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low carbs v high carbs

Sid and others
There actually is a study published about 1982 that purports to show high carb diets to be helpful.
One of the names on it is Hugh Simpson. I can't remember any others.
It's a pretty poor piece of science, because it lumps together fibre and starches all as carbs, which biochemically speaking they are!
However, we've become acustomed to separating out indigestible carbohydrates, such as cellulose, from the metabolically active ones such as sugars and starches.
Nowadays even a year 3 child[aged 8] knows that you investigate ONE VARIABLE AT A TIME.
So if this study were to be re-interpreted, it would show that a high proportion of soluble fibre in the diet is good for control. The recommended diet in the study includes lots of beans and lentils and was probably a good suggestion at the time.
I've searched the literature for years and that paper is the ONLY one I've ever found advocating a so-called high carb diet.
It's on-line somewhere, so interested people can read it and evaluate the science for themselves.
Hana
 
catherinecherub said:
If this advice is being handed out minus a meter and educating patients about the use of the meter and what it tells you about the meals you have eaten, there wouldn't be such a problem.
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Thank you Catherine again I agree with you 100%, seem to be making a habit of that recently

What is offensive in the diet sheet is not the foods listed but statements such as

Small quantities of sugar in foods such as baked beans, most breakfast cereals, should not affect your blood sugar levels.
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How do they know it should not affect MY blood sugar levels. They **** well do and dangerously so.

In my opinion the diet sheet and any similar should start by advocating a diet that would be safe for the majority of diabetics which inherently would mean advocating a level of carbs around 130g / day and then tell you by testing to try to add (or in my case) take away food or quantity from their safe list.

Sid you may not agree with that but from my perspective I went from a pre diabetic to a Type 2 with an HbA1c of >11% in a year by following what was recommended on a similar sheet. I agree other pre diabetics who followed it may well have got better, I don't deny that's a possibility.

The whole attitude of the doc is wrong. It comes over as "don't worry it's not that bad look you can still eat much what you want." It is that attitude that is so dangerous to diabetics not the list of foods or their carb content.
 

If you read papers about there being no good evidence that testing improves control for Type2's and their HBA1c's reflect this then perhaps we should be blaming some of the Type 2's who were given the luxury of testing before there were so many of us. I know some diabetics who see testing as a parlour game for friends and family and do not know how to interpret their own results. I watched a Hospital programme and this elderly gentleman tested his blood sugars whilst waiting to see the diabetes specialist. It was in the high teens and his explanation was that he had eaten three slices of toast and he would expect to get a high result. There was no sign of him worrying just a matter of fact attitude.

I think more education is the key.
 
I think everyone commenting on this does so from informed and well established positions on diabetic treatment; we all do so with a lot of baggage.

But for the newly diagnosed they have no baggage they just have these leaflets.

The original poster says that the advice appears to be eat "a high carb diet". Again I'm worried that the semantics of what low carb/high carb means will drown out the question asked. It doesn't really matter; the level that is appropriate is the one that doesn't mess up your blood sugar levels whether that's 1,000 grams a day or 10.

It's not really a point of saying where specifically does it say "high carb" what counts is what a reasonable person without the scars from hundreds of posts on this forum would understand the leaflets to say. I would suggest that the original poster sees 'eat carbohydrate with every meal' as being a green light to eat a high carb diet. That's not unreasonable.

If you were presented with a plate of pasta and you referred to your leaflet you wouldn't say 'hmm, but I must control the size of this portion to ensure I don't get a post meal blood glucose rise' or 'is this pasta low gi enough for me?' you would say ; 'pasta; is that ok? Yes it is; the leaflet specifically names it as something to have'.

Dillinger
 
Now THIS is the Diabetes forum I remember from days of old!!! (Must be a full moon or something...)

Congratulations to all of you for defending yourselves so well.

 


With respect Stephen but what I did say was the 50/50 split was relevant to those who have posted on this subject on this very forum......remember not everyone who joins here shares their experiences and we need to keep this in mind, in truthfulness we will never know the National figure of those who receives good/bad advice and are happy with their diabetes care.

Yesterday I received an email from DCUK about low-carb diets and clicked on the link, it's interesting that they regard a low-carb diet as anything up to 130g of carbs, at this upper figure you would reasonably expect that most people would be including some form of carbohydrates in the form of pulses, fruit, whole-grains etc. Here a link to the email:

http://www.diabetes.co.uk/diet/low-carb ... -diet.html

Back to the OP, as a type 2 diabetic it would be a good idea for him to follow the excellent advice given to newbies and take it from there, there isn't a diet that suits everyone and hopefully by testing and monitoring his bg levels he will find his own way.
 
