How highly would you recommend eating low carb?

[Spiker]

The other explanation is it's a degenerative disease and its course can't be altered. This could be called the "we're all going to die and there's nothing we can do" hypothesis. We can't affect the course and progression of our disease. Well maybe you and I are both in denial, but neither of us believe that.

 

[Spiker]

Ah now come one - the quiz was not concerning the point you were trying to make so nil points is harsh. We are both diabetics so the political scoring evident in the Eurovision Song Contest should be replicated here.

Er, that was exactly the point the quiz was making. "How" as in what methodology, what health evidence base. (Answer: none). Not what quango did the paperwork.

But ok. Cinq points. You had a good go. And you set up my punch line. So make it sept points.

 

[Scardoc]

Scardoc, why do you think in the entire population of diabetics, HBa1c worsens over time, regardless of tight control - testing and commitment? This is one of the most salient evidence points in the whole of diabetes management (equal in significance to "Hba1c correlates to complications", which we now take for granted).

Why is this? What is the reason? Cue deafening silence from the HCPs.

Under your hypothesis, the conclusion would be that the longer we have diabetes, the *less* committed and compliant we get. As complications arise and Hba1c deteriorates, we all take our foot off the gas and our eyes off the ball. How plausible is that?

An objective person looking in on diabetes HCPs from the outside would look at that very salient data and draw the much more reasonable inference that *the methods used are not working*.

But the HCPs behave like politicians, not scientists, and continue to blame the patients for "non-compliance" as the only explanation.

My answer to your question is simply the inescapable passage of time that all human beings are subject to. It is natural for humans to slow down and increase in weight as they get older. It is natural for your Hba1c to increase.

Don't tell me though - all of this can be reversed with low carbing?

And what is my hypothesis? The only thing I have tried to convey in this thread is that low carbing is not the be all and end all in diabetes management.

And yet again you return to blaming the HCP because they clearly are all as ignorant and stupid as portrayed by you.

 

[phoenix]

I said most points were marginal. Exercise is marginal for a T1, as is compliance with the NHS diet - marginal to negative. Testing and commitment are critical, I agree.

Absolutely disagree with the point about exercise. Insulin resistance is lowered considerably by exercise and I think it has an equal part in my management. My hospital has a picture of a 3 legged stool on the wall of the 'education room' the three legs, insulin, diet and exercise.
Every course I've done has a daily practical exercise session. You can't get away from it .The initial and pump courses are as in patients, we've walked up hills, done exercises with the physio and even gone swimming. They have exercise bikes in the department for use in the evenings (and many used them)
I know that if I sit on my backside for a couple of days then my fasting levels will increase and my basal insulin needs start to rise.

As for diet; well I've written it too many times before we don't get NHS diet advice, it's far more detailed but most definitely not low carb advice

As to compliance , it helps I think if you have input and support, rather than being left to your own devices. Diabetes' burnout' is well documented and people can become demotivated.
I continue to have yearly refresher courses .which I think helps. There is a group of 9 or 10 people that I now regularly see on these courses .We all continue to have reasonable HbA1cs . No-one I know eats a low carb diet (many though continue with a fixed amount of carbs diet) all seem to do their daily exercise whether it is just walking or something more vigorous. Maybe it says something about the quality of education and the commitment of the diabetes specialists which results in a 'compliant' band of patients with good results. I know that the consultant is still proud that there have been no amputations for diabetes amongst his patients (T1 and T2) for now more than 16 years
( NB I think I am very lucky it isn't necessarily indicative of what happens in the rest of France, hospitals have a lot of autonomy over things like therapeutic education; they even have some people in hospital for 3 or more weeks to help them to start to reduce weight, get control etc That certainly wouldn't happen in major cities with many more patients per doctor )

 

[Spiker]

It is natural for your Hba1c to increase.

No it isn't.

(I didn't come here for an argument.) ;-)

 

[Spiker]

And yet again you return to blaming the HCP because they clearly are all as ignorant and stupid as portrayed by you.

The HCPs who as a profession described low carb as "dangerous", refused to support us in it, forced it underground, out of contact with HCP support, on *literally no evidence base*? Those HCPs? The same ones who are now collectively retracting this dogma they foisted on us for 50 years (while not quite going so far as saying they were wrong, of course).

 

[Spiker]

Scardoc you are retreating to a "straw man" argument if all [you're] defending is that low carb is not the 100% solution and cure for everything.

But still you have no evidence base for your claim that the NHS carb diet is not responsible for the 94% off-target diabetics. Who knows, it might be. You don't know. No one does. So you are in no position to claim, as you did, it was "certain" not to be the case.

Personally I would be unsurprised if the NHS diet/dose regime for diabetics was responsible for well above 50% of the off-target diabetics.

 

[Spiker]

@phoenix I grant you exercise is very effective for its insulin sensitivity effects.

 

[Spiker]

@phoenix I grant you exercise is very effective for its insulin sensitivity effects.

I'd like to withdraw "marginal" for exercise, and change it to "optional but beneficial" please.

 

[donnellysdogs]

My hba1c has stayed the same 5-6 for 30 years... Am I medical wonder?

 

[Spiker]

@Scardoc the population data for Hba1c is independent of age. It correlates to time since diagnosis, not absolute age. It's not an aging effect or age-related effect. It's a "how long have you had diabetes" effect.

It probably explains why bloody-minded angry ranting correlates with time since diagnosis. 18 years and ranting more every day, in my case. :-/

 

[Spiker]

My hba1c has stayed the same 5-6 for 30 years... Am I medical wonder?

Yes, and a thing of wondrous beauty DD! xxx. ;-)

 

[Scardoc]

No it isn't.

It really does. Look it up. In the non diabetic population A1C naturally increases with age, it's nature, nothing to do with being diabetic or not.

Scardoc you are retreating to a "straw man" argument if all [you're] defending is that low carb is not the 100% solution and cure for everything.

But still you have no evidence base for your claim that the NHS carb diet is not responsible for the 94% off-target diabetics. Who knows, it might be. You don't know. No one does. So you are in no position to claim, as you did, it was "certain" not to be the case.

Personally I would be unsurprised if the NHS diet/dose regime for diabetics was responsible for well above 50% of the off-target diabetics.

Right, now you may begin to see where I was coming from all of those pages ago when I referred to this as the "low carb" forum!!!! Please, pretty please furnish us all with the evidence that the NHS diet/dose regime for diabetics is responsible? You can't. Dillinger can't. No one can. Just as I can't provide evidence to prove it's not responsible.

Hence I cited other reasons which, although initially dismissed and ranted at, now seem to be more accepted. For avoidance of doubt I am not retreating to anything, my point began many moons ago by saying that 94% of T1 diabetics are not failing to meet Hba1c targets because of the RDA of carbohydrates. You can ask for whatever evidence you want and I can't provide it. All I can tell you is that I am walking talking proof that you can eat more than the RDA allowance of carbs, be T1 diabetic and maintain a healthy Hba1c. The conclusion I would draw from this, and hope others can see, is that there are more reasons behind the poor statistics than carbohydrates alone.

And that is why I get frustrated, at what I personally believe to be, the deterioration of the diversity of this forum over the years, into a low carb forum.

*Disclaimer - that is not to say I do not think that low carbing has it's place and merits and this forum is not an extremely informative tool and has hugely benefitted and enriched, perhaps even saved, the lives of many many people, my own included.

 

[Robinredbreast]

Gosh, I've not checked in for a day or so and it's all kicked off!

Seriously though, thank you for every single reply - I think we can all agree we are very passionate about out diabetes and controlling it. I think it's all about finding what works for you and appreciating that it might not work for everyone.

Hi and yes cookiebell it can be a fractious subject , but as you say, we do care very passionately about keeping our diabetes under control with good management. I hope you find a happy medium to start off with and continue to do well with your lower carb intake, what ever YOUR number may be.
Good luck

 

[Spiker]

@Scardoc you made the "certain" claim, not me.

 

[Spiker]

So @Scardoc if all you are doing is attacking a straw man position that no one actually made, why did you bother?

 

[Spiker]

I still dismiss and rant at all NHS factors except testing and commitment, no change except I concede exercise is "beneficial but optional" for T1s rather than marginal as I first implied.

 

[Spiker]

And this is not a low carb forum, believe me. It has all sorts. Who get along and respect differences..

 

[Bluetit1802]

. It is natural for humans to slow down and increase in weight as they get older.

.

No it isn't.

 

[Scardoc]

@Scardoc you made the "certain" claim, not me.

And I stand by it. I am certain, 100% certain.

I would not say I was attacking anything but challenging the comments made by Dillinger. As you challenged my comments in return. Healthy debate they call it.