Sorry still confused.
If you are diabetic 2 but not obese[other than that exacerbated by insulin injection causing weight gain] how do you find a diet which
a satisfies[especially if you are highly stressed [ ? hair trigger adrenaline release even by thought alone] where food is a craving/sleep helper]
b fits with heart arrythmia[but low bad cholesterol] so exercise is problematic and blood pressure requires warfarin and beta blockers/ vascular dilators
c fits with standard mantra "eat more oily fish, eat more fruit" -- for general health balance
d squares off carbs v calories
e squares off with fatty liver
f fits with newcastle study [not sure of what this comprises diet wise]
g corrects failure of nhs diabetic specialists to give any practical advice eg fail to carry out standard test of fast + standard carb ?cal input +blood test at set time intervals to trace sugar rise/drop back, so that total cals eg per tin of food can be predicted to cause "n" level of b.sugar rise for "X minutes" --yes obviously varies from person to person and depends on exercise level but sedentary situation is a start and would of course be the situation during sleep -so what do you eat at bedtime to prevent too low a b.sugar level on waking[being woken by falling level] The standard eat every 4 hours isn't much help--eat what/how much ?carbs ?cals
h explains variability of post prandial b.sugar rise eg > 2 hours to register because of slow digestion [a patient variable which could be informed by personal standard testing]
i explains how long short insulin and long insulin actually take to work so that you can correlate short insulin input with b.sugar rise due to food input-- for this test g could be repeated on a different occasion introducing "n" units at the same time as the first cal/carb input
and how that correlates with advice to take metformin and short insulin before meals-- how can you predict how much insulin if you don't know your standard "n" cals. input needs "x" units of insulin
j explains how/why b.sugar level can be 7 at 6am but have risen to 10 at 9am despite NOTHING being eaten or drunk other than water and having taken long acting insulin approx. 24 hours previously
Wouldn't the nhs save millions if there was a more scientific approach to patient care including literature. If the tests at g and h above were done on say 1000 patients surely that would give a rough estimate for practical purposes[could easily be extended to 10,000 patients if that gives a statistically better result].
If newcastle/carb restricted diet is thought to be valid why not suggest it to all type 2 patients on a voluntary basis- again use of volunteers countrywide would give an enormous test pool and could save millions in drugs/patient deterioration even if only some patients followed/partly followed it. Going a step further why not prepacked set cal./carb. foods/meals to provide a balanced diet eg this can is self contained main meal "n" cals/carbs or this can contains "n" legume/fruit/fat etc cals./carbs. for you to make up your own meal. Presumably those selected for newcastle trial must be issued with something like this to make the trial valid. Are they issued with a can marked slow sugar release to take before going to bed?
Scores more Qs but hope these spur someone into a scientific response- perhaps more modern endocrinologists could give their minds to
practical real life situations especially how to utilise a more holistic approach rather than say separate diabetician/heart/liver specialists looking at only their bit of a patient and hence how to head off/reduce expensive [? soon to severely rationed] drug use
Request please- can all b.sugar figures be given on this site in all variants, failing which have a comparison table in the forum side bar, likewise fahrenheit/centigrade- some of us recognise 98.4 and rises almost instinctively but heavens knows what equivalent centigrades are[or should that be "degrees celsius" !]
Thank you.
I think you're making it far more complicated than it needs to be and in reality no regime will meet all requirements.
No one much disagrees that cutting down on your carbohydrate intake i.e. avoiding sugar, and limiting starchy foods such as rice, pasta, potatoes, bread, cereals and other flour based things is a good thing for diabetics to try as that will help stabilise your blood sugars. How much you need to cut out is very much down to the individual and should be driven by your 2 hour post prandial readings. No one will be able to tell you precisely how much as that's the individuals responsibility to find out.
As to the measurements used on this site then the vast majority of posters are from the United Kingdom and hence BG's measured in mmols will naturally predominate. Confusing the majority by adding yet another set of BG figures would not be a good thing imo. If you want to translate between mmol's and dl measures for BG's (or Farenheit and Centrigrade) then there are ample conversion sites you can refer to on Google
Redfox,
"Eating to your meter" is for me, a process of of try a food, test.
If Bg goes too high, don't retry,
If BG stays low, put on "good list",
If high but not too high, try again with smaller portion.
This is repeated with more foods until you form an "acceptable food list"
Fergus thanks very much.
I'm still confused because at any one session you have two variables that you control [and heavens knows how many variables you can't control such as rate of digestion/ non absorption] which are a] cals input b] units of insulin injected. If you start with a blood test you put in enough insulin to reduce that level to zero then you have to guess how much more to put in to counteract what you are about to eat which is where estimating low to avoid hypos creeps in. End result is a 2+ hour reading[ I say + because in my experience bs can go on rising way after 2 hours] which reflects the two contollable variables but you don't know how much of the result is due to each. If you don't inject then you can easily get to bs 20 so have to then inject 14 units of insulin [7 on the pen] to get down to recommended 6 [if you're lucky] in a yo-yo situation. By this time you are into the next eat every 4 hours time.