I don't know the fact and figures, don't have the time to research it all. I go by common sense.

Cutting carbs helps bg's. All agreed? The info being given out to newly diagnosed often recommends including carbs with each meal, or basing the meals around starchy carbs. I take that to mean the same level of carb that I was eating before diagnosis because nowhere does it mention reduction. I don't think I'm stupid, nor am I incapable of thinking for myself but I have just been given advice by my doc and leaflets to take home. So I will follow the advice, especially if I am obese as it looks like a healthy diet (and doc has suggested that if my weight drops, my diabetes will be under control.).

I had found this forum before I was diagnosed as I came here for help for my daughter. I had gleaned enough info to be able to look carefully at the advice I was given. I don't feel I was given helpful advice from the nurse (BHF leaflet) because I knew there were alternatives (I also knew for a fact that their recommendations raised my bg's-I had used my daughter's meter).

Have another look at the newly diagnosed section. How can we say that diabetics are being properly supported with the dietary changes they need to make?
Is it that hard to acknowledge that cutting down on carb foods will help bg's? Would it be so damned difficult to change the wording on these pamphlets to advise halving the amount of carbs-surely a safeguard that would not cause harm to health and could only improve matters?

I expect the NHS to do this or at the very least, encourage people to eat smaller portions of carbs.

Bottom line, yet again is the current way isn't working.
 
Patch said:
Now THIS is the Diabetes forum I remember from days of old!!! (Must be a full moon or something...)
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:lol: :lol:

On the full moon - did you see it last night? It was like a beautiful spot light in the sky; made sure I stayed on the road and kept clear of the moors...
 

Think that is the best statement I've read today in this thread ladybird64. That was precisely my problem. My wife and I brought up our family using the classic 5 a day principles, treats sweets and even puddings were weekend and special occasions only, all food cooked from raw ingredients and very little junk food so when I got the pre diabetic advice from the doc I thought, "that's really no different to the diet I'm currently eating in fact my diet doesn't even contain the amount of sweet thinks they tell me I can eat so maybe what I should do is just eat a bit less and lose some weight" BAD BAD MISTAKE
 

So the advice that you were given was to lose weight not to load up with carbs, yes?

This is the kicker isn't it, If we accept the statistics (one of my favourite subjects :lol: ) that around 80% of t2's are overweight if not obese and we assume that these figuers are similar for the newly diagnosed then isnt it reasonable to assume that at least 80% of T2's on diagnosis are advised to lose weight and no one is going to advise eating high carb diet as a way to lose weight.

Then we have other statistics that suggest that a high percentage of diabetics are not achieving NICE recommended levels and some will deduce from this that it proves the NHS advise is wrong, but it could also be deduced that some people are hiding their heads in the sand and thinking - well I'm OK at the moment and if stuff happens later I'll deal with it then - or that they simply dont care until something happens. How many smokers are told they should stop smoking? How many obese people are advised they should lose weight, now doing so may be a problem but I cant see that the advice is all bad, I myself lost over 4 stone whilst on insulin and I still ate carbs with most meals it is not impossible it just takes commitment just as any other diet does, if someone cant stick to a diet they cant stick to a diet, you cant blame the NHS, its individual choice.
I was advised several times by my GP to give up smoking it wasnt until I developed a life threatening lung condition that I finally listened and gave up smoking over night. You can lead a horse to...

You say tom_A_toe and I say tom_ar_toe
 

As this is from the original poster, first post on here, would someone like to offer advice to help a newly diagnosed Type2? Any takers?
 

Sid..did you not read that I don't do statistics, only common sense? :wink:

I'm going to be pedantic now. Yes, I was told to load up on carbs as I mentioned in a thread that I made many moons ago, that information came via a leaflet that I was given from the practice nurse and it was produced by the BHF. For me personally, I am happy to include carbs in my diet but at a reduced level as you do yourself Sid. There is no explanation anywhere from docs or in leaflets that carbohydrate can cause bg's to rise and it would therefore be wise to eat them in less quantity than before diagnosis..I honestly can't see that there is a problem with that?

I totally agree that we are responsible for what we do with our diet and that yes, there are many that stick their head in the sand and others that don't want to change-individual choice. BUT-at least give people the right information and then let them make that choice!

