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Tips for lowering glucose level

1,941 Views | 35 Replies | Last: 8 days ago by hph6203
texasaggie2015
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AG
This may be a dumb question so sorry in advance if it is.. I'm not too familiar with this specifically.

After a bit of a health scare a couple months ago, I decided it's time to be serious about my health and start doing the things I should have been doing all along. And that starts with bloodwork.

Everything looked good overall except for one thing.... glucose. That came as a surprise to both me and my doc.

It was 117 so it wasn't outrageously high, but still higher than it should be. He recommended I follow a diabetic diet for three months and then come back and see how it looks after that.

Does anyone have any tips for what I can do to lower that number and to maintain it?

Furthermore, is it possible for that number to randomly come back high? Basically, is this something I'll have to worry about long term or is it possible that it'll come back down and stay there without having to watch it like a hawk?

Side note: My blood pressure is quite high and he's still trying to figure out why. Since the labs looked good overall, I'm suspecting it might be cortisol related as I've gone through a few life events over the last few years that have been high stress. I know high cortisol can raise glucose levels as well.

Thanks!
BQ2001
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My first steps would be just start reducing carbs, especially ones in juices, candy, breads, pastas, beer, Gatorades, Starbucks coffees, etc. Not sure how much of those you currently eat, but I'd start with removing those lower quality carb sources. If it's still high you can start looking at other sources to make better choices like sweet potato instead of a baked potato, riced cauliflower or brown rice instead of white rice.

You don't have to go Keto but certainly lower your carb intake. I worked with a nutritionist for a while and did basically that and it's not a huge, huge change. Check your insurance and see if they cover that. I used the Nourish app and it was free to me. Had weekly zoom calls and then moved to once a month when I got into a rhythm. They can tailor a plan and give tips based on what you want to accomplish and give you some accountability..

Exercise can also help a lot too. Not sure of your regimen but something simple as going on walks, spin bike, body weight exercises are easy ways in.
True Anomaly
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Did you have a hemoglobin A1c checked? It's an average value over the course of 3 months to see how insulin resistant you may be.

But really, the most definitive solution is to lose weight, provided that you have body fat to lose. Higher body fat correlates very well with insulin resistance
texasaggie2015
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I actually didn't get that tested... yet.

I could definitely lose a few pounds but I'm not super overweight by any means. 5'9 187.

I could absolutely be more active though as well as be more mindful of my diet.
True Anomaly
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texasaggie2015 said:

I actually didn't get that tested... yet.

I could definitely lose a few pounds but I'm not super overweight by any means. 5'9 187.

I could absolutely be more active though as well as be more mindful of my diet.
You could just take the next three months, work on losing 10 pounds, then get your A1c checked to see what it is. Because even if your blood sugars are running high, losing weight will go a LONG ways to helping regulate it. And then you can confirm with the A1c, which will tell you if you're truly insulin resistant- and then you can make a more educated decision from there
The Grinder (99)
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My guess is you're mid 30's?

Without knowing absolutely anything else about you, let me take a stab at somethings that applies to most people.

It is common for people in this age range to start to get data back that goes against their natural mindset that they are still kids and have no issues "because I never have to go to the doctor".

Most people from their 20-40's can certainly go through this phase of life without ever going to the doctor barring some event.

Good for you for not being in that category. Seems like you actually went to the doctor just to get a routine physical.

I'm a physician and have practiced for over 20 years. A simple search will reveal I am a psychiatrist but (less obvious on this board) I'm also an internal medicine doc.

I always got such a bad feeling with patients that came in to see me in their 50's or so that would boast how "healthy" they were with their sole basis being they "never go to the doctor."

One thing I've learned over my past 30 years (school, training and practicing) is how resilient the human body is. However, there is a downside to that resiliency. The problem is that by the time we notice a problem, things are too far gone to really do much about it. I'm sure we all know of people that received some news that reflects this. Someone that goes to the doctor with some mild chest pain and is told they have >90% blockage of an artery. Or someone that is told their liver or kidneys are functioning at 10%. We see this all the time in medicine. It is not the exception, it is the norm.

This clearly explains unhealthy looking people coming in to see me at 55 years of age that proclaim how healthy they've always been and never had to go to the doctor.

The good news is, OP is (presumably) a very young man. You very likely got your first warning that everything isn't quite ok. There is likely no mystery to this…

Reality: your bmi is 27.6. Your ideal weight at 5'9" is well under 187. Unless you're a body builder, you're overweight. The mystery of elevated glucose and Bp is, there is no mystery.

This is an early sign of problems that has no appreciable correlation to "feeling sick".

