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March 7, 2005

Meal Planning, Food and Diet, Type 2

Question from United Kingdom:

I am 44 years old, female and currently borderline diabetic. I was diagnosed five years ago when clinically obese. My blood sugar was 22 mmol/L [396 mg/dl]. I subsequently lost 6 stones (84 pounds) and my diabetes disappeared. However, over the last couple of years, my weight has crept on (not all of it I am pleased to say), but my glucose levels have begun to increase again. I find that if I eat mainly proteins and vegetables/fruit, my blood sugars decrease quite rapidly, but if I add carbohydrates, even complex, they start to rise again. Is it safe for me to continue with this style of diet? Is it true that any reading over 8 mmol/L [144 mg/dl] is causing organ damage?

Answer:

First, I would recommend you not use the term borderline diabetes. You either have diabetes or you do not. Second, there is not really a safe level of hyperglycemia. If your blood sugars periodically go above normal levels, you need to speak with your physician to have this treated. It is recommended that your hemoglobin A1c be checked two to four times per year. The goal should be normalization of this level as it infers your overall glucose control for the previous three months. Given that the blood sugars respond to your lifestyle choices, you need to follow a healthy diet and exercise schedule to minimize your risk for future worsening of your control and to minimize cardiovascular and microvascular risks. Those healthier lifestyle habits you started earlier when higher sugars were a problem should be continued into the future. The problems of high blood sugars do not tend to get better over time. The tend to worsen. You always need to stay vigilant.

JTL