Is a vegan diet effective for a T2D on orals?

[Diakat]

Please refer to the sticky message regarding politeness during posting and recognition of the sensitivity surrounding dietary choices. Several reports have been received regarding this thread and edits have been made.
Dietary convictions are held by us all individually, often evidence either way will not sway us from our chosen path. The only proven solution for an individual is to eat to their meter.

 

[zand]

Well I for one am always interested in learning about other people's choices. What works for me today may not work for me tomorrow. I am interested in trying a vegan diet for my own health, not for any moral reasons, and am finding it most useful. Thank you @Oldvatr for starting it.

 

[Oldvatr]

In short, it depends who you are.

The long form I wrote includes (psh... it's basically entirely) cruft about nutrient bioavailability and how that can be a long term concern whether or not you're diabetic, and also touches on the Randle cycle, which would explain (though I don't decipher it in the festival of conjecture) why fat worsens GTT.

I will post the long form on request, but be advised that it is severely offtopic.

I think most of us have had experience of fat affecting the rise and fall of bgl levels in response to a physical ingest of glucose as happens during the GTT. The point I was making is that the claim that a LCHF diet causes T2DM used this study as justification. I could not see anywhere in either report that made that comparison or even discussed what the fat consisted of, since it appears that they used virtual fat in a modelling exercise to extrapolate what effect a 40g/day increase would have, They did not apparently subject any of the participants to an actual diet change, just guessed it.

The other assumption in the study seems to be that they tracked participants who were glucose intolerant but not diabetic at baseline, and then followed the 20 that progressed to a full T2D diagnosis within the 2 year study period. Without also considering the carb and sugar intake then these confounders have not been eliminated and could just as easily be the causal factor, not the fat. There is no reference to the particpants using a low carb diet anyway, so this study should not be used to demonstrate that LCHF causes T2DM.

I am also at a loss as to why a paper discussing vegetarian issues is using a reference to this LCHF study to justify the claim that animal products cause T2D which I believe it was trying to achieve.

 

[Oldvatr]

The only proven solution for an individual is to eat to their meter.

Disagree, That only reveals blood sugar levels, but does not address other aspects of diet that are also important.

Also your comment on chosen path is inflammatory since it is this that is causing the friction. We are not trying to convert people from a chosen path that they are happy with. We are discussing aspects of the suitability of this diet to cure or reverse T2D specifically, and no one has really advocated any alternative diet here. It is the health and curative powers being claimed for this diet that is under scrutiny. I have asked many times for what the evidence is behind these claims, and the response has been poor. The evidence I have seen here has been shown to be poor.

If someone asks me if my chosen path is safe, I have immediate access to scientific studies that back up the claims which I often share on the forum. I am not afraid to discuss it, and I am not afraid to challenge it too. Many others on this site also contribute to those discussions so I am not paving a new pathway to Nirvana on my own.

We do not have a T2D only thread, but I thought the title of my OP was clear. Those using insulin have different issues to deal with, however some aspects such as supplementation and biovalence are things that could be common to us all.

 

[lucylocket61]

The only proven solution for an individual is to eat to their meter.

Unfortunately, and to my surprise, I am finding that eating to my meter is not sufficient. When I eat, and my food choices, particularly of proteins and fats, affects my general health and overall daily fluctuations and swings and dips.

I am aiming for as flat a line a possible these days, as it seems to keep inflammation at bay, and there appears to be evidence that avoiding swings is important in the longterm.

I am finding discussion like this very helpful in making different food choices and find out about other choices (including plant based) which i may otherwise have not considered.

 

[Member496333]

In my opinion “eat to the meter” is of limited use for T2DM. Or certainly for effective and long term reversal. It tells you how much carbohydrate you can get away with before it all begins spilling out into the blood again, but tells you nothing about all-body glucose and does little to tackle insulin resistance.

 

[Mr_Pot]

In my opinion “eat to the meter” is of limited use for T2DM. Or certainly for effective and long term reversal. It tells you how much carbohydrate you can get away with before it all begins spilling out into the blood again, but tells you nothing about all-body glucose and does little to tackle insulin resistance.