Interestingly my research gave results not dissimilar to the newcastle diet which I think was a harsh 800 Cals a daySorry still confused.
If you are diabetic 2 but not obese[other than that exacerbated by insulin injection causing weight gain] how do you find a diet which
a satisfies[especially if you are highly stressed [ ? hair trigger adrenaline release even by thought alone] where food is a craving/sleep helper]
b fits with heart arrythmia[but low bad cholesterol] so exercise is problematic and blood pressure requires warfarin and beta blockers/ vascular dilators
c fits with standard mantra "eat more oily fish, eat more fruit" -- for general health balance
d squares off carbs v calories
e squares off with fatty liver
f fits with newcastle study [not sure of what this comprises diet wise]
g corrects failure of nhs diabetic specialists to give any practical advice eg fail to carry out standard test of fast + standard carb ?cal input +blood test at set time intervals to trace sugar rise/drop back, so that total cals eg per tin of food can be predicted to cause "n" level of b.sugar rise for "X minutes" --yes obviously varies from person to person and depends on exercise level but sedentary situation is a start and would of course be the situation during sleep -so what do you eat at bedtime to prevent too low a b.sugar level on waking[being woken by falling level] The standard eat every 4 hours isn't much help--eat what/how much ?carbs ?cals
h explains variability of post prandial b.sugar rise eg > 2 hours to register because of slow digestion [a patient variable which could be informed by personal standard testing]
i explains how long short insulin and long insulin actually take to work so that you can correlate short insulin input with b.sugar rise due to food input-- for this test g could be repeated on a different occasion introducing "n" units at the same time as the first cal/carb input
and how that correlates with advice to take metformin and short insulin before meals-- how can you predict how much insulin if you don't know your standard "n" cals. input needs "x" units of insulin
j explains how/why b.sugar level can be 7 at 6am but have risen to 10 at 9am despite NOTHING being eaten or drunk other than water and having taken long acting insulin approx. 24 hours previously
Wouldn't the nhs save millions if there was a more scientific approach to patient care including literature. If the tests at g and h above were done on say 1000 patients surely that would give a rough estimate for practical purposes[could easily be extended to 10,000 patients if that gives a statistically better result].
If newcastle/carb restricted diet is thought to be valid why not suggest it to all type 2 patients on a voluntary basis- again use of volunteers countrywide would give an enormous test pool and could save millions in drugs/patient deterioration even if only some patients followed/partly followed it. Going a step further why not prepacked set cal./carb. foods/meals to provide a balanced diet eg this can is self contained main meal "n" cals/carbs or this can contains "n" legume/fruit/fat etc cals./carbs. for you to make up your own meal. Presumably those selected for newcastle trial must be issued with something like this to make the trial valid. Are they issued with a can marked slow sugar release to take before going to bed?
Scores more Qs but hope these spur someone into a scientific response- perhaps more modern endocrinologists could give their minds to
practical real life situations especially how to utilise a more holistic approach rather than say separate diabetician/heart/liver specialists looking at only their bit of a patient and hence how to head off/reduce expensive [? soon to severely rationed] drug use
Request please- can all b.sugar figures be given on this site in all variants, failing which have a comparison table in the forum side bar, likewise fahrenheit/centigrade- some of us recognise 98.4 and rises almost instinctively but heavens knows what equivalent centigrades are[or should that be "degrees celsius" !]
Thank you.
Let's hope as you say the LCHF diet is gaining ground; as a 'news flash' I can announce it was featured, I think for the first time in the context of diabetes today in the British Medical Journal, arguably the most important UK medical journal !! It's because our work won through to the final round of Primary care team of the year -- We are so proud !! Result not till MayI haven't yet met with the clinical "Diabetes Team" that my GP referred me to,, but, so far, the specialists that I have seen to keep check on DB complications have said that I am doing a good job of using the LCHF diet. This is a good sign, because it might mean that when I finally get around to seeing the Diabetes Team I might be pleasantly surprised to find that they, too, are up on the diets that really work for us. Maybe there is a common-sense standard operating among clinicians, here in the States.
It seems that almost every health professional I have spoken to, including my dentist and my chiropractor, are convinced that the LCHF is the way to go. It isn't only the practitioners who have the highest amount of patients with diabetes, such as podiatrists and neurologists, who are up on this. I can assume from this that the medical profession, in general, is starting to come down to earth, at least from what I personally observe, here in the States.
My GP doesn't seem to care one way or the other how I'm getting my BG numbers under control, as long as I do it. However, she has already tried to push Rx drugs on me, which I have refused.
I appreciate that clinicians, such as yourself, care enough about people who have diabetes to do the work, putting in the time and energy to do the research. The neurologist I met with today actually used the word "cure" in reference to the track that I am trying, and he said that he wished that all of his patients were doing what I am doing. So, there is hope.
Delightful news for a vegetarian. Thank you for your detailed explanation.In my opinion yes. The labelling can make it look as if they are relatively high in carbs but they conatin a lot of fiber and also a lot of resistant starch.
Carbs come in different forms, alpha carbs, which humans can mostly digest and beta carbs which humans mostly cannot digest. Beta carbs are the sort of carbs cows digest, which is why they lay on the ground chewing all day and why they have four stomaches. It's been a long time since humans ate leaves and our appendix isn't what it used to be.
