LCHF - hypo danger ?

[phoenix]

Ian's point was that his diet hadn't caused him to have a hypo but the DUK advice is aimed at all with T2 at whatever stage or set of medications they are taking and has to give warnings.
Stephen is correct to say that hypos are drug induced however many T2s are taking oral hypoglycaemic drugs. The very next statement on the webpage mentions adjusting medications. In the full statement rather than the web update/summary these two statements are I think more linked together.
People on sulfs and mixed insulins would be very much at risk of hypos if they reduced their carb intake without careful adjustment of their medications.

The organisation uses evidence to write their statements so I wondered what evidence is there? I did a quick search using low carb/hypoglycaemia. The very first hit I got was the Yancy, low carb study which states that as part of it's protocol they adjusted medication as a result of hypoglycaemia. They also mention one subject (it wasn't a large trial) who had needed help from paramedics after missing a meal.


We had a discussion about the risks of hypos for T1s recently, in some ways we tend to expect them and the risks are certainly there. The risks are also there for T2 . Some sulfs in particular are thought to shut down protective mechanisms leading to prolonged hypos.* If the person is older, they may be even more susceptible to further risks (falls, heart attacks and strokes caused by the hypo)
This study looked at the 102 cases of comas due to hypo (drug caused) in a hospital in Israel over 7 years; 92 of them had type 2, only 10 type 1..(median age 72)
http://archinte.jamanetwork.com/article.aspx?articleid=414829
* https://www.inkling.com/read/pharma...-egan-1st/chapter-31/oral-hypoglycemic-agents

 

[borofergie]

And it's worth remembering that anyone - even non-diabetics - can have hypos. As I said before, I ended up on my face in a ditch last year by exercising (much) too hard on a low-carb diet and completely exhausting my glycogen supplies (I wasn't in ketosis at the time). I'm pretty sure that had nothing to do with my diabetes.

It was a pretty horrible experience. I don't envy T1s one bit.

 

[Brunneria]

And it's worth remembering that anyone - even non-diabetics - can have hypos...

Yes. I've noticed that a lot of people seem to disbelieve this, or claim that real hypos only happen for Type 1s or those on medication. It's a view prevalent in the NHS and it causes a lot of grief to a lot of people.

http://www.mayoclinic.org/diseases-conditions/hypoglycemia/basics/causes/con-20021103

http://curezone.org/forums/am.asp?i=1526217

http://www.nlm.nih.gov/medlineplus/ency/article/007306.htm

 

[IanD]

Ian's point was that his diet hadn't caused him to have a hypo but the DUK advice is aimed at all with T2 at whatever stage or set of medications they are taking and has to give warnings.
Stephen is correct to say that hypos are drug induced however many T2s are taking oral hypoglycaemic drugs. .......

This study looked at the 102 cases of comas due to hypo (drug caused) in a hospital in Israel over 7 years; 92 of them had type 2, only 10 type 1..(median age 72)
http://archinte.jamanetwork.com/article.aspx?articleid=414829
* https://www.inkling.com/read/pharma...-egan-1st/chapter-31/oral-hypoglycemic-agents

Notice the title of the cited paper, & the conclsion:

Drug-Induced Hypoglycemic Coma in 102 Diabetic Patients

DIABETIC PATIENTS who are treated with insulin and/or hypoglycemic drugs are at a greater risk of suffering hypoglycemic episodes than diabetic patients treated by diet only, a fact that has been supported by the widespread systemic monitoring of blood glucose during the last decade.

I think a 7 year study on the performance of patients on the DUK diet compared with the LCHF diet would have had more useful, & more surprising conclusions.

 

[phoenix]

Sorry Ian, I really don't get your point.
If someone reduces their carbohydrates and are taking hypoglycaemic drugs then since the drugs are titrated to their present diet they really have to be aware of hypoglycaemia I can just imagine the effect of someone using mixed insulin who decided to change their carb intake overnight.
. The stats weren't a trial of any sort of diet. they were the results that had been observed in a normal hospital setting and showed that hypos are common in type 2.
It's nothing to do with the efficacy or advisability of any diet, just common sense.
The Yancy study was a low carb trial and it did indeed monitor hypoglycaemia and adjust medications.
Do you think that diabetes UK should fail to tell people that this is a possibility and adjustment might be necessary?