Type 2 diabetics have problem dealing with carbohydrates, but how much carbohydrate and in what foods varies a lot between individuals. Using a meter to see the effects of quantities and types of food is the only way to establish what is right for you. You seem to have the idea that "eating to the meter" means eating as much carbohydrate as you can get away with, rather like topping up a car petrol tank until it is full but not quite overflowing. For me, and I suspect for others, it means finding out which foods to avoid or have in small amounts and which food I can eat more liberally. Your approach of only eating low or carb free food would be much too restrictive and in my view unsustainable, are you really going to live on meat and eggs for the next 30 years or so?

 

[Brunneria]

Please lets not derail here into the pros and cons of carnivory, or extreme low carb/keto, or anything else.

This is a thread about whether veganism is effective for T2s on oral medication.

I would remind everyone that when/if this thread spins off into personal disagreements, then it will be closed, like similar recent threads. Those who are interested in the subject would no doubt find that disappointing, and those who are not interested in the subject are best not using the thread to score points off each other, otherwise they will have their posts deleted.

 

[lucylocket61]

I am diet only controlled, so I hope my contribution is OK.
I intend to continue to explore plant based proteins in particular, to see if they have less of a spiking effect for me than any other source of protein. I am grateful for this thread as it has taught me a lot about the huge variety of foods in the plant world.

 

[Member496333]

Type 2 diabetics have problem dealing with carbohydrates, but how much carbohydrate and in what foods varies a lot between individuals. Using a meter to see the effects of quantities and types of food is the only way to establish what is right for you. You seem to have the idea that "eating to the meter" means eating as much carbohydrate as you can get away with, rather like topping up a car petrol tank until it is full but not quite overflowing. For me, and I suspect for others, it means finding out which foods to avoid or have in small amounts and which food I can eat more liberally. Your approach of only eating low or carb free food would be much too restrictive and in my view unsustainable, are you really going to live on meat and eggs for the next 30 years or so?

In my opinion, it’s of limited use. That’s not the same as saying it’s worthless. That is the situation as I see it. And yes, I will continue to eat the diet that I enjoy immensely and allows me to stay healthy

 

[LooperCat]

I am diet only controlled, so I hope my contribution is OK.
I intend to continue to explore plant based proteins in particular, to see if they have less of a spiking effect for me than any other source of protein. I am grateful for this thread as it has taught me a lot about the huge variety of foods in the plant world.

The Vivera range of meat substitutes is pretty good - I’ve bought them in Asda, Sainsbury’s and Morrison’s. Made from pea protein, it fits in well to a low carb diet. I especially like their vegan steaks, burgers and “pulled” kebab stuff.

 

[Oldvatr]

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.

 

[Member496333]

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.

Currently I get the majority of my micronutrients from eggs and organ meats, but I believe you are right to be concerned about the future availability of such foods at affordable prices. At this time, I feel it could swing either way.

 

[Oldvatr]

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.
.

The first one is Vitamin B12 (already discussed previously)
Essential nutrient that is not made or synthesised by our bodies.
Water soluble vitamin that gets stored in the liver.
Some say it can be absorbed from unwashed plants grown in soil used by livestock or dairy since it is from a microbe that grows in those conditions. However it does imply ingesting animal product,
Can be synthesised from algal solution by a high energy high water demand month long process so is expensive but vegan.
supplements are readily available from multiple sources.
Requires Folate to be present
Benefits from Vitamin C

High intake of seaweed, folate or Vitamin B6 (pyridoxine) can cause false highs in the blood tests.

Overdose may give nasty side effects but is not considered dangerous. excreted in urine.

Cereal and grain products sold in UK are required to be fortified with B12 by law.
in the absence of animal products in the diet, then supplementation or using fortified food products is Essential
Yeast extract is only useful if properly fortified.
Plant based meat alternatives may contain added B12 but not required by law.

There s a source used by vegetarians called spirulina, but the ingredient in it is a pseudovitamin and is biovalent = inactive. Don't waste your money on it.

