Advice for going low carb

[Charles Robin]

thanks, the blood coincided perfectly with the tv ads about peeing blood and cancer lol


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Yeah, they always seem to! I am very good at diagnosing myself with everything under the sun the moment anything is out of the ordinary.

 

[Charles Robin]

Well, I have just thrown a very successful dinner party! My wife and I made a low carb flax meal pizza, with some celeriac chips (we were just going to have pizza, then realise at the last minute we were going to have more people than the pizza was going to feed, and no more flax meal, so we had to improvise). We served a choice of almond meal chocolate cake or almond meal muffins for dessert. As it turned out, everyone had some of everything, and thoroughly enjoyed it too! I think this night will be a highlight of the year for me. At the beginning of 2014, I was on a high carb diet, and my cooking was limited to putting a ready meal in the oven. Now I have just cooked a meal for myself, my wife, and four of our closest friends. They were honest about what they thought, and gave some suggestions on how to improve the dishes, but the response was overwhelmingly positive. I also ate well from the food we cooked. My bloodsugars started at 4.6, peaked at 6.8 and finished at 5.7. Even four weeks ago these sorts of figures were an unachievable dream for me. I have lived for so long believing my life would end with complications. It's almost strange to feel that this can be averted. I now firmly believe that if I continue on my current path, diabetes will be a part of my life, and not the end of it I will not ruin my wife's life, and any children we have in the future will not have to see their father die an avoidable death many years before his time. These are some very good feelings.

 

[Andy12345]

Well, I have just thrown a very successful dinner party! My wife and I made a low carb flax meal pizza, with some celeriac chips (we were just going to have pizza, then realise at the last minute we were going to have more people than the pizza was going to feed, and no more flax meal, so we had to improvise). We served a choice of almond meal chocolate cake or almond meal muffins for dessert. As it turned out, everyone had some of everything, and thoroughly enjoyed it too! I think this night will be a highlight of the year for me. At the beginning of 2014, I was on a high carb diet, and my cooking was limited to putting a ready meal in the oven. Now I have just cooked a meal for myself, my wife, and four of our closest friends. They were honest about what they thought, and gave some suggestions on how to improve the dishes, but the response was overwhelmingly positive. I also ate well from the food we cooked. My bloodsugars started at 4.6, peaked at 6.8 and finished at 5.7. Even four weeks ago these sorts of figures were an unachievable dream for me. I have lived for so long believing my life would end with complications. It's almost strange to feel that this can be averted. I now firmly believe that if I continue on my current path, diabetes will be a part of my life, and not the end of it I will not ruin my wife's life, and any children we have in the future will not have to see their father die an avoidable death many years before his time. These are some very good feelings.

wow, what a wonderful post! good on you! simply amazing!


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[Charles Robin]

In other news, when I go to diabetic clinic, my specialist sends a letter to my GP detailing what happened at the appointment. I also get sent a copy of this. I just thought I would share the response I got to my low carb diet. What follows are the words of my Consultant Diabetes Specialist and Endocrinologist:

'I reviewed my patient today in the diabetes clinic. He had made quite significant changes to his lifestyle generally since we last saw him; he has got married, changed his job now and is a bit more erratic in terms of his lifestyle and hours etc. but has also spent a lot of time concentrating on his diabetes. He had a letter through from the retinal screeners suggesting he had some background changes and has taken this on board and tackled his diabetes fairly aggressively. This has brought his HBA1C down to 37 and unfortunately he is doing this at the expense of regular hypos, at least one a day. He is also beginning to lose his awareness slightly of these hypoglycaemias though he is doing an awful lot of testing.

We talked about the pros and cons of this method of treating his diabetes is that there isn't any awful lot of benefit having an HBA1C of 37 opposed to the previous level of 50. I have said to him there is plenty of room to increase things up. He is noticing that he is tending to dip low and then have a rebound high again and it is the highs that worry him. Conversely it is the lows that worry me and I have asked him to try and concentrate on cutting these out so intake less and less insulin until these hypos stop.

He has also adopted a very low carbohydrate diet in the last week or so as he has got a book from America that rationalises this for, of treatment. I am happy that he goes ahead with this as he is fairly insistent that he wants to try this diet as he feels a lot better on it. I just want him to do it in a balanced fashion if possible. I will therefore ask him to see on of our dieticians to see if we can help him through this; either way hypos are the key and if he needs to reduce his insulin down to very low levels then so be it.

I will see him again in four months' time to see how things are going.'

