As I posted previously, I had recent blood test results. I was surprised by an A1C of 5.9% given that my fasting blood glucose was 84 and my triglycerides were 104. I also eat lowish carb usually in the 100 to 120g a day range, occasionally higher or lower.
An A1C at that level supposedly maps out to an average blood glucose of around 123. I know this can vary and be misleading if you have long-lived red blood cells.
From research, I know that results like I received could be valid if I was spiking really high blood sugars which took a long time to come down. I wanted to know so I bought a meter and have been testing my blood glucose. My fasting blood glucose in the mornings have been around 87 to 94. I had one outlier at 110, but I retested 20 minutes later (without having eaten) and got a reading of 87. So I think the 84 fasting result at the end of December seems reasonably accurate. (I’m using a Relion Prime meter).
I have also been testing after meals, usually 1 and 2 hours after. Some of the results have been surprising. It is clear to me that some foods do raise my blood sugar to a higher level than I would like. Others are a bit more equivocal. And, some carbs do nothing bad at all.
I read Jenny Ruhl’s book on how to do this. She gives varying potential targets to shoot for. One is to be at 120 after an hour, 100 after 2 hours, which is what she says truly normal people end up at. Another option (which I gather is more for people not truly normal but which she seems to think is sufficient) is 140 after 1 hour and 120 after 2 hours. She says is up the individual which target to shoot for.
She talks on her website about what a truly normal blood sugar is. My thought is to be close to the 120/100 most of the time, with it rarely going over and to work really hard to never go above the 140/120. I recognize that some people may develop diabetes regardless of what they eat and some may never develop it. For me, I wanted to see if I was sensitive to any carbs and whether they would raise my blood sugar above 140g. If so, then my plan would be to eliminate or reduce my consumption of those carbs.
My results so far have been interesting. I’ve tried during this time to eat as normally as possible so I can get a feel for my usual diet. I did eat a few things that, in actuality, I eat only a few times a year but I wanted to see what they would do. I put things with carbs in 3 categories: OK, Problem, Borderline/Mixed. (Things that aren’t carbs are all OK for me in terms of blood sugar).
Since I’ve been testing my total daily carbs have ranged from 46 to 129. Average daily carbs is 99.
Some of the things that have been OK for me:
Pistachios (this is good since I eat an ounce of pistachios on most days)
Quest bars. I mostly eat the ones without artificial sweeteners, but I also tried one of those. They were all fine.
Dark chocolate square, at least 70% cocoa. In the tests I did I was eating one square, about 60 calories worth (which is the serving size I usually eat). Basically, of the ones I tried the ones with most carbs only had 7g of carbs and didn’t raise my blood sugar to any problematical level.
Whole wheat tortilla with high fiber, with hummus, and half cup blackberries (25g carbs, 13g fiber) – I had this a few times and it did not do anything problematical. Note that this was with only one small tortilla.
Whole wheat tortilla with high fiber, with scrambled egg, lowfat cheese, bell pepper (13g carbs, 8g fiber). Again, this was a small serving with one small tortilla.
Tuna Salad Sandwich – this was on 2 pieces of 45 calorie whole wheat bread (19g carbs, 5g fiber) – I had thought this might be much higher than it ended up being. I don’t actually often eat sandwiches like this. Usually it my husband that eats the bread we buy and I maybe eat a couple of pieces once or twice a month. Anyway, this was much better than I expected. My blood sugar was 118 at 1 hour, 106 at 2 hours, and 100 at 3 hours.
Things that were bad:
Note that many of these things are foods that I rarely eat. I tried some of these out to get an idea of whether they affected my blood sugar. Some of this was really eye-opening to me.
Salad with chicken, greens, bell peppers, cucumbers, cherry tomatoes, 3 T. friend wonton strips, 2 T. Lite honey mustard dressing – My blood sugar was 140 at 1 hour, although it was down to 99 at 2 hours. While not totally horrible, it was higher than I would like for a salad. Next time I will do this without the wonton strips.
Mexican food – Tortilla chips (about 18), chicken fajitas with 2 whole wheat tortillas, about 3/4 serving Mexican rice, few bites of charro beans. This is a meal I rarely have, but wanted to see the result. – 160 at 1 hour, 135, at 2 hours, 116 at 3 hours, 90 at hours. Definitely not having this again. I think at least the chips and rice have to go. I might be able to have 1 of the tortillas, but not sure.
Panera – Thai Chicken Salad, Mediterranean Flatbread, chips – 158 at 1 hour, 136 at 2 hours, 108 at 3.5 hours. I was surprised by this as it was so much worse than another meal I had there of a BBQ chicken salad, turkey chili, and chips. However, this meal has more refined carbs and slightly more carbs and a little less fiber that that meal. Specifically, this had fried wontons on the salad (the BBQ chicken has corn and beans instead) and the flatbread itself (the other meal has turkey chili with beans instead). Both meals have 1 oz. potato chips. I don’t actually usually eat this meal, but wanted to test it out. What this really tells me is that I probably need to stick to salads and maybe soups at Panera which is what I usually do anyway.
