DUK's new position statement on Low carbing.

[sugarless sue]

http://www.diabetes.org.uk/About_us/Our ... -diabetes/

It's a pity they do not take into account the many positive low carbers who have happily maintained low carbing for more than a year.....me for one !

 

[cugila]

I think I will just read this at my leisure for now.......... :|

 

[Daibell]

Thanks for the posting. At least DUK are finally starting to 'get it' with regard to carbs. I find it irritating that the 'researchers' assume there could be some bad long-term effects from a low carb diet but no regard is paid to the known harm caused by the standard western diet which contains excessive carbs contributing to Type 2 in the first place.

Why the concern over hypos with Type 2s and low-carb? Yes, those on insulin and those sensitive to meds such as glic need to know if they get close to hypos but the whole point about diabetes is that the problem centres around excessive BS and the serious harm that does; not low BS. Yes, there are some whose BS varies wildly and who need to take care but for T2s high BS is the key issue. If low carbs cause frequent hypos then maybe the meds if any need to be reduced? If not on meds then balance the carbs intake to match lifestyle.

 

[primmers]

I used to work in research, albeit in a different field. The recommendations are written up in line with best practice - ie they can only report that that can be proven, and the existing research has not addressed all the pertinant questions. The key sentence in all that is that there needs to be further research to establish what happens in the longer term.

Our individual experiences of weight loss and improved glycaemic control are only of anecdotal value as they have not happened against the backdrop of a set of agreed definitions and parameters, there is no control group and we have not factored out potential confounding issues. I personally might be wholeheartedly convinced that low carbing has helped me in the short term (and I am - I've lost over a stone since New Year and have lower fasting sugars than when I started, still waiting for the follow up HbA1c to confirm my expectation of a decrease there too) but it isn't possible to extrapolate from that that low carbing will help me in the long term or that it would neccessarily help everyone - even though my gut feeling is that it probably would. My gut feeling is not a scientific approach, and a scientific approach is what is needed to win the day - look at all the folk whose gut feeling was that the sun went around the earth and the world was flat :lol:

The tone is a touch negative but I'd rather there was something rather than nothing - my Mum has been very worried about my low carbing (she's type 2 on meds and the traditionally recommended complex carb diet), this will make it easier for her to accept that I'm not doing something dangerous and might make it easier for me to get her to experiment.

 

[Unbeliever]

I have noticed a few HCP's "hinting" abot low carbing recently. As many GP's now have litle input to the care of diabetic patients even a change in "tone" from DUK may help.

On the rare occasions I visit a GP they tend to like to air their knowledge of the latest newsletter from DUK . This is quite ironic I find .as I am not really allowed to consult them about my diabetes! I think they ought to re-read the statement on self-testing of blood glucose too.

The younger doctors in my practice keep repeating the mantra about there being no need to test except etc etc. This is more annoying when repeated apropos of nothing. I am not asking for test strips {i do get them on prescription} or even discussing diabetes. I am obviously just providing a platform for some showing off.



I

 

[alaska]

One problem with recommendations based on research is that the validity of the recommendations is limited by how well planned the research projects, which they're based on, are.

Diabetes UK say within their position statement:

What does the evidence show?
Although there is substantial evidence regarding low-carbohydrate diets, the strength of the studies vary. Many trials lack a control group or are of short duration (less than one year) or have varying degrees of carbohydrate restriction or include a combination of these shortcomings.

It's a touch inconsistent then that their reasons for not advocating a low carb diet for people with type 1 is largely based on the following study which employed no control group:
http://www.ajcn.org/content/89/2/518.full.pdf

 

[Daibell]

Hi Primmers

I understand and agree with your point about research reporting needing to be based on proper research methodolgy etc. However there seems to be an implied assumption within the NHS and DUK that today's standard diet enjoyed by the greater masses is proven to be 'good' and therefore there is a risk of going away from this (e.g. to low carbs) where it isn't proven safe. I'm not aware of any research that 'proves' that today's diet is safe. In fact we all know that with supermarkets full of very high calorie carb foods that this diet can be quite harmful with growing obesity, clogged arteries etc and, of course, T2 with it's extremely harmful outcomes. I would therefore prefer to take the 'risk' of going low'ish carb associated with regular BS measurement. Surely it's preferable to keep carbs low'ish, based on regular BS measurement, if the alternative is some or higher medication with it's associated risks or having high BS and the inevitable serious outcome. My choice is a mix of low'ish carb, excercise and high medication before I go onto insulin and most T2s have to make similar trade-offs to suit their T2 behaviour.

I guess one background point is that I was trained as a scientist and have been a professional engineer all of my career. I have always based my project decisions wherever possible on research or reported facts. I have often, however, had to use my 'gut feel' and as you get older this can be quite reliable as the brain does integrate assimilated knowledge very well over the years.