My old choice was two slices of brown toast for brekkie with marmite. I had the chance to test and found that the 2 slices sent me up into double figures! I now have 1 slice. If I followed the dietary advice for a healthy diet I would have carried on munching my two slices possibly with a glass of fresh fruit juice to wash it down.
Nobody told me, nobody warned me. I wouldn't have known and would have carried on in ignorance possibly losing weight but with an ever increasing HBA1C.

That's all I'm saying. Give people the correct information to enable them to make a choice. At diagnosis, along with the fresh friut and veg advice, suggest reducing amounts of carbs as part of a healthy daily diet.

Oh and by the way Catherine, Borofergie did reply to the OP in his initial post, giving good advice about testing 2 hours after eating and what are suitable levels to aim for. I'm sure Polly will not take the advice about burning leaflets too seriously, she has been given sound recommendations on what may help her other half.
 
Yes Polly we all went off on one then. Doesn't happen too often but when it does...

Here's my normal advice to new forum members

There are many ways of getting control of diabetes but many of us on the forum like to try to do this using changes to what we eat and combine that with a minimum of drugs usually an effective and safe drug called Metformin.

If your partner wants to try and control using what he eats as the primary way then a good place to start is cut down on carbohydrates especially the starchy ones rice, pasta, potatoes, bread, pastry and cereals. Cutting drastically or better still stopping completely anything sweet with a high sugar content is taken for granted. Sugar is just a refined form of carbohydrate. This would also include things like pure orange and fruit juices and non diet forms of things like Coke and other fizzy drinks.

He may find the advice I've given will conflict with later advice he may get from his NHS dietitian or nurse but he will have to believe that the vast majority of people on this forum believe that cutting carbohydrates is the key the only real debate we have is by how much (you've seen today that it can get quite heated!). If you were Swedish or German or in a number of the more enlightened countries this advice would be told to you on diagnosis however the NHS still relies on diet info that is now nearly 40 years old and is very out of date.

To start with try getting your partner to half all of the starchy carbohydrates he currently eats. That's bound to make him hungry so replace with meat, cheese, eggs, fish and especially vegetables. Try to eat vegetables that grow above ground rather than below although many of us find carrots to be ok. If he likes fruit then a small amounts are fine and the ones ending with "berry" are the best. Things like yoghurt should be fine in moderation as well.

On the half you have left try the following

Change white rice to brown basmati rice
Change white bread to wholemeal or better Burgen soya bread
Change white pasta to brown or green or the tri colour stuff

Never eat mashed potatoes it's the one form of potatoes that nearly all diabetic have real problems with. Believe it or not the best potatoes for diabetics are roast ones.

I was diagnosed just 3 months ago with extremely high blood sugar levels and by following the great advice I found on this forum I now have my blood sugar levels back to nearly being in a non diabetic range at all times of the day and have lost just under 40lbs in weight. Cutting carbohydrates is not a cure but will allow him to get control of things and will certainly make him feel a lot better.

I must say doing this has been hard work but it gets easier everyday. Also he may find that cutting your carbs by half may not be enough as many of us on here have found. I still get to eat some of the things I've warned you about but in no where near the quantities I used to. Saying that 12 weeks down the line I hardly miss them now.

The next thing most forum members would recommend is getting a meter so that he can test his own blood sugar levels. Again he may well be told that it isn't necessary by his doctor or healthcare team but how else is he supposed to understand what foods are dangerous and what foods keep him safe. You will find lots of advice on testing and what are safe blood sugar levels on the forum. What you should be aiming for is to have blood sugar levels always below 7 prior to eating and then below 7.8 two hours after eating. Again he may get told this is not necessary to do but these are the internationally recognised safe blood sugar levels that all countries work to.

If he wants to test himself and his gp doesn't prescribe him a meter then currently the meter that is cheapest but is getting good reviews by forum members is called an SD CODEFREE. The cheapest place to buy it is on the health.co.uk shop on eBay where you can pick it up with a case a spikey thing and 60 test strips for around £18. People are buying that model because buying test strips for it are far cheaper than any other model currently £4.99 per 50 strips. If you can afford to I'd buy as many test strips as you can on the initial order as you'l save on P&P later on. Make sure you buy a UK mmol/l model and not the US mg/dl version or he'll get really confused by the numbers that come up!

Around 95% of Type 2 people end of having to buy the meter and strips themselves. The UK N.I.C.E health guidelines state that a Type 2 diabetic who both understands and shows they are reacting to meter readings should get prescribed strips but in reality it happens very rarely in practice in fact many newly diagnosed people are quite aggressively told not to test as it's pointless. The trouble is the guidelines can be ignored if a gp thinks they should be.

