I'll start with saying I have an insulin pump. I have excellent blood glucose levels, (between 4.9% and 5.6%) and need to take very little insulin, my last weeks average was 23.97u. My major reason for having a pump is to be able to reduce insulin on a temporary basis for rather erratic exercise patterns. I am also in complete possesion of my mental faculties.
(Its sad but feel a need to clarify that since a posting on another thread makes a rather insulting claim that that people who post alternatives to low carbing (actually he put it as 'vehement anti low posters' )
"" common characteristics of these posters seem to be high amounts of injected insulin, insulin pumps, dangerously high HbA1c levels and complications "
I don't low carb,nor do I high carb, I try to eat a balanced diet. By low carbing, I mean reducing to the very low intakes of carbs, such as those advocated by Bernstein, Atkins , Sears and Eades. I feel quite strongly that it is neither necessary nor healthy to attempt to reduce levels to these tiny amounts. I perfectly accept that high gi carbs can raise blood glucose levels unacceptably but I also believe that a balanced diet is good for everyone (not withstanding the odd Inuit, though I don't think many post on here) .
No particular order why I don't think its a good thing.
1) Most low carb diets seem to be very low in fibre (NB not all veg is that high!) Including some fruits , wholegrains and legumes helps to boost levels. Fibre helps your digestive system to process food and absorb nutrients, it may be protective against bowel cancer,
http://www.bupa.co.uk/health_information/html/health_news/120503bowel.htm
and diverticulitis. Soluble fibre in gums and pectin( eg in oats, legumes, apples) may help lower cholesterol and control blood glucose fluctuations.
2) Low percentage carb diets must therefore be either high protein or high fat.
High protein diets can cause deterioration in people who have reduced kidney function. Many people when diagnosed as type 2 or type 1 as older people already have reduced function. Many don't seem to be aware of what their level of kidney function is. At age 57, my own was 65, as I have no protein in my urine it isn't considered to be kidney disease . If or when it goes below 60 it would be. It will inevitably deteriorate as I get older anyway. It seens to be sensible not to stress them more.
http://www.news.harvard.edu/gazette/2003/03.13/09-kidney.html
High fat diets can be high in
saturated fats, certainly ones where cream, cheese and red meat are eaten in quantity. I won't go into the arguments here, but most cardiologists or researchers into CVD warn against too much saturated fat. I would rather take my advice from them rather than highly publised blogs or yet scientific papers published in certain journals. Replacing saturated fat with 'good' fats (plus exercise and good glucose levels) appear to have reduced the amount of plaque in my arteries over just a year, five years on the arteriologist seems to have far less concerns.
3)Low carb diets, at least some of those cited on here when diets were analysed seemed to be low in calcium. On top of this diets high in protein increase the demand placed on the kidney to process the protein thus causing abnormal excretion of calcium. Calcium absorption is particularly important in post menopausal women and for all during the formation of peak bone density. (though recently I had a bonescan and have good bone density so I'm lucky, others might not be in the same situation)
4)We're often told that diabetes is a disorder of carbohydrate metabolism, well thats not the 'offical'
definition.'The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting .........' (WHO). Personally I know that protein converts very readilly to glucose in my blood stream, so much so there is very little difference in the amount of insulin I need for a low carb, high protein meal. Too much fat causes unpredictable digestion, causing early hypos and later rises is blood glucose levels when the insulin has gone past its peak. Another reason for a balanced, and regular diet.
There are alternatives to low carbing that work. There is both scientific evidence and also anectdotal from posters on this forum (sadly many have felt it necessary to stop posting recently)
What works for me is a careful choice of less processed foods, home cooked , carbs including some 'wholegrain' starches and lots of veg and fruit, good fats such as oily fish,nuts and seeds,avocados, sunflower, rapeseed and olive oils, and lean protein, not too much of anything Exercise is also very important, and although I do a fair amount I have to work at, I'm not an athlete. Despite some peoples opinion a pump doesn't do it all for me, it merely helps replace (in a less than perfect way) the insulin that my body doesn't produce,
