Eat to your meter and Controlled Carb Regimes

[xyzzy]

Phoenix.

Appreciate the looking up.

The differences (or lack of) between the UK and ADA tables you present are interesting aren't they?

Lets put the GI thing to rest for a bit. I agree both positions say its a good and useful thing. The UK seems to rate it slightly higher than the Americans "A" versus "B" but that's all I've been saying so don't see any conflict. If its gone up in the Americans estimation in the last 5 years then fine I said I thought her statement was to extreme anyway.

Both systems as you say recommend portion or plate control. I have no preference in how a T2 gets control, just that they should. I have no experience if it would make a difference to insulin users so won't comment. I can see all applicable ways work including for "techie" people like me counting carbs. My recommendation would be the same as Sid which is which ever way works best for the individual. The Swedes also recommend portion control so can't argue with them!

What I would say is both sides do concentrate on carbohydrate control as priority "A" and even though the two tables look similar the text behind the scenes in the UK doc says something else.

Carbohydrate: Although the total amount of carbohydrate ingested is the primary
determinant of post-prandial blood glucose response, there is little evidence to support
specific strategies for recommendations about carbohydrate intake in Type 2 diabetes.
The efficacy of carbohydrate counting in those individuals with Type 2 diabetes treated
with insulin is largely unknown. Carbohydrate counting based on insulin to
carbohydrate ratio has been shown to be as effective in reducing HbA1c as a simple
algorithm based on self-monitored blood glucose (SMBG) [123]

So weasel words... "Although the total amount of carbohydrate ingested is the primary determinant of post-prandial blood glucose response"

Followed by.. "there is little evidence to support specific strategies for recommendations about carbohydrate intake in Type 2 diabetes."

Carefully ignoring the evidence that say the Swedes must have been happy with to come out with "Kost Vid Diabetes" and the 30% total carbs recommendation later made in the same year as the UK doc. They are also of course carefully ignoring what must have been similar evidence to make the ADA come out with its 130g / day recommendation this year.

Like me with low carbs Phoenix your GI does no better.

• Glycaemic index: Low Gl diets have shown improvements in HbA1c of up to 0.5
per cent [77, 124], and the majority of studies have been performed in people with
Type 2 diabetes. Although two more recent randomised controlled trials have shown
no evidence of benefit of low GI to other strategies [125, 126]

My point is Phoenix whichever side of the "carbs more important than GI" or "GI more important than carbs" when will these people ever make any decisions to change?

Another set of weasel words from page 16 (my underline)

It is unclear what ideal proportion of macronutrients to recommend for optimal glycaemic
control for Type 2 diabetes, but total energy intake and weight loss are significant.
Monounsaturated fat can be substituted for carbohydrate without detrimental effect to
either lipids or glycaemic control, but saturated fat should be minimised [116, 117, 118,
120]. When protein is substituted for carbohydrate, short-term glycaemic control improves
[113,114]. A modest reduction in carbohydrate intake is associated with improvements in
glycaemic control and low carbohydrate diets can be particularly effective if associated with
weight loss.

You'd think reading that I'd be happy as effectively its kind of stating a LCHF message but the message is lost. What does "A modest reduction in carbohydrate intake" actually mean? The Swedes and the American GIVE it a measurable meaning 30% total carbs for the Swedes or 130g / day for the Americans.

It's just spin to keep the status quo. It sits on the fence neither recommending or disagreeing. No wonder I end up seeing a Nurse Nightshade. Poor woman is probably as confused as that document. :lol:

[Edited after Paul's comment]
Honestly Phoenix, putting aside our differences on emphasis of certain things and even the actual content of various health systems docs then don't you agree that compared to the Swedish "Kost Vid Diabetes" doc which states things in plain simple uncomplicated terms and offers clear advice that the UK one is a wishy washy thing that really doesn't know what its advising?

