Article in today's Times

[borofergie]

Lol slight problem I hate pasta,rice and bread doesn't agree with me. non to keen on cake either.

Sounds to me like you aren't eating enough healthy wholegrains. Unless you are very careful you're going to end up catching the diabetes, or something.

 

[CarbsRok]

Lol slight problem I hate pasta,rice and bread doesn't agree with me. non to keen on cake either.

Sounds to me like you aren't eating enough healthy wholegrains. Unless you are very careful you're going to end up catching the diabetes, or something.

Oh sh!K is it contagious? I'm getting worried now. Oh hang on a min just realised I've had the condition for nearly 50 years but hadn't taken that much notice is it serious? :shock: :lol:

 

[chris lowe]

When I was at school in a galaxy far far away (a long long time ago) I had what was then called domestic science lessons which covered a whole host of matters - I still can't iron a shirt and leave a crease in the sleeve - including cooking. I was also lucky that I had a mum who liked cooking (despite the fact dad was a meat and two veg, none of that foreign muck kind of man) so she also taught me to cook, which I passed on to my son so I guess a lot depends not only on what is taught at school and what sort of parents you have. I'm sure there are some parents whose idea of a cooking lesson is how long to put the KFC in the microwave to re heat it.

We now have so many reports, studies etc that say low carbing is good for diabetics, so there must be a reason why so called experts in the UK insist on burying their heads in the sand. :thumbdown:

 

[Etty]

Re: uote

The American Diabetes Association changed its advice on low-carb diets in 2008. It now considers them to be an effective treatment for short-term weight loss among obese people suffering from type 2 diabetes.

The DUK position is exactly the same as the ADA as far as I can see.

 

[xyzzy]

All about "the wicked pie man" and why he made them tasty. Don't fall for the "its your own fault" viewpoint.

Written by Kelly D Brownell - from his Wiki entry

Kelly D. Brownell is an American scientist, professor, and internationally renowned expert on obesity. Brownell is Director of the Rudd Center for Food Policy and Obesity at Yale, where he is also Professor of Psychology and Professor of Epidemiology and Public Health. His research deals primarily with obesity and the intersection of behavior, environment, and health with public policy. He was named in 2006 as one of "The World's 100 Most Influential People" by Time magazine.

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001254

It is an important time to reflect on the ways that the public and global health communities can engage with the food industry. There are divergent views [1]. Many political bodies, foundations, and scientists believe that working collaboratively with the food industry is the path for change. The assumption is that this industry is somehow different than others, and that because people must eat, the industry is here to stay, and like it or not, working with them is the only solution.

Based on my 30 years of experience in the public health and policy sectors, I believe this position is a trap. When the history of the world's attempt to address obesity is written, the greatest failure may be collaboration with and appeasement of the food industry. I expect history will look back with dismay on the celebration of baby steps industry takes (such as public–private partnerships with health organizations, “healthy eating” campaigns, and corporate social responsibility initiatives) while it fights viciously against meaningful change (such as limits on marketing, taxes on products such as sugared beverages, and regulation of nutritional labeling).

The obesity problem has industry's attention, and they are doing things. The question is whether these things are meaningful or are the predictable behavior of an industry under threat and are designed to stop rather than support public health efforts. The soft drink industry gave the Children's Hospital of Philadelphia a US$10 million gift—at a critical time the city of Philadelphia was considering a soda tax. Such public-sector interaction with industry could be predicted to undermine public health goals and protect industry interests [2]–[6].

The food industry has had plenty of time to prove itself trustworthy. It has been in high gear, making promises to behave better, but their minor progress creates an impression of change while larger attempts to subvert the agenda carry on. Witness the massive resistance against soda taxes in the United States [7] and the wholesale attack of marketing standards proposed by the Interagency Working Group (e.g., [8]). Worst perhaps is the issue of marketing food to children. The industry launched the Children's Food and Beverage Advertising Initiative designed to “…shift the mix of foods advertised to children under 12 to encourage healthier dietary choices and healthy lifestyles” [9]. Objective reports, however, have shown a tidal wave of marketing of calorie-dense, nutrient-poor foods to children, and if any change is occurring, marketing is on the increase [10]–[13].

