Stop the diabetes madness!

[mcdonagh47]

I have done some extensive reading during the past week and so far as I understand diabetes diagnostic tools and care are abysmal.

Diagnosis: two fasting bg readings at or above 7 OR a OGTT 2h reading above 11.1/12.2 depending on test method.

But why are the limits set so extremely high?
.

The diagnostic figures are surrogate measures of the point on the Starling Curve of the Pancreas where Insulin Resistance outweighs Beta Cell mass.

 

[Totto]

The diagnostic figures are surrogate measures of the point on the Starling Curve of the Pancreas where Insulin Resistance outweighs Beta Cell mass.

Could you be a bit more specific? Or give me a reference or two?

 

[Catden]

Because (1) T2 is entirely the patient's own fault; and (2) we're going to die anyway, so it's purely about managing our deterioration - and who would deny a dying person a cream bun?

Kate

I was born with kidney disease & finally lost my function 16yrs ago, after my Renal Transplant I was diabetic, but count as type 2 on insulin. I get so upset at 'proper' diabetics tell me its my own fault, I had no sign of Diabetes before my tx.

 

[Scandichic]

Tack ska du ha, Scandichic! Har du förresten gått med i Kostdoktorns forum än?

My aim with the thread about diabetic madness is about the fact the diagnosis seem to step in far to late and care seems slack. I really don't understand why diabetics are encouraged to eat a lot of carbs and discouraged to keep their bg at safe levels. And I really want to know what a safe bg level is. I have seen HbA1c goals of 52! Why not aim for 36? Or lower? Why not aim for a safe level? I know you are with me here Scandichic, but I am a bit upset about what I perceive as a lack of proper scientific basics that leads to diabetes being accepted as a progressive disease etc.

There is a fantastic site for thyroid sufferers called Stop the thyroid madness. I feel the diabetic madness is close in terms of madness, even though thyroid problems are more common, in women at least.

Hej!
I find the whole thing completely confusing.....
In the Autumn I had pneumonia for 5 weeks and was really ill. Off work, all the usual tests - lots of blood tests, including for diabetes and it was only when I went to the docs about cystitis, not clearing up after 2 days that the doc said. I think you're diabetic . Unfortunately he was right. I can't believe that it was an overnight thing and no one ever mentioned pre-diabetes.
Like you, I am at a loss why the British health authorities continue to recommend portion control and eating carbs. Diet doc has loads of links to scientific research into LCHF but no one has provided me with a single shred of evidence for the Portion control approach or the low GI approach. I can only conclude that there isn't any!
Are you getting the strips free from your doc? Mine refuses! Have got appointment on Tuesday so hoping to go with readings, food diary and weight loss chart (now 12lb) .
Lycka till!

 

[Totto]

I was born with kidney disease & finally lost my function 16yrs ago, after my Renal Transplant I was diabetic, but count as type 2 on insulin. I get so upset at 'proper' diabetics tell me its my own fault, I had no sign of Diabetes before my tx.

Exactly. The diagnosis is arbitrary then we are blamed for it, and the care is abysmal.

 

[Scandichic]

Because (1) T2 is entirely the patient's own fault; and (2) we're going to die anyway, so it's purely about managing our deterioration - and who would deny a dying person a cream bun?

Kate

If people choose to do nothing about their condition I could sort of understand this attitude although not necessarily agree. but t2 is not necessarily someone's fault (see poor poster with kidney issues). I have no excuse for my weight but what makes me angry is the lack of support for those of us who are trying to change our lifestyle - pretty much everyone on this forum. It amazes me how many people whom I come across in every day life feel they have the right to tell me what I should be eating - lots of carbs! Lol! Do I tell them not to smoke, drink so much etc?! No I don't - it's non of my business! Anyway, good luck to every one - I have lost 12lbs so far and reduced my bs sugar to below half.

 

[Mud Island Dweller]

At my old dr l said about trying to loose weight a few years back. Was told oh there is leaflets out there... vague wave of hand. No leaflets they had run out couple months before were getting more in...sometime.