You're a young middle aged man, you're not an old kid. It's time to accept that and be a healthy young middle aged man so you can be a healthy and active older middle aged man over the next 20-30 years

There are no secrets recipes. Get on a good sleep schedule. Wake up early and exercise. Lose weight. Eat better. Yada yada

You can do it. Those of us that are older have all been there. It's a reality we don't like to face, but the sooner we do the better off we are
DannyDuberstein
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Get a home blood pressure monitor and keep a log at home. Some people get white coat syndrome and it goes up at the doc even if they don't necessarily feel nervous. Doing it at home is a much more reliable way to do it. It might not actually be high.
7yrplan
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Good for you for getting checked and being proactive about your health.

Im in my mid 40's and have been surprised at the aging process. My mind somehow thinks I'm still in my 20's. My body clearly disagrees.

labs and bloodwork sometimes give us the bitter, honest truth.

Cut weight, add on and hang onto as much muscle as you can. Strength strain, eat Whole Foods, get your steps in and get plenty of sleep.

These things seem to be semi optional in our youth. As we get older, in my opinion, they are critical.

It does suck, but choose your hard, as they say.

I've found a lot of health issues can be self corrected with the lifestyle we know we all should be living.

Good for you for starting to recognize it.




texasaggie2015
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Isnt BMI super outdated?

I would be skin and bones if I went down to 160.

Agree with most of what you're saying… but if I were to lose 30 pounds like the BMI chart says I need to do I don't think that would be healthy.
DannyDuberstein
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Yeah, BMI does not account for muscle mass. It is also 2 dimensional and seems to skew more the taller someone is.

Approximating body fat % is a much better way to measure your actual weight related health
RightWingConspirator
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OP, Type 1 here. A1Cs run in the 4.5 - 4.7 range and have been in this range for twenty years. I eat low carb and lift five days per week. Cut the carbs and get some exercise. You'll see a marked improvement in blood sugar control is my bet.
BQ2001
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I'm 5'9" 160 (15% bf) and not skin and bones at all. I'm aiming for 150 for my next race in March. I've got down to 145 before and I still don't think I was skin and bones but was teetering there.
DannyDuberstein
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The BMI chart would consider 5'9" 126lbs "normal" and not underweight, while 5'9" 170lbs is overweight
The Grinder (99)
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BMI is not the end all be all, but it has been too easily dismissed. Yeah, if you are 5'9" and 180 and are 5% body fat, no problem. If you're 5'9" and 180+ and 30% body fat and want to say BMI is outdated then you're just choosing denial



DannyDuberstein
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So you are telling me that body fat % is what matters vs some screwy 2 dimensional chart which is pointless. Agree.
texasaggie2015
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I'm not denying I could use a few pounds, I'm just really skeptical that I'm 30 pounds overweight.

Thanks for the advice everyone.
The Grinder (99)
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He gave me two points of data. So, yes I used a two dimensional formula.

It says OP is over weight. Could it be wrong? Yes. Is it as wrong as most people like to conveniently dismiss? No

Op actually gave me 4 data points. Elevated blood glucose and elevated blood pressure. Along with height and weight. Number one reason for the two elevated labs? Being over weight

Now, would I rather have an accurate measure of body fat? Yes. Problem is, it is hard to get accurately.

Hydrostatic weights and dexa scans are most accurate but hard to get and expensive. If OP can find a convenient and affordable way to get those, go for it

Tracking body fat is preferable to tracking BMI

I would say though that using BmI to estimate about how much fat someone could lose is not way off for the average person, particularly the average person that has the two most common lab abnormalities of being overweight

No doctor is stumped as to why this occurs and what the answer is. The fact that it causes so much discussion and disagreement is the reason that the Dr probably said something like "not sure, maybe lose a few pounds though". Doc wasn't mystified, I can assure you
The Grinder (99)
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Just go get a dexa scan and put all the speculation to rest

It will accurately tell you your % body fat and how many pounds of fat you should lose

Maybe there is another reason for your elevated BP

Maybe you hadn't fasted long enough for your blood glucose to normalize


All I'm saying is, what you describe at your age (again assuming your mid 30's) is very common. The four data points you gave tell us something may be off and it all points to being over weight. By how much? I'm not saying that.

But for people to use the extreme low range of BMI as data to dismiss all the other data in front of you is ludicrous

Could there be another explanation? Sure
Candiru
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To the OP, not to diminish all the good discussion and advice, but was that 117 fasting or had you eaten in the few hours prior to the draw?
Seven Costanza
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For most of the general population, the middle of the the BMI chart is where you should be. People have a distorted view of what normal is because we are surrounded by overweight, obese, and morbidly obese people. I'm sure that you look pretty normal and healthy/borderline healthy to almost everyone that you encounter. The average male adult weight in 1960 was 166 lbs (for any height). It is highly likely that your numbers will dramatically improve if you get to about 160-165. If you don't want to accept that, then be like everyone else and start taking meds.

