Hi Brian,

I am not sure if the diet is affecting your insulin resistance, but I can tell you (I am a type 3c diabetic due to pancreatectomy) that rice, potatoes, flour, and bread (specifically white bread, crackers, etc.) are hard on glucose control (they are very simple carbs). Higher fat meals also can also slow digestion and lessen the carb spike (and blood sugar can also rebound later because it slows digestion). I generally try to stay under 150 g of carbs per day to maintain my glucose levels (using about 60 units of insulin per day)

Have you ever considered using a CGM? I can tell you that it is invaluable for me as I can measure the impact of carbs and fats after meals to get a feel for how different foods affect me. I have also used MyFitnessPal to map my carbs per meal per day against the CGM to get an idea of daily carb load.

It also may be worth checking with an endocrinologist to see if insulin would help your control.

Before I had my pancreatectomy, I was a type II diabetic and was taking 500 mg metformin twice a day for control and was eating 60g of carbs or less per day to maintain an A1C of 5.8.

Your diet doesn't sound unreasonable but for a type II, rice, bread, fruits are hard on you. There is only so much your pancreas can overcome with medication. I think counting carbs and a CGM would be very insightful for you to map out your food/glucose graph over time. You might also want to read this article to see if this applies to you as well -> https://www.webmd.com/diabetes/dawn-phenomenon-or-somogyi-effect (which is why I have a snack before bed.) Hope this helps.

Thanks
- Matt