Panera – Cinnamon Crunch bagel. I had this for breakfast. I fully expected this to be bad. I don’t often have this, but was curious. My blood glucose was 87 right before starting to eat it. An hour after eating it, my blood sugar had risen to 179. Holy cow! At 3 hours (I was not able to test at 2 hours) it was back to 100. No more of these for me.
Potato chips, 1.87 oz – 121 at 1 hour, 131 at 2 hours, 102 at 3 hours. This is a larger serving than I usually eat (1 oz). 1 oz. might work out occasionally OK for me, perhaps with a meal on an occasional basis.
French Fries – I ate grilled fish/shrimp which I don’t imagine would be much of a problem. There were limited sides available (rice or French Fries) and I decided to try the French Fries even though I rarely eat them. At a little over an hour after eating, my blood sugar was 159 and was 129 at around 2 hours which is higher than I would like. So, I will be crossing French Fries off the list.
Things that were kind of borderline/mixed
Panera – BBQ chicken salad (half), cup turkey chili, 1 oz. Panera potato chips – Somewhat to my pleasant surprise this was 118 at 1 hour. I wasn’t able to test at 2 hours, but it was at 112 at 3 hours and was 79 at 4 hours (between hours 3 and 4 I spent 40 minutes on a treadmill). I was reasonably happy with it and think it would be fine if I dropped the chips. I’m going to try this meal again and test at 1 and 2 hours.
Luvo Breakfast Burrito – Was 95 at one hour, 111 at 2 hours, 124 at 3.5 hours and 107 at 4.5 hours. This was a little higher than I would like. I want to check this one again.
Grilled fish with a Green Giant vegetable medley that had potatoes as one of the vegetables. – Even with some potatoes in the medley, I was kind of surprised that it was at 126 at 1 hour, but was 95 at 2 hours. I want to test this one again.
Skillet crisp fish with green beans and almonds. (This is Gorton’s Skillet Crisp Fish which has a light flour coating. This was baked in the oven) – 122 at 1 hr, 20 minutes. 116 at 2 hours 20 minutes and still at 109 at 3 hours. This didn’t come down as quickly as I would like. Again, I probably just won’t buy this fish again.
Mediterranean buffet – Hummus, Falafel, tabouli, small amount of pasta salad (oil dressing), chicken shwarma, fattoush salad, 1 small piece of baklava – Was not able to test at 1 hour. Was 111 at 2 hours, which was actually not that bad for what I ate. Will try this again and not include any baklava. I think without the baklava, it will probably be OK for me. We’ll see.
Conclusions – I don’t really see anything that would equate to an A1C of 5.9%. Most of the food that I ate during these several days didn’t create any issue at all and isn’t mentioned. There were only a few times that my blood sugar ever got above 140. I looked back at what I was eating before the A1C. It was a little higher carb (my test was on 12/30 right after holidays). So I could see my average blood glucose being a little higher then than it is now, but looking at what I was eating then I can’t see it actually being that high. I wonder if I’m just one of those people with long-lived red blood cells.
That said, it is clear that I do react negatively to some carbs so I want to modify my diet so I don’t have it going as high as it did with some of those meals.
Going forward, pretty much any meal below 25g carbs seems OK. Meals between 25g carbs and 65g carbs may be OK depending on what it is. The more refined carbs the less OK it is, even if the total carbs are still relatively low. The few things that I ate above 65g carbs (the Mexican food meal, the bagel and the salad/flatbread Panera meal) all raised my blood sugar a lot compared to anything else and what is notable are the refined carbs in them.
On the other hand, I don’t see a need for me to 100% avoid all grains. A single whole wheat tortilla with hummus or with a scrambled egg in it did fine. I ate 3 or 4 triscuits as part of a meal a couple of times with no problems. However, refined grains seem to be more problematical. Awhile back I went without grains for a couple of weeks (I’ve done this a few times) and I also went gluten free for a month. I didn’t find that I had personally had any negative reaction to grains, so I think limited whole grains are fine for me personally. The key there are the words “limited whole” since I think it is those grains that I can sometimes have without it bothering me. (I do recognize this may not be the case for everyone).
I also found that a square of dark chocolate was fine, so I don’t see a reason to avoid eating that which I do a few times a week. Of course, I’m sure this is a food where the portion is important. I eat a very small portion.
My sense from this is that I can fairly easily tweak my diet to avoid refined carbs that raise my blood sugar. I already don’t eat them a lot (I ate more during this period so I could test what was problematical). Some of the problem or borderline meals could be easily modified (no baklava, no chips, etc.). My 100g or so a day of carbs doesn’t seem to be a problem, if spread out over the course of the day. Even my higher carb days (in the 120s) weren’t problematical as a whole, unless individual meals created a problem.
I don’t see a reason from this to drastically lower my total carb intake specifically, but this does suggest to watch how many total carbs I eat at a meal and to avoid even relatively small amounts of refined carbs. Those don’t seem very difficult changes for me to make.