Do I need a low carb diet?

Postprandial is after meal. Normally 2 hours after. When diagnosed I tested before a meal and 2 hours after, if I spiked more than 2 points I looked at what I had eaten and tried to avoid that food. My readings were very high to begin with so I had to monitor closely to avoid being put onto meds.

HbA1c
http://www.diabetes.co.uk/hba1c-units-converter.html
http://www.diabetes.co.uk/what-is-hba1c.html
both could be helpful

I think it is very useful to write down readings before and after food and what you have eaten. Try it for a few days and you should be able to see if any foods in particular are spiking you. Once you know certain foods are fine then it's not so important to test. I didn't go very low carb, I just avoided foods that spiked me. Cereals, pasta, bread and rice but sometimes now I will have them in small quantities. I still do test but not all the time.

Yes you need to follow a Low Carb diet in order to get those high BG levels under control.

Here's some good advice on how to use your blood glucose meter to adjust what you eat and possibly normalize your blood glucose levels:

http://www.phlaunt.com/diabetes/14045524.php

Many people find carbs (e.g. porridge) at breakfast spike their blood glucose higher than the same meal at lunch or dinner.

Considering the meds you are on, it is my opinion those levels are too high. Your latest HbA1c of 53 converts to an average 8.5mmol/l over the previous 3 months. Although much better than your previous HbA1c, it means you are spending a lot of time above 8.5mmol/l, which isn't brilliant to be honest.

I suggest you have a good read round these forums and also the main website and other sites members have links to in their signatures. Try to learn as much as you can about this disease, how it is measured, and what the measurements actually mean in terms of potential complications and medication. Doing this will give you a better understanding of where you are and where you would like to be. We all set our own targets.

haf said:

I'll check out this forum more often. Cheers.

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That's one of the most valuable things you can do. Also, I appreciate you elaborating a bit more about your situation. That makes it easier to understand your situation.

It looks like your a1c levels have stayed pretty consistent which is certainly better than them rising. However, they are on the higher side which can lead to more serious problems later on.

Based on what you've shared so far, if it were me, I would absolutely be considering a very low-carb approach. That could potentially assist with lowering your levels short-term as well as assist with losing a bit of additional body fat you're carrying around.

If it were me, I would also strongly consider starting to lift weights. Any activity is always better than no activity, but heavy resistance training works wonders at reducing insulin resistance for most people.

@haf

Hello and welcome to the forum As tagged above, here is the information we give to new members and I hope it will help you, particularly with low carb diet advice. Ask more questions when you need to and someone will 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 over 150,000 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

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-and-whole-grains.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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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 bloodglucose 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.

haf said:

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Active? I play squash twice a week, I do 20 minutes on an exercise bike 2-3 times a week and I play golf twice - three times a week. I'm not sure how active that makes me. And my waist is 36.5 ins.

The message I've got therefore is that I should try to lower my BMI to the mid range level and that my 36.5 inch waist needs to be reduced. I will continue to eat as few carbs as I can (ie less pasta, rice and potatoes). I don't monitor what I eat on a daily basis closely (ie porridge in the morning but I guess reasonably balanced) so I don't know what effect my current diet is having on my short and long-term blood sugar levels? Any other advice is welcome. I'll check out this forum more often. Cheers.

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Mr. Picky says

"I will continue to eat as few carbs as I can (i.e. NO pasta, rice and potatoes). "
Try adding to that anything wheat based. Amazing what has wheat in.

As few carbs as you can is no carbs at all - which is extreme and hard to do unless you are an Inuit.

However you seem to have the mindset problem it took me a long time to get over - just reducing the things you really, really like and your body craves doesn't really kick it. I found I had to cut out the major carb based foods entirely and work through the cravings.

