Low Carb - cure or mere avoidance?

andyR57 · Mar 6, 2023

Hi. I am prediabetic and about 5 weeks ago decided to go low carb [not keto] in order to try and improve my blood sugars and the results have been a bit mixed to be honest. At lunch I had a dinner I often have which is fairly high carb and my readings are much higher than normal [before going low carb] and it's got me wondering if going low carb [avoidance] can actually result in you becoming more intolerant to carbs.? This has happened twice now. Because the results were mixed I am now considering going keto but is this a cure or just avoidance and will the avoidance increase carb intolerance?

Also, a bit confused about wholegrain - my sugars after consuming wholegrain bread spike lower but remain elevated for longer. Which is better a higher spike and quicker recovery or a lower spike but a longer period of elevation? Thanks in anticipation of any advice.

Deleted member 475901 · Mar 6, 2023

Personally, I'd avoid both white and wholemeal bread as any spike above the normal range could over time lead to diabetic complications.
How many carbs do you aim to eat in one meal and what is your total carb per day limit?
Are you checking both before and then 2 hrs after each meal?

There are several reasons why you might react more to the same meal on different days, stress, illness, etc. keep a note?

Lamont D · Mar 6, 2023

From your title............. Neither!

andyR57 said:
Hi. I am prediabetic and about 5 weeks ago decided to go low carb [not keto] in order to try and improve my blood sugars and the results have been a bit mixed to be honest. At lunch I had a dinner I often have which is fairly high carb and my readings are much higher than normal [before going low carb] and it's got me wondering if going low carb [avoidance] can actually result in you becoming more intolerant to carbs.? This has happened twice now. Because the results were mixed I am now considering going keto but is this a cure or just avoidance and will the avoidance increase carb intolerance?

Also, a bit confused about wholegrain - my sugars after consuming wholegrain bread spike lower but remain elevated for longer. Which is better a higher spike and quicker recovery or a lower spike but a longer period of elevation? Thanks in anticipation of any advice.

It is controlling the spikes in your blood glucose levels to prevent your average hba1c levels going up. With low carb, if enough of a carb reduction is acheived then control can be achieved.
With Wilkerson it is dependent on how your BG levels cope with it, whether it is a short or long spike, it is the height that is the issue.
In my experience some can improve carb intolerance but some can't, I am one of them!

catinahat · Mar 6, 2023

andyR57 said:
is this a cure or just avoidance

There is no cure for diabetes, but with the right kind of diet, it might be possible for someone with T2 to avoid suffering the many health problems caused by high blood sugar.

andyR57 said:
Which is better a higher spike and quicker recovery or a lower spike but a longer period of elevation?

My preference would be to avoid spikes of any kind if at all possible

andyR57 said:
high carb and my readings are much higher than normal [before going low carb]

This is fairly normal, as I understand it our bodies get used to the level of carbs we are eating. If you have more than usual, it takes your pancreas by surprise and it struggles to ramp up production.
That's why the standard advice when you need a glucose tolerance test, is to increase your carb intake a few days before the test, if you are on a low carb or keto diet.

andyR57 · Mar 6, 2023

TriciaWs said:
Personally, I'd avoid both white and wholemeal bread as any spike above the normal range could over time lead to diabetic complications.
How many carbs do you aim to eat in one meal and what is your total carb per day limit?
Are you checking both before and then 2 hrs after each meal?

There are several reasons why you might react more to the same meal on different days, stress, illness, etc. keep a note?

Thanks for the reply. What is the normal range - I thought the aim was to get it below 7.8 after 2 hours. Typically I test before a meal and it may be 5.5 and two hours later less than 7.8 [as low as 6.1 with a low carb meal]. I try to limit a maximum of 50g carbs at any meal and have a daily limit of 125g.{ I know that is high by many peoples intake on this forum but that is 50% of the 250g I was having a day}. Currently the reduction has resulted in 10Lb weight loss in 5 weeks? I had for dinner 80g of carbs [family occassion} and after 2 hours was 7.5 [last twice I had the same meal was 6.9 and 6.3 - hence my concerns going low carb reduces tolerance to carbs]. I have tested some meals at 1 hour and had readings as high as 10 but at 2 hours below 7.8 .