You could also listen to Peter Attia's thoughts on Zone 2 cardio and see if that interests you.
texasaggie2015
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I haven't denied that I need to lose weight. I just said that I have a hard time believing I need to lose 30+ pounds to be healthy.

But okay.

Thanks everyone for the insight. I guess I have a lot more work ahead than the doc led me to believe. Maybe he didn't want to hurt my feelings or maybe I truly don't realize how big I am.
MRB10
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I have not seen anyone in the health/fitness community recommend that 160-165 is the recommended range for all men regardless of height. I would be extremely suspicious of any suggestion that uses a single weight range for every person.

I'm single digit BF at 6' tall and 175-180lbs. I was sub 170lbs once during college and it was because I was training for a half IM and was doing a lot of cardio. The effort required to get to that range was ridiculous and my blood work/annual work up support my current weight being a good range for my build, age, and habits.
texasaggie2015
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Yeah, when I was playing baseball competitively and working out year around I was about 175 and in great shape. At least I thought at the time.

Again, maybe I'm just totally clueless.
Seven Costanza
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Quote:

I have not seen anyone in the health/fitness community recommend that 160-165 is the recommended range for all men regardless of height.
I meant for his height. I can definitely see how it was confusing, though. Middle of BMI works for most people.
texasaggie2015
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Alright so if anyone has advice on how I can lose 30+ pounds than I'll definitely take it. The hardest I've ever worked in my life I was still 15+ pounds away from that. This has been really discouraging but hopefully I can get there
DannyDuberstein
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texasaggie2015 said:

Alright so if anyone has advice on how I can lose 30+ pounds than I'll definitely take it. The hardest I've ever worked in my life I was still 15+ pounds away from that. This has been really discouraging but hopefully I can get there


When you boil it down, the sustained loss comes down to cutting calories and being consistent with the discipline to stay under the target. It's about getting under 2000 per day and staying there, however works for you to do it whether it's intermittent fasting or just making sure to watch portions/volume all day. High protein for what you do eat can help you feel more satiated which helps reduce the urges. Then fill that gut with water when you feel hungry in between
spike427
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Hey, you're doing a great job of looking out for your health and wellness. It's huge that you're willing to make some big changes!

What is the "diabetic diet"? I'm female, but the biggest shift I ever experienced with weight loss and overall feeling better was doing a Whole30. You might not have to go that extreme - maybe just replacing a grain/carby item at 1-2 meals with greens (taco salad instead of tacos... lettuce wrap instead of sandwich... eggs with spinach and salsa instead of toast). Plenty of protein plus fat from avocado really helped keep me full and satisfied. If you drink any calories, cut back on that. There are great sparkling water options and even 2 tbsp of juice livens things up if you don't like the lack of flavor.

I'm a big fan of the Couch to 5k program if you're not already active. Adding in lunges, squats, pushups and pull-ups (a park nearby probably has playground equipment that would work) can really boost fitness. If you start now, you'll see some noticeable results by the end of the year, and 6 months from now, you'll really be happy with progress!
texasaggie2015
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I did high intense cardio and all sorts of stuff year around and my lowest weight was 175. How do I lose 15 more? If you told me back then I was overweight I would have been stunned.
DannyDuberstein
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texasaggie2015 said:

I did high intense cardio and all sorts of stuff year around and my lowest weight was 175. How do I lose 15 more? If you told me back then I was overweight I would have been stunned.


Yeah, the wild card is that diet influences weight much more than exercise. You can bust your ass to burn a few hundred calories and then blow it in 2-3 minutes by what you put in your piehole

But if you were doing all that and in great shape with low bodyfat, then don't sweat what the chart says.
Seven Costanza
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You might not need to lose 30 lbs. I would test it. Make some light changes to diet and exercise, get down to 180, and get bloodwork again.

If you are committed to losing weight and exercising more, then I would focus more on systems rather than just goals. Early on, make these changes very easy to achieve until you build the habit.

For example, every day when you get home, you immediately throw on a podcast that you like and go for a walk. Look at what your average steps are per day on your phone. Make your goal to add 500 or 1,000 steps per day to that number. That's really easy; 500 more steps is a quarter mile. The system is not "I'm going to walk more" (that's too open ended early on). The system is "I'm going to walk as soon as I get home". After you build the routine, you find that you slowly going to want to track and increase your steps more and more. Are you going to lose weight from walking an extra mile a day? No, but you are giving yourself more and more evidence that you are a healthy person, which will lead to more exercise and healthier habits overall. And the movement will help over the long term with blood sugar and with maintaining healthy joints/tendons/muscles.


