Low carb diet research

[SamJB]

Hi everyone,
As many of you who have read my posts may know, I'm a T1 low carber. It's worked wonders for me and is the only method that has got my HbA1c below 6.5% and I know it works for many people here too. On a voluntary basis, I'm also a patient representative on the steering committee for the National Diabetes Audit, which collects the results of UK diabetics' check-ups throughout the year. The results make depressing reading, you can see the 2010-2011 results here: https://catalogue.ic.nhs.uk/publication ... rep-V4.pdf

In summary, only about 7% of T1 are hitting the 6.5% HbA1c target and only 25% of T2s.

It's not the business of the National Diabetes Audit to make recommendations on diets, it's purpose is to audit UK diabetes care. I care a lot about the poor results, however, and I'd like Diabetes UK to invest more into the research of low carbing and recommend it to people who want to get a good HbA1c, but can't on currently-recommended diets. In, other words, I don't want it to be THE recommended diet, but I want it to be an option. In a way, I'm jumping on the back of the recent news about DUK's investment into the Newcastle Diet.

I've made contact with the people at DUK who decide on such things and I want to collect as many research papers as I can on low carbing for T1s and T2s, good or bad.

A previous poster pointed me towards a paper for T1s (http://www.dmsjournal.com/content/pdf/1 ... 6-4-23.pdf) does anyone know of any for T2s?

 

[smidge]

Hi Sam!

Thank you for your post. I just want to say 'thank you' for the efforts you are making to try to get appropriate dietary advice available to all diabetics with the aim of improving the dire statistics of those who attain 'safe' HbA1cs.

I firmly believe that winning hearts and minds in DUK is the way to achieve this. I recently approached DUK asking them to put a low-carb diet approach as one of the options for diabetes management prominently on their web site. The initial response I received was extremely negative. However, my email was passed to a more enlightened team within DUK and I received a second, far more concilliatory response which acknowledged that many people with diabetes have great success in managing their BGs with a low-carb diet. The main concern from DUK seemed to be that many (or most) people with diabetes will not or cannot stick to it. I think that is progress! They (or at least this team) are no longer refusing to acknowledge it as an approach that can work. Ok, it's small progress but progress nonetheless!

So keep on chipping away with intelligent and reasoned arguments - I think their view is softening.

As you and I both know from personal experience, a low-carb diet can make a huge difference to Type 1/1.5 diabetes management and control. As many others will testify, it also makes all the difference to Type 2 management and control.

Good luck - and sorry I can't point you to any Type 2 low-carb research - but I'm sure others will be along who can!

Smidge

 

[SamJB]

Thanks very much for your post, Smidge. Very useful!

 

[fatbird]

Accurso, A., et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutrition & Metabolism, 9 (2008). PMID: 18397522. One of the watershed reports that summarize the major features and benefits, based on 68 scientific references.

Boden, G., et al. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Annals of Internal Medicine, 142 (2005): 403-411. In these 10 obese diabetics, a low-carb diet spontaneously reduced calorie consumption from 3100 daily to 2200, accounting for the weight loss—1.65 kg (3.63 pounds) in 14 days. Blood sugar levels improved dramatically and insulin sensitivity improved by 75%.

Daly, M.E., et al. Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes—a randomized controlled trial. Diabetes Medicine, 23 (2006): 15-20. Compared with a low-fat/reduced-calorie diet, weight loss was much better in the low-carb group over three months, and HDL ratio improved.

Davis, Nichola, et al. Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes. Diabetes Care, 32 (2009): 1,147-1,152. The Atkins diet was superior—for weight loss and glycemic control—when measured at three months, when compliance by both groups was still probably fairly good. After one year, the only major difference they found was lower HDL cholesterol in the low-carb eaters.

Elhayany, A., et al. A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study. Diabetes, Obesity and Metabolism, 12 (2010): 204-209. In overweight type 2 diabetics, a low-carbohydrate Mediterranean diet improved HDL cholesterol levels and glucose control better than either the standard Mediterranean diet or American Diabetes Association diet, according to Israeli researchers.

Haimoto, Hajime, et al. Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetes. Nutrition & Metabolism, 6:21 (2009). DOI: 10.1186/1743-7075-6-21. A low-carbohydrate diet is just as effective as insulin shots for people with severe type 2 diabetes, according to Japanese investigators. Five of the seven patients on sulfonylurea were able to stop the drug.

