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Counting Carbs: Can I eat whatever I want?

A

aaron_mky

Member
Messages
18
Hiya,

First time post, behalf of my mother.

My mum has Diabetese type 2 for almost 20 years, and she has recently turned 62 years old. She has been on oral medication to control her sugar level, which is Metfomin 500mg and Glycoside 80mg.

Like many people, my mum tends to eat the wrong food at the wrong time, and it is getting to a point where we don't want to control her diet and want her to enjoy her life.

Ideally, I want my mum to lose weight so she can improve her health and hopefully take less medicine. I still believe she can reverse her diabetes as she is still taking medicine, please correct me if I am wrong.

I have been doing some research online on how to control diabetes and even lose weight. A lot of diet plans recommend eating 40 - 50grams carbs per meal and 15 - 30 grams carb per snack. Thankfully, my mum has agreed to weigh her food and not go over her carb quota.

Anyway, my question is, can my mum eat any carbs she wants if she within her quota. For example, she can have a small bowl of plain fried white flour noodles with meat and veggies, as long as the whole meal doesn't go over her 40 - 50 grams quota? My mum is Chinese and she does miss having her bowl of white rice and noodles.

Furthermore, our goal is for her to lose weight, but her excuse is that every time she doesn't eat much carbs, she feels quite dizzy and possibly go in to hypo, which I think is more psychological. Can you please confirm if this is true?

Many thanks

Aaron
 
Hello and welcome to the forum. I think to go to 40g/50g per day straight at the start (especially when on the blood glucose lowering medicine) is not wise. It is, in my opinion, too low a figure. I will leave other advice to those members who have managed to lower their carb intake while on medicines. What I will do is to tag @daisy1 who will swing by and give you some really good information offered to all newcomers. Best of luck to you and to your Mum.
 
She said 40-50 per MEAL, not per day.
 
I would say that the amount of carbs you have quoted as being recommended for controlling diabetes and losing weight is too high. That amounts to 150g per day for 3 meals, plus whatever snacks she has. All carbs turn to glucose once inside the system, and for someone with too much glucose circulating in the body it is sensible not to add much more. She is still young at 62 (I would say that because I am almost 70 ) and hopefully she has many years still left ahead of her.

You seem to be concentrating on her reducing weight, but keeping blood sugar levels stable and low will be better for her future health.

It might help us if you let us know what her diabetes review blood tests are (HbA1c test)

Does she have her own blood glucose meter? If she does she will be able to see at a glance what her food choices have done to her blood sugar levels. They are an excellent tool for helping us to find a suitable way of eating and to control our diabetes.
 
Aaron.
Welcome to the forum, we will do what we can to help and encourage.
Tagging @daisy1 for the standard newcomer information.

In your research, have you looked at the Low Carbohydrate High Fat eating style? Similar to Atkins.
That has much lower carbohydrate targets.

You are looking at maximum 50 grams per meal (I assume 3 meals) and 30 grams per snack. If we assume two snacks (morning and afternoon) that gives (3 *50) + (2 * 30) = 210 grams of carbohydrate per day. That is pretty high carbohydrate and probably not ideal for a T2 diabetic.

If you were to go the low carbohydrate route many follow on this forum, you would be looking at closer to 50 grams of carbohydrate per day. Some go as low as 20 grams.

Your mother is on Gliclazide which encourages the pancreas to produce extra insulin. Because of this she would have to be very careful when lowering the total number of carbohydrates eaten because with less carbohydrates there is less glucose in the blood and she could experience a hypo. So gentle steps.

She may be a little late for reversal, but not for achieving normal levels of blood glucose, which can look very similar.

Your biggest issue is that she is very used to a high carbohydrate diet.
[As a side note, carbohydrate is turned by the body into glucose. The body can't store much glucose so insulin is used to turn it into fat. So eating lots of carbohydrates can result in storing lots of fat.]

Please look at the low carbohydrate forum where there are loads of suggestions about how to replace high carbohydrate favourite foods with low carbohydrate alternatives.

You have come to a good place for advice. Take your time because it takes a long time for it all to sink in. Ask loads of questions.
 
Look.
Any reduction will help but I too agree drastic change can cause further dizziness etc. If she falls it will all go pear shaped.
Avoid heavy decrease but slow decrease until her bgs are in good levels, if they aren't.
 
If your mum is on gliclazide - a sulphonylurea and living in the UK, she does I'm fairly certain, qualify for a meter and test strips free from the NHS.
Testing before and after meals is really the only way to discover the affects of food on blood glucose. We all react differently to carbs.
 
Try to change the carboydrate food she's eating. For instance stop fizzy drink and juices, use only wholegrain bread and pasta, also if you could find rice it's a good thing. Stop industrially made food if possible, because they put surprises inside it....
 
