Apples

[Anonymous]

That would imply that testing bg and hba1c checks are pointless.


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Apologies...have just got up... what implies that?

 

[Anonymous]

That would imply that testing bg and hba1c checks are pointless.


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Apologies...have just got up... what implies that?

I think that the only true answer is that it is down to an individual's viewpoint. We can all discuss, compare and argue viewpoints but, in the end, have to make the decisions for ourselves. I think that the OGTTs are useful for diagnosis and confirming 'reversal' and 'cure' and regular HbA1C tests are useful for those who have reversed or cured their diabetes, those who monitor their blood glucose regularly and those who don't.

As a T2, I have done individual, occasional testing for five years and regular testing recently in order to see the effects of other peoples' ideas and my own theories. I'm not sure why I did it now as I have gone full circle and ended up with exactly the same, individual diet that I have been on for the last 5 years, and I don't think there was a problem looking for an answer in the first place for me. I suppose I would not have come to this conclusion without recent, regular monitoring but if I hadn't bothered monitoring at all I would still be in the same position bG and HbA1C-wise. In fact, regular monitoring has thrown me into chaos both physically and mentally and I have felt less in control rather than more. I also have totally ignored night time which represents a 1/3 of every day so I can hardly claim to have anything close to the whole story. I don't regret having done the experiments but I am so glad it is all over now.

Others swear by regular monitoring and achieve the same or better results than I do, assuming that 'better' means just lower bGs, HbA1C and excess weight loss.

I can't speak for others, but there seem to be some who are on a mission to continually lower their bGs and HbA1C readings as the end rather than the means. Others set their own personal target bG limits so that a high bG reading or spike to one person is normal to someone else. Some people try to avoid spikes. There is no absolute definition of what constitutes a low-carb diet. No one is able to point to long-term, conclusive evidence of the long-term benefit or otherwise of any particular approach.

It's like 'design by committee'!

 

[msmudge]

That would imply that testing bg and hba1c checks are pointless.


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No not at all. What it means is that if you've had a high reading as a result of fruit, then the sugars won't be causing as much or any damage.


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[janeecee]

I don't get that. The blood sugar measurements, lab or glucometer, measure the concentration of glucose in the blood, don't they? It's the high glucose levels that do the damage as well as high insulin levels which would be the case when glucose metabolism is impaired. There are also lots of other biochemical reactions going on that are not desirable when glucose and insulin levels are above the norm. Besides, people don't eat pure fructose. Fruit also contains other sugars besides fructose, which will ultimately end up in the bloodstream as glucose. If eating some fruit in moderation doesn't spike you too high or for too long then you can get the nutritional and dietary benefits—vitamin c, fibre, antioxidants, etc. If it spikes you too high, or you stay too high for hours afterwards, that's not good.


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[phoenix]

Much of this is the same as Janecee's reply above but it was in preparation so I'll post anyway.

What it means is that if you've had a high reading as a result of fruit, then the sugars won't be causing as much or any damage

1)Fructose is thought to be metabolised differently to other sugars and is theoretically less likely to raise glucose levels.
2) fruits contain varying proportions of fructose ,glucose , sucrose ie not all the sugar in a fruit is glucose. (apples are relatively high in fructose but amounts do depend on variety)
3) there is a lot of evidence to show high fruit consumption is associated with good outcomes ie lower hypertension etc . The sugars in many fruits are found together with a lot of fibre. Apples for example have a lot of pectin , a soluble fibre.

4) There are debates about the problems that may be caused by large amounts of fructose ( usually refined fructose as contained in artificially sweetened foods/drinks rather than fruit) .
I wouldn't normally link to the Huffington Post but this is quite a balanced account and does link to a variety of sources.
http://www.huffingtonpost.com/2012/06/2 ... 18908.html

5) However, If your blood glucose is raised it is high in glucose not fructose. I don't think it makes any difference whether the original source is from eating a handful of glucose tablets, converted from starch, from lactos or fructose or even glucose converted from protein. It will have the same effect....(though am not going into that as it is a whole different issue)

 

[Anonymous]

Much of this is the same as Janecee's reply above but it was in preparation so I'll post anyway.

