Low Carb Diabetes Site in Trouble.

[Oldvatr]

For me it highlights the dangers of ( and to) any site / person / approach that adopts a one size fits all approach when dishing out advice on medical matters

In which case you should also include sites that offer only Eatwell#2. for example NICE and DUK for starters. At least this site DCUK has info on many different diets, and where appropriate the forum contains links to science articles both for and against .with commentary from users and discussions, which is more than the media give space to. Here you are free to choose a way to follow that suits you best, and diabetes is fairly unique in that it is one of the more heavily monitored conditions by both home equipment, and also lab tests with GP oversite, at least once a year.

 

[Boo1979]

In which case you should also include sites that offer only Eatwell#2. for example NICE and DUK for starters. At least this site DCUK has info on many different diets, and where appropriate the forum contains links to science articles both for and against .with commentary from users and discussions, which is more than the media give space to. Here you are free to choose a way to follow that suits you best, and diabetes is fairly unique in that it is one of the more heavily monitored conditions by both home equipment, and also lab tests with GP oversite, at least once a year.

No disagreement there - one size fits all is a c*** and dangerous position to take, whatever the advocated approach

 

[Grateful]

No disagreement there - one size fits all is a c*** and dangerous position to take, whatever the advocated approach

Totally agree. It's tricky though because those newly diagnosed with diabetes already get a pretty complex message, even if they are fed one of the "one size fits all" messages. It is so confusing that they could, understandably, be tempted to believe that achieving adequate BG control is too hard and just give up, or accept mediocre control and progressive worsening.

I was reminded of this recently when a new forum member said her go-to breakfast prior to diagnosis was a cup of porridge. So she wanted to know if this was OK, and if not, what next?

There followed a torrent of helpful advice, including of course from me pointing out that porridge is high-carb. But also some people saying porridge is OK for some people -- test it with your meter and see.

Totally bewildering, but largely good advice ironically.

Simultaneously, there was another new member saying his spouse had gone out to buy the "right kind of bread and cereal" for breakfast. So, once again, the passionate to-and-fro about grains, cereals, basic education really. But equally confusing. (I am one of those people who, while having given up bread altogether, does have a very small amount of home-made granola for breakfast.)

Clearly education is the key, but it is hard to imagine there being agreement on the content of that educational message any time soon. Meanwhile, conflicting voices.

 

[Oldvatr]

Totally agree. It's tricky though because those newly diagnosed with diabetes already get a pretty complex message, even if they are fed one of the "one size fits all" messages. It is so confusing that they could, understandably, be tempted to believe that achieving adequate BG control is too hard and just give up, or accept mediocre control and progressive worsening.

I was reminded of this recently when a new forum member said her go-to breakfast prior to diagnosis was a cup of porridge. So she wanted to know if this was OK, and if not, what next?

There followed a torrent of helpful advice, including of course from me pointing out that porridge is high-carb. But also some people saying porridge is OK for some people -- test it with your meter and see.

Totally bewildering, but largely good advice ironically.

Simultaneously, there was another new member saying his spouse had gone out to buy the "right kind of bread and cereal" for breakfast. So, once again, the passionate to-and-fro about grains, cereals, basic education really. But equally confusing. (I am one of those people who, while having given up bread altogether, does have a very small amount of home-made granola for breakfast.)

Clearly education is the key, but it is hard to imagine there being agreement on the content of that educational message any time soon. Meanwhile, conflicting voices.

I think one of the difficulties we are seeing is that some of the Low Carbers are LC and moderate fat, and who find they can control bgl without going full ketogenic., Then there are some who are Very Low Carb full fat for full ketogenic diet. I personally am in the first group, and I use some medication that allows me a small amout of things like bread and rice without pushing me up too high. The VLC group are aiming at zero meds, so are not so 'tolerant' of carbs, so to them porridge and cereals are poison. I think this need to get to VLC is colouring the disussions, and leading to ALL LC followers being regarded as over zealous and carb police. I can understand both diets and they can both work for T2D especially, but the VLC diet is a specialised one that needs to be kept to a rigid set of limits, but my more relaxed LC diet suits me better. I wish there was a different name for this but both seem to be branded as LCHF, Maybe something like LCKETO or LCK to make it clear.

 

[Grateful]

I think one of the difficulties we are seeing is that some of the Low Carbers are LC and moderate fat, and who find they can control bgl without going full ketogenic., Then there are some who are Very Low Carb full fat for full ketogenic diet.

I am very low-carb, but also moderate-to-low fat. I have no idea how I can tolerate this without keeling over, but for the past nine months it has worked for me. To start with I was probably keto (I never tested for ketones, but it is likely that I was). Then, having achieved adequate BG control, I upped the carbs a bit (mainly by returning to normal food-portion sizes).

