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Conventional food habits vs flexibility on basal-bolus insulin

I just visited a diabetologist (not my regular doctor who is in another city) today and my HbA1c stands at 8.3% (which though still far off the ideal < 7%) is a big improvement from my previous level of 9.7%. Probably I could have edged closer to 7% if not for my hospitalization (for diabetic ketoacidosis, which was till now undiagnosed because the doctor who treated me during hospitalization didn't suspect or treat it :(, but the diabetologist immediately made sense when he told about diabetic ketoacidosis).

He was so adamant about me getting to the 7% mark to avoid complications as I am just 23 years old as of now and have a long life ahead to live.

I currently use a flexible food routine with my NovoRapid-Levemir regimen. Whatever I eat, I count the carbs and then take the bolus. I adjust the basal if and whenever needed. By flexible, I don't take sweets, bulbous/root vegetables and other things that any diabetic shouldn't take. But I take other food items that are higher in carbs than the very safe, but I scale my insulin to that level.

But this doctor and dietician advocated a food regimen that involves spreading my eating over 6 times (which imho is a good idea) and restricted the eatable things to include only the fully safe foods in very restricted quantities. (In fact almost all the doctors in India including my regular doctor do the same). This is a new, difficult change for me to try and get used to. I can understand that this will surely help better control, but I fear that I am losing the flexibility that is possible with the basal-bolus regimen.

The doctors approach sounds very orthodox, conventional and inflexible. My heart wants me to make full use of the flexibility without compromising control. But I am scared about the control that I'd actually end up achieving.

What could be the best position to draw the line between the 2 extreme approaches?

Tags: basal-bolus, flexibility, food, habits, orthodox

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Hi Jean, your suggestions are really helpful as they touch upon various foods that I eat regularly - rice, upma, rava and etc. :) It's been a while since I stopped sugar in milk and direct sweets, desserts, colas and other dangerous stuff.

My doctor has said that my LDL cholesterol levels are marginal 105 (normal levels are < 100 and ideal is around 70). So I have started cholesterol medications.

I understand that more the carbs, more the fluctuations and risk of losing control. So I will try to gradually cut down carbs. I now consume around 200-300g of carbs every day. I am now trying to consciously bring it down to a maximum of 180g and see its impact.

My doctor has also prescribed a multi-vitamin supplement capsules and a protein drink (which of course has some carbs as well :().

I am checking my bg levels at least 6 times a day this week so that I can better understand the interplay between the food items I eat, insulin, activities. Keeping my fingers crossed :)

Gerri is correct above: ghee has no carbs (what was I thinking?) and paneer is a good source of protein. Good luck! Palak paneer sounds like it might be a good bet -- if can you eat it without rice? All that spinach is good for you and low carb. ;0)




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