A lot of systems involve adding some type of restriction to achieve caloric restriction. Time restriction is one (intermittent fasting). Food type is another restriction (lower carb, or no processed foods, or only the outer aisle of hte grocery store, or whatever you choose). Again, I would try to make a very small change that is maintainable and then slowly build the habits from there. Trying to make drastic changes is usually not maintainable. It's hard to say where the easiest changes would be without knowing your habits, though. You would have to map out what your daily eating habits are and see what the simplest thing to eliminate would be.

One interesting thing about diet. There have been numerous studies showing that animals will eat until they reach an internal daily protein target. So for example, if rats are given a diet of potato chips, they will eat an absolutely enormous amount of calories until they reach their daily protein target, and then they will stop. But if they are given more protein dense food, they will eat a much smaller amount of calories and still stop once they reach their daily protein target. And this type of idea has been repeated across many species, including insects. Point being that if you focus on eating protein dense food (chicken breast or steak, for example), you probably will inadvertantly eat fewer calories.
Quinn
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I think people over-estimate how skinny they would be at a certain weight. Not saying that you necessarily need to lose 30lb, but you'd probably look better than you expect at that weight.

I'm type 1 diabetic, and the main variables for your blood sugar are the carbs you eat, your exercise, and the insulin you take. Since you aren't on insulin, you will need to control you BS levels by decreasing the amount of carbs you eat and increasing your exercise. Eliminate most of the bread/pasta/chips/cereal/etc that you eat.
htxag09
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Man....rough turn on the thread.

First, even if someone does need to lose 30 pounds, that's daunting and can be discouraging from the start. So break it down, even 5 lbs is an improvement.

Second, I've gotten in quite a few arguments with people who dismiss BMI on here. I agree it's not perfect, but it's cheap, easy, and works for the majority of the population. Now, anyone you who has a BMI that shows they're overweight will point out they played football in HS and it doesn't do a good job with muscle weight, even though they haven't worked out in 15 years.

Third, for the last comment, about people over-estimating how skinny they would look, you can't control where you lose weight. I'm 5'9", my lowest weight as an adult was around 2020 and 172 lbs. I was training for an Ironman at that time. When I got below 175 my face started looking caved in and very, very unhealthy. Even though I still had some love handles and some belly fat to afford to lose....

I completely understand my second and third point contradict each other. Again, I think BMI is a great tool to start the conversation and look into your health. It's not the end all be all. I also realize that my BMI says I'm overweight, and I agree, I am overweight.
texasaggie2015
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Yeah I was looking for tips not to be told I'm overweight a few times
dave99ag
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The first response from BQ2001 about diet is spot on! Cut those carbs and sugars.

I was diagnosed with Type 2 back in April due to a high A1c reading (7%), which was quite a shock to me. I've been an endurance athlete all my life, but I suppose poor eating habits and genetics finally caught up to me.

I opted for lifestyle choices before going on a pill the rest of my life. That meant changing my diet drastically. I cut out nearly all carbs (pizza, burgers, pasta, beer, etc) and sugars. I don't really need to lose weight (was 6'3" 180lbs), but I dropped 20 lbs fairly quickly cutting all that out. In a few months I got my A1c under 6% and fully manageable. Now I'm mostly focused on getting enough protein / veggies and calories ito maintain a healthy weight.

If you're really curious about your blood sugar in between bloodwork, get a blood glucose monitor. They're fairly cheap and accurate for monitoring trends. I've been using an Accu-Chek Guide to monitor after meals to see how or if it spikes. If you really want to nerd out, get a Stelo CGM. They're not as accurate as a BGM, but give you continuous trends. Wear it for a few weeks and you can really see what your blood sugars do.

Moral of the story, is diet, diet, diet and get a full bloodwork done, ie. A1c.


MRB10
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I'll tell you what works for me. I stick to this nearly every week.

-No food/drink other than water and black coffee until noon.
-lunch:
1lb of ground beef or 12-16oz steak
Lara bar
5 to 8 clementines
-protein shake with milk, berries, and half a banana around 2-3pm
-dinner
Whatever the wife cooks. Eat around the bread carbs as best as possible. Apple for desert.
-No food after 7ish until lunch the next day. Rinse and repeat. Weekends are similar but we generally go out for dinner and I'll sub in pork/chicken sausage or 7 eggs for lunch.

Resistance training 5 days a week + 1 cardio day.
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