Nielsen, Jörgen and Joensson, Eva. Low-carbohydrate diet in type 2 diabetes: stable improvement of body weight and glycemic control during 44 months follow-up. Nutrition & Metabolism, 5 (2008). DOI: 10.1186/1743-7075-5-14. Obese people with type 2 diabetes following a 20% carbohydrate diet demonstrated sustained improvement in weight and blood glucose control, according to Swedish physicians. Proportions of carbohydrates, fat, and protein were 20%, 50%, and 30% respectively. Total daily carbs were 80-90 g. Hemoglobin A1c, a measure of diabetes control, fell from 8% to 6.8%. These doctors had previously demonstrated that a 20% carbohydrate diet was superior to a low-fat/55-60% carb diet in obese diabetes patients over six months.

Vernon, M., et al. Clinical experience of a carbohydrate-restricted diet: Effect on diabetes mellitus. Metabolic Syndrome and Related Disorders, 1 (2003): 233-238. This groundbreaking study demonstrated that diabetics could use an Atkins-style diet safely and effectively in a primary care setting.

Westman, Eric, et al. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism, 5 (2008). DOI: 10.1186/1743-7075-5-36. Duke University (U.S.) researchers demonstrated better improvement and reversal of type 2 diabetes with an Atkins-style diet, compared to a low-glycemic index reduced-calorie diet.

Yancy, William, et al. A low-carbohydrate, ketogenic diet to treat type 2 diabetes [in men]. Nutrition & Metabolism, 2:34 (2005). DOI: 10.1186/1743-7075-2-34. A low-carb ketogenic diet in patients with type 2 diabetes was so effective that diabetes medications were reduced or discontinued in most patients. The authors recommend that similar dieters be under close medical supervision or capable of adjusting their own medication, because the diet lowers blood sugar dramatically.

Yancy, W., et al. A pilot trial of a low-carbohydrate ketogenic diet in patients with type 2 diabetes. Metabolic Syndrome and Related Disorders, 1 (2003): 239-244. This pioneering study used an Atkins Induction-style diet with less than 20 grams of carbohydrate daily.

 

[SamJB]

Wow! Thanks, I'll take a look through all of them later!

 

[Dillinger]

Hi Sam,

Here are a few that I've saved over the years. Some of them are just abstracts and I think you'd have to pay for the full study; but hopefully they won't be completely without use

Low carb ketogenic diets and Type 2
http://www.nutritionandmetabolism.com/content/2/1/34
http://www.nutritionandmetabolism.com/content/5/1/9

Low carb diet and slowing the progression of neuropathy
http://diabetes.diabetesjournals.org/co ... /1204.full

Is saturated fat bad for you?
http://www.ncbi.nlm.nih.gov/pubmed/20071648
http://www.ncbi.nlm.nih.gov/pubmed/20089734
http://www.nejm.org/doi/full/10.1056/NEJMoa055317
http://www.scientificamerican.com/artic ... nst-cardio

A succinct reminder about the science of 'essential' nutrients
http://ajcn.nutrition.org/content/75/5/951.2.full

Best

Dillinger

 

[Andy12345]

Thankyou for your posts they are terrific, i wished i had your patience and approach towards this subject, im too stupid to be this considered, im more a "lets light some torches and march" kinda person but wished i were more like you and will try to be, well done and good luck with this approach for all our sakes :thumbup:

 

[badcat]

http://www.ncbi.nlm.nih.gov/pubmed/22562179

http://www.sciencedaily.com/releases/20 ... 203715.htm

 

[neilblackwood]

Hello everyone,

Let me introduce myself by saying that I'm not a medical doctor, my partner of over 8 years has had type 1 diabetes for 27 years so far. Living with diabetes on a daily basis I feel I've gained a great understanding of the condition, although I can only vouch for what works for my partner and other diabetics I've entered into discussion with.

In my frustration with my partner's diabetes, I've been continually researching health in a hope to find something that worked for her, we've since found a solution that works, albeit too late to prevent the kidney damage that has led to her being in need of a kidney and on peritoneal dialysis.

I recently decided to comment on some posts on Diabetes UK's Facebook page, discussing ideas that challenge mainstream dietary guidelines, excessive (~270g) consumption of carbohydrates and limited (<20g) consumption of saturated fat without making it clear that perhaps diabetics should first talk to their doctor before changing their diet or insulin/medication regime.
I was met with resistance to the ideas I posted, with one commenter labelling me as "dangerous" for promoting such ideas to diabetics. Although I understand the concern regarding changes in the management of diabetes, I had hoped that I would have been able to get into discussion about it, but alas, my comments have been largely ignored or removed.

This led me to this forum where I hope people will be more open to discussing what options should be made available to diabetics. I've been collecting information from doctors and journalists who discuss the issues with current dietary guidelines and felt that I should share the information that I've collated.

