Low carb

[DavidGrahamJones]

Could someone please help me understand why the healthcare professionals don't recommend it when I read on here how the people on a low carb diet find it helpful.

It is very simple, we have diabetes and most health care professionals do not. As a type II I progressed from Metformin to Metformin and Gliclazide, then to Metformin, Gliclazide and Januvia and the next step that I was discussing with my GP, believing that it was a progressive disease after all, was insulin.

I lowered my carbs after 17 years of being told not to, and because I wanted to shed a few pounds, my carbs accounted for 1/3 of my calories as recommended by the so called Health Care Professionals, about 700 calories.

I did lose weight, my BG dropped, my total cholesterol dropped and I gave up taking Gliclazide, Januvia, and Atorvastatin because I didn't need them. I'm not a medic but in my books that's a "no brainer". Eat carbs and take meds with all the side effects or don't eat the carbs. You'll have to ask the healthcare professionals why they don't recommend low carb, except for mine, they know that in my case I can be trusted to adhere to a low carb regime and will not be going back to recommended amounts of carbs any time soon.

 

[Mbaker]

@Nidge247 @Kristin251

Nidge well done on your control with diet alone. I don't think this is uncommon among those not quite full T1 and not fitting into the T2 category either. I too am one of these diabetics, I know it is referred to as 1.5 or LADA, but there is nothing definitive on it that I have found to distinguish.

Like you I have at times since diagnosis 3.5 years ago, managed with no insulin and maintained a HbA1c in the range 5.3% - 5.8% for the last 3 years. I say at times, because if I ventured off the LC path at any stage (e.g. my wedding, friends weddings) then my BS went very high and I had to use an insulin basal/bolus regime to get my numbers back down to the 4-7 mmol/L range. As I advance on this journey, it gets easier not to be tempted by refined carbs etc... However, after reading Dr. Bernstein's book, I felt I should be targeting a HbA1c <5.0%, and so I think the only way I could do this is with a VLC and small basal / bolus does like @Kristin251 .

Obviously all of us so called 1.5's or LADA diabetics are all different in that we all have different levels of insulin production remaining. I am curious though if you can achieve a truly normal HbA1c, i.e. 4.5% - 5.0% (what I believe is the normal range anyway from Dr. Bernstein's book) with just diet alone? Also, do you do a lot of intensive exercise to help manage the BS levels?

I would like to see evidence that non-diabetics who are adults routinely get HbA1c's close to 4.5 and what the ranges are for say age groups 25 to 40, 40 to 55 and 55 plus. Every time I watch TV programs where the general public are measured such as Trust Me I'm a Doctor, random tests appear close to pre-diabetic; the only person on TV who I have seen with tests in the 4's and 5's is Kate Quilton, also no one at wife's clinic has far tested in the 4's. There are around 6 million UK residents with HbA1c's between 42 and 46 and around 38% of Americans are pre-diabetic.

What I am saying in a long winded way is that it looks like it going to increasingly become more difficult to attain HbA1c's of 4.5% for an average non-diabetic.

 

[slikwipman]

It is very simple, we have diabetes and most health care professionals do not. As a type II I progressed from Metformin to Metformin and Gliclazide, then to Metformin, Gliclazide and Januvia and the next step that I was discussing with my GP, believing that it was a progressive disease after all, was insulin.

I lowered my carbs after 17 years of being told not to, and because I wanted to shed a few pounds, my carbs accounted for 1/3 of my calories as recommended by the so called Health Care Professionals, about 700 calories.

I did lose weight, my BG dropped, my total cholesterol dropped and I gave up taking Gliclazide, Januvia, and Atorvastatin because I didn't need them. I'm not a medic but in my books that's a "no brainer". Eat carbs and take meds with all the side effects or don't eat the carbs. You'll have to ask the healthcare professionals why they don't recommend low carb, except for mine, they know that in my case I can be trusted to adhere to a low carb regime and will not be going back to recommended amounts of carbs any time soon.

It just seems to make sense to cut down on carbs but still nobody has given a reason why the NHS is against it. I presume it must be for health reasons but what effect does severely cutting down on carbs have, if any

 

[DavidGrahamJones]

It just seems to make sense to cut down on carbs but still nobody has given a reason why the NHS is against it.

