low gi diets

Hi Pete and welcome to the forum.

There is always a lot of confusion about carbohydrates, which unfortunately is not helped by the medical profession and dieticians' insistence that we should all eat a high carbohydrate diet. If you browse around the posts on the forum you will see that many of us, particularly those who have achieved good blood glucose control, have switched to low carb diets. To allay your wife's fears, that does not mean that you have to blindly follow Atkins. The Atkins diet is simply one of many low carbs diets, and happens to have the lowest recommended carb intake of all of them (at around 20g carb per day).

If you feel that you really must eat starch then the lower GI types of bread, pasta and rice are better for you, but all that low GI gives you is carbs that convert to sugar a bit slower. They won't reduce your sugar level, just slow it down. The only way to reduce your blood sugar is to eat less less of what creates blood sugar in the first place. But you will need to work out for yourself what level of carbs per day you feel comfortable with and that gives you the control over your blood sugars that you need. We can all offer advice as to what works for us, but it doesn't necessarily follow that what works for me (80-100g carb per day) is right for you.

Your morning readings of 18-23 are extremely high, in fact dangerously high. Yes, you should certainly seek medical help because it is possible that you need to be taking a higher dose (or an alternative to) your current medication. You don't say what your levels are like at other times of the day, or your HBA1C. If your high morning levels are a great deal higher than your readings at other times of the day, then this is often down to one of two things:
- the "dawn effect" where your liver starts to release its stored glucose around 12 hours after your last meal - you can prevent this by having a small high-protein but low carb snack just before you go to bed (like a small piece of cheese or ham and a handful of nuts)
- the Samogyi effect where your blood sugar has dropped too low and you have had a hypo during the night. Again your liver will try to correct this by pumping out glucose into the blood.
In both cases the liver will just keep on pumping out more and more sugar until you signal it to stop by eating something.

What you high morning levels are proving is that your carbohydrate intake and your meds are completely out of step. You don't explain why you don't trust your GP, but you can also be treated at your local hospital - I believe that both Mayday and St Georges in Croydon have specialist diabetes units.

Hope this helps but if you have any questions please fire away - we are here to help one another where we can.

This may sound a bit strange but the Atkins diet is designed ti increase the ammount of keatones the body produces these are BAD when produced in a diabetic as its a by product of ketoacidosis. Does this not affect type 2 diabetics in the same way as type 1 ?

As Dennis said, there are many variations on the low carbohydrate theme, and the important thing is finding a balance you are comfortable with and can sustain indefinately.

I know many people became suspicious of the Atkins approach because of the number of newspaper stories that perpetuated the myth that it was a cardiovascular suicide note. There was and still is absolutely no evidence for this.

If the 2 greatest risk factors for heart disease are overweight and high blood sugars, you have already proved to yourself that the low-carb approach is the healthiest possible diet for your heart, let alone your diabetes.

All the best,

fergus

on another note, if you have both been doing a bit of exercise as well, perhaps you are building up muscle tissue, which I believe is heavier than fat, which could explain why your wife looks slimmer but the scales stay the same. For example, I have been losing around a cm from my waist every week or so but the scales have been "stuck" on a certain weight for about 5 or 6 weeks, since I've been really serious in working out.
Also, I follow a low GI diet and it works for me, the only error in logic I made for a few years was thinking Low GI meant I could eat as much as I wanted, which of course is foolish. I am fairly active every day and have 150 - 180 gms of carbs each day, 99% in the lower GI scale. Its sustainable for me in the long run which is a priority for me. I hope you find a system that you can enjoy and gets you the right health outcomes!

Pete,

Its interesting that you have been prescribed metformin and rosiglitazone, which both do effectively the same thing. Neither will make you produce more insulin but they help make your cells more receptive to the insulin you do produce (thereby reducing insulin resistance). It is possible that your pancreas is simply not producing sufficient insulin in response to the carbs in your diet.

