Advice please, for my father.

Saraband

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Hello everyone,
This is my first post here despite lurking (and learning) for the past 6 months since being diagnosed as pre-diabetic in March. I had envisaged posting soon with my own success story: I'm hopeful that the imminent fasting tests will show a significant improvement, probably taking me out of pre-diabetic levels. However my first post has now turned out to be a plea for advice for my father.

Dad is in his early eighties and has been T2 for 30 years (as was his mother...). He's been on insulin for some years now and he admits that he guesses at his doses much of the time. He's had several mini strokes in the past few years and has had several severe hypos, often at night. The strokes have certainly left him less able cognitively than before, and possibly more impulsive.

This afternoon we had a lovely chat about how well I've been doing: I've gone very low carb and feel incredibly well on it and my blood sugar readings are now both low and stable, but that's another story. However an hour or two later I got an excited call from my mother who said Dad was 'too frightened' to tell me that he'd signed up to a low-carb diet programme (I think it's naturalketosis.co.uk) so she was passing on the news instead. I spoke to Dad who was not frightened to tell me at all, but had wanted to wait until he had more to tell me when the first package arrived and he'd got started.

My concern is that to start low-carbing overnight might be too great a leap and may lead to difficulties and complications that Dad won't be able to manage but I don't want to curb his enthusiasm. When we'd been chatting earlier today I was very clear to him that I would be wary of suggesting he follow my path given that he's on insulin and I'm not, and suggested that since he was so enthusiastic, he might try making small changes such as having eggs for breakfast rather than cereal and monitoring the effects on just one meal. (His current diet is not good.) Instead he's gone the whole hog!

Am I right to be concerned? Advice would be appreciated :?
 

the_anticarb

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Hi

I can't say whether it'll be too much for your dad, but I've done the natural ketosis programme and it is really good. They send you all your meals but you can add low carb ingredients eg meat, veg etc to them so it's by no means a starvation type diet. They also have a good team of people who can be called for advice on doing the programme and a dietician. It's perfectly suitable for insulin users. When I did it myself I just dropped my mealtime insulin and reduced my background insulin gradually. I presume he knows how to adjust his insulin? The danger would be if he didn't reduce his insulin as then there'd be a hypo risk but this is pretty basic diabetes knowledge so most diabetics would be well aware of this, again not sure what your dad knows or doesn't know.

I think it's one of the best diets out there, is your father doing it for weight loss though or just to improve his diabetes? Could he talk to a dietician for advice on adjusting his meds if he doesn't know how to do this (warning: most NHS dieticians are anti low-carb and may not be receptive to this kind of programme. Doesn't mean the programme isn't right, but there is a lot of NHS 'party line' to get through when it comes to diabetics and low carb diets)
 

Saraband

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Hi anticarb, thanks for replying so promptly :D

It's good to hear that you rate the diet itself. I've looked at their website and can see it makes sense. Dad certainly has weight to lose but what's attracted him is the idea that it could stabilise his blood sugars. You've hit the nail on the head though: I'm not at all sure that he knows how to regulate his insulin and this is what worries me. Did you find the support from the company was helpful?
 

the_anticarb

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For specific diabetes advice - not that great. For general support/encouragement - yes. What kind of insulin is he on? If he's on long acting and short acting he will probably find that he needs to stop or severely reduce the short acting (as the meals will have practically no carbs in) and also reduce his long acting. If he's on mixed insulin it may be a bit more tricky. This is the bit where you need a bit of knowledge - or to have a HCP who is 'on side'. I'm worried that if your dad goes to his local practice diabetes nurse or hospital dietician they may poo-poo the diet as it is not following the nhs 'plenty of carbs' mantra. But if he does not know how to reduce his insulin then he may go too low. He could speak to the natural ketosis dietician and see if they can help, I'm not sure how good their diabetes knowledge is as I preferred to work that side of it out myself but they may be the best person to start with.

We're not supposed to give medical advice on here so I'll just tell you what I did when I followed this diet. I reduced my background to around 1/2 the usual dose and cut out the meal time insulin completely. I did the diet for 4 months and lost 2 stone. My hba1c was 6.6. Best of all no hypos, as I was not using rapid acting insulin. You can feel slightly lacking in energy the first couple of weeks but this is NOT because we need carbs for energy - it is because the body is changing fuel and learning to get its energy from non carb foods. After the first couple of weeks I had MORE energy than before and was doing running every day.

Sadly I put all the weight back on when I was pregnant but it did work for a while. If you can put up with being on a restricted diet indefinitely it is a good diet but I found it really hard to eat differently to everyone else on a permanent basis and so once you go back to carbs the weight can creep back on.

But its good as a short to medium term measure to lose weight for a while.

I wish him luck with it.
 

Saraband

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Anti_carb, thank you for this. I have agreed with Dad that he won't start the diet until I've visited, which I'm doing tomorrow. (They live over 100 miles away from me.) He has only one type of insulin which he takes 4 times a day I think, but he admits that he's not good at knowing how much to give himself. I hope I can persuade him to take things slowly though I suspect the diet will drop him right down on carb intake at least initially so perhaps I can suggest a few compromises and perhaps we can talk to the company advisors together.

I've found low-carbing really effective for myself and feel better since I started eating this way than I've felt for years, but my circumstances are very different from his. Hopefully if he takes things slowly it will be really beneficial for him. Hopefully!

Thanks again for your advice :)