 

[donnellysdogs]

I just wish i could be a person involved in any of these tests that are run!!!!!!

I am so much better for limiting the qty of carbs rather than my original set up 25 years ago of eating loads of carbs. I personally just with that these tests were picked from people on websites such as this that are interested in improving research, improving their lives, and improving diets, and improving the overall health of all future diabetics.


Has anybody on this website ever been involved in any test or research? I tried to be, but have never been called upon......

 

[JUSTFOCUS]

Once again the tests don't state the condition of anyone involved pre- anti carbing or post then we still get into that average person label that proves absolutly nothing either way . I think the money wasted on these tests should be used for funding free strips .I would be very intrested how a person ty2 or t1 would react to a completely natural diet of veg fruit meat (meaning no geneticly modified or processed food) would fair up against the absolute rubbish so called five a day processed un natural excuse for food in our shops at the mo !!!!!!!!!!!!! The question is who would take the challenge ???????????? (Anika Rice is not allowed !!!!!!!!!!!!!! :lol: :lol: :lol: :lol: :lol: :lol:
JF. :wink:

 

[IanD]

I've just started a new thread on another forum & I find this new thread! I started low carbing 3 years ago with advice from members of this forum.

I came across the July/August 2003 Balance, which had an article "investigating the truth behind a low carb diet."

I won't bore you with warnings of the dangers of "breakdown of vital muscle & body tissues" or "increased risk of heart disease, cancers & bowel disorders" or "the risk of kidney disease." Such a diet may be "suitable ... with medical supervision & with guidance from a state-registered dietitian."

A key paragraph is: "Research into the long-term effects of low-carb diets is now required. And in response to this, Diabetes UK is funding such research."

I presume the results of that research are seen in D UK's Position statement (after 2009) Low-carbohydrate diets for people with Type 2 diabetes which concludes with:

"More research is needed to assess the effectiveness of varying degrees of low-carbohydrate diet on weight, glycaemic control, hypertension and lipid profile in people with Type 2 diabetes (18) as well as to investigate the long term effects of these diets."

I can't wait for yet more long term studies - I've too much to lose. I followed their "healthy diet" for 7 years & was crippled by the complications. My low-carb diet started in May 2008. The complications disappeared in 3 months. Three years on I am well & active. There is no hint of any adverse effects in my experience. My Drs are happy with my level of health & all my blood test results.

 

[IanD]

Have any members of this forum experienced ANY adverse effects of low-carbing? We have a "Success stories" thread.

Yes, I am a subject of an on-going research project - SABRE - reported on this forum. That was 1 year into low carbing. There were NO conditions that needed any treatment. There still aren't. I'm 72 & play tennis at club standard.

A frequent warning concerns the effect of a high protein diet on kidneys. 5 years ago (on the D UK diet) my "Glomular Filtration Rate" (eGFR) was 64. When recently measured there was no change. That indicates mild kidney function impairment & needs no treatment. (Ideally above 90. Dialysis is given below 15.) Dr tells me to maintain my diet.

 

[viviennem]

Hi, IanD

Adverse effects of low-carbing - well, I'm on my second phase of it - went on Atkins in April 2004, stayed on Induction for 18 months and lost 5 stone, slipped off for various reasons in November 2005 but never went back on to my previous really high carb diet (just how much mashed potato can one person eat? :shock: ).

The weight went back on mainly due to red wine consumption, I think, though obviously adding carbs back didn't help, and nor did dropping exercise. I went back to low carb 12 months ago and am doing okay, though I need to add the exercise back in.

That's the background. I can honestly say that the only adverse effect of low-carbing that I experience is mild constipation - I say mild 'cos I always go eventually - just that it might be two or three days and I prefer daily!

The good effects - reduced BG, BP and cholesterol levels, more energy, better outlook on life - etc etc.

Atkins is basically a diet that uses unprocessed, natural foods with a low glycaemic index. You don't so much add fat as not avoid it. I have never eaten so much veg in my life as on this diet, and I really enjoy eating this way. I am never hungry! (other low-carb diets are availabe :lol: - this one suits me!).

Over the period from 2004 I have had regular blood tests, and have never had kidney or liver problems (they must be made of titanium!). Nor do I have cancer, and I've recently been (routinely) screened for breast, cervical and bowel cancer. My BP is a bit too high at present, but coming down as I low carb. Ditto cholesterol - and I would and do expect the same for BG, though I am now Type 2 diabetic and on 3 x 500mg metformin to aid the diet.

So - you're ahead of me by 11 years and I'm nowhere near as fit as you, but I have no problems whatsoever with a low-carb lifestyle.

Is this what you wanted to know? Any spaces on that trial you mentioned?

Viv 8)

 

[IanD]

Is this what you wanted to know?
Yes. A lot of us on this forum have been low carbing for several years, & I was wondering if any of the threatened complications had come about for ANY of us.

