Be patient and monitor your fasting blood glucose trend over the next few weeks.
As you make changes to your lunch and dinner menus, your fasting blood glucose is likely to come down steadily.
Alternatively, you can speed up the rate at which you make changes to your diet if you want quicker results.
Start by reducing the total fat content of your diet to a maximum of 15 percent of total calories for 14 days in a row, and monitor what effect this has on your fasting blood glucose before breakfast.
If You Experience High Blood Glucose After Breakfast
Consider adjusting the rate at which glucose gets into your bloodstream at your breakfast meal temporarily by focusing on Breakfast Option 2 described above. Additionally, limiting your fat intake to no more than 15 percent of calories will also help lower your blood glucose after breakfast. This will ensure that the foods you eat at lunch and dinner don’t negatively affect your blood glucose the next morning.
Try elevating your heart rate for about 10 to 15 minutes before or after your next breakfast meal by walking, jogging, cycling, strength training, or swimming to accelerate the rate at which glucose is burned for energy and utilized by tissues. Small exercise sessions are a very effective way to reduce your post-meal blood glucose. For more information on managing your blood glucose before, during, and after exercise, see chapter 14.
If you are using fast-acting bolus insulin, also pay attention to the timing of your insulin injection (covered in depth in chapter 9) to ensure insulin is available and active in your blood. Paying attention to your insulin timing strategy is a simple and powerful way to limit postprandial blood glucose elevations.
If You Experience Low Blood Glucose After Breakfast
If you experience low blood glucose within 3 hours of eating the perfect breakfast, this is a strong indicator that you are gaining insulin sensitivity and carbohydrate tolerance. Low blood glucose is also referred to as hypoglycemia, and is often accompanied by sweating, slurred speech, blurry vision, difficulty concentrating, and dizziness. Hypoglycemia occurs when your blood glucose drops below 70 mg/dL and can be life-threatening, so it’s important to pay close attention to how you feel to minimize your risk for an emergency.
If you are insulin-dependent, consider using the decision tree to reduce the amount of insulin you administer at breakfast, and if you are on a glucose-lowering oral medication, ask your doctor to help you reduce your dosage so you remain safe.
If You Get Hungry After 1 to 2 Hours
Because fruits are processed by your digestive system quickly, you may feel hungry after a few hours—and that’s okay. Increase the size of your breakfast bowl or eat a second breakfast in the middle of the morning. Usually, increasing the size of your bowl by adding more fruits, beans, peas, lentils, or intact whole grains solves the problem quickly.
Many people who adopt a plant-based diet are often quite hungry as they adjust to eating larger volumes of foods with lower calorie density. Feel free to eat green light foods generously in order to feel full throughout the day. Some people choose to eat fresh whole fruit every 2 to 3 hours or just snack on whole fruit when they feel hungry between meals. Enjoy as much as you like to stay satisfied!
How to Know When to Move On
By focusing on changing only one meal at a time, you are allowing your muscles, liver, and cardiovascular system time to adjust to the changes you’re making, which keeps you from feeling overwhelmed. However, when you feel satisfied with the results you’re seeing from changing your breakfast, then refer to the list below to confirm you are ready to change your lunch. In general, we recommend moving on to lunch once you feel as though you have accomplished the following:
You have eaten either of the two breakfast options for a minimum of 7 consecutive days.
You understand how much food to eat in order to stay full for 3 to 4 hours, or until it’s time to eat lunch.
You have mastered the logistics of the morning hours and understand how and when to prepare your meal as part of your daily morning routine.
If you are insulin-dependent, you understand how much bolus insulin to inject in order to maintain a post-meal (2 to 3 hours after you finish eating) blood glucose of between 80 and 140 mg/dL.
If you have accomplished these four tasks, then it’s time to move on to lunch, our favorite meal of the day!
To view the 45+ scientific references cited in this chapter, please visit us online at www.masteringdiabetes.org/bookinfo .