Companies boast of introducing healthier options, and at least one report cites this as evidence that market forces (e.g., consumer demand for better foods) will be the best motivator for companies to change [14]. But introducing healthier processed foods does not mean unhealthy foods will be supplanted, and might simply represent the addition of more calories to the food supply. Furthermore, the companies have not promised to sell less junk food. Quite the contrary; they now offer ever larger burgers and portions, introduce ever more categories of sugared beverages (sports drinks, energy drinks, and vitamin waters), find ever more creative ways of marketing foods to vulnerable populations (e.g., children), and increasingly engage in promotion of unhealthy foods in developing countries [1],[15],[16].

The food industry, like all industries, plays by certain rules—it must defend its core practices against all threats, produce short-term earnings, and in do doing, sell more food [2],[17]. If it distorts science, creates front groups to do its bidding, compromises scientists, professional organizations, and community groups with contributions, blocks needed public health policies in the service of their goals, or engages in other tactics in “the corporate playbook” [3],[18], this is what is takes to protect business as usual.

The parallel scenario most often used to justify collaboration with industry is tobacco. Often heard is that “people don't have to smoke, but they must eat” and that “the tobacco industry was simple—just a few companies and one product—but food is much more complex” [3]. Tobacco is an interesting parallel [3],[19], but is by no means the only one. A world economic crisis was fueled in part by too little oversight of financial institutions, but we all need banks. Requiring air bags in cars was stalled for years by the auto industry, but we need cars.

An emerging area in need of scrutiny is the food industry's attempts to create foods engineered in ways that thwart the human body's ability to regulate calorie intake and weight. Whether overconsumption is a consequence simply of hyperpalatability brought about by extreme processing [15] and/or an addictive process [20],[21], overconsumption is a predictable consequence of the current food environment. The arresting reality is that companies must sell less food if the population is to lose weight, and this pits the fundamental purpose of the food industry against public health goals.

We need food, but the obesity crisis is made worse by the way industry formulates and markets its products. The food industry, like other industries must be regulated to prevent excesses and to protect the public good. Left to regulate itself, industry has the opportunity, if not the mandate from shareholders, to sell more products irrespective of their impact on consumers. Government, foundations, and other powerful institutions should be working for regulation, not collaboration.

If history is to look back positively on current times, the future must bring several things. Respectful dialogue with industry is desirable, and to the extent industry will make voluntary changes that inch us forward, the public good will be served. But there must be recognition that this will bring small victories only and that to take the obesity problem seriously will require courage, leaders who will not back down in the face of harsh industry tactics, and regulation with purpose.

 

[xyzzy]

Re: uote

The American Diabetes Association changed its advice on low-carb diets in 2008. It now considers them to be an effective treatment for short-term weight loss among obese people suffering from type 2 diabetes.

The DUK position is exactly the same as the ADA as far as I can see.

I don't agree I'm afraid where does DUK say in their position statement that you should restrict to 130g / day (25%) like the ADA do?

http://www.diabetes.org.uk/Documents/Reports/Nutritional_guidelines200911.pdf

The ADA has a similar view of all diets (that they are good for short term weight loss) so the quote that the advice is just for low carb diets is not correct. The actual statement in their 2012 statement is given below. Note the statement relates to weight loss and that is entirely different to glycemic control. They are two different things.

For weight loss, either low-carbohydrate, low-fat calorie-restricted, or Mediterranean diets may be effective in the short term (up to 2 years).

 

[Etty]

[
Although I agree a move to 130g / day isn't enough for quite a few of us it is however a move to half what is still recommended in the UK and is therefore progress in my mind. The 130g / day RDA recommendation seems to have no time limit proviso as far as I can see and neither does the "Making Healthy Food Choices" pages of their web site which is essentially stating the same thing in my opinion.

130g is the minimum, not really their RDA. If you look at their book "What Do I Eat Now" , step-by-step guidance for T2's, the Introduction says of their example meals in each chapter, that you have a choice of 2 meals. The first meal is 45-60g cho per meal, the second is 60-75g per meal, plus snacks. That would give a range of 135g + snacks, to 225g + snacks per day. Then they say to choose the option that best suits your individual needs!

 

[xyzzy]

[
Although I agree a move to 130g / day isn't enough for quite a few of us it is however a move to half what is still recommended in the UK and is therefore progress in my mind. The 130g / day RDA recommendation seems to have no time limit proviso as far as I can see and neither does the "Making Healthy Food Choices" pages of their web site which is essentially stating the same thing in my opinion.

130g is the minimum, not really their RDA. If you look at their book "What Do I Eat Now" , step-by-step guidance for T2's, the Introduction says of their example meals in each chapter, that you have a choice of 2 meals. The first meal is 45-60g cho per meal, the second is 60-75g per meal, plus snacks. That would give a range of 135g + snacks, to 225g + snacks per day. Then they say to choose the option that best suits your individual needs!

http://care.diabetesjournals.org/content/35/Supplement_1/S11.full.pdf

It should be noted that the RDA for digestible carbohydrate is 130 g/day and is based on providing adequate glucose as the required fuel for the central nervous system without reliance on glucose production from ingested protein or fat.

Well their official statement does not say minimum (my underline). I don't however see that as the major factor in all of this. To me it's the fact they acknowledge you can do 130g quite safely or an effective 25% diet i.e they validate low carb as safe and acceptable. DUK's position that "you can do low carb for a year" as a diet is no where near as strong a statement in my opinion. At what g / day or % are DUK recommending? It's one thing stating "low carb for a year" but another to tell people in the UK an actual dietary value. Obviously an extreme example but without that clarity then 49% could be claimed as low carb in the UK.

 

[jopar]

When I was at school in a galaxy far far away (a long long time ago) I had what was then called domestic science lessons which covered a whole host of matters - I still can't iron a shirt and leave a crease in the sleeve - including cooking. I was also lucky that I had a mum who liked cooking (despite the fact dad was a meat and two veg, none of that foreign muck kind of man) so she also taught me to cook, which I passed on to my son so I guess a lot depends not only on what is taught at school and what sort of parents you have. I'm sure there are some parents whose idea of a cooking lesson is how long to put the KFC in the microwave to re heat it.

We now have so many reports, studies etc that say low carbing is good for diabetics, so there must be a reason why so called experts in the UK insist on burying their heads in the sand. :thumbdown:

By 11 years old, I was roasting Sunday lunch for 7 of us, taught to cook by my mum who was quite an accomplished cook, then I trained to become a chef when I left school... And the same values I was brought up with, where sweat foods and drinks were treats and special occasions items etc, I've brought my children up with!

Looking at my 3 children you would hardly believe that they were brought up with these values, my son eats very little junk foods, where as my 2 daughters choices are nothing but disgusting really... But they are now adults the foods they eat are their choices!

 

[Etty]

Well their official statement does not say minimum (my underline). I don't however see that as the major factor in all of this. To me it's the fact they acknowledge you can do 130g quite safely or an effective 25% diet i.e they validate low carb as safe and acceptable. DUK's position that "you can do low carb for a year" as a diet is no where near as strong a statement in my opinion. At what g / day or % are DUK recommending? It's one thing stating "low carb for a year" but another to tell people in the UK an actual dietary value. Obviously an extreme example but without that clarity then 49% could be claimed as low carb in the UK.

It's confusing isn't it? I think they are both being vague. The ADA 130g RDA seems extraordinary to me, and if they mean it, why isn't it in the executive summary, why are they not producing menus and recipes with carbs in line with the RDA, and why are we not hearing more about it from other sources? I can see where the 130g comes from, but I don't see why they are calling it RDA.

 

[hanadr]

I read the article, having bought hte Times today.
In general, I was pleased with it.
Wouldn't it have been nice if the writer had asked for info from those of us who have been low carbing for a number of years?
Hana

 

[xyzzy]

It's confusing isn't it? I think they are both being vague. The ADA 130g RDA seems extraordinary to me ...

