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Low Carbing

Sam

Hate to tell you I have a HbA1c of 5.8% and my hubby's HbA1c is in the mid 6% and we both eat normal foods....

The trick is to learn your diabetes inside out, learn how your food adsorbs, when/how it impacts on your blood glucose, how and when exercise impacts on your system, how stress effects you, how ambient temperature effects your control... Learn your insulin profiles, how quick QA insulin hits your system and how long it takes to burn out... Know your basal wave, so you know if you going up towards a peak or going into a trough... So you know how to adjust and deliver your insulin..

The Study isn't as fantastic as first glance might suggest..

All percipients volunteered after receiving information concerning the study, so well motivated people but at the end of 4 years 52% had stopped adhering to the regime, the group was rather small 68 people if I remember correctly, The authors has done their number crunching to see what the up take might be if they rolled it out to all T1 diabetic's in Sweden their figures came up with a range between 10-20% would uptake the diet... And it has to be remembered that Sweden is an hotspot for the LVC diet with about 25% of the population following it!

So I would suggest you get two books...

Using insulin by John Walsh, this will give you all the information about working out the in's and out's of your diabetes and using your insulin..

Then Bernstein diabetic solution... This give you the knowledge and theories to work with a lower levels of carbohydrates..

Then with these two books, you should be able to fathom out your own level of carb intake...

As it's important to find what works for you, and a diet that is your diet regime and isn't somebody else's,,,,
 
One more thing Sam to recognise. Over the past few years "low carb" has become increasingly recommended by leading health services around the world not just the Swedes. The Swedes are undoubtedly a world leader but then their health service is seen to be the worlds leading state run system so we are not talking about a bunch of mavericks.

Likewise America the worlds most advanced private health care system has been recommending a maximum carb intake (RDA) of 130 grams for diabetics for the last two years which is actually stricter than the Swedes. You can read the full ADA 2012 position statement here http://care.diabetesjournals.org/content/35/Supplement_1/S11.full.pdf. The 130g / day recommendation is also in the 2011 ADA statement and our own UK position statement references the ADA recommendations throughout. Nowadays even the UK position is to recognise the primary importance of carbohydrate control for diabetics even if we don't attach a number to it and of course there is bound to be lead time in getting that information getting down to HCP's.

Given the worlds two leading health care systems now actively promote low carb then it would appear that they consider a low carb diet to contain perfectly normal safe foods. The Swedes actually recommend a range of dietary regimes. You can read a translation of their health care position statement which includes dietary recommendations here.

http://translate.google.co.uk/trans...=/search?q=Kost+Vid+Diabetes&hl=en&prmd=imvns

For example their "radical :) " moderate reduced carbohydrate regime is summarised as

The diet consists of meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet containing amongst other things, less sugar, bread, cereals, potatoes, root vegetables and rice than traditional diabetes diet
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Nothing abnormal there I would suggest as all it's saying is eat less starchy carbohydrate and avoid processed foods.

Likewise their recommended Mediterranean regime is summarised as:

For example, plenty of fruits, legumes and vegetables, and fish and sparingly red meat. The intake of monounsaturated fats from olive oil and nuts are great. Alcohol is often consumed daily. The diet contains amongst other things, less sugar, bread, cereals, root crops and rice than traditional diabetic diet
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So again nothing extreme either with just an emphasis on reducing starchy carbohydrate and avoiding processed foods which seems eminently sensible to me but make your own informed choice.
 
xyzzy said:
...The Swedish government is actively promoting "low carb" to its general population as a means of combatting the ever increasing rise in obesity, diabetes and associated health issues. It's now though a quarter of Swedes try and follow a "low carb" regime...
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Hi xyzzy, not sure where you get your information but as a Swede I seriously doubt that 25% of us is following a low carb diet - we're a nation with a huge crush on potatoes :wink: I wouldn't say that the government is actively promoting low carb either and definitely not a very low carb one. The Swedish diabetes association recommends 4 different kinds of diets, one of them being what they call a moderate low carb. This one gives you 30-40% of your energy from carbs.
 
