New Nice guidelines

[nickm]

The updated NICE guidelines for doctors state "Do not advise adults with type 1 diabetes to follow a low glycaemic index diet..." (my emphasis)
How is this consistent with the ethical obligation of doctors to discuss alternative treatments? Surgeons are required to discuss the pros and cons of not operating, but according to NICE, diabetes doctors should only advocate a "normal" diet (they give DAFNE as an example) which to the average person means high carb and high GI.
if a patient goes to a doctor stating that they want to start a low GI diet, what will be the response? Don't do it?

 

[Blackers183]

My reading of the guidelines is that a low GI diet is not the answer to good BGL control, instead a good well balanced diet with structured carb counting and flexible insulin dosing. Low GI is not low carb, it is still carbs but in theory take longer to process in the body.

 

[donnellysdogs]

It may be because some low GI foods can give significant rises later than expected. Ie say peanuts.. These have a low GI of 14 but to some T1's-(me!!) give me huge rises 8-14 hours later...Me personally I have the same happen with almonds which again are low GI. This is only ground almond cookies though.....

I think that NICE should be advising that T1's should just test and eat products that give less than a 2.7 raise in levels.

We all vary enormously. I can no longer eat plain roast dinner with steamed veg.... All my hot meat and veg has to be casseroled or curried which means that I add in more lentils/chick peas etc which are also counted as low GI..but its the only way I can eat!!

If a Consultant told me to change I Would be on a constant supply of laxatives and enemas.

The thing is as well that annoys me is that Consultants CAN choose to ignore NICE guidelines. They do with radiotherapy... The guidelines for radiotherapy state to be started within 31days from op.. Mine will be 62 days.

So Consultants pick and choose guidelines to follow...

 

[Daibell]

There is so much politics associated with NICE and medicine in general and the result is a bit of a committee outcome. As far as I'm concerned Low or High GI has little relevance when on insulin as a T1 (or LADA). It's the carbs that matter and they need to be kept under some control to avoid weight gain and excessive insulin shots which can cause skin problems at the injection site.

 

[nickm]

And yet the Cochrane Collaboration concludes
"lowering the glycaemic index of foods in the diet appears to be an effective method of improving glycaemic control in diabetes without compromising the number of hypoglycaemic episodes"
Does Cochrane have no credibility?

 

[Daibell]

And yet the Cochrane Collaboration concludes
"lowering the glycaemic index of foods in the diet appears to be an effective method of improving glycaemic control in diabetes without compromising the number of hypoglycaemic episodes"
Does Cochrane have no credibility?

In theory and no doubt in practice, low-GI should smooth bs peaks and troughs which can only be good, but surely it still remains true that overall carb input (that the body can absorb) will affect the daily amount of insulin needed. So, low-GI should always be better than high-GI but it's not the panacea.

 

[tim2000s]

In theory and no doubt in practice, low-GI should smooth bs peaks and troughs which can only be good, but surely it still remains true that overall carb input (that the body can absorb) will affect the daily amount of insulin needed. So, low-GI should always be better than high-GI but it's not the panacea.

I think the issue with Low-GI foods for many is that you have to really work hard on Insulin timing.

With the growing numbers of CGMs and FGMs out there, we've had to re-evaluate the timing of the current crop of fast acting insulins. When you eat a lower GI food (wild rice I find to be a great example) timing is even harder. I found that coinciding insulin action with low-GI carbs action is even harder than "normal" foods. I personally think it's easier to go Low Carb than to eat Low GI, as the reality is that low-GI foods require you to Sugar Surf hugely. Low Carb just takes the carbs out of the equation all together.

 

[donnellysdogs]

I think the issue with Low-GI foods for many is that you have to really work hard on Insulin timing.

With the growing numbers of CGMs and FGMs out there, we've had to re-evaluate the timing of the current crop of fast acting insulins. When you eat a lower GI food (wild rice I find to be a great example) timing is even harder. I found that coinciding insulin action with low-GI carbs action is even harder than "normal" foods. I personally think it's easier to go Low Carb than to eat Low GI, as the reality is that low-GI foods require you to Sugar Surf hugely. Low Carb just takes the carbs out of the equation all together.

That is my experience. Totally. I don't look at low GI at all but following this thread I have taken a look at the foods that cause me problems with sugar surfing and they are all low GI...