Help please! Dietary question.

[ladybird64]

I have posted elsewhere on the forum and received a lovely friendly welcome. I do really need some advice though, my head is in a total whirl.

I initally posted on this forum back in 2010, I have a 20 yr old daughter with a rare syndrome who is also T2, she is on Novorapid 28 unitsx3, Lantus 30 units, Metformin 1gx2, Simvastatin 80 mg (yes, 80) and other meds for thyroid and hormones. Her syndrome requires her to have a low calorie diet, around the 1000 cals mark. I am her full time carer and much as I love her, she is very hard work! The syndrome causes insatiable hunger so all food places in the home have to be padlocked, fridge, cupboards etc.

I have been diagnosed with T2 myself this week and feel like banging my head off the nearest wall.I have decided that I don't want to go down the medication route (doc wanted me to start meds) and would like to try and control my Diabetes by diet and exercise alone.

Now I can see that this is a great site and there seem to be so many helpful and patient people here but I have noticed..how can I put it...a certain amount of disgreement re dietary issues, especially carbohydrates!!

I'm not daft, I know one size does really not fit all but..help.

As I have daughter and rest of family to think of I need the simplest solution possible for this dilemma. This is what I had in mind, opinions please.

Daughter has smaller portions, with more veg than anything else. She rarely eats bread as she finds it causes her tummy to swell, I usually have two slices of toast for brekkie but that would be it on the bread front for the day.
I should add I have a load of weight to lose, being stuck at home with lass has caused depression and I have turned to food..that is going to change. Sorry, I digress. Anyhoo...

If I cut down my portion sizes, particularly the carbohydrates (I love pasta and rice!) will this help control my diabetes? I have noted that fruit needs to be taken sparingly so that's a bummer, two pieces a day be ok?

Just general advice please on if you think taking general sensible measures as advised for a healthy diet is suitable for a diabetic?

Many thanks to anyone who has taken the time to read this loooong post and offer advice.

 

[donnellysdogs]

I think that you have a lot going on, and yes, although you digressed to mention depression, it is totally understandable....however...

Yes, cutting portion sizes are a great start.

Certain fruits can be blood raisers, so it will be finding a choice that suits you. I tend to share with my husband a kiwi each, 1/2 an orange each, 1/2 a banana each with a few strawberries each with a moderate tasting of strawberry onken no fat yogurt (which is one of the lowest for carbs as well). It is more than 2 different fruits, but in smaller mixed quantitys. We also follow this by a portion of brazil, walnuts and hazelnuts, with a square of darkest chocloate afterwards if we fancy it. We mix our fruit depnding ons season....for the last couple of days we have had a delicious homegrown gooseberry fool, other days (depending on quantitys of strawberries from garden) we will both have strawberries and a small amount of double cream.

if your BG levels do not rise too much after toast for breakfast then carry on having if it....no need to cut enjoyment if your bloods allow you to eat it!!!

Cutting your carbs will enable you to lose some weight, you don't mention if you snack.....to lose weight you do have to recognise that you are eating more than your body needs, and being at home caring for your daughter may have an impact on the foods, exercise and your depression....the diabetes should be seen as a warning signal..and if your GP has allowed you to stay on a non med regime at the moment-then he/she must be giving you a chance to do something about it by changing your regime....

I probably haven't helped much, but you have come to the right place for support...take a step at a time...have you got a blood testing machine in your family-does your daughter test? See waht you levels are if possible before a meal and 2 hours after. Try not to snack, unless your sugar levels are low....find something else to do instead...

There are a huge amount of success stories here of people that have managed to stay off meds...I hope that you are able to find a way to do this too...

 

[ladybird64]

You have helped a lot, thanks.

I'm afraid the doctor didn't have much choice in the matter as I told him straight away I would be refusing medication (which I have a psychological problem with) and that I felt I should at least have a chance to try and change things through diet.

I do have access to a testing machine and test strips as my daughter has to test twice daily but I will probably buy my own meter and use that. I will do as you advise and check levels quite vigilantly for a few days, hopefully I should then have a pattern I can work with.