 

[Paul1976]

There HAS to be a baseline of where to start and then tweak accordingly.The NHS (well,my surgery anyway,don't even MENTION carb cutting in any form,never mind an actual figure) Their teachings,long term,amount to Genecide!(well not intentionally I'm sure)
thank god my Endo see's the relevance of my carb cutting-I guess I was just lucky with the Endo I visited! Shame his thinking isn't uniform across ALL PCT's! :think:

 

[CollieBoy]

Nickcave1,
I too prefer to have a life , but would prefer to have it without complications. To this end, I tend to check the foodstuffs I buy for carbs, and hence when/if I wanted an Easter egg or such, I can indulge a little
Also, staying up to date on medical research means that my consultant realises that he can discuss things with me and know that I can follow his argument.
But each to their own, I suppose!

 

[jopar]

I agree that we all have a life to live...

But keeping up with new research or methods, can enable you to live your life, with better management of you condition.. As it does take time for improved regimes or way of doing things that improves our management to filter down and outwards to all diabetics..

When I first started insulin, your consultant not only prescribed the amount of insulin in two injections you had, but also the amount of carbohydrates you ate per meal and snack, and you had to have 3 meals and 3 snacks a day, worked reasonable well, but did have it's problems though as for me being prescribed 130g of carb in total a day, was a struggle my appetite isn't that large.. And well like most people the demands in my life didn't always suit my regime..

Now, I decide what I want to eat, and I work out the insulin amount I require to keep control... A method that works a lot better and allows me to live my life..

But I have met many diabetics who started off on the regime I started with, and still carry on with the same regime today, even though for them it's far from worked well and has stopped them living their lives as they wish..

Carb counting for both T1 and T2's is a very important part of their management.. In the main for T1's if you don't know how many carbs you'll eating, you won't be able to work out your insulin dose, for T2's it's more a case of, if they don't know they have no idea where a control issue lays, is it a medication problems or an intake problem!

And it's important to debate new ideas etc... As this ensures that everybody gets the information required to make an informed choice to how they want to manage their diabetes..

 

[AMBrennan]

Read to page 9 and am already confused...

Traditional diabetic diet
There is scientific support for the traditional diabetic diet based the Swedish Nutrition Recommendations (SNR) has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Moderate carbohydrate restriction
There is scientific evidence that moderate carbohydrate diet has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Mediterranean Diet
There is scientific evidence that the Mediterranean diet has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Traditional diabetes diet low glycemic index (GI)
There is scientific evidence that traditional diabetes diet low glycemic index has a positive impact on long-term blood sugar (HbA 1C ) And improves blood lipids

Positive impact compared to what? If you get positive impact as longs as you eat less, regardless of what you eat, how can you recommend any specific diet?

 

[xyzzy]

Read to page 9 and am already confused...

Traditional diabetic diet
There is scientific support for the traditional diabetic diet based the Swedish Nutrition Recommendations (SNR) has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Moderate carbohydrate restriction
There is scientific evidence that moderate carbohydrate diet has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Mediterranean Diet
There is scientific evidence that the Mediterranean diet has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Traditional diabetes diet low glycemic index (GI)
There is scientific evidence that traditional diabetes diet low glycemic index has a positive impact on long-term blood sugar (HbA 1C ) And improves blood lipids

Positive impact compared to what? If you get positive impact as longs as you eat less, regardless of what you eat, how can you recommend any specific diet?

To be honest I wondered that too! My interpretation is simply that at a point someone is diagnosed diabetic any one of those diets has been shown to have a positive impact on long term levels and outcomes. So effectively as a newly diagnosed diabetic take your pick but make a change. As a "levels is most important" person I really do have no preference just as long as whatever you change to does keep you safe. I push the "Moderate carbohydrate restriction" purely out of personal preference and for reasons such as ease of getting the foods it recommends and that it emphasises carbohydrate control as the primary control mechanism.

