Is a vegan diet effective for a T2D on orals?

Oldvatr said:

I was hoping that others would kick off and start providing answers, but it seems I need to give some prompts. Glucose control is only one aspect of a diet, and it is possible to find ways of keeping low blood sugars but using techniques that may be harmful to some, or with long term use. I want to raise some awareness of known or potential deficiencies in a non animal diet where those nutrients are otherwise naturally provided in meat or dairy products, As an omnivore considering using less animal food sources in the future, I am trying to prepare myself with whatever mitigation may become necessary. Short term there seems to be no problem with converting, but long term adherence may lead to health issues down the line especially if I remain ignorant of these issues.

I want to consider each nutrient in turn so we do not get bogged down in generalities. I am not interested in which brand is best, or where these are sourced or even what the brand name or supplier might be, So please do not discuss this since it is largely irrelevant to my OP.

I am interested in natural sources of alternative plant based foods, what form the nutrient is and its biovalence, and whether there are complications in obtaining the nutrient (such as water soluble vitamins being washed out by boiling / steaming, or destroyed by high temperture cooking. Also if the presence of oxylates or phytates affects absorbtion. Which nutrients or supplements are potentially harmful if UL is exceeded and which are safely excreted if in excess.

Two websites I have used for research are WebMD and Healthline so these do have basic info, but do not cover all the issues that arise. For example neither of them says that the non heme iron in spinach is prevented from being used because of the oxylates in the plant, thus rendering spinach useless as a source.

As an anemic, I am aware that iron needs folate and vit C to both be present for absorbtion, both natural sourced or supplemented, Therefore popping a folate supp in the morning will not cover an iron supplement in the evening etc.

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Omega-3 Fatty Acids.
Long chain fatty acid compounds
Comprise ALA, DHA and EPA submolecule groups
ALA is the only Essential nutrient that can only be from dietary sources.
DHA and EPA are non essential since they csn both be synthesised from ALA but not very efficiently
ALA is common in several plant sources and is not normally deficient. Has two isomers. the -L isomer is not very effective, so the -R isomer is more biovalent and is preferred. Most commercial supplements are mostly the -L isomer with some -R added since -R is expensive to extract.
DHA and EPA are primarily from marine animal sources, and algal oil v. Small amounts in some seeds and nuts
(or from ALA-R conversion) conversion rate ALA-r>DHA appx 5%, ALA-r>> EPA <1%

Omega-3 and Omega-6 oils tend to compete with each other and Omega-6 becomes inflammatory when in excess. A balance of !:! is normally advised. Whilst Omega-6 fats are also essential, we in the developed countries tend to ingest around 50x more than we actually need.

Oldvatr said:

I was hoping that others would kick off and start providing answers, but it seems I need to give some prompts. Glucose control is only one aspect of a diet, and it is possible to find ways of keeping low blood sugars but using techniques that may be harmful to some, or with long term use. I want to raise some awareness of known or potential deficiencies in a non animal diet where those nutrients are otherwise naturally provided in meat or dairy products, As an omnivore considering using less animal food sources in the future, I am trying to prepare myself with whatever mitigation may become necessary. Short term there seems to be no problem with converting, but long term adherence may lead to health issues down the line especially if I remain ignorant of these issues.

I want to consider each nutrient in turn so we do not get bogged down in generalities. I am not interested in which brand is best, or where these are sourced or even what the brand name or supplier might be, So please do not discuss this since it is largely irrelevant to my OP.

I am interested in natural sources of alternative plant based foods, what form the nutrient is and its biovalence, and whether there are complications in obtaining the nutrient (such as water soluble vitamins being washed out by boiling / steaming, or destroyed by high temperture cooking. Also if the presence of oxylates or phytates affects absorbtion. Which nutrients or supplements are potentially harmful if UL is exceeded and which are safely excreted if in excess.

Two websites I have used for research are WebMD and Healthline so these do have basic info, but do not cover all the issues that arise. For example neither of them says that the non heme iron in spinach is prevented from being used because of the oxylates in the plant, thus rendering spinach useless as a source.

As an anemic, I am aware that iron needs folate and vit C to both be present for absorbtion, both natural sourced or supplemented, Therefore popping a folate supp in the morning will not cover an iron supplement in the evening etc.

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IRON
Essential mineral main constituent of red blood cells (haemoglobin )
Comes in two basic forms: Heme Iron and Non Heme Iron

Blood cells require Iron, folate, vitamin c to all be present in the liver to make RBC.
Heme Iron only found in animal meat and is the more bioavailable form
Non Heme Iron is found in eggs dairy and some plant foods but is not so easily absorbed into the body.
Most plants that contain non heme iron also contain phytates and oxylates that prevent absorbtion into the body and although iron is listed as nutrient in the listings for a plant, the body may not actually be able to use it. for example, spinach is considered one of the highest iron sources in the plant world, but contributes very little for us. Especially if boiled or steamed.

The body requires that 95% of the iron absorbed in haemoglobin is in the heme form. Conversion of non heme to heme after digestion is inefficient approx 5% becomes usable heme. Our liver is only interested in Heme iron.

