Low carb or ketogenic? What is the difference please?

[Gardengnome]

I've been borderline diabetic for 6 years and for how long before I wonder? The HbA1c has hovered around 43 for the past 2 years and I bought myself a meter. Now I find my fasting finger test is anywhere between 7 and 7.6 mmol/l and I'm increasingly concerned. I see the diabetic nurse each year
I was never very overweight but 6 years ago did follow the 5-2 diet and have adopted a much healthier woe since then, or so I thoought. However although the weight fell off back then and has never returned I dread having another blood test and being put on the diabetic register. I don't need to lose any weight but really need to be serious about low carbing. Which is the best way to go - the low carb woe on this website, Diet Doctor or a Ketogenic way? I strongly suspect fruit is my downfall and have reined in on most fruit with the exception of grapefruit and oranges and berries of all kinds.
I'd really appreciate some advice that is easy to follow. Many thanks.

 

[zauberflote]

Hi and welcome @Gardengnome (love that name!), it sounds to me like you’re very aware, educated, and pro-active about your health, all exactly as it should be
I haven’t investigated DietDr at all except for the odd recipe, ketosis makes me nervous, so low carb is my personal choice for myself. I have had to drop all fruit, including the berries. I love fruit so so very much that one bite would set me off. It does make me sad, but I compensate with vegetables. Citrus fruit is pretty darn high carb (oh how I miss my morning oj! The best flavor of the whole day, it was for 60+ years!). Many here can and do eat “a few” berries successfully.
My take on low carb is that all the grains we grew up eating are not low carb. Only above-ground veggies are low carb. A mediterranean diet is not necessarily low carb. Sugar in any form is verboten. A member named JoKalsbeek has put together a wonderful fact sheet about carbs, and I hope @DCUKMod or @Brunneria will be along to give you the link to that. I’ll also tag @daisy1 to give you the official welcome packet.
Meanwhile, read around right here. The thread about “what have you eaten today?” shows just how well a dedicated person can eat, and it’s fun to drool over others’ menus. chris

 

[Freema]

I've been borderline diabetic for 6 years and for how long before I wonder? The HbA1c has hovered around 43 for the past 2 years and I bought myself a meter. Now I find my fasting finger test is anywhere between 7 and 7.6 mmol/l and I'm increasingly concerned. I see the diabetic nurse each year
I was never very overweight but 6 years ago did follow the 5-2 diet and have adopted a much healthier woe since then, or so I thought. However, although the weight fell off back then and has never returned I dread having another blood test and being put on the diabetic register. I don't need to lose any weight but really need to be serious about low carbing. Which is the best way to go - the low carb woe on this website, Diet Doctor or a Ketogenic way? I strongly suspect fruit is my downfall and have reined in on most fruit with the exception of grapefruit and oranges and berries of all kinds.
I'd really appreciate some advice that is easy to follow. Many thanks.

ketogenic is a total of around 20 grams of carbs daily or lower , which is low enough to get almost all people into ketosis, at that low level the body starts producing ketones, which means it almost live of burning fat too.

low carb I would say is anything between those 20 grams of carbs in total daily and up till 100 grams of carbs in total daily.. preferably shared on more meals if in the higher end of low carb.

moderate carb is 100-150 grams in total , but most type 2 diabetics are not able to get their number down in the right normal level if eating 150 grams of carbs daily.

but we all differ ..

 

[daisy1]

@Gardengnome
Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 147,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[Gardengnome]

Hi and welcome @Gardengnome (love that name!), it sounds to me like you’re very aware, educated, and pro-active about your health, all exactly as it should be
I haven’t investigated DietDr at all except for the odd recipe, ketosis makes me nervous, so low carb is my personal choice for myself. I have had to drop all fruit, including the berries. I love fruit so so very much that one bite would set me off. It does make me sad, but I compensate with vegetables. Citrus fruit is pretty darn high carb (oh how I miss my morning oj! The best flavor of the whole day, it was for 60+ years!). Many here can and do eat “a few” berries successfully.
My take on low carb is that all the grains we grew up eating are not low carb. Only above-ground veggies are low carb. A mediterranean diet is not necessarily low carb. Sugar in any form is verboten. A member named JoKalsbeek has put together a wonderful fact sheet about carbs, and I hope @DCUKMod or @Brunneria will be along to give you the link to that. I’ll also tag @daisy1 to give you the official welcome packet.
Meanwhile, read around right here. The thread about “what have you eaten today?” shows just how well a dedicated person can eat, and it’s fun to drool over others’ menus. chris