 

[phoenix]

AM Brennan
I think you need to read it alongside the 'systematic review' (which is itself rather lacking in detail but at least in English)

At 12 months in people with diabetes, moderate low-carbohydrate diets (30%–40% energy, E% from carbohydrates) and
low-fat diets with high-carbohydrate content (50–60 E% from carbohydrates) have similar effects on bodyweight, HbA1c
, total cholesterol, LDL cholesterol, and triglycerides (moderately strong scientific evidence ⊕⊕⊕○).
• At 12 months in people with diabetes, moderately-low-carbohydrate diets have somewhat better effects on HDL cholesterol than do low-fat diets with high-carbohydrate intake (moderately strong scientific evidence ⊕⊕⊕○).
• The effects of more extreme limitations on carbohydrate content (10–20 E%) in patients with diabetes cannot be determined due to insufficient scientific evidence (⊕○○○).
• Scientific evidence is not available to evaluate the long-term safety of moderate and extreme low-carbohydrate diets. This includes cardiovascular morbidity and other complications of diabetes

Other dietary factors, including the Mediterranean diet
General
• People with recent onset of type 2 diabetes who are advised to follow a Mediterranean diet have less need for oral antidiabetic medicines and have lower HbA1c, higher HDL cholesterol, and lower triglycerides than people who are advised to follow a lowfat, high-fiber diet (limited scientific evidence ⊕⊕○○).

(snip sections on vegetables, legumes, nuts, fish, unsaturated fat

Glycemic index (GI)
• People who have been treated with oral antidiabetic medicines for type 2 diabetes appear to achieve improved glycemic control and higher HDL cholesterol if they lower their glycemic index (GI) by around 14 units (limited scientific evidence ⊕⊕○○).The scientific evidence is insufficient for drawing conclusions on the extent to which GI reductions below 14 units affect blood glucose levels and blood lipids (⊕○○○). We found no scientific evidence upon which to draw conclusions concerning people with type 1 diabetes.
Glycemic load
• The scientific evidence is insufficient to determine whether or not people with type 2 diabetes that reduce carbohydrate content by approximately 10 E% in favor of fat (mainly monounsaturated) achieve better glycemic control than people on a diet with high carbohydrate content (50–60 E%) (⊕○○○). We found no scientific evidence upon which to draw conclusions
concerning the effect of reduced glycemic load in people with type 1 diabetes

.

Hence there are a variety of diets that may have a positive impact on the effects of diabetes ie reduce HbA1c, lower LDL, Trigs, and weight +raise HDL
The document rightly stresses the quality of much of the evidence.
http://www.sbu.se/upload/Publikationer/ ... 110517.pdf
doesn't say one size fits all though

 

[xyzzy]

doesn't say one size fits all though

... and neither do I. Like I say "eat to your meter" is my stance. If you disagree with the regime I prefer to achieve that stance, fine, go find your own way. So long as you don't end up pushing an unrealistic regime and then claim it works for the majority of people like me then I have no problem. The bottom line is for the majority of diet only T2's regardless of what regime they choose that suits them will find that regime needs to emphasise carbohydrate control to keep their levels safe. Most modern diabetic literature even the latest UK stuff says that. Simple really ...

 

[Defren]

doesn't say one size fits all though

... and neither do I. Like I say "eat to your meter" is my stance. If you disagree with the regime I prefer to achieve that stance, fine, go find your own way. So long as you don't end up pushing an unrealistic regime and then claim it works for the majority of people like me then I have no problem. The bottom line is for the majority of diet only T2's regardless of what regime they choose that suits them will find that regime needs to emphasise carbohydrate control to keep their levels safe. Most modern diabetic literature even the latest UK stuff says that. Simple really ...

At the risk of sounding like a xyzzy groupie, yet again I agree with you. The eat to your meter mantra is the only way to find out what we can and can't tolerate, irrespective of which diet we choose, Atkins, Dukkan, low carb, portion control, cabbage or flippin' meat pie. Eating to our meter allows us to check individual foods, and therefor build a picture of us as individuals. Some of us can tolerate small amounts of carbs, burgen bread, pasta whatever, others like me can't. To keep my BG's down I must remain ULC that works for me, other people can have higher carbs, but it's all down to learning what is right for us by eating to our meter. It doesn't have to be part of any diet, but it just seems like plain old common sense to me.