Snacking is my main problem, I have been eating far too much for far too long it's just sometimes very difficult..Im sure many others have the same problem. I'm not even enjoying the food half the time, guess a psychologist would have a field day.

Time for change. Thanks again

 

[viviennem]

Hi Ladybird64!

Why don't you have a look at my modified version of the Atkins Diet on the Low-Carb Forum? I'm not for a moment suggesting that you go on it (though you might find it suits you, and it certainly works, both for bg levels and weight loss!) but it lists foods you can eat on a daily basis that gives you about 20 - 25g of carb per day.

You could use it as a basis and then add in extra carbs to the level you want, trying to pick from low-GI foods, including fruit, and having small portions of things like potatoes, pasta and rice, until you find out what your blood glucose levels can take. That way you can eat food that suits you and still cook for your family. And test, test, test . . .!

I'll bump the thread up - look on the 'New Posts' tab on the Board Index. If you're interested in low-carb, there's some good discussion on there.

Viv 8)

Edited for PS - it's disappeared off the 'New Posts' - look on the Low Carb Forum. V

 

[AliB]

Hi.

Like Viv, I eat a very low-carb diet. It is also a very nutritionally-rich diet.

What I have found is that since I have dumped the carbs - although I had a lot of craving for the first few weeks - eventually that 'gnawing hunger' went away and I now can just eat what I need and no more. I get a pleasant desire for some food that is not excessive and is easily satiated, which is great. I know of others who have said the same thing. But you have to be in ketosis (fat-burning mode) for that to happen. Carbs drive blood-sugar spikes (high) and hypos (low) and when people are low they have an urge to eat. As I am in ketosis all the time (protein hardly raises the BG and fat doesn't raise it at all, I don't get hypos at all, so no gnawing hunger that goes with it.

I probably eat half the amount of food that I used to eat, but what I do eat is all natural and very nutritious. Most carbs - especially processed commercially-made ones are actually very devoid of nutrition - and some of it, like sugar that has no nutritional value at all actually robs the body of its own limited nutrition, so now I no longer eat those foods, my body is getting what it needs and is even making up nutritional ground in the deficiencies I have suffered over the years.

I have come to the conclusion that what I interpreted as hunger was driven by my unbalanced gut microbes. Too much carb - and especially processed carbs and sugar - encourages yeasts and fungus (I was a walking fungus-factory for years before L-C with raging thrush, athlete's foot, fungal patches and dandruff). I had a very poor digestion too, and that is gradually improving.

Having a digestion that couldn't cope with carbs has actually been a good thing for me. It has given me more incentive to get rid of them. I think it must be harder for those who don't appear to have any issues with them (apart from the diabetes) to have the same motivation to cut them out.

It sounds as though your daughter may well have yeast issues in the her stomach and digestive tract. The fact that her stomach swells up after eating bread is an indicator as, especially if it is eaten with protein, it will end up sitting in the stomach fermenting while the protein is being digested.

I am intruiged as to why your daughter's diet has to be lower than 1000 calories. If she was able to eat a lower carbohydrate diet and get her blood sugar in better balance, you might find that her craving would go away. It is interesting that Ketogenic diets have been found to be useful for treating all sorts of health issues.

The ketogenic diet may be a successful treatment for several rare metabolic diseases. Case reports of two children indicate that it may be a possible treatment for astrocytomas, a type of brain tumour. Autism, depression, migraine headaches, polycystic ovary syndrome, and type 2 diabetes mellitus have also been shown to improve in small case studies.[18] There is evidence from uncontrolled clinical trials and studies in animal models that the ketogenic diet can provide symptomatic and disease-modifying activity in a broad range of neurodegenerative disorders including amyotrophic lateral sclerosis, Alzheimer's disease and Parkinson's disease,[18] and may be protective in traumatic brain injury and stroke.[6][8] Because tumour cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[53] As of 2008, there is insufficient evidence to support the use of the ketogenic diet as a treatment for these conditions;[7] however, clinical trials for many of them are ongoing.[4]

Wikipedia (from an article about the treatment of epilepsy with a ketogenic diet). We have moved on somewhat from 2008 and more evidence of the benefits has been released since this article was written. http://en.wikipedia.org/wiki/Ketogenic_diet

Ali.