 

[Totto]

If people choose to do nothing about their condition I could sort of understand this attitude although not necessarily agree. but t2 is not necessarily someone's fault (see poor poster with kidney issues). I have no excuse for my weight but what makes me angry is the lack of support for those of us who are trying to change our lifestyle - pretty much everyone on this forum. It amazes me how many people whom I come across in every day life feel they have the right to tell me what I should be eating - lots of carbs! Lol! Do I tell them not to smoke, drink so much etc?! No I don't - it's non of my business! Anyway, good luck to every one - I have lost 12lbs so far and reduced my bs sugar to below half.

I think Kesun was ironic. Or bitter, rather. And I am with Kesun there.

And you have found the perfect way to loose weight AND bg! Low carbers as in Kostdoktorn forum are mostly those who need to loose a lot of weight and you do brilliant, don't you? .

 

[phoenix]

no one has provided me with a single shred of evidence for the Portion control approach or the low GI approach. I can only conclude that there isn't any!

There is lots of evidence for both, probably less under the term portion control but lots more for calorie restriction. Here's one for portion control
http://www.ncbi.nlm.nih.gov/pubmed/17592101
One for GI
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7892481
For a totally contrary but seemingly extremely successful trial of a rather whacky sounding diet look up the results of the 6 momth Ma Pi 2 macrobiotic diet ( brown rice, beans and seaweed ! the absolute opposite of a LCHF diet ) in Cuba
http://www.ncbi.nlm.nih.gov/pubmed/21483296


Seriously one can find evidence for many diets, the difficulty is sorting out the wheat from the chaff. By their very nature diet studies are hard to control and for anything over 6 months it becomes increasingly difficult to motivate people to stick to their assigned diets. (wonder how long people would stick to the Ma Pi diet outside of the metabolic ward) Many trials also are weight loss trials with results for glucose levels and other things 'thrown' in. That doesn't help people with any type of diabetes who don't need to lose weight nor those who have lost it and need to maintain weight and glucose levels.
Often the results with any intervention are less than spectacular. ( though personally, I think that there have been some good results from longer term Med diet ones recently)

I think you say that you come from Sweden. It's worth reading the report of your own SBU scientific committee. They emphasise the lack of quality in most trials . I can give you the link to the English summary but it doesn't have references. I'm sure that the full document will have.http://www.sbu.se/upload/Publikationer/Content1/1/mat_diabetes_eng_smf_110517.pdf

 

[Scandichic]

I think Kesun was ironic. Or bitter, rather. And I am with Kesun there.

And you have found the perfect way to loose weight AND bg! Low carbers as in Kostdoktorn forum are mostly those who need to loose a lot of weight and you do brilliant, don't you? .

Oh no, please don't think I was ranting at Kesun! I got the irony but am feeling cross with those people who are giving us t2s a hard time and judging by Kesuns post she had received some of that negative treatment. I can forgive people for their misguided views but find the callous, careless, patronising attitude of some medical professionals difficult to understand.

 

[Scandichic]

There is lots of evidence for both, probably less under the term portion control but lots more for calorie restriction. Here's one for portion control
http://www.ncbi.nlm.nih.gov/pubmed/17592101
One for GI
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7892481
For a totally contrary but seemingly extremely successful trial of a rather whacky sounding diet look up the results of the 6 momth Ma Pi 2 macrobiotic diet ( brown rice, beans and seaweed ! the absolute opposite of a LCHF diet ) in Cuba
http://www.ncbi.nlm.nih.gov/pubmed/21483296


Seriously one can find evidence for many diets, the difficulty is sorting out the wheat from the chaff. By their very nature diet studies are hard to control and for anything over 6 months it becomes increasingly difficult to motivate people to stick to their assigned diets. (wonder how long people would stick to the Ma Pi diet outside of the metabolic ward) Many trials also are weight loss trials with results for glucose levels and other things 'thrown' in. That doesn't help people with any type of diabetes who don't need to lose weight nor those who have lost it and need to maintain weight and glucose levels.
Often the results with any intervention are less than spectacular. ( though personally, I think that there have been some good results from longer term Med diet ones recently)

I think you say that you come from Sweden. It's worth reading the report of your own SBU scientific committee. They emphasise the lack of quality in most trials . I can give you the link to the English summary but it doesn't have references. I'm sure that the full document will have.http://www.sbu.se/upload/Publikationer/Content1/1/mat_diabetes_eng_smf_110517.pdf

Thank you for these links. I am really pleased to get a response from someone who can give me evidence (other than anecdotal) to support their arguments. I am going to go away and read these documents. This is what I asked the diabetic nurse for but she was unable to give me anything to read.
I am not Swedish but studied it at uni and lived out there for a while. I also had a job where I spoke and wrote it all day, every day so am reasonably competent.