Welcome! I don't think 62 is particularly old ... and well done to her for managing 20 years of diabetes.

As she is taking "Glycoside" (probably Gliclazide?) she could indeed suffer real hypos (not just psychological) if carbs are too low, or reduced too fast.
 

I would just like to apologise, the misunderstanding was all mine. You were quite clear in your post and I should have taken more care when reading. Sorry.
 
depends does she want an healthy old age. getting control of her glucose levels im afraid means cutting out the junk food.you do need to understand the risks of staying un controlled they really are not pleasant. until your mum get that idea she probably wont want to change. just taking 2 pills wont protect her from harm.
 

The literal answer is "yes." That is without addressing the issue of whether 40-50 grams per meal is the right "quota." Do you know what it was until now, and whether her blood glucose levels were well controlled for the past 20 years since the diagnosis, using the drug combo that you stated?
 
And if she does cut carbs she could potentially get off the gliclazide of COURSE WITH HER DOCTORS approval. And generally when we cut carbs we tend to lose weight.
 
Wow! thanks for all the replies! I am glad I found this forum

Her sugar level has been very good and her medication has been quite stable (i.e. no increase in dosage) hence why she has been on medication for the past 20 years and not injections (again please correct me if I am wrong )

My mum is generally very good in terms of staying away from sweets, cakes and fizzy drinks. However it is the carbs like bread, pasta, rice and noodles she struggle to stay away from.

She has had a blood test last week and planning to see the GP for an update. I am planning to go in with her and ask the doctor for advice on how to lose weight and possibly reduce her medication.

If we can convince the GP to omit Gliclazide, and stick to Metformin only, does it mean she would able to eat less carbs/diet and not go into hypo?! Cause that would be ideal!! I assume 80mg of Gliclazide isn't a lot?
 
I got dizziness and still do if my carb level is too severely low. Palparations and chest pains too. Not psychological but I was put on betablocker increase to stop fast heartbeat. It doesn't suit everyone but done gradually, does help with my bgs.
 
@aaron_mky

Hello Aaron and welcome to the Forum Here is the Basic Information we give to new members and I hope this will help your Mother. Ask as many questions as you want and someone will be able to help.


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 276,000 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
Reduce your 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

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.

Take part in Diabetes.co.uk digital education programs and improve your understanding.
  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
@aaron_mky

Gliclazide is a strong drug. It works by stimulating the pancreas to produce extra insulin when we eat. We need insulin to clear the glucose made from carbohydrate out of our blood stream. The more carbs we eat, the more insulin is needed. Conversely, the fewer carbs we eat, the less insulin we need. If we end up with too much insulin circulating, our glucose levels will drop possibly to hypo levels. In addition to that, the more circulating insulin we have the more likely we are to gain weight because insulin is a fat carrying hormone and deposits fat all over the body. The best plan is to reduce the amount of insulin we produce - by reducing carb consumption, but whilst on Gliclazide this needs to be done with full knowledge of the nurse and with the use of frequent and regular testing at home.
 

Just to answer this one - all carbs are not the same, in that some are absorbed faster than others. This is the concept of low or high Glycemic Index.
[Far more than you ever need to know at http://www.glycemicindex.com/.]
Fast acting carbohydrates can lead to high spikes in blood sugar; slower acting ones may not spike as high, but for longer.
Bottom line is that all carbohydrates are bad to some degree, but different ones act in different ways.

Probably straying into T1 territory here, but different carbohydrates have different effects on blood sugar after a meal.
The speed of absorption is also affected by what you eat with them, such as proteins and fats.

However in broad terms if you are keeping to a carbohydrate limit she can have what she wants, as you describe. Life is hard enough.
 
I am 66 and have been diagnosed for a year - but I suspect my diabetes has been there for a long time, just hidden by my eating low carb.
I stopped taking my tablets - because I do not need them when eating low carb.
Low carb seems to be the most powerful treatment for many type 2 diabetics as it can simply make all the symptoms of diabetes disappear. That does have to be whilst the pancreas is still producing insulin enough to deal with the amount of carbohydrates eaten. Once the pancreas is failing then one can only hope for some recovery when it is given a rest from the overproduction it has been doing for years.
I use Dr Atkins New Diet Revolution for the lists of foods - but have picked up some tricks along the way. For noodles I have used beaten egg with a little olive oil, cooked as very thin pancakes, rolled and sliced into ribbons. I have also used a spiral cutter either smooth or with teeth to make strips or spaghetti like effects of vegetables such as courgette, carrot, cucumber, daicon radish and so on.
Your mother might like some of the possibilities, but I do emphasize that the medication she is taking has rather a sledgehammer effect and there will be a real possibility of hypos if carbs are reduced whilst still taking the tablets.
 
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