Weight loss

[Don66]

Can anyone give me a link or advise for the best diet to follow. Ive been on insulin since December and have put on loads. I lost loads last year on slimming world but it started dropping off too fast and was then diagnosed with lada. So now back to square one

 

[Mbaker]

I would say "lifestyle" rather than diet. I would lean towards foods which when combined do not raise blood glucose by more than 2 mmol (I prefer no more than 1.5 mmol).

Eating to your meter will show what foods agree with you.

I start with a quality protein, as clean as possible. By clean I mean if animal based (which is my choice of meat or fish, sometimes both), as close to nature as possible. If the protein doesn't have a high fat profile, I would then focus on quality fats as either part of the dinner of afters, such as avocado, cheese, nuts. Then if I was minded to get the optional carbs these would be either berries with natural Greek yogurt or veg such as asparagus, broccoli, cauliflower, and similar. I would actively avoid potatoes, rice, beans, pasta and any derivatives.

That would form the basis of the food. I would next focus on sleep, weight training, family / friends / relationships, relaxation.

 

[Daibell]

Hi. Being on insulin enables the body to metabolise carbs and if you have too many carbs you will probably gain weight. Insulin does not allow you to eat freely unless you are an athlete! So keep the carbs below, say, 150/gm per day

 

[Shiba Park]

Without commenting on the dietary advice, the OP is LADA so the 'eat to the meter' comment is not applicable. It may however help with assessing bolus timing though.

I would say "lifestyle" rather than diet. I would lean towards foods which when combined do not raise blood glucose by more than 2 mmol (I prefer no more than 1.5 mmol).

Eating to your meter will show what foods agree with you.

I start with a quality protein, as clean as possible. By clean I mean if animal based (which is my choice of meat or fish, sometimes both), as close to nature as possible. If the protein doesn't have a high fat profile, I would then focus on quality fats as either part of the dinner of afters, such as avocado, cheese, nuts. Then if I was minded to get the optional carbs these would be either berries with natural Greek yogurt or veg such as asparagus, broccoli, cauliflower, and similar. I would actively avoid potatoes, rice, beans, pasta and any derivatives.

That would form the basis of the food. I would next focus on sleep, weight training, family / friends / relationships, relaxation.

 

[kitedoc]

Hi @Don66,
Based on my reading and experience as a T!D, not as health professional advice or opinion:

Insulin tends to put carbs in excess of those needed for energy into fat cells.
And weight gain may increase the need for more insulin and so the cycle may continue.

In the past diabetics were advised to lower fat intake in the mistaken belief that fat caused heart disease and this led to more carbs being eaten, more insulin, increased weight and so on.

With more modern thinking and debunking of some of the myths about heart disease etc the wheel seems to be turning around to a diet of less carbs and more protein and fat.

We even know now that our brain does not need 150 G of carbs per day to function. Only perhaps a 1/5 of that.
And if you think say 30 grams of carb per day is not enough, the discovery of the lower needs for carbs relates back to the fact that the Inuit, Laplanders and such tribes existed for centuries on zero carbs and just protein and fat.

What has emerged are the reappearance of low carb diets and ketogenic diets (keto- for short).

If you were to read the book or e-book Dr Bernstein's Diabetes Solution and dietdoctor.com you will find how the low carb and keto- diets help lower BSLs, reduce hypos and help reduce weight.

Of course being on insulin the advice of your prescribing doctor or nurse is advised since eating less carbs means that less insulin is required, and excess insulin could lead to hypos.

Some choose to lower their carb intake to say 100g, or 80 g or 50 g per day and according to sites like dietdoctor.com these amounts do not lead to what is so-called nutritional ketosis (or fat burning). But people have succeed in losing weight with appropriate insulin reduction.

Others choose to go very low carb, around 30 g per day. The details are on the 2 references above. And people can change into the fat burning state which helps with weight loss. etc.

You may not find your doctor or nurse are conversant with keto or low carb diets or may be reluctant or resistant to the idea of these diets because they are still be tied to the fat causes heart disease belief.

So you have choices about the way you might proceed with your weight loss plans. Higher carb with adjusted insulin as per your health team ( and suggested by @Diabell) or the lower carb options or some other option.

I fully agree with @Mbaker's approach with the same sort of foods used on a low carb or keto diet, includes healthly choices such as exercise, relaxation, socialisation etc.