What it means is that if you've had a high reading as a result of fruit, then the sugars won't be causing as much or any damage

1)Fructose is thought to be metabolised differently to other sugars and is theoretically less likely to raise glucose levels.
2) fruits contain varying proportions of fructose ,glucose , sucrose ie not all the sugar in a fruit is glucose. (apples are relatively high in fructose but amounts do depend on variety)
3) there is a lot of evidence to show high fruit consumption is associated with good outcomes ie lower hypertension etc . The sugars in many fruits are found together with a lot of fibre. Apples for example have a lot of pectin , a soluble fibre.

4) There are debates about the problems that may be caused by large amounts of fructose ( usually refined fructose as contained in artificially sweetened foods/drinks rather than fruit) .
I wouldn't normally link to the Huffington Post but this is quite a balanced account and does link to a variety of sources.
http://www.huffingtonpost.com/2012/06/2 ... 18908.html

5) However, If your blood glucose is raised it is high in glucose not fructose. I don't think it makes any difference whether the original source is from eating a handful of glucose tablets, converted from starch, from lactos or fructose or even glucose converted from protein. It will have the same effect....(though am not going into that as it is a whole different issue)

Interesting stuff. The study I linked to, if you haven't read it, is basically saying that there are multiple 'pathways' that the body uses to trigger insulin secretion, glucose being the main one. Fructose, In the right proportions and only in combination with glucose, can enhance insulin secretion. I suppose that a normal, balanced diet which includes fruit would probably provide that.

My self-test the other day showed a much smaller increase in BG than unrefined or refined sugar. Whether that was due to fructose alone or along with other sugars from the meal I ate an hour later or not, I wouldn't know.

 

[Yorksman]

Also wonder how non-diabetics react. I've read that you should never go above about 5.0 but also that you can spike by 2-3 but come back down quickly, within an hour.

Below are glucose response figures for a group of nondiabetics eating red apples and also glucose for comparison:

Red apple: 4.6; 6.8; 6.4; 4.8; 4.7; 4.5 for start, 15 min, 30 min, 60 min, 90 min and 120 min

Glucose: 4.4; 6.9; 8.9; 8.0; 6.1; 5.6 for start, 15 min, 30 min, 60 min, 90 min and 120 min

 

[Anonymous]

Also wonder how non-diabetics react. I've read that you should never go above about 5.0 but also that you can spike by 2-3 but come back down quickly, within an hour.

Below are glucose response figures for a group of nondiabetics eating red apples and also glucose for comparison:

Red apple: 4.6; 6.8; 6.4; 4.8; 4.7; 4.5 for start, 15 min, 30 min, 60 min, 90 min and 120 min

Glucose: 4.4; 6.9; 8.9; 8.0; 6.1; 5.6 for start, 15 min, 30 min, 60 min, 90 min and 120 min

Well ... that makes me feel better. If the apple has, say 14g sugar, and the glucose was also 14g then my OGTT of 14.7 looks far better than I thought. The OGTT uses 75g glucose, about 5 times that.

 

[charon]

Hba1c measures the average bg level and self testing does a spot check.
If fruit causes the bg to rise without concern then what is the point of those two tests that both assume high bg is a bad thing.


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[Yorksman]

Hba1c measures the average bg level and self testing does a spot check.
If fruit causes the bg to rise without concern then what is the point of those two tests that both assume high bg is a bad thing.

Typically home meters measure glucose levels in the blood plasma. HBA1c measures the amount of glucose bound to the haemoglobin. They are quite different things. Glucose does not bind easily to haemoglobin so elevated HBA1c levels are an indication that glucose levels in the plasma have been consistently high, which is certainly a bad thing. Plasma levels are up and down all the time but mostly for a short duration only.