I'm pretty confident that my diet and dosing is working wel. My downfall is that whilst I exercise a lot, if I'm busy in work or injured myself playing rugby then I don't go for a week and my value valid basal amounts change angel my sugar levels get ******** up. I need to be more strict on myself. If I am, my hba1c would be in the 6s. No doubt.

I think though, that I'd be daft not to try something that has the potential to give me a good hba1c. If it doesn't work out, then fine, but at least I can say I tried. Thanks for your advice though.

Xyzzy, great work on the links!! Thanks for all of your help, let's hope it does the business!
 
If you finding that when your normal exercise regime is disrupted by injury ect... Then you'll not compensated correctly with your insulin don't forget it's not just adjusting for the lack of exercise, but compensating for the body's reaction to the repair of the injury which can also increase Blood Glucose levels...

I fractured my finger a couple of years back, just a small fracture which didn't effect my normal routine/exercise but I had to turn up the basal rate of my pump by 40% to compensate for raised BG's during the healing process, I must admit I was taken back a little, as at first I thought my rise was down to how I fractured my finger, I was tossed in the air by a Collie who ran into me at full speed, hitting my shins and the momentum flicked me 4ft in the air landing in a heap :shock: But this went on for 4 weeks!

So it maybe that when you have an injury a non exercise period, you may need to up your basal insulin over this period..

My husband finds that he's got to increase his basal insulin by a couple of units, when he's has annual leave from work that lasts more than 3 days, purely based on he cycle's to work (around 6 miles a day) and finds that after a break of 3 days his BG will raise a little as the exercise effects wares off..

As don't forget, you will still have these problems with what ever diet you decide to follow with changes in exercise routines and illness, injury etc..
 
fenix92 said:
xyzzy said:
...The Swedish government is actively promoting "low carb" to its general population as a means of combatting the ever increasing rise in obesity, diabetes and associated health issues. It's now though a quarter of Swedes try and follow a "low carb" regime...
Click to expand...
Hi xyzzy, not sure where you get your information but as a Swede I seriously doubt that 25% of us is following a low carb diet - we're a nation with a huge crush on potatoes :wink: I wouldn't say that the government is actively promoting low carb either and definitely not a very low carb one. The Swedish diabetes association recommends 4 different kinds of diets, one of them being what they call a moderate low carb. This one gives you 30-40% of your energy from carbs.
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I can only go on what I find when I look so for example

http://swenglishlchf.wordpress.com/page/2/

or

http://www.dietdoctor.com/the-swedish-low-carb-revolution

and according to the IDF Sweden has the second lowest rate of diabetes in rich nations only beaten by Iceland so it must be doing something right.

If you do a search for say "Sweden 25% LCHF" on G**gle you will find very many articles that all say that fact or similar. Where I would agree with you is that a Swede saying they do LCHF is different to them actually doing it so if you analysed what they were actually eating you may end up with a slightly different story. Doesn't alter the fact that research increasingly shows an low carb or lchf diet is beneficial for diabetics of all types or that lchf is being promoted in Sweden.

I used to post a link that showed the promotion of 100 LCHF recipes in a popular Swedish Sunday newspaper supplement but the link is now dead. If the Swedish government were critical then surely I would be finding articles that said the government disagrees with that kind of thing and would be telling people and diabetics to stick with traditional high carb low fat diets?

I don't disagree with you at all regarding the fact the "Moderate carbohydrate restricted diet is a 30 to 40% restricted one (lets assume it means 35%ish for ease of typing). What that is saying is restrict to 35%ish in total. Here in the UK we are told eat a 50% carbohydrate diet and ensure 33% is starchy carbohydrates so I hope you can see that is quite a difference especially when the UK emphasis is on carbohydrate sources that increase levels. Effectively that 33% starchy carbohydrate recommendation is near enough the same as the entire "Moderate restricted regime" recommends across all carbohydrate sources. The American ADA recommendation at 130g / day equates to roughly a 25% carbohydrate regime or say half the UK recommendation.