 

[ladybird64]

Hello again.

Viv, thank you for directing me towards the link. All this is going to take time for me to read through and think about but the more info I have the better..not sure if I could do this diet due to the burger and sausages aspects to it. Because of our daughter we don't have these kinds of foods in the house but it still interesting to read how it works!

Hi Ali, thanks for your input too, I found what you had to say equally interesting..I really doubt whether I could cut out carbs but as it's early days, I will focus on cutting down and keeping an eye on my blood sugars.

Regarding my daughter's diet, the syndrome is actually a genetic one. The hypothalamus (the part of the brain that controls hunger and satiety) doesn't work properly which means that she constantly feels extremely hungry, regardless of how much she eats...she is never full.
This is a bit of info re the condition copied and pasted below.

It is common, in those whose diet has not been managed, for people with PWS to reach excessive weights by the time they reach their teens, and in a few individuals this is evident from as young as 4 years old. The life expectancy for people with PWS can be very low - death can occur from obesity-related problems in childhood, teens or early twenties. However, with good weight management, there is no reason why they should not live well into middle age and beyond. The oldest person living with PWS known to the PWSA (UK) is a woman aged 74.

There are two major reasons why obesity is such an issue in PWS and which separate people with PWS from the general obese population:

•Hyperphagia (excessive appetite) - due to hypothalmic dysfunction. It is fairly certain that a message that the person has had enough to eat is not getting through to the brain of the person with PWS. Consequently, the person feels hungry for most of the time. Researchers are currently trying to discover where this "message breakdown" is occurring. To date, appetite suppressants have had no effect on people with PWS, though some limited success has been achieved with some individuals using Orlistat (Xenical) as a treatment. This drug prevents fat from entering the body, but needs careful supervision of diet to avoid side effects such as diarrhoea and staining of underwear.

•Low muscle tone and abnormal body composition - this is also probably due to hypothalmic dysfunction, but the cause remains largely unknown. It is evident from birth, but low muscle tone can be improved with growth hormone treatment in children - although this does not address the problem of hyperphagia. The abnormal body composition means that there is more fat and less muscles (ie less lean muscle) in a person with PWS's body than in the body of someone who does not have PWS, but is obese. The person uses up less energy than other people because muscle mass requires more energy to function. The person with PWS therefore needs fewer calories than a person without PWS to maintain a reasonable body weight, and will need fewer calories when dieting than others.
Hence, the person with PWS not only feels hungry for a significantly greater proportion of the time (in some individuals, all the time), but they need less energy (calories) to maintain a reasonable level of weight.
I hope that wasn't too boring! PWS is a spectrum type disorder, some manage their weight better than others..my daughter ate a tub of garlic powder when there was nothing else for her to get her mitts on. :roll:

 

[Ka-Mon]

Hi ladybird, seen as you have so many other things going on in your life and suffering from depression and being diagnosed diabetic in the last few days, a big change in your diet would (more than likely) put more pressure on you which is the last thing you probably need right now.

The disagreements here are mainly about lowering the carbs, some believe that we should cut out the carbs completely, as low as 10-20g a day, others say about 70g while others, including me, say that carbs are an essential part of our diet and we eat more, but obviously being careful not to eat too much carbs so that our BG doesn't go high.

Personally I find that I can tolerate carbs more than a lot of others here and don't see any reason why I should give up on things that I enjoy eating but, as mentioned above, I am careful not to eat too much and try to stay within the (BG) guide lines, which I mainly am.

Best thing you can do is to test 2 hrs after each meal, lower your carbs accordingly until you find what affects (or not) your BG levels and eat accordingly.

If snacking is a big problem, as you mentioned, you really need to find a substitute that does not raise your BG. I eat 4 times a day instead of 3 so that I don't get hungry enough to want to snack but if I do snack then I eat a handful of nuts or one sugar free sweet just to see me through till next meal.

Good luck.