Best Wishes

 

[DCUKMod]

I would say "lifestyle" rather than diet. I would lean towards foods which when combined do not raise blood glucose by more than 2 mmol (I prefer no more than 1.5 mmol).

Eating to your meter will show what foods agree with you.

I start with a quality protein, as clean as possible. By clean I mean if animal based (which is my choice of meat or fish, sometimes both), as close to nature as possible. If the protein doesn't have a high fat profile, I would then focus on quality fats as either part of the dinner of afters, such as avocado, cheese, nuts. Then if I was minded to get the optional carbs these would be either berries with natural Greek yogurt or veg such as asparagus, broccoli, cauliflower, and similar. I would actively avoid potatoes, rice, beans, pasta and any derivatives.

That would form the basis of the food. I would next focus on sleep, weight training, family / friends / relationships, relaxation.

Bering devil's advocate here; bearing in mind @Don66 is relatively newly re-diagnosed and similarly on insulin, how would she know if a food which gives her a rise of, say 7, does so because the food isn't for her, or because she made a mistake carb counting, an therefore had administered the wrong amount of insulin?

Similarly, something like pizza, moussaka or even cauliflower cheese has a lot of fat in it, so the rise could be very slow, but peak at more than the desire.

Finally, it is perfectly plausible Don is honeymooning, so over time those "acceptable foods", by your metric would be cut down and down?

It seems to me you system depends on skilled carb counting, insuling doing and timing. I'd think that's maybe quite an ask 6 months in.

Of course, I could eaasily have misinterpreted your post.

Edited to correct spelling error.

 

[Mbaker]

Bering devil's advocate here; bearing in mind @Don66 is relatively newly re-diagnosed and similarly on insulin, how would she know if a food which gives her a rise of, say 7, does so because the food isn't for her, or because she made a mistake carb counting, an therefore had administered the wrong amount of insulin?

Similarly, something like pizza, mousacca or even cauliflower cheese has a lot of fat in it, so the rise could be very slow, but peak at more than the desire.

Finally, it is perfectly plausible Don is honeymooning, so over time those "acceptable foods", by your metric would be cut down and down?

It seems to me you system depends on skilled carb counting, insuling doing and timing. I'd think that's maybe quite an ask 6 months in.

Of course, I could eaasily have misinterpreted your post.

I would say because I follow the path mainly that Berstein advocates for Type 1's who want a flatter easier to manage glucose response (LCHP). With regards to timing, I am not sure how this impacts choice, the alternative is probable highs and lows. @Shiba Park, this is also the same answer, as it is a dietary methodology where the fat content can also be adjusted to suit goals. The alternatives broadly speaking otherwise are standard, Vegetarian, Vegan, etc. I think what I put forward is a reasonable option compared to slimming world.

 

[DCUKMod]

I would say because I follow the path mainly that Berstein advocates for Type 1's who want a flatter easier to manage glucose response (LCHP). With regards to timing, I am not sure how this impacts choice, the alternative is probable highs and lows. @Shiba Park, this is also the same answer, as it is a dietary methodology where the fat content can also be adjusted to suit goals. The alternatives broadly speaking otherwise are standard, Vegetarian, Vegan, etc. I think what I put forward is a reasonable option compared to slimming world.

I don't see timing impacting choice, but it could, in my observation, influence on the impact of that choice.

 

[kitedoc]

Dosing of insulin and the timing of blood sugar peaks on a low carb diet and/or in relation to a fatty meal is something discussed in a lot on forums such as True Grit Type One and Dr Bernstein's Advocates, plus on a number of sites covering keto diet and TIDs/LADAs on insulin.
With an insulin pump split doses of short-acting insulin are used by many to cater for the slower rise in bsl, or some have reverted to using Soluble insulin with its slower onset and longer time to peak effect in place of more rapid acting insulins. A sort of 'halfway house also exists where some pumpers use a mix iof say Novorapid and Soluble insulin in their pumps.
My guess is for anyone contemplating weight loss via LCHP, or LCHF/keto that a successful outcome depends on a patient willng to try it in close working relationship with a switched on health team.

 

[Scott-C]

With regards to timing, I am not sure how this impacts choice, the alternative is probable highs and lows.

What @Shiba Park was referring to is pre-bolus timing. It's an incredibly useful technique but a surprising number don't know about it.