Without wishing to emphasise differences between insulin and non insulin using diabetics then as I understand it the T1 argument for low carb is to do with reduction in insulin required, better hba1c and levels control, weight loss, hypo control and that kind of thing. Being diet only T2 I don't claim any knowledge just that many T1's on the forum seem to advocate low carb diets. From a diet only T2 perspective then low carb is crucial in recognising to get safe levels you have to drop your carbs or alternatively you have to make a choice that if you want to do a higher carb regime you are likely to need either stronger medication or elect for insulin.

Hope that somewhat explains my liking of your countries attitude fenix. :)
 
I know you're right Jo, but my basil and bolus amounts change at the same time which is obviously difficult to keep pace with and unfortunately there is no descernable pattern of change. The simple fact is I need to be more strict on myself when it comes to exercise routine. I can still exercise if I've injured myself, I just need to change the exercise. Plus if I've had a hard day in the office it can be difficult to persuade myself to exercise. I'm doing well in the other areas of Diabetes, I just need to pull my socks up with exercise routine!
 
Hi again xyzzy. This coming autumn the Swedish "Livsmedelsverket" (food agency) will publish a big study on the eating habits of us Swedes. Remind me to keep an eye out for it on your behalf!
 
fenix92 said:
Hi again xyzzy. This coming autumn the Swedish "Livsmedelsverket" (food agency) will publish a big study on the eating habits of us Swedes. Remind me to keep an eye out for it on your behalf!
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Yes please would be most interested!
 
Just thought that I'd provide an update on this. I did have a crack at low carbing for all 3 meals the week after I last posted, but I found things didn't work because my basal level was in a state of change (long story). Lesson learned - any significant changes in routine must be done incrementally and with a steady basal level.

So I got my basal level correct, and got a copy of Bernstein's book. I follow his philosophy, not his exacting carb prescriptions. I started off getting rid of bread, pasta and rice. I only eat pulses for my dinner. I then started eating the salads for lunch in Bernstein's book. It led me to eat much more tasty food than the normal boring routine of sandwiches/pasta/curry. I'm still on a small bowl of wholewheat muesli for breakfast, but will look to change that soon.

I was staggered to read my meter when it told me that I'd had 3 highs (a 13 because of a carb heavy dinner at the in-laws, and 2 10s after too much sugar exercising) and 1 low out of 60 results in the last week. It would normally be about 15 highs, 5 lows.

To paraphrase Bernstein, lots of variables go into BS levels if one or two of them goes wrong after eating loads of carbs you'll end up high. I've noticed that my highs would have normally been 12/13 when things went wrong, now it's 9.

Also (sorry to rabble on), I went out for 2 restaurant meals last week, ate 2 courses at each meal, no carbs and came back home with perfect levels - that has NEVER happened to me before.

This has genuinely been revelatory for me, so thank you so much to everyone who posted on here - this will change my life I'm sure. Thanks again :clap:
 
SamJB wrote
This has genuinely been revelatory for me, so thank you so much to everyone who posted on here - this will change my life I'm sure. Thanks again
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What a great story to read. Truly inspiring.

So glad for you :clap: :clap: :clap:

Geoff
 
Sam
I'm a T2, but I have been low carbing for several years. Unlike Jopar, I don't find it hard to stick to. It's the only way of eating which has helped me with blood glucose and weight and has not left me hungry. My husband is T1 and has reduced his carbs, but not as much as I have. he's consequently reduced his insulin demand too.[by about 50%] In addition he rarely has hypos and his complications [he has many] have stabilised.
Remember that a lot of the carbs used by T1s are simply feeding the insulin they use, because under the NHS, it's rare for the medics or the patients to work out the actual insulin need. It's more often " use so and so much insulin and eat to avoid hypos"
The secret is to keep testing and keep the insulin down to match the carbs. Bernstein actually says somewhere that it shouldn't be necessary to use more than 7 units of insulin per meal. I don't think I've ever met a British diabetic who uses so little.
Note Bernstein is a diabetic of well over 70 years of age, who has been on insulin since he was 12. He must have got something right, as he is complication free.
Hana
 
