low carb diets

Barrie Smith

Active Member
Messages
38
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
NHS and Prof Tony Weetman .
Surely you seem to be missing the point , when I was diagnosed in 1960 it was explained to me that any Insulin other than what I
produced was an alien substance , so it was advisable to keep insulin dose as low as possible whilst maintaining body weight and energy levels by counting carbs , I still weigh my bread , potatoes ,cornflakes . The higher your Insulin intake the higher the risk of complications .
 

paul-1976

Well-Known Member
Messages
1,695
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Dishonesty
Which is exactly the reason as an insulin user that I follow a low carb diet,in my book-the less I have to inject-the better.
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
Treatment type
Pump
There isn't any evidence that a higher dose per se leads to more complications.
The data from the DCCT (Diabetes control and complication trial in T1 so not applicable to T2) found this not to be the case. This was a big long term trial and started after your diagnosis. It has been extended and there is data for over 20 years.
It's aim was to find out if intensive control ie treatment to 'normalise' glucose using appropriate insulin was superior to the standard treatment of the time. This almost inevitably required higher insulin doses and more injections than the standard treatment of the time.
It was found that insulin dose in terms of insulin per kilogram was a poor predictor of long term complications. Normal clinical markers of insulin resistance such as bodyweight and ( waist size, higher trigs, lower HDL and higher blood pressure) were also poor predictors.
However, use of a formula including the waist/hip ratio, high blood pressure and the HbA1c were found both in this study and the Pittsburgh Epidemiology of Diabetes Complications Study to be predictive of complications.
http://care.diabetesjournals.org/conten ... ong#ref-16

There was indeed some concern at the start of the DCCT that the increased dosages that were necessary to keep tight control might lead to weight gain and a consequent increased risk of cardio vasucular disease. In some cases there was a gain in weight however even with this weight gain, the better HbA1cs resulted in a a reduced risk of CVD. The better glucose control was what was important.

The same study also gave advice to participants on diet but was not specifically designed to look at diet. The advice stressed a consistent carb intake matched with appropriate insulin intake. I won't go into the findings in detail but the conclusion was 'Among intensively treated patients with type 1 diabetes, diets higher in fat and saturated fat and lower in carbohydrate are associated with worse glycemic control, independent of exercise and BMI.'
http://ajcn.nutrition.org/content/89/2/518.full

Personally, like you, I still weigh my carbohydrates, not to reduce them but to calculate insulin dose. I don't eat a low carbohydrate diet, I eat a normal healthy diet with the carb levels consistent though they may increase at times of higher activity levels. For the last 8 years, I have had an HbA1c consistently in the fives (unusually about 5.8%) I don't think that eating large amounts of anything is good whether one is diabetic or not. In the long run If what you eat and the insulin you take is producing a good (ie lowish) HbA1c that is what seems to be important in regards to diabetes complications.