely due to the growing role of the commercial food industry and processed, convenience foods.  Convenience foods must have a long shelf-life, so food companies rely upon refined flours and oils, which do not go rancid.
Visual pictures of postprandial blood sugar behavior, while less scientific than GI measurements, are nevertheless powerful learning tools, providing a real flavor for how our body reacts when we eat different kinds of foods. This chart illustrates the second meal effect– that what we eat at one meal affects postprandial blood sugar behavior at the next. What we do to our children when we give them a sugary cereal or a Pop-tart for breakfast extends beyond this first meal to affect their blood sugar, hunger, concentration, and desire to overeat throughout the rest of the day.
One of the best herbs and spices to moderate blood sugar.  It can be sprinkled on hot cereals and desserts such as puddings, custards, and stewed fruits. If the body produces too little the body doesn’t get the necessary energy and the high amount of sugar in the blood can permanently damage the body.
In general, it is recommended that any blood test that is outside the normal range be repeated on a different day to confirm the diagnosis.
By monitoring in a structured manner, you can gain a clearer picture of how your blood glucose changes in response to those factors. While using the Accu-Chek 360° View profiling tool you should test before and after breakfast, before and after lunch, before and after dinner, and once before you go to bed.
Your blood glucose result may prompt you to eat a snack, take more insulin or go for a walk.
Regularly testing your blood glucose helps measure the effectiveness of your meal plan, physical activity and medications. Please be aware that we do not take any responsibility for accessing such information which may not comply with any valid legal process, regulation, registration or usage in the country of your origin.
Diabetes, or as it is known as hyperglycemia, is where there is too much glucose (sugar) in the bloodstream. If too much insulin is added and not enough glucose was taken in, the body will run out of energy and begin to show bad symptoms that should be treated with immediate sugar intake.
The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform. Monitoring before you eat (pre-meal) and 2 hours after your first bite (post-meal) can help you understand how what you eat affects your blood glucose.
Self-monitoring can also alert you to a blood glucose level that is too high or too low, which requires special treatment. This is why diabetes and obesity often go hand-in-hand (90% of diabetics are either overweight or obese). David Ludwig regarding high-glycemic foods and overeating, cited in the Recommended Reading section at the conclusion of this newsletter.
If you or someone you know is looking for information on managing GD with real food, I highly recommend it!Gestational diabetes is never part of any mom’s plan . The levels that are given after testing with a blood glucose meter should be in this range or too much or not enough insulin has been taken.
Yet there are many misconceptions about this diagnosis, both in conventional health care and the integrative medicine world. Ia€™ll also be sharing why the typicalA gestational diabetes diet fails and why a real food, nutrient-dense, lower carbohydrate approach is ideal for managing gestational diabetes.What is Gestational Diabetes?Gestational diabetes is usually defined as diabetes that develops or is first diagnosed during pregnancy.
However, it can also be defined as a€?insulin resistancea€? or a€?carbohydrate intolerancea€? during pregnancy.I prefer to rely on the latter description because, at the end of the day, gestational diabetes is the result of insulin resistance, which means a woman is unable to tolerate large amounts of carbohydrates without experiencing high blood sugar. However, in our modern world where food is rarely scarce and refined carbohydrates are everywhere, this adaptation can work against us.
This is especially true if a woman already has some level of insulin resistance before becoming pregnant, which is becoming more common.[2]Why Early Screening for Gestational Diabetes is HelpfulIn years past, it was thought that the elevated blood sugar levels seen with gestational diabetes only begin to occur in the second and third trimester, when placental hormones are at their peak and insulin resistance spikes. This is why gestational diabetes is classically screened for around 24-28 weeks of pregnancy.However, researchers have now found that gestational diabetes can be predicted earlier, by relying on a blood test called hemoglobin A1c (for short, A1c). As their pregnancies progressed, their insulin resistance got more severe, as a natural result of placental hormones and weight gain, resulting in elevated blood sugar.Moreover, gestational diabetes is increasingly believed to be an early indicator for the later development of diabetes, which means a womana€™s insulin resistance continues or worsens years after they give birth.