Iron digestion benefits from a high protein intake since amino acids aid the digestive process. High protein also triggers a high acid environment. Some meds such as antacids and PPI meds will prevent proper digestion of iron, Supplements should not be taken with or close to using a PPI or antacid.

Iron defficiency anemia is more prevalent among vegetarian and vegan populations as evidenced by studies in India.

Excess iron is not excreted meaning that overdose can become dangerous. Supplementation should be accompanied by periodic blood panels to ensure safe levels. this applies to supplementing omnivores as well. unsupplemented diets should not have that problem

Iron absorbtion is inversly affected by calcium so avoid taking both supplements together.

Heme deficiency can lead to anemia, porphyria, and alzheimers (?). Too much heme is associated with various cancers but that has not been confirmed by independant reviewers.

Biovalence for non heme iron is 1.8xRDA for non meat eaters. Note this is the conversion rate for non heme to heme when digested and so assumes no interference from phytates or oxylates, or from the food preparation methods that will further reduce availability.

Oldvatr said:

Glucose control is only one aspect of a diet, and it is possible to find ways of keeping low blood sugars but using techniques that may be harmful to some, or with long term use. I want to raise some awareness of known or potential deficiencies in a non animal diet where those nutrients are otherwise naturally provided in meat or dairy products, As an omnivore considering using less animal food sources in the future, I am trying to prepare myself with whatever mitigation may become necessary.
I want to consider each nutrient in turn so we do not get bogged down in generalities. I am not interested in which brand is best, or where these are sourced or even what the brand name or supplier might be, So please do not discuss this since it is largely irrelevant to my OP.
.

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ZINC
essential mineral requires daily replenishment
Abundant sources in plants, so normally not a deficiency issue
Blocked by phytates and oxylates. Even affected by menu choice.
Greater risk of deficiency if diet is fruit and veg only, Less risk if legumes and pulses
Need to include nuts and seeds, but this increases phytates.

WHO database reveals that there is a global deficiency rate of 31% in 2017 but Developed countries fared better due to having fortified foods especially for grain products.

Recent study showed that vegans had acceptable but reduced (compared to non vegetarians) zinc serum levels, but had low levels in hair, saliva, and mitochondria, suggeting that the zinc although ready for use was being blocked from entering the cells. The lacto vegetarian groups had no deficiencies. Women were at greater risk but that was put down to diet regime differences in that women ate more fruit and veg than the men.

Zinc is needed for insulin regulation during carbohydrate metabolism. Zinc in saliva is part of the trigger mechanism for insulin response #1 and forms part of the Krebs Cycle in the mitochondria.

According to Linus Pauling Institute, a vegetarian or vegan requires 50% more than RDA for standard diet. Phytates in the plants make this worse. so biovalence is > 1.5

Oldvatr said:

Glucose control is only one aspect of a diet, and it is possible to find ways of keeping low blood sugars but using techniques that may be harmful to some, or with long term use. I want to raise some awareness of known or potential deficiencies in a non animal diet where those nutrients are otherwise naturally provided in meat or dairy products, As an omnivore considering using less animal food sources in the future, I am trying to prepare myself with whatever mitigation may become necessary.
I want to consider each nutrient in turn so we do not get bogged down in generalities. I am not interested in which brand is best, or where these are sourced or even what the brand name or supplier might be, So please do not discuss this since it is largely irrelevant to my OP.
.

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IODINE
Trace element - essential
normally in animal and daity products
Low levels on plant based diets
25% of vegetarians found to be deficient in a recent Bratislavian trial
80% of vegans deficient in same study
9% omnivores deficient in same study


critical for thyroid function and neurological function
non animal sources include iodised sea salt, seaweed,
some plant sources but only when grown local to the sea.
Very soil dependant and can be depleted by not rotating crops properly.
A few milk substitutes are now sold sas fortified. Check labels.

Supplementation advised for those on non animal diets.

Oldvatr said:

Glucose control is only one aspect of a diet, and it is possible to find ways of keeping low blood sugars but using techniques that may be harmful to some, or with long term use. I want to raise some awareness of known or potential deficiencies in a non animal diet where those nutrients are otherwise naturally provided in meat or dairy products, As an omnivore considering using less animal food sources in the future, I am trying to prepare myself with whatever mitigation may become necessary.
I want to consider each nutrient in turn so we do not get bogged down in generalities. I am not interested in which brand is best, or where these are sourced or even what the brand name or supplier might be, So please do not discuss this since it is largely irrelevant to my OP.
.

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CREATINE
molecule only found in animal foods.
Non essential since the body can synthesise it from amino acids
used to build and maintain muscle. Useful when following an LC or keto diet to reduce muscle scavenging. But main use is in body building
Recent studies have shown an improvement in glycation in muscles when supplemented, so may be of interest to diabetics.
https://diabetes.diabetesjournals.org/content/50/1/18

Not available in plant foods.
Vegetarians and vegans hsve been shown to have significantly lower levels of Creatine in the muscles. Trial confirm that starting a lacto vegetarian diet also leads to muscle loss of creatine within a short time of commencement.
Trial also shows that vegetarians given a supplement have significnt improvements, but meat eaters showed no change.

