NICE suspend Dr Unwin’s infographics ?

[Oldvatr]

Apparently the bloke is also a vegetarian with a beef against eating meat. No problem with that, but it pretty much writes the article off as junk. A guy with no patients of his own, and an ex Olympian subject who became diabetic. Think I’ll stick with Dr. Unwin for now.

His Twitter feed is full of vegetarian and vegan commentary. He is listed in Linkedin as Health Director for the DM and other newspapers. He is mentioned in this Blog by someone who seems to know him quite well
https://www.carolagodmanirvine.com/blog/archives/04-2019

 

[HSSS]

And apparently the infographics on NICE have disappeared today!

 

[Oldvatr]

Some info on GL and GI:

https://www.gisymbol.com/what-about-glycemic-load/

https://extension.oregonstate.edu/sites/default/files/documents/1/glycemicindex.pdf


Note: a teaspoon of sugar holds about 4g of carb, seems to be the norm for carb counting. Each 1 g of carb is alleged to raise bgl by 3-4 mg/DL (US) Any carb counters here?

 

[Member496333]

In my opinion a spike of insulin is a better measure of metabolic impact.

 

[Oldvatr]

In my opinion a spike of insulin is a better measure of metabolic impact.

My BGL meter does not measure my insulin levels. Any ideas on how one might do that? The effect on bgl levels will also depend on the level of Insulin Resistance in the body. Again, how is that measured? Even the insulin clamp technique would not track a spike.

Some T2D have a poor or missing Stage 1 response (simple sugars response triggered by amylase enzyme) And others suffer impaired Stage 2 Response (basal response) Some suffer impairment to both This will affect the time response to any stimulus by carbs,

 

[Jaylee]

Some info on GL and GI:

https://www.gisymbol.com/what-about-glycemic-load/

https://extension.oregonstate.edu/sites/default/files/documents/1/glycemicindex.pdf


Note: a teaspoon of sugar holds about 15g of carb, seems to be the norm for carb counting. Each 1 g of carb is alleged to raise bgl by 3-4 mg/DL (US) Any carb counters here?

ADDED:
To quote from the OP article
"A small 150g portion of basmati rice has the same effect on blood sugar as ten teaspoons of sugar" so that seems about right.

Hi,

As a T1 keeping an eye on such matters. (& getting the calculator out for the "imperial " conversion.)
Firstly, I use 1u of insulin to 10g of carbs. But my pancreas isn putting this out.so this is going on the exogenous.
For me again, Iu of Novorapid can lower me by 3mmol.
Providing my basal insulin isn't playing up & bang on? 10g will raise me by 3mmol Or even if I am having a basal hypo. Something twix 5 or 10g will fix it..

Other T1s may vary. & I wouldn't use this as anything to go on regarding what the pancreas puts out by a non-D

And apparently the infographics on NICE have disappeared today!

Another thought crossed my mind..
Does that mean future health program broadcasts regarding diet will stop the "guess how many sugar cubes this product is worth?" Game as part of the reference in educating the viewer.?

 

[Oldvatr]

This doesn't make sense to me,
A tsp of sugar weighs 4 to 5 grams so how do we get 15g of carbs from that?
Basmati rice is about 25% carbs on a quick search so 150g of Basmati rice is about 40g carbs which would be 10 times tsp of sugar at 4 grams no?

Agree. I have edited my post. My source was using heaped tablespoons. Apparently a teaspoon of sugar is around 5g carb equivalent If rice was the same as sugar then the 150 g portion would fill 30 teaspoons not 10 as in the infographics being disputed. If one uses the GI ratio for rice, then it would still fill 15 teaspoons. Same ballpark, but not in agreement

https://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load

 

[Oldvatr]

Hi,

As a T1 keeping an eye on such matters. (& getting the calculator out for the "imperial " conversion.)
Firstly, I use 1u of insulin to 10g of carbs. But my pancreas isn putting this out.so this is going on the exogenous.
For me again, Iu of Novorapid can lower me by 3mmol.
Providing my basal insulin isn't playing up & bang on? 10g will raise me by 3mmol Or even if I am having a basal hypo. Something twix 5 or 10g will fix it..