But that's just me. The overwhelming message on this forum is, "do what works for you" but that can come across as not very helpful. I get the whole "eat to your meter" thing, and I think in most cases that may be the only way to apply the "do your own thing" advice. I did it a bit differently, simply accepting my GP's advice to go low-carb and then applying the advice found in places like dietdoctor. But if that had not been successful, I would want to tighten things up by self-testing.

 

[Boo1979]

I think one of the difficulties we are seeing is that some of the Low Carbers are LC and moderate fat, and who find they can control bgl without going full ketogenic., Then there are some who are Very Low Carb full fat for full ketogenic diet. I personally am in the first group, and I use some medication that allows me a small amout of things like bread and rice without pushing me up too high. The VLC group are aiming at zero meds, so are not so 'tolerant' of carbs, so to them porridge and cereals are poison. I think this need to get to VLC is colouring the disussions, and leading to ALL LC followers being regarded as over zealous and carb police. I can understand both diets and they can both work for T2D especially, but the VLC diet is a specialised one that needs to be kept to a rigid set of limits, but my more relaxed LC diet suits me better. I wish there was a different name for this but both seem to be branded as LCHF, Maybe something like LCKETO or LCK to make it clear.

I absolutely agree.
I also follow low carb (35-50g) carbs and take meds, although I cannot tolerate porridge, rice, normal bread etc etc even with the meds and refuse to up my meds just so I can. My body wont tolerate keto - it makes me ill!. The apparant assumption by some ( not you) that keto is the way to go for all, really annoys and worries me

 

[Grateful]

The apparant assumption by some ( not you) that keto is the way to go for all, really annoys and worries me

I think it is partly a confusion with the terms. I suspect that a lot of people who think they have gone keto are not in fact keto. Perhaps they cooked food described as "keto" and when carb-counting, assumed that they really were eating only (say) 20g of carbs per day. This is actually very hard to achieve in practice (because carbs lurk in so many places) although I may have managed it for a couple of months just after my diagnosis.

How many of the people who claim to be keto are actually testing for ketones? I wonder.

Personally, I can imagine that going keto on a short-term basis is an interesting idea. I also see people on this forum who are genuinely ultra-low-carb and keto, on a long-term basis. I also suspect that before the discovery of insulin, some of the T2 survivors who (from necessity) used diet-only may have been keto, before the science was even understood.

I read somewhere that in the days before insulin, diet-controlled diabetics sometimes died of malnutrition because of the poor diet. Mind you, it is not clear whether those were T2s or T1s.

 

[Boo1979]

I think it is partly a confusion with the terms. I suspect that a lot of people who think they have gone keto are not in fact keto

Maybe. All I know is that for me, I monitor carbs etc closely and if i go sub 20-25g carbs, with or without high fat, both my sugars and blood ketones rise unacceptably high

 

[Oldvatr]

I think it is partly a confusion with the terms. I suspect that a lot of people who think they have gone keto are not in fact keto. Perhaps they cooked food described as "keto" and when carb-counting, assumed that they really were eating only (say) 20g of carbs per day. This is actually very hard to achieve in practice (because carbs lurk in so many places) although I may have managed it for a couple of months just after my diagnosis.

How many of the people who claim to be keto are actually testing for ketones? I wonder.

Personally, I can imagine that going keto on a short-term basis is an interesting idea. I also see people on this forum who are genuinely ultra-low-carb and keto, on a long-term basis. I also suspect that before the discovery of insulin, some of the T2 survivors who (from necessity) used diet-only may have been keto, before the science was even understood.

I read somewhere that in the days before insulin, diet-controlled diabetics sometimes died of malnutrition because of the poor diet. Mind you, it is not clear whether those were T2s or T1s.

I am moderate LC diet and not generally in keto, but I do benefit from keto when my meds send me into hypoland, or when I do Intermittent Fasting. I understand that strenuous workouts such as HIIT can also give even normal dieters some keto, and I believe marathon runners can also get this.

PS, look up the Banting Diet to see what they treated diabetics with prior to finding Insulin. It is in effect LCHF in a 19th century guise. They also used it to treat epilepsy.

 

[ringi]

I don't know if I am keto and don't care. I expect I am mostly not due to the amount of protein I eat and do go into keto at times.

But I do consider that bread and cereal are poison for people with Type2 to be completely avoided until BG is under very good control. Homemade porage provided it is not overcooked may be OK for some people, but all the instant porage I have seen is much higher GI, and people mostly go for instant porage. Eggs are so much easier than homemade porage anyway....