So that's what the doc had to say. I will be interested to see what people make of it.

 

[Charles Robin]

wow, what a wonderful post! good on you! simply amazing!


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Thanks Andy! I have not got this completely cracked yet but I feel I am on the right route. My highs tend to be in the 8s and 9s now, rather than the 15s and 16s that they were. It was also a case of 'pick a number between 1.8 and 20, any number in this range is just as likely as any other.' Now, I am far more comfortable with what I need to do to being things under control. I still have my lapses, but now it's eating too much low carb cake and experiencing Chinese restaurant effect, rather than splurging on Ben & Jerry's and trying to catch up with insulin. Each day I get that bit better

 

[Totto]

Well, I have just thrown a very successful dinner party! My wife and I made a low carb flax meal pizza, with some celeriac chips (we were just going to have pizza, then realise at the last minute we were going to have more people than the pizza was going to feed, and no more flax meal, so we had to improvise). We served a choice of almond meal chocolate cake or almond meal muffins for dessert. As it turned out, everyone had some of everything, and thoroughly enjoyed it too! I think this night will be a highlight of the year for me. At the beginning of 2014, I was on a high carb diet, and my cooking was limited to putting a ready meal in the oven. Now I have just cooked a meal for myself, my wife, and four of our closest friends. They were honest about what they thought, and gave some suggestions on how to improve the dishes, but the response was overwhelmingly positive. I also ate well from the food we cooked. My bloodsugars started at 4.6, peaked at 6.8 and finished at 5.7. Even four weeks ago these sorts of figures were an unachievable dream for me. I have lived for so long believing my life would end with complications. It's almost strange to feel that this can be averted. I now firmly believe that if I continue on my current path, diabetes will be a part of my life, and not the end of it I will not ruin my wife's life, and any children we have in the future will not have to see their father die an avoidable death many years before his time. These are some very good feelings.

Absolutely brilliant! I was looking through the smiles searching for a "doing a happy dance/applauding" sort of image with no luck, but that is what you deserve!

 

[Charles Robin]

Absolutely brilliant! I was looking through the smiles searching for a "doing a happy dance/applauding" sort of image with no luck, but that is what you deserve!

That's very kind of you to say, thanks!

 

[Jessrei08]

Hi how have you maintained perfect sugar readings via the carb diet? Mine are quite erratic at the moment due to me trying to see what good will have an effect in me and pizzas are the worst for me putting me from 7 to around about 15/16


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[parameswaran]

Hi all,

After much reading up on it, I have decided that I am going to try going low carb, and was looking for advice from others that have made the switch. I am 26, and was diagnosed with type 1 back in 1990 (I was three). I am 5'11" and weigh just under 11 stone 7. Therefore weight loss is not my goal here, it is totally orientated around blood sugar control. So far the only complication I have had was my last retinal scan, which said mild diabetic changes were found, requiring no treatment. This is obviously a sign that I need to get a handle on things before they are too late. My HBA1C tends to be 7 or under, but I have frequent highs and lows from trying to compensate for large carbohydrate meals. I'm tired of seeing the worry that I am putting my wife through, and something must be done. I am currently reading Dr Bernstein's book, and want to stick as closely to his 30g carb regime as I can. Thankfully I have always enjoyed vegetables, and a diet of meat and eggs is something I can adjust to. I will definitely miss the bread and fruit, but I would rather live healthily for a number of decades than die young for the sake of a sandwich.

SO here is my plan. I have been testing loads this week while eating the diet I am used to, and noting down all my results (thank you Microsoft excel). Next week I intend to do the same, but switch to the low carb diet. I currently use Lantus for my long acting insulin and Lispro for my short acting. I was taking 24 units of Lantus at 7.30pm, but have reduced that recently to 18 units to try and control the hypos. I intend to eat a low carb meal Sunday evening, and reduce my Lantus to 8 units, testing regularly to see the effect this will have. I will then have a 6g of carb meal for breakfast on Monday, and give myself one unit of Lispro to cover it. I will make a note of all my food and results for the next week and see how it compares. I will then go to my diabetic appointment on the 3rd of February, and push the idea of low carbing with my DSN. I have not discussed anything of this nature with my diabetes department before, so I am not sure whether they are for or against a regime of this nature. I have heard from a lot of other people that they have had trouble converting their doctors to their way of thinking, so if I already have some concrete proof that the regime is working, this may help me to get them on board.

So from anyone that has left high carbs behind, does my plan sound feasible/sensible? All comments, positive or critical are gratefully received. Many thanks for reading!