After injecting, insulin takes a while to be distributed around the body before it gets to work.

If I was to inject and then immediately eat, then, yes, I'd likely get a large spike because the insulin is having to play catch up with the digested food (and that is so whether the meal is 10g, 50g or 100g).

Whereas if I inject about 20 to 30 mins before a meal, the insulin has had time to get to work so will be able to deal with the glucose significantly better because it has already been in stream long enough to start lowering bg.

I've frequently had situations where I've had no spike at all using this technique, indeed, sometimes there's a decline down.

Timing these things is important though, it can vary depending on the food gi and the type of insulin, hence Sheba's comment.

Used properly, rollercoaster highs and lows are not inevitable.

 

[Mbaker]

What @Shiba Park was referring to is pre-bolus timing. It's an incredibly useful technique but a surprising number don't know about it.

After injecting, insulin takes a while to be distributed around the body before it gets to work.

If I was to inject and then immediately eat, then, yes, I'd likely get a large spike because the insulin is having to play catch up with the digested food (and that is so whether the meal is 10g, 50g or 100g).

Whereas if I inject about 20 to 30 mins before a meal, the insulin has had time to get to work so will be able to deal with the glucose significantly better because it has already been in stream long enough to start lowering bg.

I've frequently had situations where I've had no spike at all using this technique, indeed, sometimes there's a decline down.

Timing these things is important though, it can vary depending on the food gi and the type of insulin, hence Sheba's comment.

Used properly, rollercoaster highs and lows are not inevitable.

Ok, food still needs to be ingested, so I offered a method that ticks several boxes and could work, which is what the OP requested - it is optional and just an idea that is well trodden.

 

[Shiba Park]

What @Shiba Park was referring to is pre-bolus timing. It's an incredibly useful technique but a surprising number don't know about it.

After injecting, insulin takes a while to be distributed around the body before it gets to work.

If I was to inject and then immediately eat, then, yes, I'd likely get a large spike because the insulin is having to play catch up with the digested food (and that is so whether the meal is 10g, 50g or 100g).

Whereas if I inject about 20 to 30 mins before a meal, the insulin has had time to get to work so will be able to deal with the glucose significantly better because it has already been in stream long enough to start lowering bg.

I've frequently had situations where I've had no spike at all using this technique, indeed, sometimes there's a decline down.

Timing these things is important though, it can vary depending on the food gi and the type of insulin, hence Sheba's comment.

Used properly, rollercoaster highs and lows are not inevitable.

That was exactly my point, I should have elaborated further...

I'm not able to give advice on diet for weight loss, however the comment I replied to about choosing food that limits the post meal rise to 1.5 to 2 mmol depends heavily on your starting point, the pause between bolus and eating and fat content etc. For me, that rise equates to 15g carbs difference between digestion and insulin action. For a very low carb meal that's achievable, for even modest carb it's pot luck!

 

[kitedoc]

What @Shiba Park was referring to is pre-bolus timing. It's an incredibly useful technique but a surprising number don't know about it.

After injecting, insulin takes a while to be distributed around the body before it gets to work.

If I was to inject and then immediately eat, then, yes, I'd likely get a large spike because the insulin is having to play catch up with the digested food (and that is so whether the meal is 10g, 50g or 100g).

Whereas if I inject about 20 to 30 mins before a meal, the insulin has had time to get to work so will be able to deal with the glucose significantly better because it has already been in stream long enough to start lowering bg.

I've frequently had situations where I've had no spike at all using this technique, indeed, sometimes there's a decline down.

Timing these things is important though, it can vary depending on the food gi and the type of insulin, hence Sheba's comment.

Used properly, rollercoaster highs and lows are not inevitable.

According to literature and forums: The bsl rise after a meal will depend on what the meal consisits of, thus a very low carb content meal with a large protein component may give a moderate rise at say the 3 to 4 hour mark compared to a higher carb meal with a bsl peak much sooner.
Thus the timing and type of insulin, and the deployment of insulin, ( e.g. One dose pre meal or split dose, say. a % pre-meal and a remaining % of total dose say 2 hours after a meal or even just relying on adjustment of the basal insulin are all strategies used with very low carb meals in T1Ds and LADAs - (see Dr Bernstein's Advocates website, Dr Bernstein's Diabetes Solution book).
These techniques have been recorded to show that hypos are minimised compared to other strategies.