• Guest, the forum is undergoing some upgrades and so the usual themes will be unavailable for a few days. In the meantime, you can use the forum like normal. We'd love to know what you think about the forum! Take the 2025 Survey »

Diabetics are carb intolerant

Are diabetics just carb intolerant?

  • Total voters
    94
Status
Not open for further replies.
I've not been on the forum for a few days so have missed out on the start and most of the discussions on this thread.

I'm a T2 diabetic, and AFAIC I'm "carbohydrate intolerant". For whatever reason - being overweight, or having an old and possibly wearing-out pancreas - my body can no longer handle carbohydrates, particularly those high in starch/sugar, properly - i.e. it does not tolerate them well. To help it cope, I now eat very few of them, and both my brain and my body are quite happy (much happier in fact) now that I'm mainly a fat burning rather than a carbs burning machine.

(My doctor did actually threaten me with the fact that "sugar is corrosive", and suggest I imagine the damage that this rampaging through my veins might be doing to to my body...):eek:

I also feel that if required to inform anyone of any dietary requirements, telling them that I can't eat carbs/starch/sugar is much more easily understood and less liable to misinterpretation than saying I'm a diabetic...

I do however believe that T1 and T2 diabetics have different issues but neither are "just" carbohydrate intolerant. In view of this generalisation, I've voted to abstain (which is a rather weird option as one can't actually vote to abstain from voting).

Robbity
 
phoenix said:
http://www.joslin.org/news/dietary-fat-can-affect-insulin-requirements-in-type-1-diabetes.html
Click to expand...

The thing about this Joslin piece is that it is literally describing the pizza effect that many of us will be familiar with - it's commenting that if you eat a fatty high carb meal then there is delay in the glucose being acted upon by insulin so highs appear later.

The thing is no low-carber is going to eat pizza; it's too high carb and the effect is not sustained - they are attributing the spike in glucose to a decreased sensitivity to insulin but is that what's happening? I think it more likely that there is a delay. Both limbs of the study had a normal response to insulin for their breakfast so the effect is time limited in any event.

Lastly, if you don't have any carbs at all then eating fat may still require some insulin (the 'Chinese Restaurant Effect' that we discuss elsewhere) but not nearly as much as eating the actual carbs. I think the fat = decreased insulin sensitivity position may exist or may not but either way it is hardly the main point.

Dillinger
 
Dillinger said:
The thing about this Joslin piece is that it is literally describing the pizza effect that many of us will be familiar with - it's commenting that if you eat a fatty high carb meal then there is delay in the glucose being acted upon by insulin so highs appear later.

The thing is no low-carber is going to eat pizza; it's too high carb and the effect is not sustained - they are attributing the spike in glucose to a decreased sensitivity to insulin but is that what's happening? I think it more likely that there is a delay. Both limbs of the study had a normal response to insulin for their breakfast so the effect is time limited in any event.

Lastly, if you don't have any carbs at all then eating fat may still require some insulin (the 'Chinese Restaurant Effect' that we discuss elsewhere) but not nearly as much as eating the actual carbs. I think the fat = decreased insulin sensitivity position may exist or may not but either way it is hardly the main point.

Dillinger
Click to expand...
Looks like they used an 18 hour glucose clamp so it's a real increase in insulin requirement and not just a time shift. But yes it's the "pizza effect" of fat plus carbs. I don't ever get this effect from fat on LCHF. I hate how these studies just take high carb as a given rather than controlling it properly as a variable. It's scientifically sophomoric.

High blood lipids cause immediate but transient "insulin resistance" in non diabetics and T2 by suppressing beta cell activity. I wonder what the mechanism is in T1?

Scary that Joslin are using this explicitly to argue for low fat diets when it actually argues more strongly for a low carb diet.

I wish they would give a link to the actual paper but from the write up the study was not isocaloric ?

Sent from the Diabetes Forum App
 
Dillinger said:
The thing about this Joslin piece is that it is literally describing the pizza effect that many of us will be familiar with - it's commenting that if you eat a fatty high carb meal then there is delay in the glucose being acted upon by insulin so highs appear later. r
Click to expand...