Hi Charles,

Reducing carb to very low level is not good. Anyway you get most of your energy from carb. Include fibrous food (such as whole grain - brown rice) which is having low GI. This will slow the digestion and BG will not shoot-up fast. I am taking Flaxseed powder (2 table spoon) along with my BF. This is a fibre rich food, moreover it is contains large amount of omega-3 fatty acid. I would advise you to consult with your dietitian/ doctor regarding this. Are you taking enough exercise to make the insulin absorption better?

 

[Mud Island Dweller]

Oh dear someone else who doesn't know how food works.
No we don't get most of our energy from carbs we instead as low carbers get it from the fat a perfectly acceptable method. Our body utilise far instead of storing it in great wadges around our bodies.
Your diet may work for you and the nhs however the vast majority find it doesn't work please go learn how our eating works instead of being a parrot to the nhs

 

[Totto]

Hi Charles,

Reducing carb to very low level is not good. Anyway you get most of your energy from carb. Include fibrous food (such as whole grain - brown rice) which is having low GI. This will slow the digestion and BG will not shoot-up fast. I am taking Flaxseed powder (2 table spoon) along with my BF. This is a fibre rich food, moreover it is contains large amount of omega-3 fatty acid. I would advise you to consult with your dietitian/ doctor regarding this. Are you taking enough exercise to make the insulin absorption better?

If you eat a lot of carbs obviously you get a lot of energy from them. If you eat very little carbs, you get your energy from other sources.

If you are sensitive to carbs, as so many diabetics are, a low GI high or even moderate carb diet will keep your bg too high with or without spikes.

My body, for example, fails to understand the difference between pure sugar and whole-grain bread. I am not alone in this. The simple solution is to stay off carbs and keep bg at a normal level.

 

[Charles Robin]

Hi how have you maintained perfect sugar readings via the carb diet? Mine are quite erratic at the moment due to me trying to see what good will have an effect in me and pizzas are the worst for me putting me from 7 to around about 15/16


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Hi Jess. First off, I can't claim to have perfect sugar readings, I still get highs and lows, but they are getting less frequent all the time. The key is to experiment as you are doing, but reading up on different foods will help you to get an idea of what is likely to be in what you are eating. I have found low carb to be easily the most effective way of eating, to control bloodsugars. Regarding pizza, a normal pizza from a supermarket usually has an enormous amount of carbs in it. And ordering from somewhere like Dominos is almost guaranteed to be even more of a carb fest. However, do not lose hope! I absolutely love pizza, and it was with a heavy heart that I consigned it to history when I started low carbing. I have now found a way of making my own pizza, using flax meal. It's fairly expensive so I don't make it too often, but an entire pizza will have less carbs in it than one slice of a standard pizza. I follow the recipe listed here: http://lowcarbdiets.about.com/od/breads/r/flaxpizza.htm
I cooked this for some friends at the weekend and they all loved it, even though they are not diabetic and don't low carb. Ignore the negative review given on the web page, it really is very tasty!
In essence, the viewpoint of low carbing is the idea that small mistakes have small solutions. If you eat high carb, it's much harder to predict the amount of insulin you need. Nutrition information is allowed a sizeable margin for error, I have heard different people say anything from 20% to 50%. If you eat something listing 100g of carbs, with a 20% margin for error that could be anything from 80 to 120g. Therefore you are unlikely to give yourself exactly what you need insulin wise. However, eating something with 10g of carbs could have between 8 and 12g, so the error would be much smaller.
The key is to read as much as you can, starting with Dr Bernstein's complete diabetes solution. The more info you have, the easier it is to control diabetes. And never lose hope! It's a marathon, not a sprint. If you put the effort in, the improvements will come little by little.

 

[Dillinger]

We talked about the pros and cons of this method of treating his diabetes is that there isn't any awful lot of benefit having an HBA1C of 37 opposed to the previous level of 50. I have said to him there is plenty of room to increase things up.

He has also adopted a very low carbohydrate diet in the last week or so as he has got a book from America that rationalises this for, of treatment. I am happy that he goes ahead with this as he is fairly insistent that he wants to try this diet as he feels a lot better on it. I just want him to do it in a balanced fashion if possible.

So that's what the doc had to say. I will be interested to see what people make of it.

Well, 'not an awful lot of benefit of having and HbA1c of 37 compared to 50' he says.

