Hello, Kim. I was diagnosed with type 2 diabetes a few months before I had to have my big surgery due to cancer. I probably was diabetic for a long time before it was diagnosed at 7.5 glucose.

Before my surgery I was able to control my blood sugar through diet alone by cutting back drastically on white sugar and products with added sugars, ie. ketchup, cream or mayo based dressings.  I took classes at a local hospital to learn how to read food labels, how to use the "plate method" when eating a meal, how to count carbs, and how to recognize foods with high carbs. Very soon it became second nature and I no longer counted carbs: I knew from memory which foods are good and what is high carb, and how to choose something healthier. Constantly counting carbs, fibre, and worrying about food can be depressing and boring and most people just stop. 

Educate yourself on what foods are good for diabetes control, remember their carb content, then put it aside. Use the plate method. It will soon become normal for you to look at a croissant or bagel or big bowl of pasta and know it is HIGH in carbs. You can still have pasta, white rice, just have half, and make sure you have it with a protein and some fat in the same meal. I learned to love brown rice. But I still have white rice once in a while, but only 3/4 cup or 1/2 cup cooked. I try to have it at lunch so I still have all day to burn it off instead of for dinner which will result in high numbers when you wake up next day. Try not to go to sleep with lots of sugar floating around in your blood. If you eat a carb, have it with a good protein food and a bit of good fat (olive oil, avocado, soy butter, peanut butter) because the combination will slow down the spike caused by the any carb. Choose a carb with high fibre because you subtract the fibre grams for the true carb count. Fibre goes through you, it is not absorbed by the body, so does not affect carb sugar spikes. 

After my first surgery I ate the white-starchy diet to try and thicken my stools. That was not good for diabetes, but what could I do until my pouch matured and adjusted. What helped my A1C levels during this white-starchy food period was my low weight. I was very thin after surgery, and weight affects diabetes.  Soon, I went a bit overboard, ate everything because I was so happy I could eat again, and I paid for it with high A1C levels and my weight had gone up by 20 pounds. A1C 7.8.  My endocrinologist put me on a prescription. It is not a diabetes drug like Metformin that controls your blood sugar; instead, this one simply stops your body from reabsorbing the glucose floating around inside and you pee it out.  

Because I do not want to be on any medication long-term, I cut out highly processed foods (instant meals, pizza, store bought cakes, bagels, chips, frozen foods, soda). If we have a hamburger at a good hamburger joint, I remove half the bun and have an open faced burger!  I walk after the meal.  I try and stick to "whole foods" that are minimally processed and as close to its natural state as possible. I still eat bread but now it is a sprouted grain bread specifically for diabetics called "Little-Big-Bread" by SilverHillsBakery. It is for anyone who wants low carb bread, not only diabetics.

For breakfast I have the LLB or I have a small slider bun (they are really tiny....) with roasted ham and a good cheese, and mustard, warmed in the toaster oven. Coffee with organic soy creamer and Splenda's new STEVIAsweetener. Then I am out the door. Two hours later my glucose reading will be around 7 or 8 depending on my activity level. You want to be under 10 two hours after your first bite.  Mid morning snack is a cup of Costco-Kirkland grapefruit sections. I pour out the sweetener juice and eat only the grapefruit.

Lunch can be chicken with 3/4 cup white or brown rice, and any vegetable I want. Snack will be 1 cup raspberries. Raspberries are excellent for diabetics. Powerful antioxidant, very high fibre and low sugar. I eat one serving per day. Or a small orange. I never ever drink bottled fruit juice, it is pure sugar with no fibre.

Dinner is 3/4 cup brown or basmati rice. Basmati rice has a low glycemic index and your sugar will not spike as high or as quickly. Brown rice is even better, because of the fibre. Chicken or fish with lemon, olive oil, fresh garlic and herbs, and broccoli or other greens with a dressing I found in a Japanese restaurant 1 tablespoon = 1gram carb. I dip vegetables in this dressing too. If I a man starving before bed, I will have a bite of chicken or other protein. No carb or sugar before bedtime.

I wake up and test every morning. My glucose can be anywhere from 5.7 to 7.5.  depending on dinner the night before, and something called the "dawn phenomenon" when your liver thinks you need glucose and puts it out at 3am! I am working hard on my morning readings.

I think if I went down to 4.7 (as you aim to) I would be too low and be dizzy and confused. For me, anything close to 5 is too low. My aim is 6 every morning, 9 after meals, and I can come off medication. I have lost 21 pounds since last August. My exercise is walking a lot. I drink a lots of lemon water all day, and always a room temperature glass of water before I get out of bed each morning.

I do have a dessert now and then, but only a bite or two. I buy the smallest size dessert because I would rather have a good A1C level and come off the medication forever with good, long health than to eat the entire sweet dessert!  My family members can have the rest, they are okay with blood glucose. I have heard of people who take diabetes medication and see their meds as a free ticket so they do not adjust their food, never exercise, and eat everything they want. One person ended up losing their sight; another had to have leg amputation, both due to out of control glucose and nerve loss. 

I'm sorry this is such a long post!  I wanted to give you details and arm you with lots of tips. I hope it helps you. Just remember after you learn about carb and fibre content by reading labels, and the amount of food on your plate, and manage your weight, you can enjoy so many good foods.

Hi, I thank you for all the information you have given me! I have done a lot of reading on low carbs, high fat, processed foods. I just brought Michael Pollan's book "FOOD RULES". I am learning a lot about lowering my A1C. I don't  know is all of the things that I have been doing is going to work because the doctor said I have a 50% chance of getting type 2 diabetes because both parents had it in there 60's. I am 60. I am the type of person to over do it with exercise and diet. I am not giving up! How are you feeling ?  Are you all done with the surgeries? Kim E

While it’s true that carbs tend to be helpful during the post-op period, in the longer term many J-pouchers do much better on a low-carb diet, since that seems to reduce the impact of pouchitis. While it may take some exploring to find what works best for you, reducing the carbs tends to be very J-pouch-friendly.

Hello, Kim.

I am doing really well. My surgeries were completed two years ago!  I have no complaints with my j pouch. The first few months of j pouch life were difficult with frequency, burning, and a few bouts of pouchitis that were resolved with cipro and food choices. After the first tricky year, everything settled down and I can eat what I like, but I always avoid nuts and seeds because they don't dissolve. I can even eat spicy food!  

The challenge now is getting my diabetes A1C glucose level down to 6 so I come off the meds. If you are pre-diabetic, try not to worry about it all the time. Genetics is genetics. Stress can drive up your glucose readings. Keep working on your food choices and keep moving. Don't be hard on yourself if you indulge once in a while. Try not to go to bed with lots of sugar floating around. You can do it.