Many vegan friendly B12 supps are derived from seaweed. Be aware that the weed is often dried first, and this destroys the B12 active ingredient.

Like many supplements, the active ingrdients need to make it to the small intestine, but the acid environment in the stomach can damage or degrade the vitamins. For B12 this may be why GP's offer injections rather than orals. Vitamin C is also degraded in the stomach, (or in the glass if in a smoothie)

 

[zand]

Currently I get the majority of my micronutrients from eggs and organ meats, but I believe you are right to be concerned about the future availability of such foods at affordable prices. At this time, I feel it could swing either way.

This is where my diet is lacking. I don't like any of those things (bad experiences when I was young) so I need advice on alternatives which is why I have read this and other vegetarian threads.

 

[Oldvatr]

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.
.

Folate B9
water soluble essentisl vitamin
Not stored in the body so needs topping up daily
Available in green leafed veg and some citrus juice drinks (not in abundance though) Some fruits
Legally required to be added to cereal and grain products fortification.
Can be harmful if overdosed
often required during pregnncy, but normal diets will provide. Low carb diets may be at risk
High levels can mask the signs of anemia in blood tests.

 

[lucylocket61]

I think the quantity needed to be eaten of the foods containing these nutrient is also important, and the calorific values of those quantities.

I have to watch both my carb intake AND my calorie intake to avoid gaining weight so if I have to eat a lot of a certain foods or a large quantity of food a day, that also impinges on my overall weight and health.

 

[Mbaker]

May I too make a

Type 2 diabetics have problem dealing with carbohydrates, but how much carbohydrate and in what foods varies a lot between individuals. Using a meter to see the effects of quantities and types of food is the only way to establish what is right for you. You seem to have the idea that "eating to the meter" means eating as much carbohydrate as you can get away with, rather like topping up a car petrol tank until it is full but not quite overflowing. For me, and I suspect for others, it means finding out which foods to avoid or have in small amounts and which food I can eat more liberally. Your approach of only eating low or carb free food would be much too restrictive and in my view unsustainable, are you really going to live on meat and eggs for the next 30 years or so?

Just on a point of information, when you have been broken by food as badly as Jim and I have, the thought of tickling the carb monster has no appeal, and actually conveys feelings of sickness - hence why we find low carb methods so easy, as the previous complications were both scary and a reminder of mortality. Whilst not everyone wants simple choices, it depends on the mental relationship one has with food. I go a bit further than Jim on variety, but I keep to a safe list as death warmed up I really don't want to face again.

 

[Oldvatr]

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.
.

Vitamin D
Fat soluble vitamin - non essential since body can synthesise with sunlight
the biovalent form is Cholecalciferol (D3) found mainly in animal ptoducts and can be synthesised from some algal / lichen sources.
The less effective form is Ergocalciferol (D2) found in plant foods
The most effective way of getting the vitamin is by letting natural sunlight shine on skin.

Research is showing that dietary takeup requires the vitamin K2 to be present.
D3 is often used to fortify milk and cereal products to assist dietary intake.

elderly and infirm people require higher levels than RDA.
Some medical conditions and medicines restrict access to the sunlight.
Difficult to meet requirements if dark skinned, housebound, or in northern latitudes, or using sunscreens
Deficiency detection requires special blood test not normally done on NHS unless rickets is suspected.
vitamin D2 in plants is an alternative source, but not very biovalent

Common for UK omnivores and vegetarians to require supplementation and fortified foods to obtain RDA
non animal sources of D2 are primarily fungal, and although many plants do have D2 it is in minute quantities and not feasible as a main source. Sunlight and / or supplementation is recomended.Some macroalgal sources are showing possible use as a source, notably phytoplankton.

 

[zand]

There are also some drugs which make you burn if you are in direct sunlight so its doubly important to supplement. Amiodorone, a heart drug, is one. I was told to keep out of the sun for months so consequently my vit D level got low. Some NHS Trusts offer a postal.Vit D check for maybe £30?

Edit vit D needs vit K2 in order for the body to use it properly.