KennyA · Mar 6, 2023

andyR57 said:
Thanks for the reply. What is the normal range - I thought the aim was to get it below 7.8 after 2 hours. Typically I test before a meal and it may be 5.5 and two hours later less than 7.8 [as low as 6.1 with a low carb meal]. I try to limit a maximum of 50g carbs at any meal and have a daily limit of 125g.{ I know that is high by many peoples intake on this forum but that is 50% of the 250g I was having a day}. Currently the reduction has resulted in 10Lb weight loss in 5 weeks? I had for dinner 80g of carbs [family occassion} and after 2 hours was 7.5 [last twice I had the same meal was 6.9 and 6.3 - hence my concerns going low carb reduces tolerance to carbs]. I have tested some meals at 1 hour and had readings as high as 10 but at 2 hours below 7.8 .

Hi andy

Congratulations on your progress. On your "cure or avoidance?" keto question - it's not a cure. At the moment there is no cure. I am however avoiding the nasty symptoms I did have, and avoiding the others that might have come along. I can do that by controlling my blood sugar levels, and I see nothing at all wrong with that as a principle.

The figures themselves aren't really the aim in my book. If your blood glucose hasn't gone up by more than 2 mmol/l or gone up over 7.9mmol/l it shows your system could cope with the carbs in the meal. If the figures are otherwise, you couldn't cope with it.

The point is not taking in more carbs than you/we can cope with.

Given the allowed 15% meter inaccuracy, and the possibility of other factors, none of your readings particularly stand out - they all seem to be around the same mark. It's common for me to get rises within the first hour that rapidly tail off to baseline by two hours (hot milk demonstrates this really well) - it shows the insulin response being triggered and dealing adequately with the glucose in the bloodstream.

I certainly haven't found an intolerance to carbs after over three years of ~20g a day. If anything I'm coping with excess carbs much better, which I put down possibly to my system having had a bit of a break from carbs. I also think there is a lot in the theory that the body adjusts insulin production to a given carb level and then has to gear up a bit to cope with a change, which leads to higher glucose levels short-term: although this doesn't happen to me, it does seem to happen for a lot of people.

AndBreathe · Mar 7, 2023

In terms of your mixed results, without a real definition of that I'm guessing a little here, but bear with me, because there is some sense in it.

Our bodies like to work to patterns and rhythms, whether that be usual amounts of sleep, or whatever. Our bodies are very clever at providing us with what we need to deal with those general patterns and rhythms, but have you ever had a really big meal, like at Christmas time or other celebration, where you may not have eaten anything troublesome, but you've still ended up with indigestion and maybe some discomfort, then just wanted to snooze it off?

Part of that is because our body is taken by surprise by the foods and amounts of foods we have consumed at that time, and simply isn't prepared for it, in terms of digestive juices and enzymes, so we get the discomfiture.

By Boxing Day if we rerun the exercise, the chances are we won't have quite so much discomfort, because the body is second guessing you, and of course there's likely to be a degree of self-moderation going on, in terms of what one might consume after the indigestion etc.

Soooooooo, if we low carb for a while, then have a carbier meal, our body isn't expecting it, so doesn't handle it quite so well. If we repeated the process, it could handle it better second or subsequent times around.

On the other hand a consistently low carb approach is likely to show more consistently lower blood sugar numbers than mixing it all up with low and less low carb days.

Many of us have found that after a persistent period of LC eating we're not so bothered about eating carbs.

I'm not telling you what to do or how to eat, just trying to explain why things can appear inconsistent.

Of course, things other than what we eat and drink can impact our blood sugars, including stress, exercise, sleep or lack of it, the weather (yes, really) and for those of us of a female persuasion, cyclical hormones.

So, the simple answer is, there isn't really one. I'd urge you to look at your blood glucose trends and go from there. There can always be outliers in any given data set, so it isn't usually important to spend much time on analysing those.

andyR57 · Mar 7, 2023

AndBreathe said:
In terms of your mixed results, without a real definition of that I'm guessing a little here, but bear with me, because there is some sense in it.

