Eat To Your Meter

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If you think this article is just for those with diabetes, you would be wrong.  If you are overweight, this post is also for you….

People often ask me how many carbohydrates they should eat.  While I can give general guidelines, without knowing your personal needs, I cannot answer this question with any degree of accuracy.  My general guidelines for carbs would always typically include getting under 100g total carbs per day.  I think 100g is more than enough for the majority of people following this page.  Now, if you are an avid athlete, insulin sensitive, with normal weight and muscular build, to be honest, you can probably tolerate more.  But the majority of my readers are not from among this group.

Now, if you are overweight and have any metabolic issues (pre-diabetes, diabetes: type 1 or 2, high blood pressure, high triglycerides, insulin resistance, heart disease, etc), then it is my personal opinion that up to 100g of carbs will be too much for you.  I would typically recommend getting under 50g of carbs for people in this category.  Some with significant risk factors, like me, may choose to go lower, say 30g.

But once again, this advice is not specific FOR YOU.  Therefore, I am going to help you determine how many grams of carbs per day is healthy for you.  You will need two things: (1) your finger and (2) a blood glucose meter.  Then you will need to remember this motto “EAT TO YOUR METER.”

Your blood glucose meter will tell you exactly how to eat.  Does this apply to those without diabetes?  Yes.  If you are overweight, you have a significant risk factor for Type 2 diabetes and are most likely WELL on your way to diabetes (many of you, about 90 million, are already there and don’t know it.  I was there and didn’t know it…)

How do you “eat to your meter?” 

First, you have to determine which blood glucose (BG) targets you are shooting for.  Normal, non-diabetic, blood glucose levels are typically mid 80’s or lower at fasting and pre-meal and <110 at peak post meal.  Those are my targets.  (In fact, I try to stay <100 post meal.  But, I think <110 is fine for most people.)  This is far different from the targets set by various organizations.

The AACE (American Association of Clinical Endocrinologists) sets the targets at <110 pre-meal and <140 post meal.  But remember, these are targets that are considered “normal” for diabetes.  I prefer shooting for non-diabetic numbers.  But if you have diabetes, and are typically well above the AACE targets, then these targets may be a good starting point for you.

If you have diabetes, you may also be familiar with the ADA (American Diabetes Association) targets of <130 pre-meal and <180 post-meal.  PLEASE DISREGARD THESE TARGETS.  These targets WILL NOT protect you from serious diabetes complications.  Just because these are considered “average” or “normal” diabetic blood glucose levels, it is also “normal” for many with diabetes to develop heart and kidney disease, strokes and undergo amputations.  These are considered just part of the “normal” progression of diabetes by organizations like the ADA.  PLEASE, disregard these targets!  (Please see my article “Diabetic Normal Blood Sugar is NOT Normal Blood Sugar  HERE.)

So let’s review:

Normal BG:      Pre-Meal <85              Post-Meal <110   BEST

AACE Targets:   Pre-Meal <110            Post-Meal <140   ACCEPTABLE*

ADA Targets:     Pre-Meal <130            Post-Meal <180   UNACCEPTABLE

*Acceptable as a starting point for those with advanced diabetes.  This should be the maximum acceptable BG for those with diabetes.

So, if you look more closely at these targets, notice that this leaves you NO MORE than about a 25 point spike in blood glucose to maintain normal blood glucose and NO MORE than about a 30 point spike in blood glucose to maintain “diabetic normal” blood glucose.  We will discuss the ADA targets NO MORE.

So, here is how you “eat to your meter.”  Take a blood glucose reading before a meal.  Eat your meal.  If you are NOT diabetic, test your blood glucose 1 hour after a meal (if diabetic, test 1 1/2 hours after a meal.  If you are diabetic and commonly experience blood glucose levels over 200, then test 2 hours after a meal).

If you experience more than a 25-30 point spike in your blood glucose between your pre and post meal readings, then identify the carbohydrate (grain, starch, legume or fruit) on your plate.  THAT FOOD IS NOT YOUR FRIEND!  (Article: “Should I Eat Fruit?  How About Grains, Starches and Legumes?”  HERE.)

What do you do if you find a food that spikes you over the target range?  Well, next time, try cutting the portion of that food to a very small amount.  For instance, I would personally have a significant blood glucose spike from 10 strawberries, bur very little spike from 3 strawberries.  So, I have learned my limit with this particular food.

If you still have a significant blood glucose spike from the food after consuming only a very small portion, then, in my opinion, this food has to be eliminated from your diet.  Why?  Because your body cannot process this food without significant blood glucose rise.  If you continue to eat foods that cause a significant rise in blood glucose, you will eventually need medication (or MORE medication) to help you process these foods.  To me, no food is worth more medicine and the side effects that come along with it.

Now, when you find a food that causes very little blood glucose spike, put it on a “safe” list.  After a few weeks of testing like this, you will have built up a nice sized safe list, and you will have eliminated obvious trigger foods.  Concentrate your meals around your “safe” foods.  Once I have determined which foods are “safe”, I personally, no longer test for those foods.

I did this several years ago and built a “safe” list for myself.  I have chosen stricter targets for myself, choosing to keep my post-meal blood glucose <100.  I literally have dozens of items on my “safe” list that cause less than a 5-10 point spike in my blood glucose.  Many of the foods I eat have almost NO glycemic impact.  Here is an example of one of my pre-meal, 1-hour and 2-hour post-meal blood glucose from a food on my “safe” list.

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Many in the low carb circles who are trying to reverse diabetes, opt for stricter blood glucose targets for themselves, as I have.

Don’t be discouraged if you have had diabetes a long time and these targets seem mind-boggling to reach.  Initially, shoot for no higher than AACE targets.  Once you have achieved these targets, then try to go lower if you can.  Try to make normal, non-diabetic blood glucose your ultimate goal.  “Diabetics are entitled to the same normal blood sugars as non-diabetics.” – Dr. Richard K. Bernstein (himself a Type 1 diabetic for about 60 years.)

The bottom line is, never just accept a meal-related high blood glucose.  Always investigate and find out where an unsafe rise in blood glucose came from and determine what is needed to prevent this from continuing to happen.  Reduce or eliminate foods that cause unsafe rises in blood glucose.  Eat to your meter is the absolute best way to determine how to eat the healthiest way for you!

Bon apetit!

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