How well do type 2s tolerate carbs?

[rosserk]

Hi all

These may seem like really stupid questions but I'm gonna ask anyway..

I was wondering how well type 2s tolerate carbs? For example if you only ate 30g of carbs would you expect to see a three point rise in your blood sugars after two hours? Would you consider three points an ok rise and continue to eat 30g of carbs or would that be unacceptable and discourage you from eating them again? What would you consider acceptable?

 

[Gezzabelle]

Personally I aim for no more than a rise of 2 for anything I eat. If I ate 30g of carb I would get more than 3 unless it was spread out over a days meals. I would try to avoid 30g of carb in one go as it would take hours to come down but of course everyone is different with how they tolerate carbs. I try to eat less than 50g of carb a day in total

 

[Totto]

How well you tolerate carbs are individual and depends on a lot of different factors.

As to 30 grams of carbs I usually stay below this amount per day and my personal goal is to be back to baseline at two hours.

 

[eddie1968]

Personally I aim for no more than a rise of 2 for anything I eat. If I ate 30g of carb I would get more than 3 unless it was spread out over a days meals. I would try to avoid 30g of carb in one go as it would take hours to come down but of course everyone is different with how they tolerate carbs. I try to eat less than 50g of carb a day in total

I agree with you, everyone's different. A lot of factors must be taken into consideration. For example how well your pancreas is functioning, insulin resistance if you have it, your meds if you're on any, speed of gastric absorption, sex, weight and fluid intake are some.

 

[Brunneria]

As said above, everyone is different.

I would get a bigger rise than that with grains, and a smaller one with potato.

When you low carb, your pancreas gets out of practice at dealing with carbs, so if you surprise it with an extra portion the bg will rise dramatically. However, if you increase carb consumption slowly over several days, your pancreas adjusts to cope.

 

[britishpub]

Yes, I think (for me anyway) it depends on what the Carbs are, as much as the amount. I don't think I've eaten 30g in one meal since I started LC'ing so the actual effect on my BG is unknown, but if I had a 3+ plus point rise I would be unhappy.

 

[Bluetit1802]

It all depends on personal circumstances, state of the pancreas, type of carbs, medication, metabolism and other factors. If I saw a rise of 3 at any time after any meal I would be devastated. Personally, the type of carbs matters for me. Bread is far worse than potatoes.

 

[SunnyExpat]

It all depends on personal circumstances, state of the pancreas, type of carbs, medication, metabolism and other factors. If I saw a rise of 3 at any time after any meal I would be devastated. Personally, the type of carbs matters for me. Bread is far worse than potatoes.

Can I ask why?

If you went from a 4 to 7 for example, why would you feel devastated?
To me that seems within a normal number.

 

[Bluetit1802]

Can I ask why?

If you went from a 4 to 7 for example, why would you feel devastated?
To me that seems within a normal number.

Yes, I would still be horrified because my pancreas hadn't dealt with the carbs efficiently. My aim is to keep my post meal rise as gentle as possible, like a gradual curve rather than a sharp peak. (Evening meals I test at 1 hour, 1.5hrs and 2 hours, and keep going if necessary) It isn't always possible to maintain a gentle curve because it depends on the combination of foods eaten, but it is my aim.

 

[rosserk]

Hi all thanks for the responses. Not sure I phrased the question correctly based on the responses, I will try again.

Firstly I know everyone is different which is precisely why I'm asking, if we were all the same I wouldn't have asked lol

My question was how many carbs can 'you' personally tolerate 20/30?
If you ate 20g of carbs and rose 2 points would you find that acceptable?

I personally try to hover around 20g-30g of carbs per day and regularly see rises of 3 points from base reading which are still within acceptable limits. I'm wondering how other type 2s would react to those results. Would it prompt you to cut carbs further or would it be acceptable to you personally based on your knowledge of diabetes?

 

[rosserk]

As said above, everyone is different.

I would get a bigger rise than that with grains, and a smaller one with potato.

When you low carb, your pancreas gets out of practice at dealing with carbs, so if you surprise it with an extra portion the bg will rise dramatically. However, if you increase carb consumption slowly over several days, your pancreas adjusts to cope.

Does the pancreas get out of practice or does it manage the lower carb based on the lower amounts of insulin it's producing? After all that's the point of low carbing surely? It would be a dangerous scenario to coerce our pancreas into forgetting how to deal with carbs?

 

[rosserk]

Can I ask why?

If you went from a 4 to 7 for example, why would you feel devastated?
To me that seems within a normal number.

That's my point exactly. Is this an individual response and why?

 

[Brunneria]

Does the pancreas get out of practice or does it manage the lower carb based on the lower amounts of insulin it's producing? After all that's the point of low carbing surely? It would be a dangerous scenario to coerce our pancreas into forgetting how to deal with carbs?

As I mentioned before, it is a simple response to ingesting lower carbs - the body gets out of practice with dealing with them, and produces fewer enzymes. The amount of enzymes produced is based on the amount needed in recent meals, so the fewer carbs you eat, the less well prepared the body is to produce enough insulin to deal with a sudden large portion.

This explains why low carbers have a disproportionatly high spike in bg when they eat a larger than usual amount of carbs.

Anyone can re-introduce carbs into their diet at any time, if they wish (providing they don't have too many compromised beta cells -but then they may well be on insulin). It is a simple matter to 'wake up' the enzyme production, over a few days, by eating gradually more carbs. I have done this before going on holiday for example.