Below are a few of the prominent doctors doing research into appropriate diets, not just for diabetics, but for everyone, so when you have the time to do some reading, or watching (I've included some videos to some of the better lectures/conversations) I encourage everyone to at least view the information I'm sharing and come to their own conclusion on the data presented. If this only helps 1 other diabetic from developing the issues that my partner has, then I feel that I've provided help to someone that needs it. My hope would be that more discussion on diet can be had and I'd eventually like government guidelines (who most of the general public regard as having our best interests at heart) to reflect what is appropriate for human consumption.

Richard K Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S., FCCWS (Type 1 Diabetic for 67 years)
http://www.diabetes-book.com/
http://youtu.be/vyOI9bk3VZc

Dr Malcolm Kendrick (GP in the UK)
http://drmalcolmkendrick.org/
http://youtu.be/chUjOUQdIio

Jay Wortman M.D. (Type 2 Diabetic)
http://youtu.be/zjUdtK6ukqY
http://www.drjaywortman.com/

Peter Attia, M.D. (Insulin resistent)
http://nusi.org/about-us/meet-our-president/
http://eatingacademy.com/dr-peter-attia

Eric Westman M.D.
http://youtu.be/dSLf4bzAyOM
http://medicine.duke.edu/faculty/details/0081489

Michael R. Eades M.D. & Mary Dan Eades M.D.
http://youtu.be/Akz9B-zMS-4
http://www.proteinpower.com/authors.htm

Al Sears, M.D
http://youtu.be/iCVo8HbDpXI
http://www.alsearsmd.com/about-dr-sears/

Robert H. Lustig, MD
http://youtu.be/dBnniua6-oM
http://www.diabetes.ucsf.edu/members/robert-lustig

Gary Taubes
http://youtu.be/bTUspjZG-wc
http://garytaubes.com/

Professor Tim Noakes, M.D. Dsc
http://youtu.be/5IYVIdztWWs
https://twitter.com/ProfTimNoakes

Dr. Chris Masterjohn
http://youtu.be/S0khESue2bA
http://blog.cholesterol-and-health.com/

Uffe Ravnskov M.D. PhD
http://www.ravnskov.nu/

Dr John Briffa
http://www.drbriffa.com/


Documentaries challenging conventional dietary guidelines

Fat Head Movie
http://youtu.be/v8WA5wcaHp4
http://www.fathead-movie.com/

Statin Nation:
http://youtu.be/Ry1Z8buyd8I
http://www.statinnation.net/

The Men who Made us Fat - BBC (No longer available on iPlayer)
http://youtu.be/E6nGlLUBkOQ
http://www.bbc.co.uk/programmes/b01k0fs0


Thanks for reading,

Neil

 

[Daibell]

Great work and thanks. I cannot understand the hypocrisy within the NHS/DUK which in general is negative about low-carb diets for T1/T2 and yet T1s and others on insulin are given carb-counting guidance where there is assumed to be a linear relationship between units of insulin and carb intake typically 1 unit for 10gm carb. Surely this carb-counting guidance correctly demonstrates that carbs increase blood sugar with insulin needed to 'eat it up'. How does anyone explain this gap in diabetes logic? Am I missing something?

 

[mrman]

For me, matching my insulin to carbs works brilliant. I understand that of course carbs puts up levels. Correctly matched to my ratios they only increase by 1~3mmol at the most. Do I need to eat the carbs~yes. Will this cause me to gain weight, hopefully. Still underweight for my body type/age etc since diagnosis whilst also trying to build muscle. Weight going on very slowly, muscle definition coming nicely. am I the only diabetic in this position of course not. should I be overweight at any time what would I do. Reduce food intake, including carbs, thus reducing insulin, thus reducing weight.
Always two opinions (or more).
What do non diabetics do, if there trying to gain weight eat more, their body naturally gives them more insulin. if they try to loose weight, they eat less and excercise so their body gives them less insulin.
Diabetics using insulin do the same but must match insulin to food wether they low carb or not.
Those not injecting I appreciate may have more obstacles to overcome, even those who do may have other issues. For me I would be lost without dafne.
Sent from the Diabetes Forum App

 

[noblehead]

yet T1s and others on insulin are given carb-counting guidance where there is assumed to be a linear relationship between units of insulin and carb intake typically 1 unit for 10gm carb. Surely this carb-counting guidance correctly demonstrates that carbs increase blood sugar with insulin needed to 'eat it up'. How does anyone explain this gap in diabetes logic? Am I missing something?

No your not missing something at all, if you read back what you wrote above it will all make sense, carbs raise bg and insulin brings it back down

 

[fatbird]

Wonderful to see so many links recommending a low carb diet.