Hi Chris, thank you for your reply. interesting that you say you have a problem with fruit as well. My main problem is that we grow an awful lot in the garden and last year had a bumper crop of most things. I was really shocked at how much apples raised my glucose levels, not to mention plums. Luckily berries are available all year in the supermarkets as well as from our freezer and they don't have the same effect. But I would miss my morning grapefruit so might just keep that going for now and see how things go with low carbing in other ways. I just need to get to grips with it, the diabetic nurse has been warning me for a few years and I have been in denial up to now.

 

[Gardengnome]

ketogenic is a total of around 20 grams of carbs daily or lower , which is low enough to get almost all people into ketosis, at that low level the body starts producing ketones , which means it almost live of burning fat too.

low carb I would say is anything between those 20 grams of carbs in total daily and up till 100 grams of carbs in total daily.. preferably shared on more meals if in the higher end of low carb.

moderate carb is 100-150 grams in total , but most type 2 diabetics are not able to get their number down in the right normal level if eating 150 grams of carbs daily.

but we all differs ..

Thank you Freema. Actually counting the carbs is going to be tricky to start with, a bit like counting calories which I have always felt was a faff. I suppose it becomes easier the more you do it but the quantities you give are helpful, thanks.
It's obviously worked for you anyway going by your CV. Well done.

 

[Gardengnome]

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

Thank you Daisy for your helpful advice. I think you are too polite about the NHS not being able to give the advice 'it would like to deliver'. Whenever I have seen the diabetic nurse she has quoted the Eatwell Plate. I was probably being too simplistic but I pointed out that even when I was a schoolgirl over 60 years ago, we learned that all starch turns to sugar once in the bloodstream!

 

[Robbity]

If you your main aim is to keep your glucose levels down at pre-diabetic levels and stable long term, use your meter to tell you how you react to various carby foods, and use this as a guide. What you need to do is to find the number of carbs which allow your diet to be both sustainable long term and to keep your glucose levels where they need to be. It matters not whether you end up labelling your diet low carb or ketogenic - neither is a magic formula!

For me a ketogenic diet is simply a lower version of a low carb one. so basically I've reduced my carbohydrate intake low enough and for long enough that my body is producing ketones and able to use these and stored body fat for fuel. The level at which this happens can vary , but reducing carbs to 20-25 g a day should ensure this, but you don't actually need to keep down to this level long term. Once your body has (re) adapted to using stored fat - which might take a while longer than simply getting into ketosis - it will do as nature intends and after using the (reduced) carbs and dietary fat will start burning body fats when/if necessary. If you're eating enough (fat) it won't need to do this and you'll not lose weight. I've maintained my weight within a kilo or two either way for over five years eating my low carb/ketogenic diet (max target of under 50g carbs a day). I use this mainly to manage my glucose levels rather that my weight though, and I'll be in/out of ketosis all the time depending on what I eat - which does include regular small quantities of low carb fruits.

There are much stricter versions of a ketogenic diet which can be used for therapeutic purposes, e.g. control of epileptic seizures, and there are members of the forum who prefer to keep to these very low carbohydrate levels for other reasons too. But many of the benefits are also obtained with low carb diets anyway.

Robbity

ETA If you are concerned over counting carbs, just try avoiding /cutting down on all the obvious sugary and starchy foods and that without counting anything should keep your glucose levels down. You can then refine things if needs be,

 

[zauberflote]

@Gardengnome you should meet @ianpspurs , who is a major fruit grower also. And many folks keep rhubarb in their repertoire, which cheers me! My morning “favorite flavor of the whole day” had been orange juice for decades... but for me it’s just not worth the hit.
My matters are (self-) “complicated” by the fact that I won’t eat meat. Fish and fowl yes, but I entered vegetarianism back in the 70’s, and just can’t face meat now. Especially given the state of Big Agri in the US here. My other complication affects the types of fats I ought to consume. My cardiologist did not like my recent lipids panel one bit, and as she quite literally has saved my life, I have to get along with her until she retires!! Somewhere on here people say that your cholesterol numbers first go up and then way down on eating fatty meats (and butter/cream/cheese which are my saturated fats) with your LC, so I’d love to see that come to the rescue, but can’t count on it.
So, I’ll think with pleasure of you with your cold juicy tart grapefruit each morning and live vicariously