The DCCT and EDIC trials which are the cornerstone of the NHS treatment strategy for diabetics say; 'keeping blood glucose levels as close to normal as possible slows the onset and progression of the eye, kidney, and nerve damage caused by diabetes. In fact, it demonstrated that any sustained lowering of blood glucose, also called blood sugar, helps, even if the person has a history of poor control.'

Normal in this context was an HbA1c of 6%.

Your current HbA1c in old money is 6.2% (an excellent result). Putting you in the top7% or thereabouts of Type 1 diabetics in terms of control in the UK.

Your old HbA1c is 8.1%.

Just looking at the big complication; cardiovascular disease this is what was found;

'the risk of any heart disease was reduced by 42 percent in people who had been in the intensive treatment group (i.e. HbA1c of 6%). Volunteers in the intensive treatment group also cut their risk of nonfatal heart attack, stroke, or death from cardiovascular causes by 57 percent.

Have a look at the other benefits across the array of complications that you get from having such excellent control:

http://diabetes.niddk.nih.gov/dm/pubs/control/#cardiovascular

So, whilst you consultant is being very 'kind and tolerant' of you and your 'American book' he's talking, with respect, nonsense.

The final point is that the DCCT and EDIC were both done with high carb diets and lots of insulin (carbs per day were about 240 in both limbs of the study). If we can get low HbA1c without lots of insulin it's win win surely?

When I first started low-carbing seriously I got an HbA1c of 5.8% - my GP said that is far too low please get that up. Like a fool I listened to him and have yet been able to return to those levels. I put that advice down as the worst and most damaging medical advice I have ever received.

Stick to your guns Charles - you can see the benefits don't be fobbed off by well meaning but intransient HCPs.

Also; well done on the dinner party!

Best

Dillinger

 

[phoenix]

Are you having lots of hypos as your doctor implies because that is important. Losing hypo awareness can lead pragmatically to a loss of a driving licence (especially as it's your consultant that may fill in the form for the DVLA) , more seriously, at very low levels hypos can be dangerous.

Whatever diet you adopt you have to get this right as though I totally agree with Dillinger that a HbA1c of 6.2% is fine (mine is slightly lower so I can't argue!) I also think that severe hypos are an immediate risk and need to be averted.

Personally, I used to get hypos very frequently certainly at the level your doctor says you are having them and I did begin to lose awareness. They are now to a couple a month and that has included a skiing holiday this month. It was at the expense of a few % of HbA1c but at my lowest I was down at 4.9%.
I don't low carb (more moderate as not nearly up to 200g either) I am now extremely aware of hypo prevention, knowing when they will happen and taking steps to prevent them ie before exercise and for me that includes housework/shopping as well as the more conventional forms of exercise.
If you are having hypos then he is right you are taking too much insulin for your lifestyle and diet, the rapid insulin you take for a meal is not out of the system for 4 to sometimes five hours and you have to take that into account. Personally, if I am about to exercise (as above) and I am quite low I will eat a low GI carb (not too much) during extended exercise I take regular single dextrose tabs (actually I believe Dr Bernstein also recommends this during exercise!.

 

[Charles Robin]

Well, 'not an awful lot of benefit of having and HbA1c of 37 compared to 50' he says.

The DCCT and EDIC trials which are the cornerstone of the NHS treatment strategy for diabetics say; 'keeping blood glucose levels as close to normal as possible slows the onset and progression of the eye, kidney, and nerve damage caused by diabetes. In fact, it demonstrated that any sustained lowering of blood glucose, also called blood sugar, helps, even if the person has a history of poor control.'

Normal in this context was an HbA1c of 6%.

Your current HbA1c in old money is 6.2% (an excellent result). Putting you in the top7% or thereabouts of Type 1 diabetics in terms of control in the UK.

Your old HbA1c is 8.1%.

Just looking at the big complication; cardiovascular disease this is what was found;

'the risk of any heart disease was reduced by 42 percent in people who had been in the intensive treatment group (i.e. HbA1c of 6%). Volunteers in the intensive treatment group also cut their risk of nonfatal heart attack, stroke, or death from cardiovascular causes by 57 percent.

Have a look at the other benefits across the array of complications that you get from having such excellent control:

http://diabetes.niddk.nih.gov/dm/pubs/control/#cardiovascular

So, whilst you consultant is being very 'kind and tolerant' of you and your 'American book' he's talking, with respect, nonsense.

The final point is that the DCCT and EDIC were both done with high carb diets and lots of insulin (carbs per day were about 240 in both limbs of the study). If we can get low HbA1c without lots of insulin it's win win surely?