Sometimes our pancreases can be lazy and need a kick up the backside to produce a bit more insulin. Have you been tried on one of the sulphonylurea meds like gliclazide (Diamicron) or glimepiride (Amaryl)? These work by forcing the pancreas to produce more insulin, but in doing so can trigger a hypo so you need to be on the lookout for hypo symptoms.

KimSuzanne said:

This may sound a bit strange but the Atkins diet is designed ti increase the ammount of keatones the body produces these are BAD when produced in a diabetic as its a by product of ketoacidosis. Does this not affect type 2 diabetics in the same way as type 1 ?

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In type 2 there is usually background Insulin production which will prevent ketoacidosis. It is unusual for a type 2 present in DKA. The ketosis is different whe linked to the Atkin's diet. But unfortunately this profounf weight loss is not usually sustainable.


ps I am type 2 and did present in DKA with a foot infection. Been on insulin since.

mm do u know I have actually had enough of the health prof bashing on here. I have been lurking on here for weeks after a patient told me how scary he found this forum!

I have spent most of the day with diabetics sorting their diets and I have really good results - the average A1c in my practice is in the 5s because they get very intense input and it is geared to the local population.

Every time I assess an atkins type regime i find a diet low in calcium and many other nutrients and pateints complaining that they feel unwell.

Stop this continuous bashing of the overstressed diabetes workers

Sorry Ally but no one is bashing the GOOD health care workers! I have read stories on here that have made my hair curl because people are being wrongly advised by SOME advisers.Read Haseys posts able her doctor for instance.Good on you if you are getting good results we need more people like you.Read how some members have come onto this board scared and confused and are now getting their diabetes under control and are now helping others.We should all be singing off the same hymn sheet but there still seems to be a lot of misinformation out there.

Sorry sue but I am sick of listening to the bashing.

Often i think Diabetics do not get the right input because there is alack of the right input. Nurses and doctors are often the culprits because they do not have the depth of nutrition knowledge - i have the practise nurses well trained! But the 2 gp practises i work for are getting a really good service and patients do not wait - i see them within 2 weeks of diagnosis - not the 6 months at the local hospital. I bet most people do not know that in the UK there are only around 6000 properly trained dietitians - there are many who think they are after a weekend course. So my blood boils when I read rubbish like before - even if I have a good sense of humour. !!!

Of course there are good and bad but dietitans that i know are not Rx huge amounts of carbs but are not using silly amounts like 20g - i do note that there is no data on patients staying on the likes of bernstein etc long term because i think it would look uncormfatable reading for him - I have lost track of those falling of the wagon bcause its unsustainable. The BBC diet trials study has shown that people cannot sustain very low carb longterm!

Well i must admit that my dietitian kept telling me I wasn't eating enough carbs and I certainly was not eating a very low amount.I think Fergus has been on a low carb diet for a while but then he is a very inventive cook! my son tried the Atkins diet,just to lose weight,which he did but promptly put it back on again! not a diet I fancy doing.If you would like to stay I am sure any input you could give us would be helpful especially for the newly diagnosed who have yet to see a dietitian.

thing is Sue its getting the individual advice for u is the key and for me knowing the people - I live in the area i work.

For anyone to follow a lower carb intake u need to have a fairly good understanding of food and physiology and some people do not want to understand. My advice will vary from person to person - people vary so much.

Now that's exactly what we try and tell people here! we all have our stories to tell and I have no doubt that quite a few have been helped because they tell us so but we are all individuals and what works for one does not work for others.That is why testing is so important to type 2's.In order for them/us to find out which foods put up BS or do not affect BS they need to test on a regular,daily basis.

yes and the testing is vital - i am not sure what that study last week was trying to show. I saw a man today who had no bs for 10 months - what use is that to him - he had some problems other than diabetes but he slipped thro the net for variuos reasons but iv got him back. That is why i get annoyed at the stuff on here as u do not hear about all the good things.

Then it's good to have some one tell us the good stuff!!