Take care and keep asking as many questions as you need to.
 
Okay, Catherinecherub, I will!

Pollyvent, many of the people who use this forum have found that controlling our carbohydrate intake helps us to control our blood glucose levels and lose weight.

I was diagnosed Type 2 very early, because my doctor looked on me as a prime candidate and checked by BGs regularly. I was morbidly obese at the time (2 years ago), weighing 21.5 stone on a 5' 6" frame. I also have a spinal condition which means I am not very active.

I went straight on to a diet that I knew had worked for me in the past - Atkins. The diet I use is a modified version of the Atkins Induction phase - it's a 'Sticky Thread' called Viv's Modified Atkins Diet. It is very low carb, about 30g per day; on this diet I have lost 4.5 stone, dropped my HbA1c from 6.5 to 5.2, come off blood pressure meds, and improved my cholesterol greatly. It works for me. I am upping my carbs a bit as my figures improve - now on about 50g per day.

My diet is too low carb for many people, and possibly too low to go straight on to - a very drastic change. It's a useful basic food list, however; if your husband wants to eat more carbohydrate, use that list, get a Carb Counter book, and add in more Low G I carbs to the level you want. Grazer (a regular poster - on his hols at the moment :mrgreen: ) eats around 130g of carb daily, has lost weight, and has good control of his BGs - without meds, if I remember rightly. Other people, such as Sid Bonkers, control their BGs perfectly well using portion control - small portions of carbohydrate at every meal.

The most important tool for a Type 2 in the early days is a blood glucose monitor. Test just before and 2 hours after every meal, and your husband will soon find out which foods spike him. I can manage a sandwich using wholemeal multigrain bread occasionally; I have fish and chips occasionally (but share the chips); I can eat out quite happily by avoiding the really high carb things - I don't do puddings anyway; cheese is fine, with or without a biscuit. I don't really go for chocolate, but I eat really dark chocolate (up to 90%) if I feel the urge come on.

How did I get over 21 stone? Red wine - which I still drink, but in much less quantity, and much less often. At least, I do try :crazy: . Also far too much food. Incidentally, my BGs start creeping up when I drink too regularly, and it plays hell with my cholesterol breakdown. I'm being very good at the moment :angel: - my next HbA1c is next week :shock:

A low-carb diet can be interesting and varied - have a look at the Low-carb Recipe thread, some wonderful ideas on there. It's not the end of the world by any means.

Apart from Atkins' original book, one I would recommend is Atkins Diabetes Revolution, by M C Vernon and J A Eberstein. Worth a read! There are others.

Viv 8)
 
I'm a bit late joining this one, being away as you know, but if the leaflets Borofergie has shown don't suggest a high carb diet, I don't know what does. If you tell a newly diagnosed type 2 to "base his diet around starchy carbohydrates", without explicitly saying "by the way, only about x grams a day though", then by definition you're saying eat lots of carbs. There seems to be some "defending the indefensible" going on here. Surely we all agree that modifying carb intake, particularly starchy carb intake, is the only alternative to strong meds for a type 2? So why aren't these guidances saying that clearly? As they stand, they are clearly bad advice in my opinion. Ah well, back to the beach now. Have fun.
 
Sid Bonkers said:
"where does the NHS state that diabetics should eat a HIGH CARB DIET?"
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Here:
http://www.nhsgrampian.org/nhsgrampian/files/Diet.doc
http://www.bathdiabetes.org/index2.php?section_id=399
http://www.worcsacute.nhs.uk/file_download.aspx?id=ac60944e-659b-44e9-98cf-323e1aff2c11


Sid, are you satisfied that 45-60% of your dietry energy intake constitues a high carbohydrate diet? (That's 280 to 375g a day for someone eating 2500kcal). If getting over half your energy from carbs is not a high-carb diet, what does a high carb diet look like?
 
BTW Sid, I think you believe a lot of us make up the "bad advice" bit, based on your personal experience of getting good advice. But bear in mind you went straight on insulin on diagnosis so I suspect had access to better advice than most of us. Us on diet only / metformin get the sort of advice that LEADS us to insulin if we follow it. THEN we get good advice....... Silly eh?
I can only assure you that I was told face to face to eat far more starchy carbs than I was on my normal (non diabetic) diet. I was also told to eat far more potatos, and that my normal Saturday night pizza was fine. My BGs were mad until I started doing the opposite of what I was told.
 