Any spaces on that trial you mentioned?

No.

SABRE was "Southall And Brent REvisited" to assess factors affecting the health of Immigrants compared with English. I haven't seen the final report. The follow up - AMORE - hasn't got off the ground, as far as I know. Lack of funding will probably kill it. They were hoping to use NHS facilities for testing the effect of exercise on health. We were disqualified because we exercise already.

 

[IanD]

Sue - should we organise a forum petition to D UK to get them to organise a diet survey?
e.g.
How would you describe your diet?
D UK starchy carb
Low carb

When did you start that diet?

What other diets have you used?

Why did you change?

Have you experienced any complications?

Space for comments should be included. May be somewhat complicated as most of us have used several diets.

 

[kateincornwall]

What a good idea Ian
I am a very fit almost 64 year old , I embarked on a lower carb regime at diagnosis of Type 2 in 2009 . I had tried other regimes, ones recommended by HCP to try and stave off diabetes when I was in a pre diabetes state , the high carb low fat ones , they didnt work at all and I am convinced that the higher carbs led to diabetes being diagnosed .
Having researched , I decided to ignore the advice previously given , I had three months in which to try and improve my BG before being put onto medication and so I started on reducing carbs .
Since diagnosis , I have lost 5 stones in weight, have improved my cholesterol and also improved my previously high BP , now acceptable although I am still on Beta Blockers .
I have not suffered from any adverse reactions to low carb , blood tests for liver, kidney etc. all come back normal and so in year two of this way of life , I feel fitter and more active than I did in my 40`s , I walk miles every day with my dogs and feel fantastic .

 

[Unbeliever]

yes, excellent idea. I can't believe they are so slow to investigate such a simple way to cut costs to the NHS.

The advice to eat a "normal healthy diet" is one thing but to actively push the starchy carbs is another

Until accidental diagnosis I had low carbed naturally for years as that seemed most suitable for my digestion, It probably helped keep me symptom free for years.. When I was diagnosed I was not gibven any dietary advice as it was thought unnecessary . The starchy carbs were advised when i suffered side effects from Metformin. I was also offered medication for side effects by the first GP I saw- rather than prescribe the modified release metformin which ,at that time ,cost £! more per month!

It would be very interesting to see how many can testify to an improvement as a result of low carbing..
Not a scientific result I know but still might help to persuade someone to undertake the research.

 

[catherinecherub]

According to this page from DUK, there is a 2yr. study going on.

http://www.diabetes.org.uk/Research/Arc ... c_control/

Royal Devon and Exeter Trust. Reducing carb intake for achieving weight loss and risk factor control in Type 2 Diabetes.

This study will aim to see if a LCD can work for up to two years, both in losing weight and keeping it off.

We have too many variables here because people are not only low carbing, (that in itself is open to interpretation). Some are taking supplements, some are not. Some eat large amounts of fats, some reduce their fat intake. Some eat some starchy vegetables and fruit, some do not etc, etc........ You could ask if it is the method used, including other aspects of the diet, that is the success as there does not appear to be a uniform diet.
With trials people eat the same foods as everyone else.

According to DUK then I am a low carber but many here would disagree with that and so do I. You have to have rules to decide who is eligible to put forward their success and an overall interpretation of what low carb actually means.

 

[noblehead]

Given time I would imagine that DUK and the relevant health organisations will recognise the importance of reducing carbs in diabetes management, the benefits can no longer be ignored and some diabetes clinics (my own included) are more open in letting patients devise a diet based on their own experiences.

What we need to do in the mean time is move away from the term 'low carb'. When I suggested I was reducing my carb intake some 2 years ago my consultant was horrified and thought I was following a low carb diet such as Atkins and Bernstein, this couldn't be further from the truth but nonetheless they were concerned that I may be putting myself in harms way by following such a diet. Using a term such as 'reduced' or 'moderate' carb would go a long way to distance the association with likes of Atkins and others and may get the HCP on our side, once the myth is erased that everyone who reduces carbs doesn't eat a high fat/high protein diet then we can begin to move forward and change hearts and minds.

Nigel

 

[IanD]

According to this page from DUK, there is a 2yr. study going on.

http://www.diabetes.org.uk/Research/Arc ... c_control/

Royal Devon and Exeter Trust. Reducing carb intake for achieving weight loss and risk factor control in Type 2 Diabetes.

This study will aim to see if a LCD can work for up to two years, both in losing weight and keeping it off.

According to this link DRN 026 (Diet and weight loss) the study was completed in 2005 & published. That study is NOT included in the D UK "Position Statement." Can anyone locate it?

I have clicked on your link, & looked at the D UK "Research project directory." That Exeter study would not appear to be current.

 

[IanD]

I emailed for a copy of the report & it was bounced:
"Delivery to the following recipients failed.