LOW CARB DIET - A NEWBIES GUIDE

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mikethebike

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I am very interested in the low carb diet suggestions.
I have been type 1 for 42 years and luckily do not seem to have developed any significant complications yet.
By the definitions posted I am presently on a high carb diet.
However I try to avoid processed foods and gain carbs from as many 'natural' sources as possible.
My weight,cholesterol etc etc are all fine.
Dailiy Insulin is 18U Lantus and 7-10U Novorapid.

I would like some advice if I were to try a low carb diet.

My concern is that I regularly participate in long distance cycle riding.
For example, yesterday I rode the London to Brighton, also riding to the start and then back home from Brighton which added up to approx. 140 miles.
I reduced insulin to a very low level but probably consumed 210 carbs as fuel during riding alone. That is on top of breakfast and evening meal.
My blood glucose was 4.5 at the end of the ride and has been pretty low since. 6.5 best otherwise 2.9 to 4.3 every 3 or 4 hours. (I guess still too much insulin)
I feel fine and could go out and do it again, once the blood readings are a little higher, but today I am getting fed up of eating every couple of hours to prevent a hypo.

I also cycle around 40 miles 3 or 4 times a week
Would a low carb regime be suitable considering the need for fuel I seem to have developed.
My weight is probably at its optimum now so I dont want it to drop any further.

Sorry to waffle on but I would like to know if the low carb diet could help/is suitable. :?
 

rcampbl

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Hi fergus
you have made the idea of low carbing sound easier so thanks for that I am going to give it a go as my blood sugars are averaging out at 14 which is way too high. How soon after eating should i check my blood?
Rosemary
 

fergus

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Type 1
Hi Rosemary,

your blood glucose would probably peak at around 1 hour after eating a meal based around carbs. A meal low in carbs and higher in protein or fat will probably peak later and a 2 hour test will be better. Good luck with the new diet, I'm sure you won't regret it.

Mikethebike, chapeau! If a low carb diet is good enough for Lance 'hold the pasta' Armstrong, it's good enough for me.

fergus
 

mikethebike

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Thanks Ken & fergus

Well the link worried me looking at the competitve cyclists blood glucose fluctuations.

I have already moved to moderate carb and reduced novorapid to 7units per day.
All seems good so far.

I will take it stages and should be able to gradually reduce the Lantus.
 

fergus

Well-Known Member
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1,439
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Type 1
Hi Mike,

Well, I for one don't think much of the runsweet site. It seems to recommend enormous quantities of carbs to fuel exercise and makes no allowance for the fact that they are simply not essential for exercise, or anything else for that matter. They seem to think an hour's intense cycling needs more carbs than I eat in a week! And I do 6-8 hours intense cycling every week.
To me it looks like they have bought into the myth that only glucose can fuel the muscles, and that's pretty far from the truth.

fergus
 

rcampbl

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4 days into low carbing and I can't belive it. for the first time sinse I was diagnosed I am below double digits. bg was 9.5 2 hrs after my dinner last night, i was amazed as I have been sitting around 14.
I haven't weighd myself yet but hopefully will have lost a couple of pounds as well.
once again thanks for all your wonderful advice
Rosemary
 

inwales

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rcampbl said:
4 days into low carbing and I can't belive it. for the first time sinse I was diagnosed I am below double digits. bg was 9.5 2 hrs after my dinner last night, i was amazed as I have been sitting around 14.
I haven't weighd myself yet but hopefully will have lost a couple of pounds as well.
once again thanks for all your wonderful advice
Rosemary

I wonder how many type 2s out there in the world are so frustrated by high BGs and not able to bring them down?

Low carbing must bring more happiness
 

samcogle

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We had a wellbeing day at college yesterday and diabetes UK were there. I had a chat and she gave me a diet booklet after I told her I was low carbing and I have to admit I was pleasantly surprised with the booklet. It recommends low GI, which is a start :)
 

inwales

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samcogle said:
We had a wellbeing day at college yesterday and diabetes UK were there. I had a chat and she gave me a diet booklet after I told her I was low carbing and I have to admit I was pleasantly surprised with the booklet. It recommends low GI, which is a start :)

I wonder when Diabetes UK will get into Low GL too!
 

jan123

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I don't find it daunting, I've found it very useful and a kick up the backside! I shall be going low carb from now on :D
 

cugila

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THE CASE FOR LOW CARBS. DILLINGER

THE CASE FOR LOW CARBS.