 

[donnellysdogs]

I've put in quite a few postings that I believe that changes are best made in a gradual manner so that your body and brain does not kick back at the changes...I personally vary between 90-130g of carb per day and stay static with my weight on this.

I have seen programmes on the illness that you describe for your daughter and only through the programmes realised the stress on the parents....you must face challenges during the days and meal times that we would find very hard to fully understand.

Be positive about the changes you will make, and a belief that 'you can'.....you will do it and there is great support here..

 

[ebony321]

One thing that i'd like to add which hasn't really been mentioned is exercise.

Combining exercise with a healthier diet will do you good on the losing weight front.

also it's always mentioned exercising makes your body release happy hormones which could give you a little uplift that you seem to need

with your daughters condition it could be good if you both got out and exercised together? doesn't have to be heart stopping of strenuous, it could also help her condition a little if She's out doing things??

I've heard of your daughters condition before but certainly am no expert so i'm not sure if there's anything that would stop her from going with you, going for walks, or if you have a dog you could walk him around any near by lakes or woods. I find when i'm walking my dogs that i never notice how far i've walked!! :lol:

It may also help on the diet front if you ate similar to your daughter? if she is having lots of veg and things like that, as you'd already be making it.

View on the amount of carbohydrates to eat will always be different, it's based on what an indiviual can eat. Concentrate on getting your diabetes in control with just diet and exercise (which will please your doc no end im sure) and i think you may find the weight loss will follow as a result

Good luck and all the best

 

[phoenix]

It may also help on the diet front if you ate similar to your daughter? if she is having lots of veg and things like that, as you'd already be making it.

That's what I thought too. I looked up a bit about the symdrome and found a pyramid. This had veggies at the bottom, 3-5 small portions of starchesand fruits at the next layer, a couple of portions of dairy, some protein with fats and sweet things at the top. You might need slightly bigger portions than your daughter though, 1000 calories is very low.
To me it sounds very like this: (which I think is based on 1200 calories.
http://www.extension.uidaho.edu/diabetesplate/
I know there are people with T2 on here that have obtained good results by planning their diet in a similar way to this. They also have made use of the GI to choose the starch element of their meal.
so for example boiled new potatoes rather than mashed, berries or other low gi fruits rather than ones like pineapple etc
http://www.glycemicindex.com/

As Ebony says, exercise is really important, it lowers insulin resistance as well as helping with weight loss.

 

[ladybird64]

I just wanted to add a post to thank everyone who has taken the time to give me their opinions, advice and encouragement both here and by PM..I prefer to gather my information from those who live with Diabetes, I can then make informed choices.

I am already figuring out what I can get away with (a roast spud! ) and what i can't (my two slices of morning toast have gone for a burton )..bascially it's trial and error. I have decreased my portions. luckily I love I love green leafy veggies and salads so it's not been too bad.
Dealing with my "grazing" habit hasn't been as bad as I thought it would be so that's good too.

Re exercise..erm..

I have become a couch spud and I know that too has to change. Without wishing to make excuses (I promise I'm not!) along with the bouts of depression I have Panic attacks and a degree of Agoraphobia. My world became very closed in a few years ago and I am going through a bit of a blip over the past few months but I always try and do my best, I have never given in to it.
I always encourage daughter to come walkies with mum (as you say, exercise it very important) but she often refuses as she feels so tired, she is also morbidly obese.
Good news though, her blood sugars (can't remember the terminology!) have come down from long term dangerous levels (mid teens pre brekkie to low to mid twenties pre dinner) to much lower. we have a way to go yet as we have only hit single figures a few times but she has definitely got more energy since this lowering so I am going to try and coerce her to come out with me more.

I took a walk today, not bad because my asthma is really playing up. It's quite funny really, I started to get very panicky walking to my destination so walked faster..and faster..couldn't bloomin breathe so kept hitting the Ventolin..heart pounding, sweating buckets..I think that is probably the best bit of exercise my body has had for a while! Wished I had felt a bit better though to be honest..never mind, hopefully will be better soon and doing a regular walk, even if I do get panicky!

Onward and upward :wink: