Hi this is all very confusing to me and I am struggling a bit. The whole diabetes issue with my husband newly diagnosed alone is stressing me out big time, but having never accessed a forum before is adding to the dilemma. My first post was in the wrong area so hopefully I am now where I should be. Can anyone tell me if he -with type 2 and on 1 Metformin a day- should be limiting his carb intake. Nurse said to have meals mainly based on pasta rice or potatoes, but he is feeling terrible whilst following this advice. Help please??? Thanks Malian
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Carbs or not???
- Thread starter Malian
- Start Date
daisy1
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- Type 2
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- Tablets (oral)
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Hi Malian and welcome to the forum 
My advice is to reduce carbs as they make your BG levels go up. Have a look at this information (which gives more information about carbs) we give to new members which I hope you will find useful. Other members will be along soon to give you their advice.
BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS
Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.
A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.
On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.
The role of carbohydrate
Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.
If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.
The bad news
Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.
The good news
People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.
Controlling your carbs
The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.
The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.
Choosing better carbohydrates
Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html
The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.
Read more on carbohydrates and diabetes
Eating what works for you
Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.
To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.
The blood sugar ranges recommended by NICE are as follows:
Blood glucose ranges for type 2 diabetes
Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.
You may also be interested to read questions to ask at a diabetic clinic
Note: This post has been edited from Sue/Ken's post to include up to date information.
My advice is to reduce carbs as they make your BG levels go up. Have a look at this information (which gives more information about carbs) we give to new members which I hope you will find useful. Other members will be along soon to give you their advice.
BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS
Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.
A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.
On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.
The role of carbohydrate
Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.
If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.
The bad news
Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.
The good news
People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.
Controlling your carbs
The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:
- Reduce your carbohydrate intake
- Choose ‘better’ carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.
The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.
Choosing better carbohydrates
Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html
The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.
Read more on carbohydrates and diabetes
Eating what works for you
Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.
To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.
The blood sugar ranges recommended by NICE are as follows:
Blood glucose ranges for type 2 diabetes
- Before meals: 4 to 7 mmol/l
- 2 hours after meals: under 8.5 mmol/l
- Before meals: 4 to 7 mmol/l
- 2 hours after meals: under 9 mmol/l
- Before meals: 4 to 8 mmol/l
- 2 hours after meals: under 10 mmol/l
Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
- structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
- self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education
Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.
You may also be interested to read questions to ask at a diabetic clinic
Note: This post has been edited from Sue/Ken's post to include up to date information.
I can't thank you enough. I now think we might see a light at the end of the tunnel, as at last we have somewhere to ask some of the multitude of questions that are constantly present. We have had little advice from our diabetic practice nurse. Just sent away with lots of leaflets and told to always include carbs with every meal. I have bought books but even they give conflicting advice. It will be good to talk to people who are actually in the same boat.
Daibell
Master
Hi, as Daisy has said our advice as people with experience of diabetes is to significantly reduce carb intake through portion control and you don't need them with every meal. Your nurses guidance is based on traditional NHS mantra and I'm afraid is bad advice which would make most Type 2s worse. Sad isn't it; don't blame the nurse but the out of date advice handed down from on high. You will find if you go to the NICE Diabetes website they updated their advice late last year to have low-GI carbs and no mention of having carbs with every meal; this is sensible advice from the experts. So, follow Daisy's advice ref carbs and try to get hold of a meter so you can check yourself the effect of different foods and adjust the diet accordingly. Go for low-GI carbs such as wholemeal bread and pasta and control portion sizes. Mash is the worst form of potato due to the starch being more quickly absorbed and converted to glucose. Don't worry too much about fats as they can slow carb absorption which is good and don't affect blood sugar. Have unsaturated fat where you can such as fish.
Wow! That all makes sense now as to why my hubby is feeling so awful all the time. I have bought a meter and his BS is around 10 whilst on the Metformin. It had gone up more last night after a shepherds pie meal . I just couldn't understand why. Now I realise it was probably the mashed potato on the top. Thanks for putting us in the picture, but as you said it is very sad that we weren't given the correct advice in the beginning. Thank Goodness for forums eh?
Thanks for that. We were considering testing more regularly. However after a visit to the GP when hubby told him we were testing daily( BP and BS) which were both high, the GP became surly and reluctantly prescribed BP tablets for 1 month only. I believe he thought we were questioning his ability . Hence my husband stopped testing regularly. However I have recently persuaded him to continue testing regardless of the GP's attitude and I think we will follow your advice and test before and after meals to see which foods he can tolerate better that others. Expensive though!!!