PS
I do have a calculator with me[in my phone] most of the time, but Idon't use it to tally up my carbs or my 2 x 500mg metformin per day.
I simply avoid eaing anything that I know is "carby". It's simple and doesn't take time. I don't use insulin, so that's a mathematical process I'm avoiding.
I eat normal food, usually home cooked. my main meals consist of meat/fish/eggs/cheese and green leafy veg. Once in a while, Ieat a SMALL portion of fruit. I avoid anything with sugar or flour. or grains
It's that simple.
A tiny portion of root veggies I'll eat, but never a large one. my meals are small.
I've lost a lot of weight, blood glucose is pretty much always normal [around 5] Blood pressure is good. cholesterol is low [ probably lower than it needs to be]
Because it's simple, I don't drop off the wagon. I make a few mistakes even now, but just get back up and sort it out
I plan a weeks main meals at a time and buy the ingredients. It saves time and money and my health.
Most of the time, Iignore my diabetes. I'm not ill, I just have an "iffy metabolism" which I need to compensate for in my eating.
Life is for living
Hana
 
Thanks everyone! After trying the low carb diet, I really feel that the NHS should be more pragmatic, innovative and bespoke in their advice on carbohydrate. I think the "eat as much carbs as you like and cover it with insulin" philosophy is incorrect advice for some diabetics like myself. Assuming this low-carb thing works for me then surely it has the potential to change everyone else who was trying hard, but not quite making the 6s in their hba1c results.

I haven't felt hungry, or tired, as I would expect to be from coming off the carbs. I have a desk job and can say that I don't need them in dense forms like pasta, rice, bread or potato. I've even lost a couple off inches from my belly!
 
hanadr said:
Bernstein actually says somewhere that it shouldn't be necessary to use more than 7 units of insulin per meal. I don't think I've ever met a British diabetic who uses so little.
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:wave: .....Typically I use 5 units for breakfast, 6 units for lunch and 6 units for my evening meal, you'd be surprised Hana how many British Diabetics inject less than 7 units per meal.



BTW well done Sam :thumbup:
 
noblehead said:
hanadr said:
Bernstein actually says somewhere that it shouldn't be necessary to use more than 7 units of insulin per meal. I don't think I've ever met a British diabetic who uses so little.
Click to expand...


:wave: .....Typically I use 5 units for breakfast, 6 units for lunch and 6 units for my evening meal, you'd be surprised Hana how many British Diabetics inject less than 7 units per meal.



BTW well done Sam :thumbup:
Click to expand...

I'm on a diet at the moment, but when I'm not, my typical daily insulin intake was 30 units, of which 13 were basal, so a total of 17 units for breakfast, lunch and dinner - averaging out at less than 6.
 
Firstly, good to hear of your experience Sam.

I've bought the Bernstein book, his general advice is sensible - don't eat anything wrapped in cellophane etc and these last two weeks (after what seemed to be an endless round of friends' birthdays - inconvenient :eh: ) I've knuckled down and near completely chucked out the carbs.

My readings are great, it's just a case of mentally getting out of the habit of giving yourself 12 units for an evening meal and scaling it back to 6/8. I had a couple of minor hypos as I was erring too much on the size of caution when I was only having a home-made ham and egg salad for lunch.

What do people say on what some diets recommend - have one 'blow out' day a week? I miss my bangers and mash...
 
[/quote] I also find my energy levels are much higher and am less prone to crashing out; that is because if you are in ketosis you have a constant supply of energy. Low carbers who do marathons don't hit the wall as there is no wall to hit if you're burning fat.


At the risk of showing my ignorance, I have to ask you about this: I always thought it was not safe to be in ketosis, and I should avoid it at all costs? Please explain :D
 
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