I'm not too sure, however this is how Scheiner explains how a high fat meals causes insulin resistance:

So what about after the carbohydrates are finished doing their thing? That's when the fat itself begins to exert its effects. The process goes something like this:

  1. You eat a high-fat meal or snack (this is the fun part).
  2. In a few hours, the fat begins to digest; this continues for several hours.
  3. The level of fat in the bloodstream (triglycerides) rises.
  4. High triglycerides in the bloodstream cause the liver to become resistant to insulin.
  5. When the liver is insulin resistant, it produces and secretes more glucose than usual.
  6. The blood glucose rises steadily as the livers glucose output goes up.
This is what causes the gradual, delayed blood glucose rise after consumption of large amounts of fat. The response seems to be dose-dependent the more fat you consume, the more insulin resistant the liver becomes, and the more glucose it produces. The type of fat also appears to play a role. Saturated fats (the type found in dairy and animal products) seem to cause more insulin resistance than monounsaturated and polyunsaturated fats (the type found in vegetable products).

But we have been here before with this discussion Dillinger, didn't your consultant think that your insulin resistance was down to your LCHF diet?
 
noblehead said:
But we have been here before with this discussion Dillinger, didn't your consultant think that your insulin resistance was down to your LCHF diet?
Click to expand...

OK, don't shoot me, I'm no scientist but I do like logic. I have been told several good pieces of information by consultants and a few bad bits too which were completely wrong. Just because a consultant thinks something it doesn't mean it's true. (Running for cover now).
 
zand said:
OK, don't shoot me, I'm no scientist but I do like logic. I have been told several good pieces of information by consultants and a few bad bits too which were completely wrong. Just because a consultant thinks something it doesn't mean it's true. (Running for cover now).
Click to expand...


No your quite right Zand, but given that some people who very low-carb are on similar doses of insulin to those who eat carbs in moderation there has to be something else at play, we were discussing this very subject only last year.
 
Dillinger said:
The thing about this Joslin piece is that it is literally describing the pizza effect that many of us will be familiar with - it's commenting that if you eat a fatty high carb meal then there is delay in the glucose being acted upon by insulin so highs appear later.

The thing is no low-carber is going to eat pizza; it's too high carb and the effect is not sustained - they are attributing the spike in glucose to a decreased sensitivity to insulin but is that what's happening? I think it more likely that there is a delay. Both limbs of the study had a normal response to insulin for their breakfast so the effect is time limited in any event.

Lastly, if you don't have any carbs at all then eating fat may still require some insulin (the 'Chinese Restaurant Effect' that we discuss elsewhere) but not nearly as much as eating the actual carbs. I think the fat = decreased insulin sensitivity position may exist or may not but either way it is hardly the main point.

Dillinger
Click to expand...
Not really, the pizza effect was always a sort of short hand way of describing fat slowing of carb absorption.
This is demonstrating a need for more insulin over a longer period ie a reduction in insulin sensitivity. They used a closed loop system so were able to measure the amount of insulin required to keep glucose levels in a target range. The high fat meal required 42% more insulin, if it were merely a delayed effect then it would have required the same amount but delivered later or over a longer time. The glucose levels were in fact higher even with this much more insulin. T
There are a lot of references in the paper referring to free fatty acids and insulin resistance. It also might have been different with different fats (mono or polyunsat fats)

What it confirms to me is that I have to take into account all three macronutrients ie all food. (the insulin index showed that many years ago (you can't divorce the fat from the protein in the protein high foods, nor the fat from the carbs in some of the 'confectionary/snack foods)
 
noblehead said:
No your quite right Zand, but given that some people who very low-carb are on similar doses of insulin to those who eat carbs in moderation there has to be something else at play, we were discussing this very subject only last year.
Click to expand...
Ah, that's OK then, I missed that one because I didn't really 'get into' the forum until Jan/Feb so that's why I don't know about it. I understand what you are saying now. Phew :)
 
zand said:
Ah, that's OK then, I missed that one because I didn't really 'get into' the forum until Jan/Feb so that's why I don't know about it. I understand what you are saying now. Phew :)
Click to expand...


That's all right Zand, life is a big learning curve and diabetes is no exception :)
 
Status
Not open for further replies.
Back
Top