 

[charon]

Gezzathorpe
I've tried bananas and it consistently sends my BG from around 5.0 to around 7.0. Takes a couple of hours to come down. Probably not a big issue but not something I would like to do every day. Maybe half a banana would be OK. Seems to affect me a lot more than you - maybe because I'm eating less at the moment. I'm probably starting work again soon which will affect my diet so might try again later.

Yorksman
Home meters and HbA1c measure different things but they are connected. You can think of the meter giving a spot check and HbA1c and average. The HbA1c isn't really an average as more of the older glycated haemoglobin will have disappeared when the test is taken so should be biased towards more recent conditions.
They are both affected by BG levels though and you would expect consistently high meter readings to appear as a high HbA1c unless there is some systematic bias as to when the tests are taken.
If it's possible to raise the BG without this impacting either of these and that raised BG also causes complications then it circumvents both of the tests.

 

[Anonymous]

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Yes shows how individual we all are. Sounds like you've found how much banana you can take!

 

[Yorksman]

Home meters and HbA1c measure different things but they are connected. You can think of the meter giving a spot check and HbA1c and average. The HbA1c isn't really an average as more of the older glycated haemoglobin will have disappeared when the test is taken so should be biased towards more recent conditions.
They are both affected by BG levels though and you would expect consistently high meter readings to appear as a high HbA1c unless there is some systematic bias as to when the tests are taken.

I think I said as much when I wrote "Glucose does not bind easily to haemoglobin so elevated HBA1c levels are an indication that glucose levels in the plasma have been consistently high." Mrs Yorks is a Biomedical Scientist and has been working n Blood Sciences for 35 years. I have picked some of this up you know.

 

[mpe]

I read one of the earlier Newcastle studies that a protein snack 2 hours before breakfast reduced pst prandial BGs. It was 75g yogurt and 30g soya beans. Hardly appetising, is it?

Did what were BGs like after the "snack"? What happened when people got up two hours before "breakfast"? (Shouldn't the "snack" actually have been called "breakfast", with the later meal called something like "mid-morning meal"?)

 

[mpe]

I'm not sure how true it is, but I have been led to believe that fruit sugars do not cause any tissue damage for diabetics. So we are able to eat fruit without cause for concern, even if it does cause of Blood sugars to rise.

"Fruit sugars" are a mixture of glucose, fructose and sucrose. In addition fruits contain galactan and typically contain seeds high in starch. (processing fruit, including cooking, can make seeds easily to digest.)

The level of blood glucose matters regardless of if it comes from food, glycogen hydrolysis or GNG.

 

[janeecee]

mpe, you'll need to google the study and read it for yourself for the answers. The study is referenced in the ND papers.

From what I remember, the BG levels rose as a result of the snack. The snack was at 8am, the breakfast at 10am. The conclusion was that the snack—in the terminology of the study—reduced breakfast BG levels.

No point challenging me about it, take it up with the authors of the study. They wrote it, not me.


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[charon]

Wouldn't rule out them all being wrong. It's happened a number of times in the health industry.

Don't think there is an issue with spikes as long as the level comes down reasonably quickly and doesn't rise again - which is a lot to do with diet.

There is a issue with the definition of diabetes - it's used as a synonym for high bg but I think you can be type 2 with consistently low bg. It's about how high bg goes and how quickly it comes down with different intake.

Also my nurse said progression to insulin and complications are inevitable. I'm hoping that's wrong too.


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[janeecee]

I wouldn't say researchers get it "wrong" as mostly they are seeking to answer questions through experimentation and inquiry. All they can say is "this seems to happen" but mostly they discover more possible lines of enquiry rather than absolute and definitive answers. I have more faith in academic studies than I do in popular science and fad diets, but it's also difficult to work out what has a solid basis and what is just half-baked pseudoscience and people flogging books about their own brand of dietary fads. But no-one has "the answer". The problem I'm having is finding a way of eating that works for me and improves my BG levels, and as I never had a bad diet in the first place, and as I've no weight to spare, I'm stuck between a rock and a hard place. If I cut carbs, I cut calories and I risk being clinically underweight. If I eat high fat I risk lipotoxicity which contributes to beta cell loss—and yes, there is some research on that which you may choose to believe, or not. If I exercise I can precipitate a relapse in my ME/CFS symptoms. There really isn't much point on me bring on these forums, TBH.