 

[Totto]

Found this abstract: http://www.abstractsonline.com/plan...d10&mKey=7e87e03a-5554-4497-b245-98adf263043c

24 healthy objects ate a lunch of 511, 743 or 1034 calories respectively, carb content 50 E% so in the largest meal the carb content was 130 grams, a huge amount in my eyes. The bg readings went up from 4.something to just below six in 30 min, then went down. So this is the normal response. To eat 130 grams of carbs in one go and not even go above 6.

 

[douglas99]

Found this abstract: http://www.abstractsonline.com/plan...d10&mKey=7e87e03a-5554-4497-b245-98adf263043c

24 healthy objects ate a lunch of 511, 743 or 1034 calories respectively, carb content 50 E% so in the largest meal the carb content was 130 grams, a huge amount in my eyes. The bg readings went up from 4.something to just below six in 30 min, then went down. So this is the normal response. To eat 130 grams of carbs in one go and not even go above 6.

That's an interesting study. Admittedly they are nothing like me, well maybe when I was 25, (but on reflection, getting closer again apart from the age).

Twenty-four healthy lean subjects (12 M, 12F, mean age 25 yrs, BMI 22.2 kg/m2)

I've tested others in my age group, and above 6 seems to be happening frequently. Much as I'd love to be 25 again, I think comparing me to one now isn't going to happen.


The interesting result was from the lower amount of carbs in the healthy group.
A low blood sugar reading was observed.
"lower caloric intake results in an overshoot of insulin, which may elicit post-lunch hypoglycemia."

 

[xyzzy]

The interesting result was from the lower amount of carbs in the healthy group.
A low blood sugar reading was observed.
"lower caloric intake results in an overshoot of insulin, which may elicit post-lunch hypoglycemia."

That's a well known effect as the amount of insulin released is somewhat "guessed" at by the body and is based on how many carbs you ate in the previous few meals so, if you have a working pancreas, and eat an average amount of carbs then eat a low carb meal too much insulin may well get produced and you can get low bg's. In most people this is rarely felt as anything physical as the liver will dump glucose to sort the problem out without the person ever being aware that its happened. It has probably happened hundreds of times in the average middle aged persons life.

From some of your previous posts Douglas you seem (like me) to be using the "insulin response is based on the previous average" to good effect. Even though my pancreas doesn't work at 100% it does work reasonably well so as long as I keep under its impaired ability I have trained it to cope with probably nearly double the carbs a day (up to around 130g) than that I could tolerate in the first year after diagnosis. This in no way implies that those who keep to very low carb levels a day are doing anything wrong and in fact I'd recommend it to the newly diagnosed as it gives your pancreas the well deserved rest it needs.

 

[DiamondAsh]

I have done some extensive reading during the past week and so far as I understand diabetes diagnostic tools and care are abysmal.

Diagnosis: two fasting bg readings at or above 7 OR a OGTT 2h reading above 11.1/12.2 depending on test method.

But why are the limits set so extremely high?

The result is that when the medical staff finally take notice we already have organ damage as this start when bg goes above 6 for any length of time.

we are told to check bg two h after a meal when the levels are going down again, but not to check at 45-60, where bg peaks. Why?

Most of us are told not to check bg at all so we are completely in the dark. And we are told to eat enormous amounts of carbs that will make our bg shoot up and cause more organ damage.

And we are recommended bg targets that are sure to damage us more and lead to stroke, heart failure, blindness, renal failure, amputations, cancer and dementia.

I really don't get this.

I will however be given a bg monitor on prescription tomorrow, after threatening not to eat a single carb ever more in my life until I was given one.