I agree with you Etty. It's just I think that DUK is more vague than the ADA! As I've already said that 130g number is important as for me it gives "official" backing to low carb down to that point regardless of if you do end up eating more. Obviously many including me who do "Eat to your meter" may well find they have to do less or can do more than 130g in any event.

I think the vagueness may in some regards be on purpose as a carbohydrate regime at that 130g or 25% level would naturally imply lchf and that is a message the ADA still resists as it still tells you to choose low fat options. I hope this will be as a pretty transitory state of affairs and is, in my opinion, where politics and the food and drinks industry are still exerting undue influence. It is why I personally find the Swedish message much more honest and I have no doubt that once the marketeers work out a way of making profit from lchf it will be all change.

If you analyse say the Annika Dahlqvist Swedish lchf diet against the ADA recommendations that is the noticeable difference. Both recommend a reduction in starchy carbs and emphasise replacing with veg and low GI on what remains of the starch but the ADA then effectively say "do low fat" whereas the Swedes say "do safe fat". I think the Swedes are more honest because of the inherent criticism that low carb, low fat, low protein diets don't actually exist as they do not provide enough calories long term but I know others disagree.

 

[RoyG]

I urge everyone to write to their MP's quoting there own experience, without too much detail and copy and paste this thread as a link on the email.

My MP has already been made aware of this website and has promised to investigate further the ppor advice being given out.

It's all looking very promising indeed.

Mary x

PS many thanks libralising and desidiabulum for posting it.

I just did, Thanks.

Grazer I hope you don't mind I used your explanation as I thought it explained things rather nicely :thumbup:
Dear Ms Cooper,

As I am sure you are aware of the growing number of people in the UK who are now getting Type 2 Diabetes. I would like to voice my concerns regarding the level of care and information that is being given by the NHS.
May I first point out that I myself was diagnosed with Type 2 Diabetes back in May of this year, At my diagnosis I was given a booklet describing what foods I should be eating and should not be eating, and sent packing being told that I have dietician appoint in 3 months and an podiatrist appointment would follow in the post. That was it basically no support from my Doctor and little from the Nurse, (apart from when I rang the Nurse to ask could I have a BG meter ( Answer NO) and to tell her I was going on a low Carbohydrate diet (Shock Horror you don't need or want to do that) But as you can Imagine my shock and horror at being told this life changing diagnosis. I now have what is primarily a life threatening illness, that at best has terrible debilitating complications and at it's worst gives you 50% more risk of stroke/coronary failure or death.

My own mother in law has late onset type 1 diabetes, and has now gone blind in one eye and is having laser treatment on the other eye, so I was fully aware what my outcome may well be, not good.

I generally like to find out about a condition I have been diagnosed with, using various methods and my own research. So I started trawling through the internet and got books from the library, however I came across a web site called Diabetes.co.uk, within that web site I found masses of useful information and helfull friendly people. But amongst it all I got the impression that the diet given out by the NHS was pitifully lacking in sound advice. Indeed if followed, would make my condition very much worse. What did seem to stand out by miles was a diet completely the opposite to that issued by the NHS and backed by a multitude of studies and Specialist’s worldwide, that of a low carbohydrate diet. Let me try and explain it in layman’s terms what is basically needed,

The lack of understanding amongst health care professionals of the need for reduced carbs for a diet only/metformin controlled type 2 - indeed, a lack of understanding amongst many in the whole health and diabetic community.

That is, a T1 looks at the amount of carbs they are going to eat and injects an amount of insulin accordingly.
A T2 (diet) looks at the amount of effective insulin available (fixed) and takes an amount of carbs accordingly.

Put another way, a T1 varies the insulin to match the carbs.
A T2 varies the carbs to match the insulin.

Same equation, same problem, I can't vary my insulin. I find out my "effective insulin available" by testing using my Blood Glucose meter. Then test now and again to make sure that amount isn't changing or if I try a new food.

Simple explanation, To describe our need to lower carbs AND to test which is being denied me by my NHS?

NHS and dieticians, are advising diabetics to ingest 50% of their diet from Carbohydrates which is basically "Sugar" the one thing that has the potential to cause a diabetic great harm. Another cause for concern is the attitude not to allow type 2 diabetics to test their blood, as explained above, even though the NICE guidelines say if a patient is showing evidence of good self-management and asks for them they should be given. The reason I got for not letting me have one was very patronising and assumed I was stupid, being, it will make me paranoid? and cause my fingers to become sore? this according to my Nurse, Yet when I pressed my Doctor on a totally different matter and believe me it took some pressing the overlying reason is down to cost.

This saddens me, that the NHS is so short sighted, in saving a penny now it could cost the NHS far more in the future due to improper blood glucose control and complications, Education is also something sadly lacking in most PCT's and GP surgery's.

For me testing has been an invaluable tool and a necessity, I bought my own meter and strips @ £27 per pot of 50 strips, I use on average 100 a month,I also started my low carb diet. and found out what foods can be eaten safely without spiking my Blood sugar. Started an exercise regime at Nye Bevin Gym and amazingly, have now lost over 27lbs, I have also lowered my Blood pressure in the process to normal, Due to the testing I have managed my Blood sugar at an average of 5.5mmol/L which is not far off normal. I feel better than I have in over 3 years, and all with no help or encouragement from the NHS a very sad testament, and to me concrete proof they are very wrong in the advice that they are administering to patients, more over it's out of date and various other country's have changed their dietary advice completly, USA, Sweden and other parts of Europe.But you don't have to take my word on this.

I would like to post some links to various web sites. scientific studies and my forum, which I hope you may find time to read some of them at least, to enable you a better understanding of what I am trying to say.
I used some of the links found on this site. Posted by us all.

 

[hanadr]

There is no RDA for carbs[look on food labels]
Reason;
no=one has ever been able to determine one, or even to show we need any at all.
Hana
PS
they pretend to have one deduced by guesswork they "estimated" how much carb the brain needs per day and added a bit for error.

 

[Sid Bonkers]

It's confusing isn't it? I think they are both being vague. The ADA 130g RDA seems extraordinary to me, and if they mean it, why isn't it in the executive summary, why are they not producing menus and recipes with carbs in line with the RDA, and why are we not hearing more about it from other sources? I can see where the 130g comes from, but I don't see why they are calling it RDA.

I think the reason they are both vague and the reason no one is producing menus is that you can never have a RDA that is going to be right for everyone, someone like borofergie, a big guy who runs a lot is always going to need more energy than a 60 year old bloke who does very little exercise like myself. We will never have the same dietary needs so how would it be possible to offer menus and allowances, menus and allowances for who? They can only ever be vague with a recommendation that they should be tailored to individual needs.

As for why we are not hearing about other opinions from other sources, would you really expect the NHS, DUK or NICE to recommend anything that can be found on the web, the amount of misinformation on the web is astounding, not to mention the amount of profit orientated internet entrepreneurs offering to sell all manor of diet information and products most of which are just total rubbish if not down right dangerous.

As I have said many times recommended anything is hogwash as nothing can be recommended for everyone even HbA1c's as there may be other medical conditions to take into account. We are all different - we are all different - we are all different.

 

[jopar]

That is, a T1 looks at the amount of carbs they are going to eat and injects an amount of insulin accordingly.
A T2 (diet) looks at the amount of effective insulin available (fixed) and takes an amount of carbs accordingly.

Sorry but this is wrong..

Firstly, For T1's to work out your correct dose of insulin is a lot more complicated than just inject for carbs you eat!

It goes something like this,

Firstly you test to see what your BG is..
Then you work if and how much active insulin you've got on board, from previous bolus or correction injection
Then you workout any adjustment factors, which are
Exercise already done
Exercise you'll going to be doing
Stress (are you or are you going into a stressful situation etc)
Then ambient temperature

Once you've worked out this and what adjustments you need to make, you then

Count your carbs, to get insulin figure then decreased/increase the dose by your workings out above...

Secondly I would point out, that for T2's insulin isn't 'Fixed' it fluctuates, and it's generally insulin resistance and/or the body's ability to utilize the insulin produced effectively... For some it will be the response time/lag of producing the insulin causing problems..

 

[MaryJ]

That is, a T1 looks at the amount of carbs they are going to eat and injects an amount of insulin accordingly.
A T2 (diet) looks at the amount of effective insulin available (fixed) and takes an amount of carbs accordingly.

Sorry but this is wrong..

Firstly, For T1's to work out your correct dose of insulin is a lot more complicated than just inject for carbs you eat!

It goes something like this,

Firstly you test to see what your BG is..
Then you work if and how much active insulin you've got on board, from previous bolus or correction injection
Then you workout any adjustment factors, which are
Exercise already done
Exercise you'll going to be doing
Stress (are you or are you going into a stressful situation etc)
Then ambient temperature

Once you've worked out this and what adjustments you need to make, you then

Count your carbs, to get insulin figure then decreased/increase the dose by your workings out above...

Secondly I would point out, that for T2's insulin isn't 'Fixed' it fluctuates, and it's generally insulin resistance and/or the body's ability to utilize the insulin produced effectively... For some it will be the response time/lag of producing the insulin causing problems..

To be fair Roy has quoted a letter he's sent to his mp, he has given a basic explanantion.

His point of the letter is to get his MP to understand the mis-information being given by the NHS etc. (as is this thread really) I dont think he could (or should) have gone into such detail succintly.

Cheers

Mary x

 

[RoyG]

That is, a T1 looks at the amount of carbs they are going to eat and injects an amount of insulin accordingly.
A T2 (diet) looks at the amount of effective insulin available (fixed) and takes an amount of carbs accordingly.

Sorry but this is wrong..

Firstly, For T1's to work out your correct dose of insulin is a lot more complicated than just inject for carbs you eat!

It goes something like this,

Firstly you test to see what your BG is..
Then you work if and how much active insulin you've got on board, from previous bolus or correction injection
Then you workout any adjustment factors, which are
Exercise already done
Exercise you'll going to be doing
Stress (are you or are you going into a stressful situation etc)
Then ambient temperature

Once you've worked out this and what adjustments you need to make, you then

Count your carbs, to get insulin figure then decreased/increase the dose by your workings out above...

Secondly I would point out, that for T2's insulin isn't 'Fixed' it fluctuates, and it's generally insulin resistance and/or the body's ability to utilize the insulin produced effectively... For some it will be the response time/lag of producing the insulin causing problems..

Jopar,
Firstly I thought it apt as a simple level of explanation to an MP, I really did not want to get into the finer scientific points of how a Type 1 diabetic works out their dosage, or Type 2 checks how many carbs are in what foods, and I thought Grazer explained it simply and quit well. If she wants to examine the details ! which I am sure she wont, unless she happens to be diabetic her self, I furnished enough links in the email to check those facts out. Secondly my point was not to explain in any great detail the where and why fores, but more aimed at the level of service most of us receive from our NHS, GP's and DSN's along with Poor diet advice and the fact they will not give the vast majority of us (type 2's) meters and strips, so I tried to explain the importance of those points. Poetic Licence comes to mind, and your missing the point of the email entirely to my MP not the forum.

 

[phoenix]

On diagnosis I was told exacty how many carbs (and everything else) when to eat, and just a tiny amount about adjusting my insulin (according to yesterdays results!) It was pretty inflexible. The regime meant that I became so uncomfortable at a grandchilds Christening party that I left it and walked the streets in tears.As a result, that Christmas I refused to go anywhere and stayed by myself at home. Thank goodness for the Americans on US forums and the books written by US diabetes educators that taught me the principles of dose adjustment to carb intake.
Fortunately the hospital has moved with the times and have changed that approach now and they offer a French version of dose adjusment. Not for all though, they are elitist and feel it can only work for those who are both motivated and have a certain level of education. I meet a lady every now and then who was diagnosed about a year before me. She rigidly maintains her original regime but hates it and hates her diabetes. She has an OK HbA1c but is very unhappy. It must be even worse for children and teenagers condemned to this inflexibility