1. The Logic of a Low Carbohydrate Diet and Type 1 Diabetes

Type 1 diabetes is a chronic endocrine disease resulting in an absolute failure of the body to metabolise glucose. It cannot make sense to treat the condition on the basis of metabolising high levels of glucose.

Non diabetic people have a very limited spectrum of blood sugar ranges with corresponding HbA1C’s of 3.5-5.5%.

The ideal position for a diabetic must be to match non diabetic blood glucose profiles provided that in doing so they are not put under risk of serious problems such as severe or regular hypos.

This can best be achieved by eating a much reduced amount of carbohydrate and reducing your insulin levels. This strategy greatly removes the chances of hypos and means non diabetic blood sugar levels can be achieved.

2. The Lack of Evidence of Adverse Medical Effects from a Low Carbohydrate Diet

The Cochrane review (which collated data from 11 randomised trials in 402 patients), confirms a shift in the evidence in recent years, with a number of recent studies suggesting a low-carb diet could offer long-term benefits to diabetics. These benefits include sustained weight loss with no significant effect on glycaemia or lipid levels.

The Cochrane review shows that patients on a diet of foods with a low glycaemic index had an HbA1c level (average blood glucose level) 0.5 per cent lower than controls. There were also significantly fewer episodes of hypoglycaemia in patients on a low-GI diet, with a reduction of 0.8 episodes per patient per month achieved in one trial.

3. The Difference Between Ketosis and Ketoacidosis

Ketosis is not the same as Ketoacidosis and is a normal metabolic response to low carbohydrate content in the diet and/or fasting where insulin is present. It occurs at a mild level with insulin present at low or non diabetic insulin levels.

Ketoacidosis is a type of metabolic acidosis which is caused by high concentrations of ketone bodies formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced are acetoacetic acid and β-hydroxybutyrate.

Ketoacidosis is an extreme and uncontrolled form of ketosis. In ketoacidosis, the liver breaks down fat and proteins in response to a perceived need for respiratory substrate (i.e. where no insulin is present to metabolise glucose even though high levels of glucose are present) causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased.

Insulin inhibits ketosis and therefore a diabetic on a low carbohydrate diet (with an appropriate insulin regime) will not develop ketoacidosis but will merely display trace or low levels of ketones produced via normal metabolic ketosis.

On a low carbohydrate diet we aim to achieve low level ketosis and there are no studies to suggest that ketosis has any detrimental effect on liver function or other negative health implications.

4. The mechanics of Triglyceride Formation and Reduction

Triglycerides are so called because they are composed of three fatty acids attached to a single glycerol molecule.

Triglycerides are the key component of LDL (low density lipids) in the blood. The ratio of LDL to HDL (high density lipids) is a key indicator of cardiovascular risk
(Source: Circulation (1997;96:2520-2525) Gotto AM Jr. Triglyceride: the forgotten risk factor. Circulation 1998;97(11):1027-8).

Some triglycerides in our bodies come from the fat in our diet, but the majority are manufactured in the liver from fatty acids and glycerol. The glycerol part is a by-product glycerol phosphate and the use of glucose in cellular metabolism so that the more glucose in the bloodstream, the greater the production of triglycerides.
(Source: Ref. - Krauss, R. M. 2005. “Dietary and Genetic Probes of Atherogenic Dyslipidemia.” Arteriosclerosis, Thrombosis, and Vascular Biology. Nov.;25(11):2265-72)

As one might expect, triglyceride levels rise significantly following the consumption of large quantities of carbohydrates, not dietary fat and this link between glucose and triglyceride levels has been clearly demonstrated in clinical studies.
(Source : Ostos MA, Recalde D, Baroukh N, Callejo A, Rouis M, Castro G, et al. Fructose intake increases hyperlipidemia and modifies apolipoprotein expression in apolipoprotein AI-CIII-AIV transgenic mice. J Nutr 2002;132(5):918-23).

The easiest way therefore to reduce triglycerides and improve the LDL/HDL ratio is to reduce the carbohydrate content of our diets rather than reduce the fat/protein content.