When people ask if eating carbs are OK, my view is, just don't eat them (other then above ground veg) until BG is under good control, then using a BG meter see if you can cope with them. I can cope with sweet potatoes (lower carbs than normal potatoes), but would never tell a new poster that I eat them, as they are not worth the risk until the person understands low carb and has good BG control.

Eating to your meter, seems to be the best way to prove to people, they should ignore their GP's advice about diet, and hence eat fewer carbs then the NHS "eat well plate". But just keeping my BG under control is not good enough, as I need to reduce insulin resistance as well, so I don't consider it safe to eat "up to my meter" and aim to have fewer carbs then I can "get away with" most of the time.

 

[AloeSvea]

I do think it important that we go back to the meaning of this thread - which is that low carbing - one of the main go-to ways of eating with insulin resistance diabetes - is being dragged through the mud in the mainstream British press, right now, due to this one case of digestive problems on changing diet.

And yes, I do believe the reporting that she was "no carbing" to have been put in for shock value (in order for readers to gasp at the strangeness of it all). If the woman in question was in fact able to go straight from a (presumed) HCLF diet to meat and poultry and fish, dairy and eggs (for instance) only diet in order to be no-carb (or in fact very very very very low carbs) - I would be hugely impressed. I don't think it is shocking at all to eat that way, but it certainly would have shock effect these days, especially in the media.

And yes absolutely - the reporting is stunning for its lack of actual information - ie what she was eating. And what her malady actually was. ("Stomach cramping" just isn't enough for us, is it?)

And a comment on the scientific information behind LCHF - there is plenty of it. People's lives and careers go on the line for this many times over. And when I say people's lives - a lot of those lives are insulin resistant diabetic ones! (Yes, like myself.) And the fact that we as a species have only been eating the very high levels of carbs and the new bad fats in the last 40 years or so. (Note - saturated fats are not the new bad for us fats!) This is such an obvious fact I am stunned that it is necessary to make this point in the whole healthiness of LCHF debates. (Ditto for Paleo eating, and the real no-carbing.)

Extraordinary to me is that in this age of huge ill health due to our badly mismatched-to-us-as-a-species modern diet - the people and websites etc advocating low carbing can be as pilloried as they are.

 

[Boo1979]

My mum was 84 when diagnosed diabetic
She has never been overweight and never eaten a very high carb diet - her carbiest foods were bananas, apples, porridge once or twice a week dark chocolate and 1 loaf of home made wholemeal bread a week - as a vegetarian her main meal were stir fied veg, eggs, cheese, home made veg soup, tofu and occasional brown rice with the stir fry she also walked several miles most days
I don't think its safe to assume that the factors behind very late onset T2 (as appears to have also been the case with the lady who was the focus of the story too) are the same as for the more usual middle age onset in the context of obesity and poor diet

 

[slinkimalinki]

I am with you on this, I just can't wrap my head around the reason why 'the others' think that eating real food is such a shocking thing to do. I am certainly not going to die because I don't eat potatoes or bread or cereals or sugar etc.

 

[paulus1]

I'm in my 15th week, but I am doing the coward's version, 900 to1000 cal. I am losing weight steadily but very slowly. My BGs came down with quite a jump at first but have now levelled off around the lower end of prediabetic level.I shall need to do another 6 weeks or so to lose 15% of my original weight. I would certainly not recommed ND to any little old ladies. My diet is low in both carbs and fat.Like your wife and friend I go faint and wobbly when my blood sugar drops, and old ladies are prone to falls anyway. Plus when they do have falls they are more prone to break bones than when they were younger.

you seem to be promoting very low cal dieting. that itself is a dangerous form of dieting. it puts your body into starvation mode. ive done loads of those diets even down to 500cals a day they are prone to making you sick, dizzy and at risk of blackouts. lchf and i mean healthy as apposed to high works well. my consultant is very happy with my bloods i have heart issues and its reduced my risk factors. but no one claims there is one way to lose weight if needed. re the elderly lady we dont know enough. was she fat. was she eating normally. the stomach pains what was the cause. and yes constipation can make you feel like your dying. and if untreated it can kill. but any sudden change will do that. even the standard eatwell plan recommends a cal reduction and switch to slow release carbs would equally cause an older person problems. the lack of advise from doctors and nurses could equally be to blame if supported properly she would not have needed to surf the web.

 

[paulus1]

My mum was 84 when diagnosed diabetic
She has never been overweight and never eaten a very high carb diet - her carbiest foods were bananas, apples, porridge once or twice a week dark chocolate and 1 loaf of home made wholemeal bread a week - as a vegetarian her main meal were stir fied veg, eggs, cheese, home made veg soup, tofu and occasional brown rice with the stir fry she also walked several miles most days
I don't think its safe to assume that the factors behind very late onset T2 (as appears to have also been the case with the lady who was the focus of the story too) are the same as for the more usual middle age onset in the context of obesity and poor diet

you mum is amazing. complement her when you next see her.