Our bodies like to work to patterns and rhythms, whether that be usual amounts of sleep, or whatever. Our bodies are very clever at providing us with what we need to deal with those general patterns and rhythms, but have you ever had a really big meal, like at Christmas time or other celebration, where you may not have eaten anything troublesome, but you've still ended up with indigestion and maybe some discomfort, then just wanted to snooze it off?

Part of that is because our body is taken by surprise by the foods and amounts of foods we have consumed at that time, and simply isn't prepared for it, in terms of digestive juices and enzymes, so we get the discomfiture.

By Boxing Day if we rerun the exercise, the chances are we won't have quite so much discomfort, because the body is second guessing you, and of course there's likely to be a degree of self-moderation going on, in terms of what one might consume after the indigestion etc.

Soooooooo, if we low carb for a while, then have a carbier meal, our body isn't expecting it, so doesn't handle it quite so well. If we repeated the process, it could handle it better second or subsequent times around.

On the other hand a consistently low carb approach is likely to show more consistently lower blood sugar numbers than mixing it all up with low and less low carb days.

Many of us have found that after a persistent period of LC eating we're not so bothered about eating carbs.

I'm not telling you what to do or how to eat, just trying to explain why things can appear inconsistent.

Of course, things other than what we eat and drink can impact our blood sugars, including stress, exercise, sleep or lack of it, the weather (yes, really) and for those of us of a female persuasion, cyclical hormones.

So, the simple answer is, there isn't really one. I'd urge you to look at your blood glucose trends and go from there. There can always be outliers in any given data set, so it isn't usually important to spend much time on analysing those.

Thanks for the reply which explains things very well and makes a lot of sense to me. I have to say I am not really missing the carbs and dinners seem to be more tasty without potatoes. It seems low carb is a diet for life rather than a short/medium term intervention. The only problem is I cant afford to shed many more pounds since I was not over weight to start with and I just haven't got comfortable with increasing fat too much. Early days yet!

andyR57 · Mar 7, 2023

KennyA said:
Hi andy

Congratulations on your progress. On your "cure or avoidance?" keto question - it's not a cure. At the moment there is no cure. I am however avoiding the nasty symptoms I did have, and avoiding the others that might have come along. I can do that by controlling my blood sugar levels, and I see nothing at all wrong with that as a principle.

The figures themselves aren't really the aim in my book. If your blood glucose hasn't gone up by more than 2 mmol/l or gone up over 7.9mmol/l it shows your system could cope with the carbs in the meal. If the figures are otherwise, you couldn't cope with it.

The point is not taking in more carbs than you/we can cope with.

Given the allowed 15% meter inaccuracy, and the possibility of other factors, none of your readings particularly stand out - they all seem to be around the same mark. It's common for me to get rises within the first hour that rapidly tail off to baseline by two hours (hot milk demonstrates this really well) - it shows the insulin response being triggered and dealing adequately with the glucose in the bloodstream.

I certainly haven't found an intolerance to carbs after over three years of ~20g a day. If anything I'm coping with excess carbs much better, which I put down possibly to my system having had a bit of a break from carbs. I also think there is a lot in the theory that the body adjusts insulin production to a given carb level and then has to gear up a bit to cope with a change, which leads to higher glucose levels short-term: although this doesn't happen to me, it does seem to happen for a lot of people.

Thanks for the reply. I was hoping that a few months of low carbs would help my system to get more efficient at dealing with carbs so then when carbs are increased I could handle them but it's looking like carb reduction has to be a permanent action which I don't really have issues with apart from replacing the calories carbs gave me - I have started eating nuts and using olive oil but still have issues with increasing fats to higher amounts [having been told for 50 years + its unhealthy]. Sure I will get there eventually.

becca59 · Mar 7, 2023

@andyR57 the numbers you quote for your family meal are fairly similar to the previous ones. As a type 1 that sort of difference I wouldn’t bat an eyelid at. As others have said for @ type 2 it is about that differential rise from before to after eating.
You say it was a family meal. That could mean excitement, sitting down longer afterwards, alcohol? laughter! All these things conspire against me. You are learning that food is just one of the factors.

KennyA · Mar 7, 2023

andyR57 said:
Thanks for the reply. I was hoping that a few months of low carbs would help my system to get more efficient at dealing with carbs so then when carbs are increased I could handle them but it's looking like carb reduction has to be a permanent action which I don't really have issues with apart from replacing the calories carbs gave me - I have started eating nuts and using olive oil but still have issues with increasing fats to higher amounts [having been told for 50 years + its unhealthy]. Sure I will get there eventually.

Yes - one of things about the T2 journey is unlearning many of the things we have been told "as true" over the last thirty years or so. It goes back to an earlier style of eating, without many carbs, processed or otherwise. The wikipedia entry on rationing (WW2 version) shows that diabetics lost the sugar ration but gained meats and fats rations: a version of low carb was how things were done.

See how the "calories" thing goes for you - I have never bothered with counting calories, just eat when I'm hungry, stop when I'm not. I have no idea how many calories I'm taking in, and it hasn't been an issue.

Lamont D · Mar 7, 2023

andyR57 said:
Thanks for the reply. I was hoping that a few months of low carbs would help my system to get more efficient at dealing with carbs so then when carbs are increased I could handle them but it's looking like carb reduction has to be a permanent action which I don't really have issues with apart from replacing the calories carbs gave me - I have started eating nuts and using olive oil but still have issues with increasing fats to higher amounts [having been told for 50 years + its unhealthy]. Sure I will get there eventually.

It's not the calories, it's the carbs!
No need to count calories.

AndBreathe · Mar 8, 2023

andyR57 said:
Thanks for the reply which explains things very well and makes a lot of sense to me. I have to say I am not really missing the carbs and dinners seem to be more tasty without potatoes. It seems low carb is a diet for life rather than a short/medium term intervention. The only problem is I cant afford to shed many more pounds since I was not over weight to start with and I just haven't got comfortable with increasing fat too much. Early days yet!

When diagnosed, I didn't have oddles to lose either, but I did have "love handles", which disappeared in short order when I began low carbing.

When looking to stall weight loss I would urge you to do one thing at a time. I addressed my challenge in the following way. It was a slow process, but has allowed me to become a stable, slight T2, with a fighting weight circling the low end of the (albeit very flawed) BMI scale.

Firstly, I just had slightly larger portion sizes of what I was eating. That may have slowed things a bit, but didn't do the trick.

Next I concentrated on adding more protein (and as such reducing veg a little to make tummy room. Still not quite the answer.

Finally, I added nut, in measured "doses". Not because that's how I live my life, but so that I could understand exactly what was going into my body to achieve a status quo. Only then could I start to meddle a bit more in terms of general meals.

Now? My eating is almost by instinct, although I am away on a long trip at the moment and have lost weight, which I am addressing by means of pork scratchings (the local, street vendor scratchings are incredible!), and keto, sugar free icecream, as sold by the gym in our building.

I seem to have stabilised my loss again at last, but will have to claw that couple of kilos over time - likely when I get home, next month.

It's not a quick fix, to gain weight, based on nutritionally dense foods, not padding.

(Just to add if I really overdose on fats my relationship with the little room closens, so I di have to be a little careful of that. You may get away with mainlining cheese or butter, but for me that's a bit of a Russian Roulette.)

bulkbiker · Mar 8, 2023

andyR57 said:
At lunch I had a dinner I often have which is fairly high carb and my readings are much higher than normal

Do you mean you ate a meal for lunch that you would usually have in the evening?

In that case many people have noticed that their carb tolerance improves over the day so it may have been the timing of the meal.

andyR57 said:
a bit confused about wholegrain

Has the same amount of carbs as "normal" so best avoided altogether.

andyR57 said:
I am now considering going keto

Great idea worked extremely well for me maybe ally it with some time restricted eating too.

andyR57 said:
is this a cure or just avoidance and will the avoidance increase carb intolerance

I think for you that ship has sailed.. if you go back to eating the way you did to develop T2 then I'd hazard a guess that that particular way of eating isn't great for you so why would you want to go back to it?

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