Other T1s may vary. & I wouldn't use this as anything to go on regarding what the pancreas puts out by a non-D



Another thought crossed my mind..
Does that mean future health program broadcasts regarding diet will stop the "guess how many sugar cubes this product is worth?" Game as part of the reference in educating the viewer.?

Viewers are to be kept in the dark and fed.
NICE do not support SBMG for T2D so let them remain in ignorance. Confuse them with technospeak instead. Spoons of sugar? Nope that makes it understandable.

We all saw the government adverts that showed how soda pops are absolutely awash with sugar spoons. It was their way of explaining the justification for the Sugar Tax How many spoons in a Coke? Or a Starbucks coffee?

 

[Mr_Pot]

Agree. I have edited my post. My source was using heaped tablespoons. Apparently a teaspoon of sugar is around 5g carb equivalent If rice was the same as sugar then the 150 g portion would fill 30 teaspoons not 10 as in the infographics being disputed. If one uses the GI ratio for rice, then it would still fill 15 teaspoons. Same ballpark, but not in agreement

https://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load

A 150g portion of cooked rice contains about 50g of carbs so equivalent to 10 teaspoons of sugar.

 

[Jaylee]

Viewers are to be kept in the dark and fed.
NICE do not support SBMG for T2D so let them remain in ignorance. Confuse them with technospeak instead. Spoons of sugar? Nope that makes it understandable.

We all saw the government adverts that showed how soda pops are absolutely awash with sugar spoons. It was their way of explaining the justification for the Sugar Tax How many spoons in a Coke? Or a Starbucks coffee?

The more I have read about the official diatary advice given to T2s. (& the experience on this topic.)
Including what my T2 dad was advised.
The more it looks like very old advice I was given as a T1.possibly with a DSN sprinkling of, "your insulin won't work unless you eat with your dose." Then being cheerily told by a pre D DSN when i informed her I don't do breackfast, that she eats a banana for hers.? "OK? See you laters down the chemist in the prescription queue, then."

 

[Member496333]

My BGL meter does not measure my insulin levels. Any ideas on how one might do that? The effect on bgl levels will also depend on the level of Insulin Resistance in the body. Again, how is that measured? Even the insulin clamp technique would not track a spike.

Some T2D have a poor or missing Stage 1 response (simple sugars response triggered by amylase enzyme) And others suffer impaired Stage 2 Response (basal response) Some suffer impairment to both This will affect the time response to any stimulus by carbs,

Currently we can’t measure insulin at home. Or at least I’m not aware of a commercially available meter. Nevertheless that is the information needed in order to fully gauge what is happening metabolically as a reaction to food.

 

[HSSS]

In my opinion a spike of insulin is a better measure of metabolic impact.

That may be so but as we can’t measure it its not a lot of good to us - and all we can do is measure bgl then that’s what we have to do til someone invents an insulin meter.

 

[Member496333]

That may be so but as we can’t measure it its not a lot of good to us - and all we can do is measure bgl then that’s what we have to do til someone invents an insulin meter.

I don’t disagree. My point was that the data in this article is pretty meaningless without knowing a measure of the insulin resistance in the subject.

 

[HSSS]

The point of the post wasn’t so much yet another hatchet job in the press or it’s contents but that NICE seem to be reacting to it......

 

[Mbaker]

This is how you turn a square into a circle, or see what you want to. Both results are not great wins for those advocating bananas , sugar or rice. I get nervous approaching a 2 mmol rice for a 2 to 3 course meal.

I have seen other banana tests. This one is a 5 banana
https://www.diabetes.co.uk/forum/threads/interesting-blood-sugar-readings-28-year-old-vegan.161542/
- 11.3 spike. Interesting about the missed spike in the initial test. In general I would be concerned for this younger man, as my numbers are generally lower with less variance; the wide variance from fbg to post prandial would worry me at that age.

I stopped reading the article when they said low carb produces increased glycemia. Something fishy, "we" get lower results consistently.

 

[Jaylee]

This is how you turn a square into a circle, or see what you want to. Both results are not great wins for those advocating bananas , sugar or rice. I get nervous approaching a 2 mmol rice for a 2 to 3 course meal.

