I used to follow Quantified Self research about a decade ago, then got busy with TechShop and drifted away. But now I’m interested in testing how different foods, different times of eating/sleeping, and activities affect my blood sugar. I just don’t know how to get a prescription for a CGM and I can’t afford enough test strips to get enough data.
About 6 weeks ago, my doctor announced that I have crossed the threshold into pre-diabetes. She and the medical center diabetes dietitian can’t agree on the definition of a “low carb diet” or how often to test blood glucose. However, the doctor says Medicare isn’t buying more than one test strip a day (true) and I just need to test at different times of day and track the trend. She believes that my A1C will tell her everything I need to know about how well my lifestyle changes worked. Except I won’t know how strict I need to be for acceptable results, and I don’t want to fall into orthorexia worrying about A1C.
I have a history of agreeing to go on low carb fad diets for bogus quack reasons that seemed credible at the time because I didn’t know biology. So I don’t want to go down the rabbit hole again of being obsessed about carbs and eating so little that I slow down my metabolism. Everyone I know with Type 2 says I don’t need to make big changes, but apparently “eat more healthy stuff like beans, grains, fruit, and plain yogurt” how I got to be pre-diabetic (and so did a friend’s husband).
What I would like is an individual counselor who would take everything into account, but I suspect I can’t get that. Another idea is to get blood glucose feedback data. Frequent measurements would let me know how strict I need to be, and how lazy I can be. Sometimes I’m having a bad day with my other disabilities and making fresh food isn’t going to happen or the weather or air are too bad to exercise. Also, how to tell if I’m really hypoglycemic vs. hungry for no reason, since I’ve always had an appetite like a Labrador and my blood sugar can be anywhere between 65-99 when I’m sure I’m starving.
I could probably learn a lot if I got a Freestyle Libre 24-day for $60 at Costco and started taking food pictures to guestimate carbs and mark times. But I don’t know how to get a prescription.
My doctor thinks I’m making too big a deal even to ask for help planning a diet around my limitations. She just said after I had problems with the dietitian that all she meant was “Stop eating big pieces of chocolate cake and no more white bread.” Ok, so does that mean small pieces of cake are ok? How often? Could I eat half a loaf of whole grain rye bread in a day? All the fruit I want? I’m guessing not, but there’s a huge gap between what she said and what an actual low carb diet looks like or even the clinic’s handout. I think she’s making assumptions based on my weight, and I’m already shopping for a new doctor.
And I have a limited budget for low carb food (lean protein, fresh veggies) once PUA ends. Eating bread and pasta was how I made sure I didn’t starve, and my grocery spending is up 5-6x what it was before. Food banks rely on white flour to keep people fed on a budget–if you’re at Grocery Outlet, take a look at that “$5 donation feeds a family for a day” display. Ramen, spaghetti, etc. plus rice and beans which are not part of the diabetes diet from my clinic in significant quantities, either.
VMC my plate- english 1.pdf (677.0 KB)
Anyway, I don’t know how to get a prescription. I looked at some online doctors and they are pretty expensive, and I don’t even know if they’ll agree this is a good enough idea to prescribe it. Does anyone have experience with this?