When I first started low-carbing seriously I got an HbA1c of 5.8% - my GP said that is far too low please get that up. Like a fool I listened to him and have yet been able to return to those levels. I put that advice down as the worst and most damaging medical advice I have ever received.

Stick to your guns Charles - you can see the benefits don't be fobbed off by well meaning but intransient HCPs.

Also; well done on the dinner party!

Best

Dillinger

Thanks mate, as usual your replies are encouraging and insightful . Just one thing I wanted to check, you said on the new scale an HBA1C translated as 6.2. I thought it was roughly 5.5, and 50 was 6.7. I hate it when they change ways of measuring things, and I may be way off, but I thought I would double check just in case. Are the numbers in this link correct? http://www.wales.nhs.uk/sitesplus/documents/866/HbA1c converter.pdf

 

[Charles Robin]

Are you having lots of hypos as your doctor implies because that is important. Losing hypo awareness can lead pragmatically to a loss of a driving licence (especially as it's your consultant that may fill in the form for the DVLA) , more seriously, at very low levels hypos can be dangerous.

Whatever diet you adopt you have to get this right as though I totally agree with Dillinger that a HbA1c of 6.2% is fine (mine is slightly lower so I can't argue!) I also think that severe hypos are an immediate risk and need to be averted.

Personally, I used to get hypos very frequently certainly at the level your doctor says you are having them and I did begin to lose awareness. They are now to a couple a month and that has included a skiing holiday this month. It was at the expense of a few % of HbA1c but at my lowest I was down at 4.9%.
I don't low carb (more moderate as not nearly up to 200g either) I am now extremely aware of hypo prevention, knowing when they will happen and taking steps to prevent them ie before exercise and for me that includes housework/shopping as well as the more conventional forms of exercise.
If you are having hypos then he is right you are taking too much insulin for your lifestyle and diet, the rapid insulin you take for a meal is not out of the system for 4 to sometimes five hours and you have to take that into account. Personally, if I am about to exercise (as above) and I am quite low I will eat a low GI carb (not too much) during extended exercise I take regular single dextrose tabs (actually I believe Dr Bernstein also recommends this during exercise!.

I was having plenty of hypos, often on a daily basis. This was while I was on a high carb diet. I could never get the balance right, and had a permanent season ticket on the diabetic roller coaster. Since changing to low carb, I am having a fraction of the hypos I was, and the ones I have had I can easily explain. for instance, a couple of weeks ago my blood sugars were 9.4. I wanted to lower them, so I gave myself 3 units of lispro. I forgot, and repeated the dose 5 minutes later. When I felt weird two hours later and my bloodsugars were 1.8, I immediately knew why. My low carb diet has helped me in so many ways, but my brute stupidity has not cleared up yet.

 

[Dillinger]

you said on the new scale an HBA1C translated as 6.2. I thought it was roughly 5.5, and 50 was 6.7

Ooops; you're absolutely right; I misread the link here http://www.diabetes.co.uk/hba1c-units-converter.html

They give it as 5.5% which equates to an average blood sugar of 6.2 mmol/ml

If you can keep the hypos at bay then that's even better!

Best

Dillinger

 

[Charles Robin]

I seem to have been hypo a lot this evening. It may have something to do with the 40 miles I cycled…
Next time, I will try having a dextrose tablet every 4 miles, testing my blood sugars along the way to see what that does.

 

[char87]

Hi.I am a type one and have recently started a reduced carb diet (about 60g a day) but am having a lot of hypos. I posted about this in another thread and it was suggested that when doing lower carb, your basal needs reduce. I just wondered if there are any rules/ suggestions of how much your basal needs to be reduced by when lower carbing or is it just a case of testing and working it out? Thanks.

 

[Scandichic]

I seem to have been hypo a lot this evening. It may have something to do with the 40 miles I cycled…
Next time, I will try having a dextrose tablet every 4 miles, testing my blood sugars along the way to see what that does.

Hi Charles,
If you want more info on LCHF, there is a website called Dietdoctor.com it is the largest health blogg in Sweden and is written by Andreas Eenfeldt who is a doctor, specialising in obesity and diabetes. If you are looking for recipes there is a thread on this website. I usually go to LCHF receipt.com but it is in Swedish. If you see a picture of something you like, you can pm me and I'll translate. Dietdoctor is in English as well as Swedish so might be useful. Totto pointed me in this direction and you can even email the good doctor (I did and got a super quick reply) . Glad it's going well!