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Re: [IP] Dietary concerns

From: "Felix Kasza (lists)
> > I am surprised the doctor is waiting for an HbA1c result; if a
> series of BGs over a few days are all above 180, mine would not
> wait.

I totally agree with you. She should have indeed. Although we tried to get 
her to prescribe based on our facts, apparently meter results aren't 
official enough - ironic given the fact that I base my life on these 
numbers, but whatever!! But couldn't convince her otherwise. It's next to 
impossible to have conversations with drs on the phone - you must come in 
for an appointment to discuss anything, because they can't charge our 
provincial health plan for phone consults.  So the doctors won't give advice 
like that, but many patients live far away from doctors due to severe dr 
shortage in Ontario, so our options are very limited. We live more than an 
hour away from the dr and my husband doesn't drive, and I commute far - our 
logistical issue, but still have to get around it. We'll be pursuing a 
referral to an endo, and I'm happy with mine but that can take weeks/months 
to get in. But over the next while, we just have to deal.

> In the end, it comes down to the old "calories in minus calories out".
> "Calories in" come from only three classes of substance --
> carbohydrate, fat, protein. The only thing you can try increasing
> is protein.

If he is limited right now for cholesterol reasons, protein sources are 
rather limited? Chicken? A little egg? low fat cottage cheese?... any other 
ideas? He loves sausages and bacon... with obvious side effects so we've 
taken that out of the mix.

> Note that T2DM is often diagnosed very late, because of a
> long-time absence of overt symptoms. That means that kidney damage
> may already exist; you may want to discuss this aspect with a
> doctor before cranking up your husband's protein intake.

Good advice, and we have cut out the "bad proteins", and haven't ramped up 
much protein anyway. The doctor has also ordered some testing to identify 
that. I neglected to mention that in my original post. The D condition is so 
obvious though, and I thought she should prescribe for that at least, and do 
all the additional tests and adjust treatment based on that.

> Somewhat counterintuitively, your husband may want to try a
> strength workout program, with an emphasis on building muscle
> mass, if he doesn't already. That is an excellent use for protein,
> and it has very pleasant effects on overall BG control (not just
> during and shortly after workouts) and, apparently, lipid levels.
> Plus, you would be able to feed him more carbs without sending him
> on the BG roller coaster.

He does walk daily every day, sometimes twice, quite fast too as his guide 
dog sets the pace, about 1.25 to 2 hours a day, and with the nicer weather 
he will continue. We live in a small town with no public transit available 
and he doesn't drive (there's enough "blind" drivers on the road!) to get to 
anywhere that could provide him with workouts, and we don't have any such 
equipment in the house. It could be a goal for one day, but right now it 
isn't possible.

In the meantime, I welcome any ideas for strength training as I don't know 
much about that myself (links to sites, etc.)

Thank you,

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