Healthy eating is a different matter. From everything I read I understand that this is not part of the DAFNE curriculum. The US guidelines highlight DAFNE as a good example.


the ADA guidelines for 2012 refer back to the 2008 fuller guidelines for T1 . In this document they say
http://care.diabetesjournals.org/conten ... f_ipsecsha

I ndividuals using rapid-acting insulin by injection or an insulin pump should adjust the meal and snack insulin doses based on the carbohydrate content of the meals and snacks. (A)

(A is the top grade of evidence)

The first nutrition priority for individuals requiring insulin therapy is to integrate an insulin regimen into their lifestyle. With the many insulin options now available, an appropriate insulin regimen can usually be developed to conform to an individual’s preferred meal routine, food choices, and physical activity pattern. For individuals receiving basal-bolus insulin therapy, the total carbohydrate content of meals and snacks is the major determinant of bolus insulin doses (84). Insulin-to-carbohydrate ratios can be used to adjust mealtime insulin doses. Several methods can be used to estimate the nutrient content of meals, including carbohydrate counting, the exchange system, and experience-based estimation. The DAFNE (Dose Adjustment for Normal Eating) study (85) demonstrated that patients can learn how to use glucose testing to better match insulin to carbohydrate intake. Improvement in A1C without a significant increase in severe hypoglycemia was demonstrated, as were positive effects on quality of life, satisfaction with treatment, and psychological well-being, even though increases in the number of insulin injections and blood glucose tests were necessary.

A couple of points from the previous discussion.
US terminology definitions
see: http://www.nap.edu/openbook.php?record_ ... 0&page=290

RDA for carbohydrates (this is national and thus reflected in the diabetes guidelines) This is set as the minimum amount necessary for 97-98% of the population. ( This is the same in the US whether for diabetics or the rest of the population. The RDA is set at a level that is equal to the EAR plus 2 standard deviations.
The EAR is the estimated average requirement (ie at the 50% of population level) This for carbs in the US is 100 so the RDA is 130 and is condsidered the amount for most people to remain healthy.
The 2008 ADA document (referred to in the 2012 guidelines ) the RDA for carbohydrate (130 g/day) is an average minimum requirement
http://care.diabetesjournals.org/conten ... f_ipsecsha

It is not the only recommendation the US also sets an Acceptable Macronutrient Distribution Range which for carbs is 45-65%

The UK gave up using RDAs in 1991. Since then we have various recommendations. That for carbs is a percentage of calories.
In the UK the DRV (dietary reference value) for carbs is 47% percent of energy
(the GDA is a part industry sponsored measurement , the GDA works out at 47-8% of the calorie figures they give which may be too high for many people)

Plate Method is not 25% Carbohydrates
US diabetes Educators have been using the plate method for ages. It is also the method used in a couple of the GI books, by the dietitan to teach people with diabetes here and by the Swedes in the recent past . I've mentioned it several times on here as it's roughly what I do for proportions, though I use slightly larger amounts.
( Its called either the Idaho or the Swedish plate method)
It doesn't work out at 25% carbohydrate. For a standard 9 inch plate and 3 meals a day it results in about 1200 calories and 135-150 g carb a day, therefore the carb percentage works out at 45- 50% of the diet.
http://www.nwprimarycare.com/pthandouts/Idaho.pdf .
If you read the reports of people on US forums they often get told to eat a couple of snacks a day. This is confirmed in a presentation by the lead author of the US guidelines.
http://www.mcw.edu/FileLibrary/User/bco ... ay20th.pdf

 

[Grazer]

Firstly I thought it apt as a simple level of explanation to an MP, I really did not want to get into the finer scientific points of how a Type 1 diabetic works out their dosage, or Type 2 checks how many carbs are in what foods, and I thought Borofergie explained it simply and quit well.

Quite so Roy G. But I am deeply and mortally offended. That is twice you have credited Borofergie with my little invention of "simple explanation"
viewtopic.php?f=1&t=31361
As you say, it was not of course supposed to be a detailed accurate explanation, but a "simple illuminator" for those to whom we need to be brief.
Not really offended. We all know Borofergie isn't clever enough to think of that! :lol: