How often should I check blood sugar with type 2 diabetes?

Question

Hello doctor,

I was recently diagnosed with type 2 diabetes. My fasting glucose was 108 mg/dL, and my A1C was 6.6 %. I was not put on medication yet, but instead will work on my weight, exercise, and diet over the next three months before my next visit to see if I can prevent getting worse. I am 6'1" and 285 lbs. I am mostly sedentary, but will be introducing an elliptical workout every other day for about 20 to 30 minutes at a time. I purchased

a diabetes monitoring system, but I need to know how often and when I should check my blood sugar, and what my target ranges should be? I need to know what my daily gram and carbohydrate intake should be. Or, even better, what should my percentages be based on my 1,790-calorie daily intake of carbohydrates, protein, and fat?

Currently, they are based on the ADA recommendations. Carbohydrates 40 %/179 g, protein 35 % per 157 g, and fat 25 % per 50 g. I also have high blood pressure. I am on 100 mg Losartan, and my reading today was 117/84/77 bpm. Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

You have provided good, necessary information to start.

As a diabetes specialist, I like to do a very detailed analysis to make a customized approach for each patient. Based on the information you provided, you should be on medication, from my experience, like low-dose Metformin 500 mg twice daily with meals, or Metformin 500 mg. Extended-release once daily. While you work on diet and exercise, this also helps prevent complications from diabetes. Metformin will help you lose weight, too. Metformin also improves how your insulin works for you, for better and quicker control of blood sugar. You can check your blood sugar three times weekly, at different times. E.g., one-day fasting (before breakfast, second day post-lunch, and third day at bedtime. (2 hours post-dinner). Keep diary readings.

However, you prefer to see the trend of your blood sugar. Normal range fasting in the morning is 90 to 120 mg/dL. A post-meal 120 to 140 mg/dL average is good. I recommend a high-protein, low-carbohydrate diet for you. You are in a top weight category, so you surely need to lose weight gradually. Do not attempt instant aggressive weight loss. You will end up injuring yourself and will gain weight, too. I would keep carbohydrates less than 140 grams per day overall. An 1800-calorie diet max will be fine for you; if you wish to lose weight, then you should eat 1500 calories. You are more than welcome to request a 30-minute to 1-hour consult as well. I go into much detail to have a full analysis, and I address all potential complications, nutrition, and medicines.

I hope this helps.

Please revert in case of further queries.

Thank you.