Having discussed the Newcastle Diet with my own GP I can say that my GP is not alone in thinking that although people in general can follow a strict regime, whatever the carb amount, there are probably a lot of people who will not be able to stick to it. It is therefore easier to dish out the tablets because that way, they have control over the outcome, not you. If you are restricting carbs to keep BG down, you cannot afford to go off the straight and narrow, maybe once in a while, but not recommended.

I'm trying to put myself in the position of a doctor, everything I've been taught says 1/3 calories from carbs and that's how I've been treating my diabetic patients, with medication. Then a group of diabetics decide they know best and will restrict their carbs and not require the meds. We probably come across as a right pain in the backside, they have to deal with us differently and it would be much easier if we just conformed to the "rules".

I think the general thinking is changing, certainly I'm lucky in that all the nurses and doctors at my surgery are very open to low carb, maybe not fully supportive but certainly not against. My GP even told me that I was one of very few patients she could trust trying a Newcastle Diet type of regime.

I presume it must be for health reasons but what effect does severely cutting down on carbs have, if any

Ask anybody on this forum who has restricted their carb intake to any degree and see how they are. Personally, when my GP said I needed carbs for energy, I just pointed to the fact that I'm overweight, surely my energy should come from what I've already stored rather than giving it more, it would be like pouring petrol into a full tank.

but what effect does severely cutting down on carbs have, if any

I lost weight, the primary objective, I stopped taking three different drugs, I haven't felt better in many years and in many different ways. I certainly don't feel hungry, I've been a lot happier, so long as I avoid newspapers, more positive about being in control of my outcomes (mostly).

There is a debate about LCHF or LCLF or some variation there of. At the end of the day it's all down to what's best for you.

 

[ringi]

If you are over wieght the fat in LCHF can come from your own body, hence LCLF is LCHF for a lot of us........... But fat makes me feel full up, so I add some fat for that reasons. I expect that on LCHF I am eating less fat then I was before as the better meals result in me not have lots of crips etc between meals.

 

[slikwipman]

Having discussed the Newcastle Diet with my own GP I can say that my GP is not alone in thinking that although people in general can follow a strict regime, whatever the carb amount, there are probably a lot of people who will not be able to stick to it. It is therefore easier to dish out the tablets because that way, they have control over the outcome, not you. If you are restricting carbs to keep BG down, you cannot afford to go off the straight and narrow, maybe once in a while, but not recommended.

I'm trying to put myself in the position of a doctor, everything I've been taught says 1/3 calories from carbs and that's how I've been treating my diabetic patients, with medication. Then a group of diabetics decide they know best and will restrict their carbs and not require the meds. We probably come across as a right pain in the backside, they have to deal with us differently and it would be much easier if we just conformed to the "rules".

I think the general thinking is changing, certainly I'm lucky in that all the nurses and doctors at my surgery are very open to low carb, maybe not fully supportive but certainly not against. My GP even told me that I was one of very few patients she could trust trying a Newcastle Diet type of regime.



Ask anybody on this forum who has restricted their carb intake to any degree and see how they are. Personally, when my GP said I needed carbs for energy, I just pointed to the fact that I'm overweight, surely my energy should come from what I've already stored rather than giving it more, it would be like pouring petrol into a full tank.



I lost weight, the primary objective, I stopped taking three different drugs, I haven't felt better in many years and in many different ways. I certainly don't feel hungry, I've been a lot happier, so long as I avoid newspapers, more positive about being in control of my outcomes (mostly).

There is a debate about LCHF or LCLF or some variation there of. At the end of the day it's all down to what's best for you.

What is the Newcastle diet?

 

[CHIET1]

Agree, it is no surprise really given the high levels of refined carbs and sugars consumed nowadays.

However, I do have non-diabetic family members with HbA1c levels in the 4's.