I have to say I've yet to meet a healthcare professional that wasn't extremely committed, hard working and motivated by the very best intentions. Ah, but I've also met many who are badly informed about nutrition, as you suggest Ally. I have a lot of sympathy for the poor dieticians asked to defend the indefensible.

Here's just one example. 'Food choices and diabetes' by Diabetes UK. Page 1 - ' Diabetes mellitus is a condition in which the amount of glucose in the blood is too high because the body cannot use it properly. Glucose comes from the digestion of starchy foods such as bread, rice, potatoes, chapatis, yams and platain, from sugar and other sweet foods, and from the liver which makes glucose.

OK so far, but wait!

Page 2 is entitled 'Eight steps to healthy eating' and begins with step 1 - 'Eat regular meals including starchy foods such as bread, pasta, chapatis, potatoes, rice, potatoes, rice and cereals. This will help you control your blood sugar levels and all varieties are fine.'

Not only is this irrational and illogical, it's actually making peoples diabetes more damaging and much harder to control. I've been lo-carb for 7 years, Ally, and not only is it sustainable, it's delicious too. I wouldn't care if I never ate a starchy carb again.

That's one reason forums like this are invaluable. It's an opportunity for diabetics to expose the flaws in the dogma and share advice and experiences. Without it, we would be extremely isolated but, together, our experiences can inform and motivate others too.

Perhaps that's why some in the medical profession are so dismissive of some of the threads. Empowered patients ask awkward questions!

All the best,

fergus

mm do u know I have actually had enough of the health prof bashing on here. I have been lurking on here for weeks after a patient told me how scary he found this forum

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I agree entirely. I have been lurking but have not joined in because I have found some of the advice disturbing . And I have to admit I'm rather wary of coming out of the closet here.
I appreciate that everyone is different but I really worry when newly diagnosed people are told immediately that the first thing they must do is cut carbs (often without knowing what the persons diet is like in the first place) sometimes the implication seems to be that the only thing that will work is to adopt a Bernstein or Atkins type diet.
I don't live in the UK, (although I am British). I have been lucky and seen a dietician on several occasions, in hospital after diagnosis , on an intial diabetes course and a later one for pumping. I don't think that her advice differs from the advice I read from British mainstream sources. I eat what I consider to be a healthy balanced, but low fat diet. I count the carbs but I eat a wide variety and they account for about 50% of my calories. I eat potatoes rice and pasta, legumes, fruit and lots of vegetables. Exercise also plays a big role in my 'regime'. For me it works, my last Hb A1c was 4.9%, I have low triglycerides and LDL and high HDL.
The funny thing is I don't think that there is a low carb movement amongst diabetics here, certainly I've never met anyone who has ever heard of Dr Bernstein. On my pumping course a fellow diabetic told me off for not eating enough carbs for lunch that day!

Diabetes uk cannot put specific advice on a web site and peoples understanding varies so what u know is different to some of the people i saw yesterday - beleive it or not many people have little understanding whwn i use words like protein etc! So info needs to be simple to understand.

I am not allowed by my code of conduct to give other than general advice - I am still a bit wary but get irrate when I read stuff on the internet! I was threatened by a guy from the US last year who disagreed with me my career felt very threatened!

I do think that maybe many do not appreciate the skills of a dietitian - we are well trained and do lok at all the evidence. We also have very practical skills - studies are one thing but at the end of the day its getting a meal on the table ! The problem for alot of patients is that they may only get 15 mins with one - dietetic depts are struggling with underfunding and more and more patients. even more frustrating when half of last years graduates cannot get a job!

I am involved in diabetes education sessions across an LHB and the dietetic input is really patchy - the 2 gps I work for have their patients seen by mein less than 2 weeks but the other practices either have no access or a 6 month waiting list.

I work freelance now but have friends still working and they are so overworked working with critically ill pateients!

Excuse my moan but i am really sick of the bashing - perhaps its some of the psuedo nutritionists u should look at - now dont get me started on that one!

Actually going back to th GI topic - i think that is flawed in some ways so use both aim for low GI and carb count for some patients.