I think much of the trouble and confusion stems from the stereotyping of T2s. Wasn't there a study a few years ago which found that T2s were often from the lower socio-economic classes , poorly educated with restricted access to fresh food and/ 'or from certain ethnic groups.? Oh and mainly elderly , of course,

The one-size -fits -all approach has obviously been formulated to fit this profile and explains a great deal.

PCTs in areas where many T2s do fall into these categories have produced dietary leaflets with these people in mind.
The trouble is that they are given to all patients and then find their way into other areas where they may be totally irrelevant and do more harm than good.

I remeber being given a "pack " when I was diagnosed. I could ot believe one of the leaflets in it concerning diet. I knew it did not apply to me but could not understand why it was given to ANYONE.

Not only breakfast cereals but cakes , biscuits and other items were referred o by brand no just tyoe.

Because I had o neeed to lose weight and the Dr had recommended the GI diet I had been following for years, I did not assume for one moment that he would have advised me to abandon this and adopt a diet high in sugars and carbs and processedd foods.

Eventually I followed thi sup and foiund that the leaflet had been obtained from a neighbouring area {different PCT} whe hey were searching for materials to make up the pack . Apparently noonehad paid uch attention to the contents.
When I asked why anyone would sugges such a diet I was told that that it was better than the diet followed by most of the ewly diagnosed in that area . It was considered that a ruluy healthy diet would be too difficult - alien and not sustainable.

They had been handing out this leaflet for years and I was the first person to query it. I daresay others had had the same reacio but hadn't bothered to mention it.
For many people a leaflet handed to hem in a pack from their GP would be taken as a NHS leaflet . Why would they thik otherwise? How many people even know a PCT is?
It is certainly the case that as Catherine says the newly diagosed will often be numbed by shock and misunderstand what is said to them or don't ask the right questions. It is also a fact that HCPs are unable or unwilling to answer questios or answer them correctly. Patients may be ill with other conditions or as a result of medication and highly confused by conflicting advice.

I was diagnosed almost 5 years ago. My main concerns were trying to cope with the system - which oone else seemed to understand - with the GP's requiremens for testig = which was never explained - and wih the horrific side effects of metformin.

Then , almos immediately i was referred o the hospital - for no good reson at the ime and had o cope with multiple appointments there too. A very confusing and frightening experienc

More personalised reatmet would solve many ills and would ot necessarily cost more. The righ treatmet and advice to begin with would probably mean hat most patients would gain control more quickly. Maybe the NHS should allow dietitians more autonomy and not even attempt to promote any sort of diet. If patients could all be seen by dietitians and a diet was worked out for the individual, weight loss and a sustainable . healthy diet might be easier to achieve.

The whole system need to be re-thought. We are people not machines.
 

No not at all, these links are saying that the percentage of energy intake should be 45 -60% not that you should eat 45-60% of your meal as carbs. Now I have no idea what percentage of my energy intake comes from carbs but I do know that I am not going to increase my fat intake regardless of how many pro high fat links you post as I believe that a high fat diet is not good for me. Then you mention the calorie thing saying that I must be eating 280 - 375g of carbs a day, well I can assure you that I am not so I can only assume that your maths or your theory does not add up


You only post the % of carbs and not the % of fat, it really just brings us back to your theory that we should all eat more fat which many of us do not agree with.

Yes we all need to eat fewer carbs to control our bg levels but we dont all need to eat more fat, the fact that you keep insisting that we all do seems strange to me, is it some sort of crusade?

Eat to your meter and only eat the carbs that suit you, the individual. Eat more fat if you like but dont keep telling me to please, it aint going to happen because 99.999% of the medical profession tell me that it is bad for my cardiovascular system and I tend to believe them over you mate :thumbup:
 
Sid Bonkers said:
No not at all, these links are saying that the percentage of energy intake should be 45 -60% not that you should eat 45-60% of your meal as carbs.
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Sid, with respect, that doesn't make any sense. If you are taking 45-60% of your energy from carbs then then, by the application simple mathematics, you must be eating an absolute minimum of 45-60% of your meal as carbs.

Sid Bonkers said:
Now I have no idea what percentage of my energy intake comes from carbs but I do know that I am not going to increase my fat intake regardless of how many pro high fat links you post as I believe that a high fat diet is not good for me.
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They aren't pro-fat links, they're NHS dietry guidelines for diabetics.
 
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