Oldvatr said:

Glucose control is only one aspect of a diet, and it is possible to find ways of keeping low blood sugars but using techniques that may be harmful to some, or with long term use. I want to raise some awareness of known or potential deficiencies in a non animal diet where those nutrients are otherwise naturally provided in meat or dairy products, As an omnivore considering using less animal food sources in the future, I am trying to prepare myself with whatever mitigation may become necessary.
I want to consider each nutrient in turn so we do not get bogged down in generalities. I am not interested in which brand is best, or where these are sourced or even what the brand name or supplier might be, So please do not discuss this since it is largely irrelevant to my OP.
.

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CARNOSINE
Anti oxident associated with muscles and the brain.
Non essential and is synthesised from amino acids found in animals, not plants
Can be supplemented with a beta-analine protein and apparently there are vegan sources for this.
Also involved in Insulin Resistance, so may be of benefit to diabetics:
https://www.ncbi.nlm.nih.gov/pubmed/27040154

A vegan blogsite is claiming carnosine is present in asparagus, and that a compatible protein is in green peas, so if this is true then a vegan supplement is coming. Most websites say it is not available for vegans.

The vegan variant is derived from a different amino acid found in peas. The animal version is called L-Carnesine because it has two isomers, and the vegan one is called Carmesine, and is also called Carnosine, This implies a different isomer. Now fructose and glucose have a similar identity problem - same chemical, different isomers, and has different effects in the body. So will Carmesine do the same as L-Carnosine? Not sure.

Oldvatr said:

Glucose control is only one aspect of a diet, and it is possible to find ways of keeping low blood sugars but using techniques that may be harmful to some, or with long term use. I want to raise some awareness of known or potential deficiencies in a non animal diet where those nutrients are otherwise naturally provided in meat or dairy products, As an omnivore considering using less animal food sources in the future, I am trying to prepare myself with whatever mitigation may become necessary.
I want to consider each nutrient in turn so we do not get bogged down in generalities. I am not interested in which brand is best, or where these are sourced or even what the brand name or supplier might be, So please do not discuss this since it is largely irrelevant to my OP.
.

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TAURINE
molecule involved in muscle function
Non essential since body can synthesise it from animal proteins
Involved in bile salt production (apparently)
has ben shown to be effective in reducing insulin resistance in rats
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509183/

Vegan friendly supplements are available. No evidence of effectiveness since artificially synthesised from unknown sources.

OK I was out in town today, and felt peckish, felt I needed a pastie, so went to an emporium dedicated to the noble pasty, World renowned even, I have had a nice steak pasty from them before and it was not a major challenge to my endocrine system. So I ventured in
It was Market day in town, and they had run out of normal pasties. All they had was a vegan special, so I bought it. My bgl before I ate it was 5.7 mmol/l. My 2 hr PP reading was 23.8mmol/l and my 5hrPP at home was still 16.3 So not only was it too spiced up and horrible to eat, it did for me, Normally I can get a spike to 10 on a bad choice such as cheesecake pudding, but these results take me back to when I was in hospital on Eatwell with all my meds stopped. So this T2 on orals is allergic to shop made vegan fare,

Diakat said:

Surely unscientific without a control of a meat pastie? What on earth possessed you?

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It was my intention to start with a standard or steak pasty simply coz I wuz passing and succumbed. It was not my intention to test myself against my own OP, but there was no direct alternative available at that time. I usually get a standard pastie from ASDA but they normally stock in the morning and sell out by lunchtime. So I would have had to go to Greggs but have an aversion to that shop. So having queued in the heat of their bakers shop I just wanted to fill my face, so grabbed one of the remaining pasties not knowing what was in it or what it would do to me. I know better now, Still ignorant of the ingredients though. I suspect a large helping of carageenan since the filling was similar (?) to melted cheese in colour and texture but not in taste. Bit too many herberts and spices for my palate. Think it was meant to be a copy of a cheese and bacon pasty, but the red bits were fried or grilled red pepper or chillies.

Erin said:

Do doctors investigate the PDF or FDA regarding the adverse effects of B12 at 1000 or higher doses? I do not have any faith in vitamins, except perhaps C for scurvy. It is sad that Novel prizes were given for some of these vitamins.

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Generally if a doctor diagnoses a B12 deficiency then it will be intravenous injections not oral tablet that they would prescribe. Since B12 is classed as an essential vitamin, i.e. it is essential for maintaining a healthy body function, namely in the formation of haemoglobin, then this presents a problem for vegan purists since B12 is only found in a human biovalent form in animal meat or dairy, and the vegetarian equivalent derived from algae is not as effective for a human to metabolize. Maybe a vegan B12 supplement at 1000 mcg is needed whereas for an omnivore eating some animal products then such a large dose may not be required and could be harmful,

Edit to add: oral vitamins do not normally survive the transit through the stomach to the gut, and are generally neutralised before they reach anywhere where they might do somr good. This can also apply to those lovely probiotics that are sold in yoghurts for our biome. since most are killed off before they pass GO.