Daibell
Master
Hi. Glad that you are able to learn from all the different posts as there is so much to learn for each knew medical problem. My diabetes GP recommended I buy a BP measuring kit as she said it was better to test at home rather than have the 'white-coat' problem in the surgery i.e. BP higher than normal due to not being relaxed. I don't think you'll find it necessary to test BP every day once you get used to the typical BP reading your husband has unless it does vary a lot. Re BS testing doing it before and 2 hours after a meal is ideal but if there has been a good meal gap then you can to some extent assume you are back to 'normal' level before the meal hence only the after meal test is needed. It's your choice balancing cost and annoying lancet jabs versus accuracy. BTW you can buy test strips on eBay at around half the cost thru bidding which I've done. Do check they give you an end-date on the strips. There are a few counterfeit strips around but not many so just be aware.
EllisB
Well-Known Member
Hi Mailan,
If it is available in your area, get your husband referred to an X-PERT course, you can go along too. They offer evidence-based training following NICE recommendations.
Our bodies need carbohydrates to function. When you eat a meal, your BG starts to rise and you pancreas releases insulin that lets the cells absorb the glucose quickly. You won't get a big spike in BG and after a couple of hours, your BG will be down to a normal level. A T2 diabetic person's body responds differently, it can be they can't produce as much insulin or as quickly, but also, the cells need more insulin to absorb the glucose. The result is that the glucose is not absorbed by the cells as quickly, resulting in a higher concentration in the blood.
The advice about eating carbs with every meal is about spreading your carbs out across the day, less, more often. Some carbs are harder to digest than others, meaning that they release their glucose more slowly. Balancing the carbs with other foods (good fats, protein, fibre, even water) also slows the absorption of the carbs.
You mention pasta, rice and potatoes, you need to be a little more selective. Basmati Rice and new potatoes, with their skin on are lower GI than other types. Fruit is another good source, within reason, because the fructose needs to be converted to glucose by the liver before it is usable.
Everyone is different, both in how fast they absorb a particular food and how much carbohydrate they need. You just need to learn what works for your husband. The GDA for carbs is 300g for a man, but as you get older your requirements do fall off. That figure is currently under review.
It is not just about diet and medications, exercise is also very important, not just because it makes the cells burn more glucose, making it easier for the cells to take more up.
If it is available in your area, get your husband referred to an X-PERT course, you can go along too. They offer evidence-based training following NICE recommendations.
Our bodies need carbohydrates to function. When you eat a meal, your BG starts to rise and you pancreas releases insulin that lets the cells absorb the glucose quickly. You won't get a big spike in BG and after a couple of hours, your BG will be down to a normal level. A T2 diabetic person's body responds differently, it can be they can't produce as much insulin or as quickly, but also, the cells need more insulin to absorb the glucose. The result is that the glucose is not absorbed by the cells as quickly, resulting in a higher concentration in the blood.
The advice about eating carbs with every meal is about spreading your carbs out across the day, less, more often. Some carbs are harder to digest than others, meaning that they release their glucose more slowly. Balancing the carbs with other foods (good fats, protein, fibre, even water) also slows the absorption of the carbs.
You mention pasta, rice and potatoes, you need to be a little more selective. Basmati Rice and new potatoes, with their skin on are lower GI than other types. Fruit is another good source, within reason, because the fructose needs to be converted to glucose by the liver before it is usable.
Everyone is different, both in how fast they absorb a particular food and how much carbohydrate they need. You just need to learn what works for your husband. The GDA for carbs is 300g for a man, but as you get older your requirements do fall off. That figure is currently under review.
It is not just about diet and medications, exercise is also very important, not just because it makes the cells burn more glucose, making it easier for the cells to take more up.
viviennem
Well-Known Member
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- Wensleydale, North Yorkshire
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I have to disagree with you, EllisB, about our bodies needing carbohydrate to function. All carbohydrates are metabolised into glucose, which will be used as the primary fuel. If we don't eat carbs, or eat only a very small amount of them, our bodies turn to a perfectly natural mechanism called "ketosis" (which must not be confused with the dangerous "ketoacidosis"). In ketosis our bodies use our fat stores for energy, and we can function perfectly well that way.
In addition, about 20% of the protein we eat is metabolised slowly into glucose, so we are not totally without it, even on a carb-free diet.
Everyone is different, but my body certainly can't handle carbohydrate. I prefer to eat very-low-carb; around 30g to 50g carb daily. On that amount I can keep my blood glucose levels within the non-diabetic range, and I lose weight (which is needed :wink: ). If I go up to 70g daily I stop losing weight; over that and I start gaining weight; even worse, my blood glucose starts creeping gently up again.
It seems I simply cannot handle carbs; since my body can't cope with them (I'm an insulin-resistant Type 2) I prefer to keep them to the minimum. Why give my system something it can't cope with? When I'm eating very-low-carb I'm perfectly well and I have plenty of energy; my blood pressure is fine and my cholesterol/lipid profile is excellent.