It's certainly a bit of a shambles when it comes to doctors and diagnoses. Good job we have this forum to guide us. I'm not wiating for a diagnosis, I;m trying to sort my BG levels out now.

 

[parameswaran]

Tack ska du ha, Scandichic! Har du förresten gått med i Kostdoktorns forum än?

My aim with the thread about diabetic madness is about the fact the diagnosis seem to step in far to late and care seems slack. I really don't understand why diabetics are encouraged to eat a lot of carbs and discouraged to keep their bg at safe levels. And I really want to know what a safe bg level is. I have seen HbA1c goals of 52! Why not aim for 36? Or lower? Why not aim for a safe level? I know you are with me here Scandichic, but I am a bit upset about what I perceive as a lack of proper scientific basics that leads to diabetes being accepted as a progressive disease etc.

There is a fantastic site for thyroid sufferers called Stop the thyroid madness. I feel the diabetic madness is close in terms of madness, even though thyroid problems are more common, in women at least.

Hi,

I think diabetics are not encouraged to eat lot of carbs. Actually diabetics have to limit the carb, eat fiber rich foods (which will slow down the digestion and prevent BG peaking) and othe low GI foods. Take enough protien and fat. Fruits are also to be limited to control BG.
HbA1c less than 6.5 is good.,

 

[izzzi]

Because (1) T2 is entirely the patient's own fault; and (2) we're going to die anyway, so it's purely about managing our deterioration - and who would deny a dying person a cream bun?

Kate

I think your being a little unfair to type 2 patients. There is no way you can be a expert in making such a comment.
Yet you have succeeded in hurting many genuine type 2 diabetes patients that have strong feelings regarding blame..
never mind I will exchange my cream bun for a wee dram well before I die.

 

[CollieBoy]

I think your being a little unfair to type 2 patients. There is no way you can be a expert in making such a comment.
Yet you have succeeded in hurting many genuine type 2 diabetes patients that have strong feelings regarding blame..
never mind I will exchange my cream bun for a wee dram well before I die.

izzzi, as others have said, Kate was being ironic here quoting the "usual" condemnations from "The Great Unwashed" (which include a lot of HCPs!)

 

[douglas99]

That's a well known effect as the amount of insulin released is somewhat "guessed" at by the body and is based on how many carbs you ate in the previous few meals so, if you have a working pancreas, and eat an average amount of carbs then eat a low carb meal too much insulin may well get produced and you can get low bg's. In most people this is rarely felt as anything physical as the liver will dump glucose to sort the problem out without the person ever being aware that its happened. It has probably happened hundreds of times in the average middle aged persons life.
From some of your previous posts Douglas you seem (like me) to be using the "insulin response is based on the previous average" to good effect. Even though my pancreas doesn't work at 100% it does work reasonably well so as long as I keep under its impaired ability I have trained it to cope with probably nearly double the carbs a day (up to around 130g) than that I could tolerate in the first year after diagnosis. This in no way implies that those who keep to very low carb levels a day are doing anything wrong and in fact I'd recommend it to the newly diagnosed as it gives your pancreas the well deserved rest it needs.

I reckon I keep load down, which helps.
I did read an interesting guide to lchf, which suggested keeping carbs to less than 70 to 100g a day, otherwise you should cut down on fat to less than 30% total diet by the time you're on 150g a day.
Even on those numbers I reckon insulin response would still be reasonable for me, providing I didn't have all the carbs as high GI food in one go, as they did here in just one meal.

 

[JanS59]

Because (1) T2 is entirely the patient's own fault; and (2) we're going to die anyway, so it's purely about managing our deterioration - and who would deny a dying person a cream bun?

Kate

Kate - I am horrified by your comment. T2 is NOT "entirely the patient's own fault". I have recently being diagnosed as having T2 following a kidney transplant (genetic issue) one of the side effects of the medication needed is that aout 30% of transplant patients develop T2. So please be very careful about your facts and stop being so judgemental. If Member's on this site can not be supportive of each other, then what is the point. PS: My BMI is 22 I eat a very healthy diet and exercise regularly, so less of the stereotyping. Thanks.

First time I have found this site, whilst looking some info up, if this is the type of comments that are being posted it will also be my last.