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[Anonymous]

I wouldn't say researchers get it "wrong" as mostly they are seeking to answer questions through experimentation and inquiry. All they can say is "this seems to happen" but mostly they discover more possible lines of enquiry rather than absolute and definitive answers. I have more faith in academic studies than I do in popular science and fad diets, but it's also difficult to work out what has a solid basis and what is just half-baked pseudoscience and people flogging books about their own brand of dietary fads. But no-one has "the answer". The problem I'm having is finding a way of eating that works for me and improves my BG levels, and as I never had a bad diet in the first place, and as I've no weight to spare, I'm stuck between a rock and a hard place. If I cut carbs, I cut calories and I risk being clinically underweight. If I eat high fat I risk lipotoxicity which contributes to beta cell loss—and yes, there is some research on that which you may choose to believe, or not. If I exercise I can precipitate a relapse in my ME/CFS symptoms. There really isn't much point on me bring on these forums, TBH.


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Today, I had a white bread sandwich (2 slices) with smoked salmon and salad filling and my bGs were 5.0, 9.2 and 4.2 ( at +0, +1 and +2). This peak is consistent with my last OGTT test which was 14.7 at +1:00 after 75g glucose which is about double the carbs of the sandwich. My HbA1C is 38, down from 58 five years ago and my GP, DN and the path lab. all say I am diabetes resolved. In fact, there have been experienced diabetics who are adamant that I never was diabetic in the first place. So both professionals and experienced diabetics are agreeing that my figures are fine for a non-diabetic. Who could argue with that wealth of experience. Therefore, I can only conclude that the above bG pattern is normal for me. So, I ask myself, why be scared of spiking? Isn't spiking perfectly natural? Isn't a spike as a result of glucose secretion into the blood which then triggers insulin secretion (hopefully)?

If I assume that I have been diabetic only since diagnosis (5 years) as I can't go back any further than that, then, if my spiking is bad, would you expect me, by now, to be experiencing complications of one sort or the other and having a higher HbA1C?

Either my GP, DN, path lab and experienced diabetics are all right or they're all wrong since they all agree with each other.

 

[janeecee]

You can only go by the numbers on the meter.

Yes, I get fed up with it all because different people have different risk factors and are at different stages along the continuum when they discover they have a problem. Some people can reverse it if they lose enough weight if that was the cause of the problem and they take action early enough. That doesn't mean they didn't have a problem in the first place.

For me, it isn't a factor and even my modest loss of a few pounds has failed to make any impact. I explained elsewhere my BMI throughout my adult life was consistently around 20, and I wouldn't have maintained that weight on that on a diet of pies and burgers and doughnuts, so there weren't any dietary changes I could make. I've had to drastically cut back on healthy foods like fruit and whole grains because I had nothing else to cut out. I can prevent my BG levels spiking too high after meals but to achieve that I end up on 900-1000 kcal per day, and that's not good. Overall, my fasting is still in the same range as it was 3 months ago but my preprandial levels have increased and my BGs don't fall much between meals. I can't do much more to influence it, so I've come to the conclusion that I've lost beta cells and that I've progressed too far to reverse it.

The fatty liver/fatty pancreas theory of the ND, I can't see it being applicable in my case. No sign of my beta cells "waking up" after being de-fatted. I would like to think otherwise but there's no evidence of it. I think I'd be seeing changes already.

If you can return quickly to low-ish BGs after meals then I don't think the spikes will cause much damage. However, if you remain hyperglycaemic, even at a relatively low level, you can still harm your beta cells as they aren't given the chance to recover between meals. It's a downer for me to know that. I had hoped that something in the ND theory could work for me but I can't see it.


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