I have seen other banana tests. This one is a 5 banana
https://www.diabetes.co.uk/forum/threads/interesting-blood-sugar-readings-28-year-old-vegan.161542/
- 11.3 spike. Interesting about the missed spike in the initial test. In general I would be concerned for this younger man, as my numbers are generally lower with less variance; the wide variance from fbg to post prandial would worry me at that age.

I stopped reading the article when they said low carb produces increased glycemia. Something fishy, "we" get lower results consistently.

Interestingly the guy in your link was a vegan..? So was my mum.. For many, many years. (Approx 35 to 40?) Diagnosed with Alzheimers about 7/8 years ago? Nothing in her "lifestyle" according to the clinic "nothing" to suggest a trigger of the condition... But...
She forgot she was a vegan as part of the process. My dad was a meat eater & in fairness she would cook meat whilst he was ill & incapable for him.
It was a "Jack sprat could eat no fat, his wife could eat no lean" setup..

So, i started to notice my mum had hit the bacon.. Now she has a varied diet & to my mind has not progressed with the Altziemers . My time with her she has times of lucidity & even remembers what was going on the night before & seems aware of current news. (Though a little confused on the details.) She is now head butting 88.


So in my looking up on the condition of Alziemers. (Like you do when it's your mom. & coming across autopsies of people who had this condition.) It has been recently "dubbed" a type 3? Localised brain insulin resistance anyone's? (In lay man's terms & probably over simplified.) carbs?

 

[Oldvatr]

Interestingly the guy in your link was a vegan..? So was my mum.. For many, many years. (Approx 35 to 40?) Diagnosed with Alzheimers about 7/8 years ago? Nothing in her "lifestyle" according to the clinic "nothing" to suggest a trigger of the condition... But...
She forgot she was a vegan as part of the process. My dad was a meat eater & in fairness she would cook meat whilst he was ill & incapable for him.
It was a "Jack sprat could eat no fat, his wife could eat no lean" setup..

So, i started to notice my mum had hit the bacon.. Now she has a varied diet & to my mind has not progressed with the Altziemers . My time with her she has times of lucidity & even remembers what was going on the night before & seems aware of current news. (Though a little confused on the details.) She is now head butting 88.


So in my looking up on the condition of Alziemers. (Like you do when it's your mom. & coming across autopsies of people who had this condition.) It has been recently "dubbed" a type 3? Localised brain insulin resistance anyone's? (In lay man's terms & probably over simplified.) carbs?

I think this topic (T3D) deserves its own thread for discussion. There is certainly awareness and research into this and related topics. Would anyone else like to kick one off? I do not have any personal experience in this.

 

[Jaylee]

I think this topic (T3D) deserves its own thread for discussion. There is certainly awareness and research into this and related topics. Would anyone else like to kick one off? I do not have any personal experience in this.

Ooooh, my bad here.
I did go off on a tangent regarding what is considered the recomended diets probable outcome whilst reviewing the DM article.
& watching a novice on YouTube with clowning a meter..

Please accept my apologies.

 

[pdmjoker]

The graph in the sugar Vs banana test

Some observations:
It should be noted that a half-green banana would have far less sugar content than a really mature one - how ripe was their banana?
Also, different foods affect people to different degrees so not hard to find two people for whom 24g sugar would react more than a barely ripe banana.
Sugar is half glucose and half fructose, and the fructose isn't used by the body but stored as liver fat. Is the six-spoons graphics trying to convey the total load rather than just blood glucose effect? (Not difficult to take a simplification for communication purposes and find it has scientific limitations.)
It's worrying if NICE pays more attention to one DM article (a paper not renown for objectivity) rather than years of effective work by a senior GP...

 

[pdmjoker]

Now that's rather interesting. There is an insinuation there was a CGM involved with the test..
Which made me question what was happening with the highlighted graphs posted.?

Unless they were finger testing every 15 minutes for 2 hours.. it still doesn't explain the graphs looking like data collated every 5 minutes.?

View attachment 42623

Those look like somewhat green (ie unripe) bananas to me which (surprise, surprise) have less sugar content than ripe ones.