Carbs!

Hi. The nurse was talking rubbish. Your body can derive 'energy' i.e. glucose from most foods and hardly needs any carbs. Carbs turn to glucose in the body and guess what - your blood sugar can go up. Can you tell us what insulin regime you are on e.g. mixed or Basal/Bolus. If the latter are you carb-counting? It sounds like you are not injecting enough insulin? Your diet is great. Are you overweight and if so is it reducing on the the good diet. Let us know more and we may be able to offer some guidance.

@Alipossum it is interesting that you mention the afternoon nap. That is one of the things that I have really noticed, I don't need one! It's great isn't it.

Alipossum said:

I've been on insulin for a couple of months now, and I'm tearing my hair out! My blood sugars are still really high - a couple of days ago I managed 11.8, but this morning I was 20.2! I have changed my diet to lots of veg, eggs, white meat and fish, with minimal dairy and no grains. Mentally and physically I feel great - more energy, no brain fog, no afternoon nap - but when I spoke to a nurse at the local hospital about my insulin dose and mentioned that I had cut back on carbs, she became very antsy and said that she needed me to be eating carbs for energy! I'm about fit for giving up! What do I do now? - keep taking increasing amounts of insulin?

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If mentally and physically you feel great, more energy, no brain fog and no afternoon nap, I'm may not be a medic, but it doesn't sound like you need any more energy. Don't worry too much about what the nurse says (is she diabetic?), there are a huge number of people with type I and type II diabetes who control their blood glucose levels to some degree or another by cutting carbs. Check out this and other diabetic forums.

In my particular case I pretty much cut potatoes, pasta, rice and bread from my diet, I do eat some bread at weekends and some rice now and again so about 80gms a day (I have some software that I enter my food intake into and it tells me 10 different things). I'm type II and it helped me avoid going onto insulin (c-peptide test that I paid for showed insulin production in the normal range), I no longer take Gliclazide or Januvia and I also threw away the statins because my cholesterol dropped so much. Yes we need energy, no we don't necessarily need carbs.

Noticed it was your first post, welcome, there's a lot of knowledge on these forums, based on good old fashioned first hand experience. Take care.

If my memory serves me well, you're spot on with reference to Gliclazide, it does encourage the pancreas to produce more insulin. I forgot to mention that by reducing my carbs I also lost 3 stone, something calorie reduction and exercise had not not enabled me to do in the years that I stuck to a strict regime (1800 calories a day when my BMR was 2800).
I wouldn't like to comment on the state of your poor old pancreas although what you say sounds very logical. I wonder if a c-peptide test would help. It would at least tell you how your pancreas was doing. In fact I'm tempted to say that giving you gliclazide I would have thought the GP and medical team would be interested in how healthy your pancreas was. Maybe ask them, see what they say.
You say that you would like to lose 4 stones, I still have 6 stone to lose. Without going into how much we should eat and how much we do eat even saying that we take on more energy than we use is over simplifying what could be going on, but if it were the case then you obviously don't need all that energy that the nurse is referring to. I'm trying to be careful because I don't want to offend and as someone who is eating about 1,000 calories a day (900 less than my BMR) and exercising (personal trainer, swimming, golf) and still not losing weight for the last 6 months, I know the calories in/calories out thing isn't the whole story.
If your new regime, which looks sensible to me, is keeping you happy, and with enough energy and you've lost weight into the bargain, then I'm afraid old nursey is barking. Keep up the good work. Maybe the insulin does need upping, but I think you need to see what you pancreas is up to. All the best. Graham

if it was me...I'd cut all grain, grain product- bread pasta pastries etc., starchy veg. fruit and sugary stuff. for a couple of months, 20-50g carb a day from dairy, veggi and nuts

http://www.dietdoctor.com/lchf it’s a long page and a video

For me, the more carbs we eat the more carbs we want. they don’t give up easy.
http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm
http://lowcarbdiets.about.com/od/lowcarb101/a/firstweek.htm

dietician lc plan
http://www.lowcarbdietitian.com/blog/carbohydrate-restriction-an-option-for-diabetes-management

Alipossum said:

Hi, Graham, thanks for getting back to me. I'm seeing my GP in a couple of weeks, and I shall discuss getting a c- peptide test done. It does seem pointless to me to be taking a medication to jazz up my pancreas if the poor thing is already out for the count!

As far as weight loss goes, isn't it a bummer?! I'm sure that portion size has a huge part to play in weight gain and loss, allied to one's attitude to food. My husband tends not to think about food until he's hungry, when he will then hoover up anything going, whereas I tend to eat because it's mealtime! Since we first got together 23 years ago I have given myself permission to keep up with him, which is how I managed to gain a total of 5 stones! I then had pancreatitis, since when I have lost about 2 stone, but I intend to get close to or below my starting weight. I definitely find that grainy or carby foods make me want to keep eating - the last couple of weeks, since I've properly cut stuff out, I have found it so easy not to snack and nibble. On a bad day, I can eat dinner at 7-ish and then nibble all evening, but not this last couple of weeks. They do say that protein makes you feel fuller for longer - perhaps that's what's doing the trick!

I am nowhere near as active as you, which I need to remedy, though I think walking is more my thing than the gym. You must be so frustrated with such a long plateau in your weight loss. I'd be sorely tempted to throw my toys out of the pram and stuff myself rigid! As you say, weight loss is not as simple as calories in/out. However, what has helped me with cutting stuff out is how much better I feel without it - and yes, I think you're right, nursey is barking!! Many thanks, and take care, Ali.