 

[ianpspurs]

@Gardengnome I think @Robbity has just about covered it all. My personal experience feels far less successful for bg control than that of hers but works for weight as she says. The fruit issue is not so much of a problem for me. I don't really like citrus and as for berries we grow strawberries, raspberries and blackberries. I eat those in season and moderation - I think eat the season is a good maxim. We also grow apples, pears and rhubarb. Stewed rhubarb is low carb if sweetened with LC sweeteners. I will eat fruit from the trees in season whilst walking about - few bites when they are perfect for me then give rest to our chickens. Good luck with whatever you decide to do and I hope you enjoy it - many do. (I don't really enjoy it and see no point lying)

 

[Gardengnome]

If you your main aim is to keep your glucose levels down at pre-diabetic levels and stable long term, use your meter to tell you how you react to various carby foods, and use this as a guide. What you need to do is to find the number of carbs which allow your diet to be both sustainable long term and to keep your glucose levels where they need to be. It matters not whether you end up labelling your diet low carb or ketogenic - neither is a magic formula!

For me a ketogenic diet is simply a lower version of a low carb one. so basically I've reduced my carbohydrate intake low enough and for long enough that my body is producing ketones and able to use these and stored body fat for fuel. The level at which this happens can vary , but reducing carbs to 20-25 g a day should ensure this, but you don't actually need to keep down to this level long term. Once your body has (re) adapted to using stored fat - which might take a while longer than simply getting into ketosis - it will do as nature intends and after using the (reduced) carbs and dietary fat will start burning body fats when/if necessary. If you're eating enough (fat) it won't need to do this and you'll not lose weight. I've maintained my weight within a kilo or two either way for over five years eating my low carb/ketogenic diet (max target of under 50g carbs a day). I use this mainly to manage my glucose levels rather that my weight though, and I'll be in/out of ketosis all the time depending on what I eat - which does include regular small quantities of low carb fruits.

There are much stricter versions of a ketogenic diet which can be used for therapeutic purposes, e.g. control of epileptic seizures, and there are members of the forum who prefer to keep to these very low carbohydrate levels for other reasons too. But many of the benefits are also obtained with low carb diets anyway.

Robbity

ETA If you are concerned over counting carbs, just try avoiding /cutting down on all the obvious sugary and starchy foods and that without counting anything should keep your glucose levels down. You can then refine things if needs be,

Thank you Robbity for such practical advice. You make the whole low carb issue seem much more relaxed and achieveable. I don't need to lose weight and my weight has stayed within a couple of kilos according to season for over 6 years. Prior to that I was a weight watcher for 40 years until I realised what a con it all was. It was all low fat and high carb - weight loss wasn't sustainable and I lost the same weight over and over again over the years. Only after I did the 5:2 diet did I understand the limitations of weight watchers. Since then the weight has stayed off and although I am careful I don't diet. Carbs are another matter especially where fruit is concerned.
I assume the insulin resistance started over the years of weight watching, all those high carb/low fat meals until eventually I was found to have hypertension and pre diabetes.

 

[Gardengnome]

@Gardengnome I think @Robbity has just about covered it all. My personal experience feels far less successful for bg control than that of hers but works for weight as she says. The fruit issue is not so much of a problem for me. I don't really like citrus and as for berries we grow strawberries, raspberries and blackberries. I eat those in season and moderation - I think eat the season is a good maxim. We also grow apples, pears and rhubarb. Stewed rhubarb is low carb if sweetened with LC sweeteners. I will eat fruit from the trees in season whilst walking about - few bites when they are perfect for me then give rest to our chickens. Good luck with whatever you decide to do and I hope you enjoy it - many do. (I don't really enjoy it and see no point lying)

As the rhubarb season is about to start I am looking forward to eating the stuff again. We do grow quite a lot and it's good to know it's low carb, we live in the Rhubarb triangle too! I have had half a grapefruit for breakfast for as long as I can remember so intend to keep going with that for now at least. I enjoy raspberries or blackcurrants mashed up with Greek yogurt into a fruit fool as well.