Alpha carbs come in different levels of complexity and starches are broken down into the simpler sugars for digestion. Legumes in general are high in a group called oligosaccharides which are resistant to being broken down. We lack the enzymes which can do the job. What happens is that those parts of a lentil meal which have not been broken down by enzymes get broken down by bacteria in the gut. This causes gassing and wind, typical of beans, lentils and peas. What it means for diabetics though is that only a part of every lentil is turned into glucose and the remainder is either fibre or resistant carbohydrate. They are an excellent source of fiber, folate and manganese, a very good source of iron, and a good source of copper and thiamin.
The list of legumes is considerable and you can have great fun trying lots of them out. They work well with various asian cuisines. Have a look at Indian Vegetarian Cooking and have a quick look at this list of legumes.
also how does high fat fit with fatty liver?
Non Alcoholic Fatty Liver Disease usually improves fast on a low-carb-high-fat diet, as it is the carbs that causes fatty liver when alcohol isn't the issue.xyzzy thanks. as a newcomer i seem to have posted my Qs, which are real not theoretical, to wrong part of the site.
Moderator please would you reallocate to correct part and let me know where that is.
incidentally what is eat to your meter- at any single eating session you will get a 2-"x" hour response rise in bs but unless you eat exactly the same food each time you will get different results hence my Q about carb/cals stated quantities as rough guide eg tin of peas has info on label but an avocado pear doesn't so how do you predict insulin dose with food + simultaneous short insulin as you don't know any figures till at least 2 hours after the event even treatment of low bs says eat sugar/sweet + biscuit but would be helpfulif said take at least "x" cals of glucose so you can know how many glucose tablets/etc to take
also how does high fat fit with fatty liver?
I agree with much of your analysis (ages back, I started this yesterday)
Re partial agreement SDocs diet. In spite of the division that sometimes (often!) occurs on here. I actually don't know of any people on here who use a very low fat diet / high carb diet . This would normally be 20% or fewer calories from fat. Ornish's heart diet is only 11% from fat with 71% from carbs. I've come across T2 vegans/vegetarians elsewhere who have claimed to successfully use this sort of diet
The opposite is the very low carb and high fat (80%fat 18% protein and 2% carb) or the Bernstein 6, 12,12 diet. Again, I've seen only a handful of people who actually use this sort of diet on diabetes forums.
Most peoples diets seem to be somewhere in between the two. There is certainly no way could you eat Southport Docs vegetable soups on the lowest carb diets. Indeed, Bernstein quite explicitly forbids it and even limits tomatoes to a slice. On the other hand, people who eat any animal products would find it very hard to adopt the very lowest fat, with consequent higher carbs and often very much higher fibre than most people are used to eating.(look up the Ma Pi 2 diabetes diet)
Given that most people aren't at the extremes , it's not surprising that many people see at least some similarity between their own and Southport Docs fairly moderate diet. (and yes I do too!)
One place in your post I'd comment on is this:
" "controversial" non standard "low carb" advice is to up natural saturated fats (eggs, cheese, butter etc).....
agree that is very controversial
However there are fats other than sat fats . I think that most things I have read recently still suggest that Sat fats tend to raise LDL and suggest replacing sat fats with polyunsaturated fats rather than carbs (particularly any sort of refined carbs)
The Mediterranean diet is relatively high in fat but that fat is mainly monounsaturated . The successful (re CVD) Predimed diet contained about 20% of cal from monounsaturated, 10% from sat fat and 7% from polyunsatfat . These were mainly from olive oil, nuts, and fish, the diets tended to emphasise white rather than red and processed meats plus fruit, veg, legumes, real whole grains and some dairy. The Lyon heart trial with a similar diet (though they used rapeseed margarine rather than olive oil) was also very successful. (the BMJ article that was headlined in yesterdays newspaper articles comments, favourably on those trials)
However, as you say there is a gap between the 38/40% fat contained in the Med diet and one of 60+%.
That's where I would think more carbs in the shape of more veg, possibly more low GI fruits but particularly more legumes (their properties were discussed elsewhere on the thread by Yorkman). The people on the Predimed diet ate 3+ portions of legumes a week.
Izzy I like the way you use a pragmatic approach and reduce things to simple messages, as I have to do as similar thing when first introducing the idea of lower carbing. The single fact that wins with many sceptical Health professionals is the higher glycemic index of even whole meal bread compared to table sugar. Followed up with 'starch is how plants concentrate glucose for storage' If this is accepted the rest follows.
It's a bit bonkers but I would like to see the slogan 'starch in concentrated sugar' on hoardings ,the sides of buses,as a full page advert in the papers. Everyone got the fat debate eventually but it was flawed we need the sugar and starch debate to get going now if the epidemic of diabetes is to be halted
And now you can actually test for non-celiaci gluten sensitivity as the cyrex tests are available in UKThanks Modesty that is a very well researched piece of work - amazing number of references Also I think far more people have problems with gluten than is generally known The book Grain Brain has a lot more detail
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