Women who have gestational diabetes have a 7-fold higher risk of developing type 2 diabetes later in life.[4]Can Gestational Diabetes be Prevented?Not all women with gestational diabetes have preexisting issues with glucose tolerance or insulin resistance, but research does show that wise preconception practices may prevent some cases of gestational diabetes. For women with a body mass index (BMI) greater than 35, the risk of gestational diabetes is five times greater than a woman at a healthy weight, most likely because insulin resistance tends to go up at higher body weight.[8]Vitamin D deficiency has also been associated with gestational diabetes (and, not surprisingly, insulin resistance).
When those two arena€™t enough to bring the blood sugar levels down to normal, a woman may need insulin or medication.Many women would rather make dietary changes to control their gestational diabetes, than jump right to medicine (and most doctors feel the same way).
Often, much to their disappointment, my patients had to start medication or insulin in order to control their blood sugar. Carbohydrates are the primary macronutrient that raises the blood sugar, so why are we suggesting they eat lots of carbohydrates?The primary reason clinicians are afraid to endorse a lower carbohydrate diet for pregnancy is that theya€™ve been given outdated information regarding ketosis.
This topic is so complex that I devote an entire chapter to in my book,A Real Food for Gestational Diabetes.
But the short answer is that low-level nutritional ketosis is common during pregnancy, does not carry the same risks as starvation ketosis or diabetic ketoacidosis, and does not negatively impact the brain development of a baby.[19]What Level of Carbohydrates is Best?There will likely always be controversy around the ideal level of carbohydrates a woman should consume during pregnancy and frankly, I believe it will vary woman-to-woman based on her blood sugar control.
But, in general, I find most women with gestational diabetes benefit from a diet that has less than 175g of carbohydrates per day.My approach is to have a woman monitor her blood sugar while eating her usual diet (using a home glucose monitor) to get a baseline of how food affects her blood sugar. Below are some simple tips you can implement.Request getting your HbA1c (hemoglobin A1c) measured with your first trimester labs to get a better idea of your baseline blood sugar control. That way, you can take action earlier in your pregnancy if you need to.Ask to have your vitamin D levels measured (25-hydroxy vitamin D), so you can correct deficiency if ita€™s present. Depending on where you live, time of year, and time spent outdoors in sunlight, you may need to add a vitamin D supplement to meet target levels.[22]If you have gestational diabetes, monitor your blood sugar in the morning (fasting) and after each meal to learn your bodya€™s unique pattern and response to different foods (and combinations of food). Adjust your diet and exercise levels accordingly, knowing that carbohydrates tend to raise your blood sugar the most, fat and protein tend to stabilize your blood sugar, and exercise tends to lower your blood sugar.Emphasize foods with plenty of fat and protein, both of which stabilize, rather than directly raise, the blood sugar. Pasture-raised meat (including organ meat), poultry, eggs, wild-caught fish, full-fat cheese, heavy cream, nuts, seeds, avocados, olives, butter, and some coconut products fit into this category.Embrace low-glycemic sources of carbohydrates, like non-starchy vegetables (lots of these!), nuts, seeds, and low-sugar fruit (like berries). For example, ita€™s better for your blood sugar levels to have a servings of sweet potatoes alongside grass-fed beef, sauteed spinach, and butter rather than by itself.Avoid large portions of carbohydrates at one time to prevent blood sugar spikes. Ita€™s far better to have fruit as a snack twice per day than to have a large fruit salad in one sitting.Exercise regularly.
A real food approach is ideal for gestational diabetes, because it emphasizes nutrient-dense foods that provide a baby with all the critical nutrients for growth, while also minimizing blood sugar spikes.Knowledge is power.
2Real Food On A Budget Pregnancy 10 Comments About Lily Nichols, RDN, CDE, CLTLily Nichols, RDN, CDE, CLT is one of the countrya€™s most sought after a€?real food for pregnancya€™ experts whose approach to nutrition embraces real food, integrative medicine, and mindful eating.She is a regular speaker at medical conferences on gestational diabetes and prenatal nutrition.
I had gestational diabetes during my pregnancy and it was one of the most frustrating and depressing seasons of my life.
I had no traditional risk factors other than maternal age over 30, although since then I’ve done a lot of research and discovered there is a link between autoimmune disease and gestational diabetes.
I could talk on and on about my experience, what I learned, what I will do differently next time, etc (supplements, exercise, diet).
I felt like the focus was on birthing a baby of a certain size rather than on our day-to-day health and well-being.
In the end my son was born healthy at 39 weeks with barely any sign that his mom had gestational diabetes.
Our great frustration is that he is now allergic to all the foods I was required to eat in large quantities for that diet- dairy, eggs, chicken, blueberries.
Brewer’s Pregnancy Diet is an excellent resource that eliminates many pregnancy complications. The whole diagnosis of gestational diabetes can be a real pain to deal with without the right kind of help. Protein, vegetables, a little fruit (low on the glycemic index), higher fat dairy…Thanks for this post! Instead of hearing snarky comments like, “You do know that *half* a banana is one serving, right?” Yeah, maybe not eating bananas at all would have been easier! I have been gluten free for several years and I feel that I should have been gluten free when I was pregnant. My fasting levels are checked every year or so because of my high risk of developing Type 2 diabetes.
I was able to get my blood sugars under tight control basically how you suggested- monitoring and adjusting my diet accordingly. I’m so nauseous and all I can tolerate (barely) is crackers, bread, rice, and watered down juice or broth. On the other hand, I think I am actually glad I was diagnosed with GD, because it certainly gave me a huge kick in the butt down the path of healthy living, good nutrition, and label reading!



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Comments

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