I would like to see evidence that non-diabetics who are adults routinely get HbA1c's close to 4.5 and what the ranges are for say age groups 25 to 40, 40 to 55 and 55 plus. Every time I watch TV programs where the general public are measured such as Trust Me I'm a Doctor, random tests appear close to pre-diabetic; the only person on TV who I have seen with tests in the 4's and 5's is Kate Quilton, also no one at wife's clinic has far tested in the 4's. There are around 6 million UK residents with HbA1c's between 42 and 46 and around 38% of Americans are pre-diabetic.

What I am saying in a long winded way is that it looks like it going to increasingly become more difficult to attain HbA1c's of 4.5% for an average non-diabetic.

 

[slikwipman]

I would like to see evidence that non-diabetics who are adults routinely get HbA1c's close to 4.5 and what the ranges are for say age groups 25 to 40, 40 to 55 and 55 plus. Every time I watch TV programs where the general public are measured such as Trust Me I'm a Doctor, random tests appear close to pre-diabetic; the only person on TV who I have seen with tests in the 4's and 5's is Kate Quilton, also no one at wife's clinic has far tested in the 4's. There are around 6 million UK residents with HbA1c's between 42 and 46 and around 38% of Americans are pre-diabetic.

What I am saying in a long winded way is that it looks like it going to increasingly become more difficult to attain HbA1c's of 4.5% for an average non-diabetic.

My father (whose Mother was type 2 in her later years) thinks he will have the same problems has always tested between 4&5.

 

[DavidGrahamJones]

Newcastle diet?

From this very organisation: http://www.diabetes.co.uk/diet/newcastle-study-600-calorie-diet.html

Small update, it's a very low calorie diet, now 800 cals per day, used to imitate what happens when diabetics have bariatric surgery. It is said to reverse type II but even the Professor involved in this research, with funding from diabetes.co.uk by the way, says that more research is required, certainly in following up those who took part in the initial study.

At the beginning of the year my HbA1c was awful despite 4 years successfully managing my BG with low carb. Deteriorating insulin resistance was one theory, but very little way of proving because although I now have a number for my insulin resistance, I don't have a number for last year, I only found the test by accident.

Another possibility was that my body was converting protein into glucose, more probable because as my FS LIbre showed my BG spikes were happening up to 6 hours after eating any low carb meal with protein. I successfully managed a very low calorie diet for 6 weeks and discovered that my BG was much more stable, between 5 and 7 the whole day, so there was improvement, I also lost weight, about a kg per week. It is very difficult and I started to re-introduce certain proteins, but will be giving it another go in the very near future.

 

[Mbaker]

My father (whose Mother was type 2 in her later years) thinks he will have the same problems has always tested between 4&5.

Does he eat carbs freely and fast food.

 

[Nidge247]

@Nidge247 @Kristin251

Nidge well done on your control with diet alone. I don't think this is uncommon among those not quite full T1 and not fitting into the T2 category either. I too am one of these diabetics, I know it is referred to as 1.5 or LADA, but there is nothing definitive on it that I have found to distinguish.

Like you I have at times since diagnosis 3.5 years ago, managed with no insulin and maintained a HbA1c in the range 5.3% - 5.8% for the last 3 years. I say at times, because if I ventured off the LC path at any stage (e.g. my wedding, friends weddings) then my BS went very high and I had to use an insulin basal/bolus regime to get my numbers back down to the 4-7 mmol/L range. As I advance on this journey, it gets easier not to be tempted by refined carbs etc... However, after reading Dr. Bernstein's book, I felt I should be targeting a HbA1c <5.0%, and so I think the only way I could do this is with a VLC and small basal / bolus does like @Kristin251 .

Obviously all of us so called 1.5's or LADA diabetics are all different in that we all have different levels of insulin production remaining. I am curious though if you can achieve a truly normal HbA1c, i.e. 4.5% - 5.0% (what I believe is the normal range anyway from Dr. Bernstein's book) with just diet alone? Also, do you do a lot of intensive exercise to help manage the BS levels?

@CHIET1

Firstly great to hear from someone with similar circumstances; your experiences do sound very familiar.

I don't as a rule do ANY intensive exercise, merely two 20-30 minute brisk walks with the dogs each day. If I have taken on excess carbs, I will simply extend the length of these walks to great effect.