On your exercise levels:
I can't really comment on the golf but from the very few times I've played recently it seems to be mainly a stroll not a brisk walk. With a nice rest at each tee and green.
I was always told that you got fit to play squash, rather than the other way round.
The general advice is, I think, that you do 150 minutes of exercise at least per week with the equivalent effort to a brisk walk (i.e. you are pushing yourself a bit, getting warm, breathing more deeply).
30 minutes a day on the exercise bike, pushing yourself so that you are breathing deeply, would seem to achieve this and more. Can get boring, though.
I find that I need to mentally shout at myself (oops! occasionally I may do this out loud) to remember to keep pushing so I am working hard enough when I am out on my bike. It is easy to settle into a rhythm where you are exerting minimum effort. So a brisk cycle ride as an alternative to a brisk walk. Brisk!

I thought I was well fit when I cycled about 15km to work and back.
I now feel I am not that fit when my training ride is 50k - because people keep passing me.

Moral - always push yourself where you can. Your aim is to get just that little bit fitter.

Hiitsme said:

Hi @haf and welcome. The Newcastle diet/study has worked for a number of people. That is based on shakes etc of 800 calories a day. There are a number of threads on this. This is not low carb. This was what @bulkbiker was referring to. So not all suggestions are low carb. I wanted to try this when diagnosed but as my GP would not give me his backing I did my weight loss a lot slower eating 500 calories less per day than I was burning. All I can say is I do have some control but do not think mine is reversed. I also reduced carbs, using a meter to see which ones spiked me.

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Sorry but I was not referring to the ND except in the quote from the Guardian. I am Low Carb High Fat with occasional fasting days. Controls my sugars without meds. Regards
M

haf said:

Why thankfully no Gliclazide? Does it have bad side effects?

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It encourages your pancreas to produce more insulin and this could mean that the beta cells wear out more quickly meaning you will need to inject insulin sooner.

haf said:

mmmm ... maybe I should speak to my diabetic nurse?

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About what? Getting a gliclazide prescription?

zand said:

and this could mean that the beta cells wear out more quickly meaning you will need to inject insulin sooner.

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I have yet to see any sort of scientific proof to support this theory. It seems to be nothing more than a rumor created on one of the Internet diabetes forums.

TorqPenderloin said:

I have yet to see any sort of scientific proof to support this theory. It seems to be nothing more than a rumor created on one of the Internet diabetes forums.

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I agree. I was worried about this when I was on max dose Glic for many years and saw these concerns on the web but I have also never seen any research data on it. So, the Jury is still out....

Daibell said:

I agree. I was worried about this when I was on max dose Glic for many years and saw these concerns on the web but I have also never seen any research data on it. So, the Jury is still out....

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If you think about it, if your beta cells could "Wear out" we'd probably have many more elderly people diagnosed with type 1 after 80+ years of life.

Not saying it isn't possible, but I try to separate fact from theory.

TorqPenderloin said:

If you think about it, if your beta cells could "Wear out" we'd probably have many more elderly people diagnosed with type 1 after 80+ years of life.

Not saying it isn't possible, but I try to separate fact from theory.

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It is a relatively easy fact to confirm with a bit of research.

From recent research into ways to solve the known (for around a decade) problem of beta cell exhaustion and apoptosis (death) caused by sulfonylureas:

"Sulfonylurea is one of the commonly used anti-diabetic drugs that stimulate insulin secretion from β-cells. Despite their glucose lowering effects in type 2 diabetes mellitus, long-term treatment brought on secondary failure characterized by β-cell exhaustion and apoptosis. http://www.ncbi.nlm.nih.gov/pubmed/22186619

" Sulfonylureas, such as glibenclamide and tolbutamide, act as K(ATP) channel blockers and are widely used in diabetes treatment. These antidiabetic substances are known to induce apoptosis in pancreatic beta-cells or beta-cell lines under certain conditions." http://www.ncbi.nlm.nih.gov/pubmed/16306272

A couple more, for good measure:
http://www.ncbi.nlm.nih.gov/pubmed/17316868
http://www.ncbi.nlm.nih.gov/pubmed/15483097

A LowCarb diet helped me reverse my diabetes and loss weight, not much exercise and no drugs ,nothing complicated about it