 

[phoenix]

Xyzzy,
I wasn't actually referring to your post above mine, when I made my last remark. We crossed posts.

I heartily agree with using a meter... although I think that the tool has to be used with a bit of caution; i know only too well that identical meals can have very different results on different days (because all the other variables including emotions come into play)

My point is that the Swedish authorities do not recommend one particular type of diet.They recommend individual dietary advice, (and the guidelines are aimed at professionals as are those in the US) starting from where the person is and adapting that. They then suggest 4 diets and a variety of individual foods all of which have some evidence to show that they are beneficial in some way.
I have great reservations to the suggestion that in the US the advice you receive would be vastly different to in the UK
( Here is the text on a slide taken from a lecture given last year at a Diabetes Symposium by the lead author of the ADA guidelines (M Franz))
http://www.mcw.edu/FileLibrary/User/bco ... ay20th.pdf
she does indeed focus on counting carbs:
(and please can I emphasise that I'm not saying that I agree with her, just reiterating what she says)
carbohydrate recommendations
Start with 3-4 servings per meal for women, 4-5 servings per meal for men, 1-2 for a snack'
emphasise day to day consistency
test post meal glucose < 160-180mg/dl
The slide before says that
(carbs are from desserts, milk, fruit and starches , veggies are free foods, 1 serving carbs=15gcarb)
the following slide says
Locate total grams of fat (refers to a food label)
– 3 or less g of total fat for every
15 g of carbohydrate
– 3 or less g of total fat per 7-8 g
of protein
– 1/3 or less of total fat g from
saturated fat
For a man this amounts to more than 200g of carb and with the fat restrictions really doesn't sound that different to what might be suggested in the UK The Diabetes UK guidelines actually reference the most recent ADA ones and were updated last year)

 

[xyzzy]

No problem Phoenix

I do not disagree with much you have written in this sense at least. Yes I accept that all countries the UK included should be recommending dietary guidelines on a per individual basis. That makes a great deal of sense and that joint US / European self management doc was one I gave to my DSN the other day with the sections on making individual choices and targets being the ones I highlighted to her.

I agree the Swedes do recommend more than one diet but at least they do and at least the ones they recommend would seem to have some chance of working.

We could argue the US DO have a 130g RDA carbohydrate recommendation in their 2012 position doc but to me again its a pretty futile argument for us to have. I do take your point that the UK guidelines DO reference the ADA ones. A post you made on this thread showed that and I do not really dispute it. I do dispute that even though the UK doc does reference the material it by no means clearly endorses those references in fact I think the UK doc studiously avoids recommending anything of substance and is by no means as clear and concise as either the American or Swedish recommendations.

So as you can see Phoenix I am trying to be as accommodating as I can. If you accept the "eat to your meter" principle (and I agree that isn't as black and white as it sounds for any number of reasons) then as long as you accept I have a right to choose how I "eat to the meter" by emphasizing carbohydrate control just as you have every right to choose your way then really we should just accept that and move on and continue in my view to work for the common good of everyone. Everyone has the right to choose whatever way psychologically suits them the best or else we end up undermining each others ability to control our conditions.

Now accepting the above doesn't mean we can't have some fine and fun debates! So I'll go down a bit of a tangent and readdress section 3 of my original post "The failing NHS" as we haven't done that for a while and it always leads to some stimulating debate because it isn't just all dry numbers and carbs and GI and mmol/l. So lets have a bit of a debate about that.

I've accepted that those UK guidelines are similar to the US ones in terms of recommendations. My problem is has the NHS accepted those guidelines? It's all very well some clever people writing the guidelines but they are particularly pointless if they never get implemented. So here's an example of what I mean. Considering the bad press we diabetics are getting because we cost the tax payer far to much cash then surely it is this rubbish that needs to be changed. I see no correlation between what's in the image and what you or I are calling the UK or US guidelines. Do you?