Over the last 4 months I have been conducting a minor experiment on myself. I have been eating between 80g to 130g carbs daily. I have gained about 4 lbs, and my BGs are in the Type 2 recommended range rather than the non-diabetic. I'm having my next blood tests on Monday at 09:00. I can almost guarantee that my HbA1c will be up from last time (5.7) and that my lipid profile, particularly triglycerides (1.0 last time) will be worse. I'll come back in a week and let you know the results.
One size certainly doesn't fit all with Type 2 diabetes; some can handle far more carbs than others. That's why it's so important, in the first few months, to keep testing so that you find out what foods you can and can't handle. We can still have very occasional treats; I've even been known to eat cake without too much harm, though I much prefer to eat savoury rather than sweet. Fish and a small chips is also on my "treat" list - about 3 times a year :lol: .
If anyone is interested in the diet I use, it's a "Sticky Thread" in the Low-carb section of the forum: Viv's Modified Atkins Diet. It's a good basis for a low-carb diet; if you want more carbs, add them on using the lower-carb and low GI vegetables and fruits. Carb Counter books and apps are available.
Viv 8)
(edited for typo; "very-low-crab", indeed! :lol
In addition, about 20% of the protein we eat is metabolised slowly into glucose, so we are not totally without it, even on a carb-free diet.
Everyone is different, but my body certainly can't handle carbohydrate. I prefer to eat very-low-carb; around 30g to 50g carb daily. On that amount I can keep my blood glucose levels within the non-diabetic range, and I lose weight (which is needed :wink: ). If I go up to 70g daily I stop losing weight; over that and I start gaining weight; even worse, my blood glucose starts creeping gently up again.
It seems I simply cannot handle carbs; since my body can't cope with them (I'm an insulin-resistant Type 2) I prefer to keep them to the minimum. Why give my system something it can't cope with? When I'm eating very-low-carb I'm perfectly well and I have plenty of energy; my blood pressure is fine and my cholesterol/lipid profile is excellent.
Over the last 4 months I have been conducting a minor experiment on myself. I have been eating between 80g to 130g carbs daily. I have gained about 4 lbs, and my BGs are in the Type 2 recommended range rather than the non-diabetic. I'm having my next blood tests on Monday at 09:00. I can almost guarantee that my HbA1c will be up from last time (5.7) and that my lipid profile, particularly triglycerides (1.0 last time) will be worse. I'll come back in a week and let you know the results.
One size certainly doesn't fit all with Type 2 diabetes; some can handle far more carbs than others. That's why it's so important, in the first few months, to keep testing so that you find out what foods you can and can't handle. We can still have very occasional treats; I've even been known to eat cake without too much harm, though I much prefer to eat savoury rather than sweet. Fish and a small chips is also on my "treat" list - about 3 times a year :lol: .
If anyone is interested in the diet I use, it's a "Sticky Thread" in the Low-carb section of the forum: Viv's Modified Atkins Diet. It's a good basis for a low-carb diet; if you want more carbs, add them on using the lower-carb and low GI vegetables and fruits. Carb Counter books and apps are available.
Viv 8)
(edited for typo; "very-low-crab", indeed! :lol
Seems like there is some conflicting comments. I guess it does mean that not all diabetics are the same. Hence it's a case of experimenting. No quick fix! However my husband has reduced (not drastically) his carb intake and his readings are now on the whole below 7. It is difficult and the shopping is taking longer to do, but I am becoming more adept at reading labels. Thanks to all who have offered advice-it does help.
robertconroy
Well-Known Member
Bottom line, we all need to learn about the glycemic loads of foods. If a healthcare professional tells you to focus on eating potatoes, bread, pasta, etc. you need to find a new doctor and nurse. These are the foods that cause type 2 diabetes in the first place. We don't need any grains at all. Potatoes and wheat are higher glycemic than sugar, by weight, almost double. Grains are the highest glycemic foods we eat, other than dried fruit. That's why the Paleo diet is now considered the most healthy - no grains. Eating high glycemic foods spikes your insulin and high insulin has now been found to be the cause of most all major chronic diseases - obesity, insulin resistance, type 2 diabetes, cancer, inflammatory diseases like arthritis, cardiovascular disease, dementia, Altzheimer's, etc. Taking diabetes drugs treats the symptoms, but not the disease. They also raise your insulin to dangerous levels and make insulin resistance even worse, both putting you at higher risk for heart attack and cancer and death.
BUY THIS BOOK and live: The Easy GL Diet Handbook by Dr. Fedon Alexander Lindberg
BUY THIS BOOK and live: The Easy GL Diet Handbook by Dr. Fedon Alexander Lindberg