This is the reason that low carbers are advised to eat 'normal' amounts of carbs before an oral glucose tolerance test. Health care professionals interpret the results based on standard 'normal' carb diets. So unless they prepare beforehand, low carber OGTT results would be disporportionately high.

 

[Clivethedrive]

Yes, I would still be horrified because my pancreas hadn't dealt with the carbs efficiently. My aim is to keep my post meal rise as gentle as possible, like a gradual curve rather than a sharp peak. (Evening meals I test at 1 hour, 1.5hrs and 2 hours, and keep going if necessary) It isn't always possible to maintain a gentle curve because it depends on the combination of foods eaten, but it is my aim.

As you noted bluetit1802, a rise of more than 2 mmol at any stage is to be avoided

 

[Gary1205]

My honest answer to your questions as someone who adopts a balanced diet approach and is lucky enough for whatever reason to be more tolerant of carbs than others is this. I tend to eat really to my meter as well as using a portion/calorie control. I dont like exceeding 8.5 two hours after and that does not mean that I aim for 8.5 either, just the higher I am pre meal would cut back on some the content and also learn what does push my levels up and avoid those things in future. The other night for example was 4.8 pre meal had shepherds pie and cabbage in what I consider sensible portions and had a little bit of baked apple afterwards as I was in the 4's and after two hours was 5.7 and according to my calculations based upon the carbs and cals book a meal of 70g approx of carb which I know would be too much for some but is at the moment at least okay for me.
So in answer to your question, I probably aim more for keeping below the 8.5 figure rather than worry about an increase of 3 say. That having been said with what I currently eat in my balanced diet based on portions/calories, it has been rare for me to have that sort of increase.

 

[fred1234]

I would be happy with rise within normal limits. I haven't yet got then hang of carbs counting but doing it at a slower pace.....trying really hard but don't find it easy I must say. Probably because until I started counting didn't realise just how many carbs I had been eating. I find bread the hardest of all to give up. I do allow myself as a treat a bit toast now and again, but it's never enough lol I want the whole loaf!!!

 

[SunnyExpat]

As you noted bluetit1802, a rise of more than 2 mmol at any stage is to be avoided

@Clivethedrive
That's an interesting opinion.
As the normal pre prandial is 4 to 5.9, rising to 7.8 two hours after eating, and in fact mine was 3.8 before a meal yesterday, I have no problem with a rise of even 4 in that case.

I know the combination of the liver and pancreas control BG levels between them, what mechanism controls the rate of change in a non diabetic person?

 

[rosserk]

As I mentioned before, it is a simple response to ingesting lower carbs - the body gets out of practice with dealing with them, and produces fewer enzymes. The amount of enzymes produced is based on the amount needed in recent meals, so the fewer carbs you eat, the less well prepared the body is to produce enough insulin to deal with a sudden large portion.

This explains why low carbers have a disproportionatly high spike in bg when they eat a larger than usual amount of carbs.

Anyone can re-introduce carbs into their diet at any time, if they wish (providing they don't have too many compromised beta cells -but then they may well be on insulin). It is a simple matter to 'wake up' the enzyme production, over a few days, by eating gradually more carbs. I have done this before going on holiday for example.

This is the reason that low carbers are advised to eat 'normal' amounts of carbs before an oral glucose tolerance test. Health care professionals interpret the results based on standard 'normal' carb diets. So unless they prepare beforehand, low carber OGTT results would be disporportionately high.

Eating normal carbs before OGTT would be misleading then because from what you're saying you've re-educated the pancreas to release more insulin in the days before the test, which might show a negative test result with adequate insulin release that would be unsustainable in the long term if the person continued eating high carbs? Wouldn't it be better to continue low carbing which would prove the pancreas is not responding appropriately to sugars? Other wise there's a possibility that there are people who regularly low carb having high blood glucose responses to an increase in carbs? Which would surely mean a number of people being misdiagnosed?

 

[Brunneria]

The OGTT is a test that shows how high your bg is 2 hours after ingesting a set amount of glucose. Nothing misleading about that.

An OGTT is a diagnostic tool used by the NHS, under standard conditions (one of these conditions is that the patient has been eating a 'normal' diet containing carbs). Unless the standard conditions are met, the test results are useless because they will not conform to the NHS's diagnostic standards.

For this reason, I have declined an OGTT for the last three years.
And because I have declined the test, and because my HbA1c is controlled and below the level the NHS considers to be diabetic, my doctor will not diagnose me as Type 2.

With the NHS, you play the game, or you don't. There are consequences to each choice.

 

[Bluetit1802]

Eating normal carbs before OGTT would be misleading then because from what you're saying you've re-educated the pancreas to release more insulin in the days before the test, which might show a negative test result with adequate insulin release that would be unsustainable in the long term if the person continued eating high carbs? Wouldn't it be better to continue low carbing which would prove the pancreas is not responding appropriately to sugars? Other wise there's a possibility that there are people who regularly low carb having high blood glucose responses to an increase in carbs? Which would surely mean a number of people being misdiagnosed?

Eating normal carbs before the OGTT doesn't mean just the day before, it means for 2 or 3 or 4 days before. Doing that, your pancreas has plenty of time to adjust. Then at the test it gets hit by a large shot of glucose, usually Lucozade, to see what the reaction to that is. A diabetic will react because the pancreas can't cope with the extra glucose in one shot. The actual test is a fasting one, so before the Lucozade there is no food in your system.