 

[Grazer]

A few thoughts here on carbs and Gi

Read to page 9 and am already confused...

Traditional diabetic diet
There is scientific support for the traditional diabetic diet based the Swedish Nutrition Recommendations (SNR) has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Moderate carbohydrate restriction
There is scientific evidence that moderate carbohydrate diet has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Mediterranean Diet
There is scientific evidence that the Mediterranean diet has a positive impact on long-term blood glucose (HbA 1C ), Promotes weight loss and improves blood lipids.

Traditional diabetes diet low glycemic index (GI)
There is scientific evidence that traditional diabetes diet low glycemic index has a positive impact on long-term blood sugar (HbA 1C ) And improves blood lipids

Positive impact compared to what? If you get positive impact as longs as you eat less, regardless of what you eat, how can you recommend any specific diet?

I agree that it sounds odd; anything works almost! But when i think about it, it doesn't surprise me at all. Most diets are compared to the traditional (UK at least) 300 grams carbs for men GDA (250 for women), and we can see from Phoenix's post that one diet (50% from carbs) came to almost that figure. Truth is though, I suspect MOST type 2's on diagnosis are eating a great deal more than the GDA figure. I wasn't overweight; (well, barely) with a BMI of 25.2. But I was eating a lot more than 300 grams of carbs a day. So following ANY diet, meddy, 50% carb supply, 30% carb supply, ALL would result in lower BGs for me because they ALL include a great deal less carbs than my actual figure. My 150 grams a day of carbs is 50% of GDA, but maybe 30% of what I actually ate.
We all acknowledge though (I think?) that less carbs = lower BGs for a T2 on diet/metformin. It's just a matter of how many less before we go to option 2), stronger meds. Some may want to do that long before they get down to a VLC diet. Others will be happy to eat to 30 grams a day. At least it is an option for us.
I do also think GI is important. Sorry xyzzy! I do think total carbs come first for a T2, but high GI, lets say a bar of fry's orange cream (Memories!) will we know give us a very quick response in way of BG rise and require a good phase 1 insulin response which we don't have. Levels thus go high, and our Pancreas has to work much harder to produce the amount of insulin needed in phase 2. So more pancreatic work, more damage and higher averages because each peak that's higher also lasts longer and adds more to our averages. Not much as a one off mathematically, but on a regular basis it's significant. So, for me, it's total first but GI a very important second. Actually, think I'm agreeing with you xyzzy, other maybe than to the level of importance!

 

[xyzzy]

So, for me, it's total first but GI a very important second. Actually, think I'm agreeing with you xyzzy, other maybe than to the level of importance!

Yeah strange how people end up agreeing with me when they think they don't :lol:

but actually Grazer I suspect the confusion is that for me it's normally level first, count second, gi third but that's just me occasionally I do find level first, gi second, count third and the likes of Catherine and Phoenix have correctly pointed out why I shouldn't be surprised. As I mentioned back in the earlier discussions of GI I have no intention to trash it far from it. The intent was to show that various people and various countries view GI slightly differently. The same can be said for carb counting. As a reductionist I think I take all of those things into account and reduce it down to "do whatever you think works but keep yourself safe." i.e. level is first.

 

[borofergie]

but actually Grazer I suspect the confusion is that for me it's normally level first, count second, gi third but that's just me occasionally I do find level first, gi second, count third and the likes of Catherine and Phoenix have correctly pointed out why I shouldn't be surprised.

Well done! You've just derived the Glycemic Load from first principles. Well almost; the beauty of GL is that it doesn't matter if you prioritise count, portion or index. I minimise count and index to the extent that portion size is irrelevant.

 

[Grazer]

but actually Grazer I suspect the confusion is that for me it's normally level first, count second, gi third but that's just me occasionally I do find level first, gi second, count third and the likes of Catherine and Phoenix have correctly pointed out why I shouldn't be surprised.

Well done! You've just derived the Glycemic Load from first principles. Well almost; the beauty of GL is that it doesn't matter if you prioritise count, portion or index. I minimise count and index to the extent that portion size is irrelevant.