5. The Benefits of Having as Little Insulin As Possible

Insulin is an anabolic hormone which has many metabolic effects besides simply lowering blood sugar. It is the principal regulator of dietary metabolism such that its serum levels largely determine whether fuel is stored or burned. Elevated insulin levels effectively displace fatty acid metabolism in the Krebs cycle and preferentially burn glucose while storing excess as triglycerides. High levels of insulin will mean that fat is not only stored but is specifically not metabolised. Weight gain results.

Recent evidence supports the role of insulin and IGF-1 (insulin like growth factor) as important growth factors, acting through the tyrosine kinase growth factor cascade in enhancing tumor cell proliferation.
[Source: Integr Cancer Ther. 2003 Dec;2(4):315-29.] This means that whilst elevated insulin levels are not shown to increase the risk of cancer they will enable cancers to proliferate.

A recent study has suggested that one of the effects of high insulin levels is the ‘chronic activation’ of the sympathetic nervous system and that this is what induces cardiovascular damage in insulin resistant Type 2 diabetics.
[Source: Effects of insulin on vascular tone and sympathetic nervous system in NIDDM. C J Tack, P Smits, J J Willemsen, J W Lenders, T Thien and J A Lutterman]

Individuals with abnormal glucose and insulin metabolism have a higher incidence of hypertension, and recent interest has focused on the fact that patients with untreated essential hypertension have higher than normal insulin concentrations in their blood, are resistant to insulin-stimulated glucose uptake and often have accompanying lipid disorders.
[Source: American Journal of Nephrology Vol. 16, No. 3, 1996]


6. A Response To the Purported Implications of the Accord Study

The ACCORD study is a large U.S clinical study of adults with established Type 2 diabetes who are at especially high risk of cardiovascular disease.

Three treatment approaches were studied: (i) intensive lowering of blood sugar levels compared to a more standard blood sugar treatment;(ii) intensive lowering of blood pressure compared to standard blood pressure treatment; and (iii) treatment of blood lipids by a fibrate plus a statin compared to a statin alone.

Note, that the intensive lowering of blood sugars was not done by a low carbohydrate diet but was done by increased medication. Participants in the intensive group were more likely to be on combinations of drugs than participants in the standard group. For example, 52% of participants in the intensive strategy group were on three oral medications as well as insulin, compared to 16% of those in the standard group.

In its regular review of the available study data, the ACCORD DSMB noticed an unexpected increase in total deaths from any cause among participants who had been randomly assigned to the intensive blood sugar strategy group compared to those assigned to the standard blood sugar strategy group and stopped the intensive blood sugar strategy group element of the trial.

On the whole, the death rates in both blood sugar strategy groups were lower than those seen in similar populations. That is, although the death rate was higher in the intensive treatment group than the standard group, it was still lower than death rates reported in other studies of Type 2 diabetes.

The ACCORD participant treatment is scheduled to end in 2009, and researchers plan to report the final results in 2010.

[Source :U.S Department of Health & Human Services, National Heart Lung and Blood Institute web site - http://www.nhlbi.nih.gov/health/prof/he ... .htm#trial].

To sum up then; it is an ongoing Type 2 study, the increased mortality is related not to tighter control but to the manner in which the tighter control was attempted (i.e. high medication), the intensive blood sugar strategy group still had a better mortality rate than non-control Type 2 diabetics.

Therefore, this is not applicable to Type 1 diabetics on a low carbohydrate diet and certainly should not be used to equate tight diabetic control with increased cardiovascular risk. If anything this demonstrates that increased medication is the problem rather than tighter control.

7. Why tight control is essential, and the NICE guidelines are too high

NICE currently suggest that diabetics should aim for HbA1c targets of less than 7.5% for the prevention of microvascular disease and less than or equal to 6.5% for those at increased risk of arterial disease of levels.
[ Source: NICE AND DIABETES: A summary of relevant guidelines July 2006 ]

However, for every percentage point drop in HbA1c blood test results (from 8.0 percent to 7.0 percent, for example), the risk of diabetic eye, nerve, and kidney disease is reduced by 40 percent. Lowering blood sugar reduces these microvascular complications in both Type 1 and Type 2 diabetes.