I have, since going lchf experimented with some running, but the dogs couldn't keep up and I wasn't all that fit to continue! Had I persevered though, I'm sure I could have benefitted further.
I have found though, if I DO run the same distance rather than walking, I can drop a full unit of BG or more, which I have done on occasion when figures drifted higher than I would have liked.

I have allowed my BGs to drop as low as 3.5 on occasion before taking on carbs, as taught on the DAFNE course where the hypo inception point was moved from the usual 3.9 to 3.5, I would point out however, than my hypo awareness does kick in when dropping below 4.8, as for me it was important to stay above "5-to-drive". These days it rarely gets below 4.2, and a usual day would keep it between 4.8 and 5.3; but then my body runs fine on that so I see no need at this point to try to fine tune it further, when I may need that leeway later on in life.

If eating out where carb excess may be an issue, I would target the high fat foods first, as these slow the release of the carbs and gives my pancreas time to cope with it. I do find it fascinating how once your body has adjusted to burning fat instead of glucose, not only does life become simpler but healthier and no more snacking between meals either. Carbs have an awful lot to answer for!

 

[CherryAA]

After reading posts about low carb diets I am confused why so many people on this forum find it helpful in managing their diabetes but trained healthcare professionals are against it. Could someone please help me understand why the healthcare professionals don't recommend it when I read on here how the people on a low carb diet find it helpful.

I don't think its necessarily that they are against Low carbs per se - doctors in general understand the carbs metabolic pathway. They do tend to be pro " low fat" - even when at the same time recognising that carbs might not be good for a diabetic . The sheer impossibility of following a low fat and low carb diet especially if there is any recognition at all that massive doses of protein is probably not in your best interests, ends up with brain meltdown - the fear of fat outweighs the benefit of low carbs, carbs make diabetes control harder, but that can be dealt with by pills and more exercise , fat on the other hand make you fat so stop eating fat and you will get thin! ( so goes the mantra ) .

Doctors are trying to deal with the generality of people in circumstances where many don't listen to their advice. it would be interesting to hear from Dr Unwin. just how hard it was to recruit people into his own low carb. group once he made the decision to trial it amongst his own patients.

We are all able to make individual decisions, and all self motivated often many directly contrary to the advice of our doctors . Its would be interesting to know how many people appear here, look at the LCHF or ND debates and conclude we are all raving lunatics before retreating to the comfort of the Eatwell Plate!

 

[Kristin251]

@Nidge247 @Kristin251

Nidge well done on your control with diet alone. I don't think this is uncommon among those not quite full T1 and not fitting into the T2 category either. I too am one of these diabetics, I know it is referred to as 1.5 or LADA, but there is nothing definitive on it that I have found to distinguish.

Like you I have at times since diagnosis 3.5 years ago, managed with no insulin and maintained a HbA1c in the range 5.3% - 5.8% for the last 3 years. I say at times, because if I ventured off the LC path at any stage (e.g. my wedding, friends weddings) then my BS went very high and I had to use an insulin basal/bolus regime to get my numbers back down to the 4-7 mmol/L range. As I advance on this journey, it gets easier not to be tempted by refined carbs etc... However, after reading Dr. Bernstein's book, I felt I should be targeting a HbA1c <5.0%, and so I think the only way I could do this is with a VLC and small basal / bolus does like @Kristin251 .

Obviously all of us so called 1.5's or LADA diabetics are all different in that we all have different levels of insulin production remaining. I am curious though if you can achieve a truly normal HbA1c, i.e. 4.5% - 5.0% (what I believe is the normal range anyway from Dr. Bernstein's book) with just diet alone? Also, do you do a lot of intensive exercise to help manage the BS levels?

My A1C has been 5.1 the last 4 6 month tests. I've been LADA for 3 years and it took a bit to sort out insulin and food. It would be under 5 if not for the DP!!!
I follow Bernstein suggestions for laws of small numbers with less room for error but I don't do any strenuous exercise anymore. Raises me sky high and can't control the rollercoaster. I'm not up for the challenge of adjusting insulin yet.

 

[DavidGrahamJones]

They do tend to be pro " low fat"

I'd forgotten about that, they hear low carb and automatically read "high fat". Many do well with LCHF, personally I can't hence the ease at trying ND.