+1 Stephen. I suppose I use GL more than count or GI, but tend to do it subconsciously now.

 

[xyzzy]

but actually Grazer I suspect the confusion is that for me it's normally level first, count second, gi third but that's just me occasionally I do find level first, gi second, count third and the likes of Catherine and Phoenix have correctly pointed out why I shouldn't be surprised.

Well done! You've just derived the Glycemic Load from first principles. Well almost; the beauty of GL is that it doesn't matter if you prioritise count, portion or index. I minimise count and index to the extent that portion size is irrelevant.

+1 Stephen. I suppose I use GL more than count or GI, but tend to do it subconsciously now.

Well going to disagree with you both.

Levels are first for me. GI, GL & Carb Count will give a good approximation of what is going to happen to my levels over some period of time. Again without wishing to sound over critical of GI I call it a good approximation of what is going to happen because of the stuff I raised earlier in the thread. I would also add the carb counting is also in my mind only a good approximation. My personal belief is that carb counting (that simplistically approximates how much of a spike something will give) is slightly more important to me as diet T2 than GI (that simplistically approximates how long it takes to process a spike).

The keyword as a "levels" man in the previous paragraph is not GI, GL or carbs but spike. Where spike is how much eating something has raised my blood glucose levels. So if my levels have been raised they need to come down again and of course the thing that does that is insulin. Therefore something that predicts a required insulin response is more fundamental in my reductionist "levels" head than either GI, GL or Carbs. Up until Phoenix told me about it a few weeks ago I never realised a thing that measures such a response exists but it does and its called Insulin Index

http://en.wikipedia.org/wiki/Insulin_index

The Insulin Index is a measure used to quantify the typical insulin response to various foods. The index is similar to the Glycemic Index and Glycemic Load, but rather than relying on blood glucose levels, the Insulin Index is based upon blood insulin levels. This measure can be more useful than either the Glycemic Index or the Glycemic Load because certain foods (e.g., lean meats and proteins) cause an insulin response despite there being no carbohydrates present, and some foods cause a disproportionate insulin response relative to their carbohydrate load.

The original research is here: (thanks Phoenix)

http://www.ajcn.org/content/66/5/1264.full.pdf

Now just because I like it doesn't mean it's easy to use - they don't print the insulin index on packets! Also if you look closely at the research done the data isn't quite there yet and shows some weird unexpected discrepancies. Consequently as much as I like the Insulin Index feory it needs more work at the moment in my opinion.

What I hope you can see is the slight difference in perspective that a "levels" person has compared to say a VLC'er, LC'er, GI'er or GL'er. Pretty close to both but not quite. Everyone is different! :lol:

I often wonder if I'm the only one who thinks that psychologically deeply that levels are the thing. It is obvious in other members posts that they have deep psychological attachments to their own control methods and that's all fine by me as each of us needs to control using what we think suits us best as individuals. Any other levels men or women who think roughly the same or am I just a weirdo? :lol:

 

[catza]

In addition to the link that you have shown in the above post I also came across the Insulin Index when I was doing my own research into what I could eat once I decided to go low carb and these were the sites that I also bookmarked.

http://www.mendosa.com/insulin_index.htm .................. http://web.healthorize.com/gi_insulin_index.htm

I found the idea interesting so I guess you could say I would be a levels person if a more comprehensive list existed as all I could find were foods listed that, in the main, I have already eliminated from my diet.

 

[phoenix]

My personal belief is that carb counting (that simplistically approximates how much of a spike something will give) is slightly more important to me as diet T2 than GI (that simplistically approximates how long it takes to process a spike.

quick one: (far too many things to discuss on a Saturday morning)
GI doesn't measure speed or length of the processing... we tend to use the terms fast, slow but that isn't really what is happening. It is the total amount of glucose produced that counts ie the area under the curve. In the graphs below you can see potato, glucose a soft drink and lentils all reach their peak at about the same time but result invery different amounts of glucose.