 

[neilblackwood]

For me, matching my insulin to carbs works brilliant. I understand that of course carbs puts up levels. Correctly matched to my ratios they only increase by 1~3mmol at the most. Do I need to eat the carbs~yes. Will this cause me to gain weight, hopefully. Still underweight for my body type/age etc since diagnosis whilst also trying to build muscle. Weight going on very slowly, muscle definition coming nicely. am I the only diabetic in this position of course not. should I be overweight at any time what would I do. Reduce food intake, including carbs, thus reducing insulin, thus reducing weight.
Always two opinions (or more).
What do non diabetics do, if there trying to gain weight eat more, their body naturally gives them more insulin. if they try to loose weight, they eat less and excercise so their body gives them less insulin.
Diabetics using insulin do the same but must match insulin to food wether they low carb or not.
Those not injecting I appreciate may have more obstacles to overcome, even those who do may have other issues. For me I would be lost without dafne.
Sent from the Diabetes Forum App

Hi Brett,

I'm interested to know if there's a reason why you need to eat carbs, is it purely to put put on weight/fat?

It would also appear that, at least for this non diabetic, people can eat as many calories from fat as they want without increasing their fat mass, so long as their diet is low enough in carbs:
http://live.smashthefat.com/why-i-didnt-get-fat/

Here's another interesting analogy, if a farmer is looking to fatten up their animals, the main ingredient in their commercial feed is going to be grain, something promoted by government that we should all be eating on a daily basis....

I do appreciate that DAFNE is a step forward on previous methods of diabetes management and might be a good approach to attain a weight that you're comfortable with, but longer term, if you'd be interested in preventing cellular damage from short term exposure to blood glucose levels above 6-7 mmol/L, low carb can offer protection until a better performing insulin becomes available, and from the research I've listed on the previous page, it seems to be the way we've all been biologically programmed to eat anyway.

Neil

 

[mrman]

Yes, trying to gain weight ,but NOT trying to gain fat. Trying to gain weight through muscle gain by eating lots of protein, including shakes,lots of complex carbs. is working just not as quick as I would like, but nothing never is I suppose.

Sent from the Diabetes Forum App

 

[mrman]

An easier way to answer your question would be the term used in the link you posted. I'm having a "bulking" phase.

Sent from the Diabetes Forum App

 

[goslow]

Hi Everyone,

Its a year or more since I've posted on this sight, I was diagnosed with Type 2 about 5 yrs ago and I'm for ever thankful that I did as it led me to going on a reduced carb diet and drinking good red wine. So at 69 I'm still on diet and exercise with HBa1c at around 40-42 with very little effort at all.

Reason I'm posting is that everyone is talking about the 800 calorie diet when it is only in fact a very low carb diet. The only carbs in these drinks is some low starch vegetables. Five years ago dieticians, doctors and DSNs would not even talk about a low carb diet but I knew I'd won when my doctor started talking about the 'caveman' diet and how there were no carbs thousands of years ago!

So now DUK is spending £2.4m on research with a result in 5-10 years. I think the amount of research your post has uncovered show that DUK have had it wrong for years! Well done

 

[Dillinger]

Not that I read The Daily Mail (etc., et.,)

http://www.dailymail.co.uk/health/artic ... iment.html

Not sure that this counts as research but it certainly anecdotally follows what we all see on a day-to-day basis.

Best

Dillinger

 

[paul-1976]

A very interesting read and the n=1 experiment demonstrates that CICO is not gospel as many of us have found.

 

[douglas99]

Hi Everyone,

Its a year or more since I've posted on this sight, I was diagnosed with Type 2 about 5 yrs ago and I'm for ever thankful that I did as it led me to going on a reduced carb diet and drinking good red wine. So at 69 I'm still on diet and exercise with HBa1c at around 40-42 with very little effort at all.

Reason I'm posting is that everyone is talking about the 800 calorie diet when it is only in fact a very low carb diet. The only carbs in these drinks is some low starch vegetables. Five years ago dieticians, doctors and DSNs would not even talk about a low carb diet but I knew I'd won when my doctor started talking about the 'caveman' diet and how there were no carbs thousands of years ago!

So now DUK is spending £2.4m on research with a result in 5-10 years. I think the amount of research your post has uncovered show that DUK have had it wrong for years! Well done

The 800 calories diet is a zero fat diet.
The evening meal is veg, which is carby.
Caveman diet was carby when they lived off fruit and tubers, which was probably a staple if the animals refused to lie down.

And I'm still puzzled,

"A high-carb diet increases the amount of glucose in the bloodstream, which in turn means you produce more insulin. The more insulin the body produces, the more fat gets stored."

I should be able to eat carbs by the bucketful, as I don't even produce enough insulin to reduce the glucose in my bloodstream, yet alone store it as fat.

I low calorie, low fat, and I now have a "normal" Hba1c, and lost 3 stones.