Intensive blood sugar control in people with Type 1 diabetes (average HbA1c of 7.4%) reduces the risk of any CVD event by 42 percent and the risk of heart attack, stroke, or death from CVD by 57 percent.
[Source: DCCT/EDIC, reported in December 22, 2005, issue of the New England Journal of Medicine.]

Furthermore a recent study conducted at Cambridge University analysing results from 33,000 Type 2 diabetics found getting HbA1c levels closer to the level of non diabetics could cut the risk of heart attacks by 17%.

[ Source: BBC News website Friday 22nd May 2009]

Dillinger
 

pensingrug3

Newbie
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:roll: Hi there, I am a carer to which I mean I cook for my husband, his BS is not too bad but he does have problems with carbs his dietitian and Dr insist he has a high carb diet, which I have ignored, it has been much better since I have lowered his carb intake. I bought a book on carb counting and it has at the back a section on carb units ,my question is do I count carbs off the food packets or do I have to convert, I am trying to aim for 100g of carbs but is that straight carbs or the unit of carbs. My husband is type 2 on tablets and diet he was diagnosed nearly 11 years ago and been on tablets about 5 years. He is 74
Joan
 

Serial45

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eating around 90g of carbs a day split between "Low GI foods - fruit, veg, low gi cereal (ALL-Bran). Would this qualify to be low enough GI to fill the rest of my diet with nuts, and mainly meat eggs etc? I mean I hear with the low carb diet you have to have low carbs otherwise you will just bloom with extra weight / high collesterol,

Wondering can anybody post me up a full diet of what they eat on a typical day?

Cheers
 

MING

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My husband is newly type 2 and our doc and practice nurse both told us low GI diet. So maybe the word is out and things changing. Very rural in Scottish borders practice. I hope it means I will lose some weight too....be a first ! :mrgreen:
 

gbswales

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Where can I find a good online carbohydrate calculator which contains most foods and ingredients including approximation for meals out etc = I have searched but most of the me are US product oriented and other than that I get loads of other search engines giving me lists which take me to more search sites!! I just thougtht maybe someone on here has already discovered one
 

MING

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That would be good, esp if it had some meals listed. I got the wee Collins Gem book but by the time I find what I'm looking for he's got bored and et something else ! :mrgreen:
 

Serena51

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I have printed out the marvellous newbie guide - thankyou sooooo much for that.

I have been trying to lo carb and reduce my metformin but the gp insisted it should stay the same as my bg had only come down to 6.9 from 7.4. He will not let me test my own blood daily as the NHS have decided that it makes people's bg worse! However he has acknowledged that both my bad cholesterol and triglycerides have improved.

I am going to see a NHS dietician next month to try to help me formulate my diet to help me lose weight - current BMI is 26.5, and I am going to take my guide with me in the hope that she/he will approve and not force me to go on a lo fat, hi carb regime. :)

I have tried some lo carb instructions but I have a bowel problem and when I was strictly lo carb ended up in hospital with kidney infection and faecal back up. The only way to 'regulate' me is to have All bran each breakfast and I have been soaking this in water and then adding cream before eating. The all bran weighs 50g so if after that I have an apple or clementine and some greens with evening meal of meat/fish would this be too much for weight loss to occur?
 
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Sorry to ask a really silly question but I'm new to all this - diagnosed in March and doing well on low GI and watching what I eat. My weight is coming down (almost 2 stone) and blood sugar from 11+ to about 5.5 most of the time. Where do porridge oats fit into low carb? They are carbs (I think) but oats are supposed to be good for us. I eat 30g each morning made into porridge with skimmed milk and don't eat much in the way of starchy stuff otherwise. Is this low carb? I'm really unsure about what carbs are, I understand protein but that's about it!
 

sugarless sue

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If you can tolerate the amount of carbs in them. 30g of Porage Oats ( Scott's) is 60 g of carbs per 100g, therefore 30g = 18g of carbs.

If your blood sugar levels at two and especially three hours are within normal limits then you can probably tolerate this for a meal.

The GI (Glycaemic Index) of this porridge is roughly 50.
So to calculate the GL ( Glycaemic Load)
You take the GI value = 50 x by number of grams of carbs per serving =30, then divide by 100.
Therefore

50 x 30 = 1500 / 100 = 15. So Medium GL. Portion size is everything here.
 
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