 

[Grazer]

What I hope you can see is the slight difference in perspective that a "levels" person has compared to say a VLC'er, LC'er, GI'er or GL'er. Pretty close to both but not quite. Everyone is different!

Vive la difference! :thumbup: But can't do french accents on my keyboard!
Not sure there is a difference though? Not even sure you're disagreeing with either of us? I think we are all "levels" people first and foremost. Look at Stephen when he got his HbA1c of 4.5, and how we all feel when we get a BG in the 4's. We're all levels people but we express how we focus on that differently. Stephen is saying that he KNOWS his levels (spikes) will be fine because of the inherent low carb nature of his eating. How can you get a spike when you eat one pea a day? I know my spike response according to number of carbs I eat and GI, so although I look at numbers and GI, it's with the first aim of controlling the peaks. Although I know GI results vary from person to person, we all know that at extremes it predicts rates of rise well - glucose will certainly raise my BG quicker and higher than a bag of walnuts. And testing has showed me how I relate to GI tables with my response.
The insulin response tables were really interesting, but even Phoenix admitted to being a bit baffled by the figures for cheddar cheese. The quote about insulin response to protein may, I suspect, depend on the normal diet of the individual outside of the test. For example, Phoenix I think suggested that a person who normally consumes a large amount of carbs and then just eats protein for a test could have a high insulin response in anticipation of carbs to come. And as you say, insulin response tables aren't very helpful in allowing us to check food for content, but the insulin response is indeed what it's all about in my book. Every high insulin demand for a T2 on diet is another few steps towards a weaker Pancreas in my view. So a high GI item like pastry or white rice is going to give a higher peak and resulting insulin demand than, say, the same carb count of new potatos (for me at least, as tested)
So levels and peaks are key in my mind and I agree with you; it's only our method of looking at them and controlling them that might vary. As the heading of the thread says, "eat to your meter", but to do that we have to make assumptions (hopefully empirical) before we eat to give ourselves a chance, (based on whatever system we choose to use) then hopefully we adjust as a result of the test to end up on the levels we desire.
I forgot what I was trying to say half way through that so just rambled I think.....problem of age....

 

[xyzzy]

Thanks to all who have replied and posted will read the links later Catza like Phoenix am trying to be busy today. Yes Phoenix realise I horribly simplified but that was to try and emphasise "levels" only. You were right to correct my over simplification.

Yes I do think a lot of this is semantics and can be over analysed and Grazer I think you and I are probably very close in attitude it's just I'm a bit more of a levels fanatic than you. Like you said in your post yesterday you do all this pretty sub consciously which is exactly how I try and approach it.

Another reason why I like Insulin Index or equivalently looking at what does or does not produce an insulin response is it "internalises" all of what goes on inside of me so its my blood glucose level and my insulin response that form the fundamentals of how I control my db. Like I say a lot of this is quite psychological if I really self analyse it.

Here is a difference though between me and Stephen - I think - he'll probably come back and say its not being the contrary guy he is or show me I'm wrong!

I've said in recent posts on other threads MW now worships at the shrine of Stephen. She cooks all this really nice VLC stuff which I recommend cos its nice not because its VLC. Now being a reversed pre diabetic on a VLC regime she has no real need to really concern herself too much about an insulin response and to her at the moment its all about keeping herself in ketosis to burn the fat etc to lose weight so all standard VLC stuff.

Come dinner time she'll put some of what she's made with a load of salad for herself specifically to keep the carb count as low as possible. Me I'll do some stir fry or veg as I'm not that into "rabbit food" and have to fancy it so I end up having a load more carbs than her BUT to me that's fine because the stir fry or veg no don't cause me any major insulin response. However having those veg when combined with the other stuff I consume over the day may well keep me out of ketosis. Whether or not it does or does not effect ketosis is to me largely irrelevant. If I found eating a zero carb (or low GI) meal actually spiked me more than eating a 50g (or higher GI) one I would choose the 50g (or higher GI) option because I'm a levels person.

Any clearer?