Eat to Your Meter

When you first received your diagnosis of type 2 diabetes, you likely were given your test results that indicated that you had diabetes. You may have been given a blood sugar meter that can be used at home. And, depending on how high your numbers were, you may also have been given a prescription or two.

I would venture to guess that no one told you to “eat to your meter.” It is a relatively new concept about how to keep your blood glucose levels in your target range.

It is much more likely that you were given a brief overview of scary complications, told to lose weight, and maybe shown how to use a blood glucose meter. You probably heard about possible prescription drugs and recommended visits to specialists in the field.

And you likely left your appointment with a high level of confusion and anxiety about your “new normal.”

So Many Questions and New Things to Learn

• Now what?
• Will this affect my work? My social life?
• How did I get this?
• Can it be cured? Can it be controlled? Can it be reversed?
• Did I do something to cause it?
• Do I have to make changes?
• What are the potential complications?
• Kidney disease?
• Heart disease?
• Vision problems and blindness?
• Nerve damage?
• Amputations?
• Can I avoid complications?
• Why are there so many different ideas about how to treat it?
• Who should I listen to?
• What are the best choices for me?

Do recognize that you are not alone, even if it feels like it.

According to the ADA (the American Diabetes Association), as of 2018, approximately 10.5% of Americans had diabetes. New cases in the United States are expected to grow at a rate of about 1.5 million cases per year.

Whether you are on medication or not, whether you follow an ADA recommended diet or a lower-carb diet or even a form of a keto diet, learning to “eat to your meter” is for many of us a better way than just following a prescribed food list or meal plan. Taking the time and investing in testing, especially in the early days. It will give you a great deal of valuable information about how your body is handling carbs and insulin.

If you are totally new to the world of diabetes, here is a quick overview of the different ways to test blood sugar. When you visit your health care provider, they will generally do take a blood sample while you are in a fasting state. From that sample, they will run a fasting glucose test and a hemoglobin A1C.

A fasting blood glucose test shows what level your glucose is at a specific point in time. The hemoglobin A1C shows an approximated average of your glucose levels for the past 2 – 3 months.

There are other tests that can be used, but in addition to at home monitoring, these are the two most common. They will generally be requested by your medical provider at 3 – 6 month intervals to monitor how well your chosen diabetes care plan is working.

And then there is the daily monitoring you will be doing at home. There are currently two primary options for daily monitoring at home. The first is a portable glucose meter and test strips. This is currently the least expensive and sometimes the only choice depending on your insurance and how you are currently managing your disease. A small drop of blood is required for testing. Glucose meters can be purchased over the counter and online without a prescription.

The second option are CGMs, or continuous glucose monitors. They are available from a handful of companies. They have a sensor inserted into the skin that measures glucose through interstitial fluid instead of blood. The most widely used are the Freestyle Libre and the Dexcom. Both are devices that monitor your levels continuously, so you have much more data to use when making decisions than you have with the portable meters and test strips. However, they require a prescription and are quite pricey unless your insurance determines that they are necessary.

So What is Eating to Your Meter?

In the simplest of terms, each time you eat or drink anything, especially carbs, your body responds with insulin to help the energy enter your cells. In someone with type 2 diabetes or even pre-diabetes, the body may produce MORE insulin than usual, but your body does not have the same insulin sensitivity it once did, so it struggles to utilize the insulin as intended. A vicious cycle occurs where you create more insulin, and yet the amount of glucose remaining in your blood continues to rise.

When you visit your health care provider, you will most likely have the two most common blood glucose tests. The first is the fasting test, and the second is an A1C. The fasting glucose test shows what your blood glucose is at that specific point in time without having eaten anything. The A1C test shows a rough average blood glucose level for the past 2 to 3 months.

While these are useful tests for what they show, they don’t tell you precisely how your day-to-day choices are affecting your blood sugar and your ultimate long-term health.

By eating to your meter, you can see the near immediate results of the food choices and exercise decisions you make. If you choose to own your disease and make the best decisions you can make, eating to your meter will give you far more complete information than the periodic tests ordered by your healthcare provider. You will still need these tests, but they don’t show you the whole picture.

Why Eat to Your Meter

Every person diagnosed with type II diabetes is different. The level of insulin resistance that exists before a diagnosis of type II is different for everyone. The amount of damage to the pancreas, which ultimately affects how much insulin you produce, is also different from one individual to another. These differences between individuals are why there are no one-size-fits-all answers for treatment.

Rather than a doctor or dietician giving you a set diet plan to follow with a set number of carbs per meal and snack, you will test to see how your body responds to different foods and levels of activity, among other things. There is a list of off-limit high carbohydrate-containing foods and a list of foods that are generally fine for everyone. But in between, some foods may or may not affect a specific individual. And the total number of carbs that work for each person is very individual too. The only way you will know what works for you is by testing.

To eat to your meter, you will test your blood glucose before each meal and again at set intervals after—and plan on checking your blood sugar first thing in the morning and before bed. If you want a bit more information, testing before and after exercise will give you additional insights too. Decide on a method of logging your numbers. You can use a simple paper log or a digital app.

A Day of Eating to Your Meter

If your doctor gave you a blood sugar test kit, start with that. It likely came with at least a sample quantity of test strips, a lancing device, and lancets. Or if they gave you a prescription, start with that.

Do be aware that glucose meters, test strips, and lancing devices can be purchased over the counter and are often less expensive that way than paying your insurance co-pay. And if your diagnosis is Type 2, your insurance is not likely to allow as many strips as you will require for eating to your meter.

You begin your day by checking your fasting blood glucose as soon as you wake. Testing, before doing anything else generally gives the most consistent results. Some people experience what is known as dawn phenomena in which their blood glucose rises before waking. Some people also experience a rise if they take a hot shower before testing. Or if they exercise before testing. The first thing in the morning before any activity seems to be the most accurate for most people.

Test your blood glucose for the second time just before your first meal. This test gives you a baseline of where you’re at before consuming anything. You may or may not notice a significant difference between the second test and the first fasting one in the morning. When you have completed this second test, set a timer for one hour, and consume your meal.

Your third test will occur when this timer goes off. That’ll be one hour after the first bite of your first meal of the day. If the food you consumed is of reasonable carb content, ideally, you would hope to see no more than a 20 point rise between the second and third tests.

In the beginning, I would suggest doing the fourth test at two hours after your first bite. At the two hour point, ideally, your numbers should be back down to where they were just before eating your meal.

As a side note, when I first started practicing eating to the meter, I also chose to test at 1 1/2 hours after my first bite just to verify that I was catching the peak. This additional test is optional and was a personal choice based on my curiosity. I did find that when I consumed meals with a higher percentage of protein and fat, the peak would be closer to the one and half hour points than the one-hour mark. Again this is strictly my personal experience, and everyone is different.

Continue testing for the remainder of the day, following the same pattern with each meal. Ideally, you should be eating each meal about 3 to 4 hours after the completion of the previous one. This schedule will not leave a lot of space for snacks. Snacks are certainly not necessary and are not encouraged.

Test again before going to bed.

How to Eat to Your Meter – Short List

I know it can seem like a lot in the beginning but it does pay off in giving you more information to make better-informed choices.