 

[AloeSvea]

My mum was 84 when diagnosed diabetic
She has never been overweight and never eaten a very high carb diet - her carbiest foods were bananas, apples, porridge once or twice a week dark chocolate and 1 loaf of home made wholemeal bread a week - as a vegetarian her main meal were stir fied veg, eggs, cheese, home made veg soup, tofu and occasional brown rice with the stir fry she also walked several miles most days
I don't think its safe to assume that the factors behind very late onset T2 (as appears to have also been the case with the lady who was the focus of the story too) are the same as for the more usual middle age onset in the context of obesity and poor diet

My mother is 82, and her blood glucose level started to rise into the prediabetic range at 80 , and she also is highly active. (I believe she lowered her BG level to normal levels inadvertently just by being even more active, which she enjoys). She is not overweight either - in fact she is in the borderline skinny range (BMI 18). But it never occurred to me I have to say, that her intermediate hyperglycemia came from anything other than the food. Also, as a diabetic myself, that she too is prone to insulin resistance (IR) does not surprise me! (We share 50% DNA, and the body type that is prone to developing IR in a high sugar and high carb food environment.) It just took her body a lot longer than mine (due to major diet differences in her childhood compared to mine) to develop the IR and the blood glucose dysregulation, is how I figure it. Not that there is some extra elderly dynamic occurring to lead to (IR based) T2D. Who knows.

According to the overloaded liver (and therefore pancreas) theory of hyperglycemia, what level of carbs and glucose overload is an individual thing - so for someone that porridge, grains and bread, and the banana could be part of their personal threshold. But I hear you if she has been really unlucky and does not eat any of the added sugars that many of us have had in our diets but still got IR that developed into T2D.

Otherwise it isn't type two? And the lady in the story, as all? would have/should have been correctly diagnosed as a LADA, Mody, etc.

Or is it being suggested that maybe some kind of elderly hormonal thing is going on? Then it would be the same as for the rest of us and related to stress hormones, lack of sleep, anxiety etc? Or something else?

Something to think about for sure.

 

[Boo1979]

Tis a strange thing. My mums sister was overweght / obese all of her life and all the signs of impending diabetes were there - she had a massive (11.5lb) baby, loved everything sweet - indeed in her later years ate virtually nothing but sweets and cakes. Everyone in the family and her medical team were convinced that she was a prime candidate for diabetes but there was never a sign of it and she died at 82 diabetes free whereas my skinny mum got the D bullet at 84

 

[lucylocket61]

I believe you need the diabetic gene or something to get diabetes.

 

[AloeSvea]

I believe you need the diabetic gene or something to get diabetes.

It's not a diabetic gene, per se. But a body type (made up of literally thousands upon thousands of genes), according to my understanding, with particular fat storage pathways. You need to have the body type interacting with the environment. You don't have the environment (like our high sugar high carbs food environment) you don't get T2 diabetes. Hence the 'epidemic', and now what was called adult onset diabetes occurring in very young children.

The type of body that is prone to get diabetes now is exactly the type of body that withstood long periods of food scarcity and famines, ie, their descendants (like us!) lived on to reproduce and pass on this body type down the line. This is why it is so prevalent now. Not due to a sudden crop of diabetic genes, but a natural part of our species - the ability to store fat (yeah for many of us that dreaded dangerous belly fat) and live off of it in times of food scarcity. But now there is no scarcity, but food with enormously high carbs (and/or calories if you prefer to look at it that way) and with bad fats toxic to our bodies to boot.

 

[lucylocket61]

It's not a diabetic gene, per se. But a body type (made up of literally thousands upon thousands of genes), according to my understanding, with particular fat storage pathways. You need to have the body type interacting with the environment. You don't have the environment (like our high sugar high carbs food environment) you don't get T2 diabetes. Hence the 'epidemic', and now what was called adult onset diabetes occurring in very young children.

The type of body that is prone to get diabetes now is exactly the type of body that withstood long periods of food scarcity and famines, ie, their descendants (like us!) lived on to reproduce and pass on this body type down the line. This is why it is so prevalent now. Not due to a sudden crop of diabetic genes, but a natural part of our species - the ability to store fat (yeah for many of us that dreaded dangerous belly fat) and live off of it in times of food scarcity. But now there is no scarcity, but food with enormously high carbs (and/or calories if you prefer to look at it that way) and with bad fats toxic to our bodies to boot.

Then why do the majority of people who eat like that not get diabetes? There has to be more than the trigger foods to switch on diabetes.