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Hi Ali,
I'm not exaggerating when I say that I've been counting calories for 8 years and it's how in my case that I know that it isn't just about calories. The diet industry make millions or is it billions out of people who want to lose weight and a sensible diet and exercise regime is a very good place to start. That's where the problem lies, what's sensible for me isn't sensible for everyone else. I even gave up alcohol 8 years ago because it's just something else I had to count and I couldn't be bothered. One beer frequently turned into a few, and even with good BG control, I gave up and I don't miss it.
It's good that you're happy with your lower carb intake, I feel the same, much better. I'm also very smug about the fact that I can help control my diabetes without resorting to loads of meds and the pleasure of kicking statins out the window after 17 years of muscle pain, sleepless nights and brain fog was immense. Brain fog still a bit of a problem but so much better. Total cholesterol is around 5 and I'm not going to panic. Just had a heart echo cardiogram and apart from a slight enlarged left ventricle the pipes seem to be in good shape.
I think walking is an excellent exercise, my father, also type II, used to walk a fair bit and it helped his BG a lot. Then at the age of 87 his GP said "your cholesterol is a bit high, take these". Statins, he can't walk the 200 yards to the nearest Tesco Express any more. He doesn't listen to me, his GP knows best. That's why he's injecting insulin and his way of coping with high BG is not to measure in the afternoon when he knows it goes high. My dad used to have brains.
Sorry for prattling on, keep up the good work. Just having a mini whinge, look out for when I really get going. LOL

I'm eating more 'calories' on a low carb enough fat diet than I ever did while rationing my 'calories' and eating more carbs. And I'm slowly losing weight.

Not all 'calories' are created equal!

Each of our bodies is unique - and that extends to what we need to enable weight loss.

I needed to lose 3st 7lbs but ended up losing 4 stones and am happy. I stuck to 1200 calories a day, including about 60g of carbs. To do this and eat 1200 calories I had to increase my fats as I was already eating sufficient protein. I religiously counted my carbs and my calories. My weight just shifted, with no plateaux at all between February and September, so a nice steady loss. My problem was stopping the weight loss, and that has been difficult. I never thought I would ever be saying this about myself. I am now just about stable having increased my calories with some more fat and a little more protein. I couldn't have done it without the calorie counting in addition to the carb counting, but hey ho! Other than 2 x 20 minute walks a day I don't do much exercise. That's me and how I did it.

Brunneria said:

Not all 'calories' are created equal!

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Too true!

Alipossum said:

I've been on insulin for a couple of months now, and I'm tearing my hair out! My blood sugars are still really high - a couple of days ago I managed 11.8, but this morning I was 20.2! I have changed my diet to lots of veg, eggs, white meat and fish, with minimal dairy and no grains. Mentally and physically I feel great - more energy, no brain fog, no afternoon nap - but when I spoke to a nurse at the local hospital about my insulin dose and mentioned that I had cut back on carbs, she became very antsy and said that she needed me to be eating carbs for energy! I'm about fit for giving up! What do I do now? - keep taking increasing amounts of insulin?

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Sounds like quite a high protein loading there. The body can metabolised excess protein to glucose as well and contribute to a blood sugar rise.

A good guideline is a palm-sized piece of protein, couple of eggs etc, lots of veg. Personally I don't eliminate the complex carbs but I have cut the refined carbs right back and upped the fat intake for calories. I've not put myself into nutritional ketosis as I couldn't sustain it with my job, but some people do. I'm typically on <100g carbs per day and still manage endurance exercise. Last weekend, with two hours on th ebike as well, I still only went up to 165g carbs

Alipossum said:

I do often feel that I'm stumbling about in the dark with this. I know that if I eat whole grain cereals, wholemeal bread, pasta or rice on any kind of regular basis, even in small portions, it completely skews my blood sugar levels, and yet the nurse in the local hospital diabetic centre says that it's what I have to eat! I think I need to live at a health farm!

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Having cut out pasta/rice/bread/potatoes with just a little cheat at weekends (can't have poached egg on Saturday without toast or a bacon butty on Sunday morning if there's no bread). Oh, and just a bit of rice if we have a curry during the week. So I average out at 80+gms of carb a day, against the RDA of 250+gms. It was enough to bring my BG and total cholesterol down so that I no longer take Gliclazide, Januvia or Atorvastatin. I do eat bucket loads of courgettes, onions, peppers, broccoli, well veg in general so I have enough fibre not to have problems there.
One thing I have found if losing weight and calorie counting is involved is that weighing everything and writing it all down is essential because it will highlight where things might be going astray. It is a pain in the backside, so is being diabetic, but that's where we are.
I probably said it before, politely ignore the nurse, she is following guidelines rather than looking at what diabetic people do to help control their blood glucose.
You've already identified what "completely skews my blood sugar levels", so you know the answer.
Good luck and all the best.
Graham
BTW if you can find some free software for your PC or app for whatever device you might have, they're very useful. I use something called "Weight by Date" which I paid for years ago, I just click on a food (once I've found it), enter the weight and it tells me up to 10 different things like cholesterol, fat, carbs, protein, etc etc. It adds everything up and I have a weekly report, day by day. My only bug bare is that being american it has a lot of brand name things which is great in the US. There's still plenty for us Brits plus the opportunity to add things.