The sheer impossibility of following a low fat and low carb diet especially if there is any recognition at all that massive doses of protein is probably not in your best interests

Almost impossible. LOL

Its would be interesting to know how many people appear here, look at the LCHF or ND debates and conclude we are all raving lunatics before retreating to the comfort of the Eatwell Plate!

I can count several non forum members, friends and family who hear the words pre-diabetic from their GP and start asking me what I do and decide against it. Obviously I'm not painting a cosy enough picture for them. Why do they all think it's going to be straight forward?

 

[JohnEGreen]

Jut tell them the truth there is no such thing as pre diabetes because the diagnostic levels where set artificially high so Type 2 diabetes would not be diagnosed till blood sugar levels where high enough that they could be safely treated with insulin this was in the seventies and they have never been revised down to the proper levels.

 

[slikwipman]

Does he eat carbs freely and fast food.

He doesn't control his carb intake in any way. Fast food is not something he eats more than a couple of times a year. He is now in his seventies and eats what I would call an old fashioned balanced diet

 

[slikwipman]

From this very organisation: http://www.diabetes.co.uk/diet/newcastle-study-600-calorie-diet.html

Small update, it's a very low calorie diet, now 800 cals per day, used to imitate what happens when diabetics have bariatric surgery. It is said to reverse type II but even the Professor involved in this research, with funding from diabetes.co.uk by the way, says that more research is required, certainly in following up those who took part in the initial study.

At the beginning of the year my HbA1c was awful despite 4 years successfully managing my BG with low carb. Deteriorating insulin resistance was one theory, but very little way of proving because although I now have a number for my insulin resistance, I don't have a number for last year, I only found the test by accident.

Another possibility was that my body was converting protein into glucose, more probable because as my FS LIbre showed my BG spikes were happening up to 6 hours after eating any low carb meal with protein. I successfully managed a very low calorie diet for 6 weeks and discovered that my BG was much more stable, between 5 and 7 the whole day, so there was improvement, I also lost weight, about a kg per week. It is very difficult and I started to re-introduce certain proteins, but will be giving it another go in the very near future.

Is it possible to do a manual job on only 800 calories a day?

 

[bulkbiker]

funding from diabetes.co.uk

Funding from diabetes.org.uk I believe not us..

 

[ringi]

Is it possible to do a manual job on only 800 calories a day?

That depends on the job and how much fat you have to burn off, people do manage it.

But you may find that just by avoiding all high carb food you lose weight without having to think about calories.

 

[derry60]

I'd forgotten about that, they hear low carb and automatically read "high fat". Many do well with LCHF, personally I can't hence the ease at trying ND.



Almost impossible. LOL



I can count several non forum members, friends and family who hear the words pre-diabetic from their GP and start asking me what I do and decide against it. Obviously I'm not painting a cosy enough picture for them. Why do they all think it's going to be straight forward?

I am one of those people who was diagnosed as a person with high sugar, they did not use the word pre-diabetes to me in the letter I received, but the letter did tell me that if I did not do something about the high sugar I could become diabetic. That was enough for me to do some research, hence finding this site.It was difficult for me to get my head around the high fat thing as being a person with a heart condition, have been conditioned to eat smaller portion of carbs such as potato,cous cous,rice pasta etc and low-fat foods. The NHS never advocated a large portion of the foods that I have mentioned. For two years I fell off the wagon and started to eat the fat of the meat, increased the carb intake such as the foods I have mentioned. My cholesterol went up, was it the fat or increase of carbs? Although I did start to have some takeaways also, probably the wrong kind. Anyway, I follow the low carb diet, but I don't eat the fat of meat. My sister loves the fat from meat and eats very basic meals, what I would call plain, meat potatoes and veg. She is not a big eater either yet she has just been diagnosed with high cholesterol and the LDL not so good. This was 5 weeks ago , she has been eating lean meat and her cholesterol has dropped dramatically. I have lost weight on the 20 grams of carb and lean meat fish chicken,seeds,almonds,walnuts,cheese,and just a little cream,and my BG levels have gone down,but not through eating fat of the meat. Oh and lots of vegetables,sometimes I will have carrots. I also eat berries.