Managing bGs

[xyzzy]

The main point is, I think, the overall similarity in 'benefit' in terms of bGs and weight loss.

I'm not quite sure how you come to that conclusion. Both graphs show some improvement of function but are are nothing like you would expect to see from a "bog standard non diabetic". When I did my OGTT earlier in the year I did it with a group of other people ranging from non diabetics through prediabetics and people like myself with full T2. Across that range was a wide variation of carb intakes right from sub 30g / day VLC to 200g + people. There was no correlation between the shape of the graph and their carb intake. This is what you would expect as an OGTT is measuring how diabetic you are not how many carbs you consume. Effectively you can use the area under the curve as a measure of severity of diabetes.

Putting medication to one side for the moment then different people will have different tolerances to carbs depending on the severity of damage done to their systems in terms of beta cell loss and insulin resistance. Some people will have a high tolerance to carbs (like yourself) but others will have far less tolerance. From the 100's of people I've seen pass through this forum I would guess when newly diagnosed the average tolerance is around 130g / day. As that's an average then some people will cope with far more and some with far less. The point is they are all diabetic and they ALL need to develop a long term strategy to control the disease. Effectively people who VLC split into two groups. The first group are those who HAVE to VLC because their tolerance is so low. They could elect to take meds to help but that's their choice and they have every right to choose a method they are comfortable with in the same way as someone with a higher tolerance finds their own way. The second group are people who choose VLC as an option i.e. they may be able to cope with more carbs but like the VLC lifestyle. Again that is their choice as again they are simply choosing a long term lifestyle that works for them.

I think the nearest thing there is to a diabetic "crime" is when one diabetic attacks the regime of another as effectively you are attacking how that person is controlling the condition and the attacker risks undermining the long term stability of people whose dietary regime is being attacked. The bottom line is there are many ways to control the condition each is entirely valid for the person who is using it assuming it does actually work of course.

Most people who VLC do low carb high fat not low carb high protein (as you stated) because they recognise that high protein diets aren't particularly good for kidney function. Note that in other countries notably Sweden which, if you ignore Luxemborg, has the 2nd lowest Type 2 diabetes rate in the industrialised nations (Iceland is first) low carb high fat dietary regimes are recommended to it populace and VLC is an accepted way of treating T2 (so long as its monitored by HCP's). Restricted carb routines are the defacto advice given to T2 diabetics. The classic diet in Iceland is also low carb high fat in nature. Even the ADA has a 130g / day carbohydrate recommendation in their position statements for the last few years and recommends a "quarter plate" attitude to carbs rather than the half a plate advocated here.

 

[xyzzy]

Just want to say thanks to xyzzy for your advice and information. Thanks for sharing.


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No problem. Thanks for the thanks!

 

[xyzzy]

How would you work out someone's activity level from the graphs?


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You can't, I just think I know who person x is.

Person X said they were 'laid up' for the three weeks leading up to the test with an injury. So, chances are I was exercising more, don't you think?

I doubt it. As Phoenix says we both know who Person X is and I can assure you they did far more exercise than you up to and including running half marathons on a lchf lifestyle.

 

[xyzzy]

Just want to say thanks to xyzzy for your advice and information. Thanks for sharing.


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+1 BlindDog is a top bloke who has devoted 100's of hours and many more advising and helping people including me..I didn't even know what a carb WAS when I was diagnosed but through his and others teachings my life is transformed now..Love ya Steve!

Ta very much Paul

 

[janeecee]

Well, Gezzathorpe is the only one of these two people who is here talking directly about his own experience, and we can't really assume the other story by proxy. What matters is that each person has his or her own strategies which work for them, for now at least. No two people will have identical metabolisms, energy requirements, or even predisposing risk factors. Not everyone chooses the LFHC way of eating. Some people can and do opt for a moderate carb intake and can get their numbers under control.

Being brutally honest here, it's not always down to diet, is it? There's exercise, medication, significant weight loss—and all weight loss comes about through consuming fewer kcal than is expended, regardless of how this is achieved. No-one can say it's all down to one type of diet if other parameters have also been changed at the same time. Everyone's physiological make up, is different too. The important thing is what works for the individual.


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[Anonymous]

The main point is, I think, the overall similarity in 'benefit' in terms of bGs and weight loss.

I'm not quite sure how you come to that conclusion. Both graphs show some improvement of function but are are nothing like you would expect to see from a "bog standard non diabetic". When I did my OGTT earlier in the year I did it with a group of other people ranging from non diabetics through prediabetics and people like myself with full T2. Across that range was a wide variation of carb intakes right from sub 30g / day VLC to 200g + people. There was no correlation between the shape of the graph and their carb intake. This is what you would expect as an OGTT is measuring how diabetic you are not how many carbs you consume. Effectively you can use the area under the curve as a measure of severity of diabetes.

Putting medication to one side for the moment then different people will have different tolerances to carbs depending on the severity of damage done to their systems in terms of beta cell loss and insulin resistance. Some people will have a high tolerance to carbs (like yourself) but others will have far less tolerance. From the 100's of people I've seen pass through this forum I would guess when newly diagnosed the average tolerance is around 130g / day. As that's an average then some people will cope with far more and some with far less. The point is they are all diabetic and they ALL need to develop a long term strategy to control the disease. Effectively people who VLC split into two groups. The first group are those who HAVE to VLC because their tolerance is so low. They could elect to take meds to help but that's their choice and they have every right to choose a method they are comfortable with in the same way as someone with a higher tolerance finds their own way. The second group are people who choose VLC as an option i.e. they may be able to cope with more carbs but like the VLC lifestyle. Again that is their choice as again they are simply choosing a long term lifestyle that works for them.

I think the nearest thing there is to a diabetic "crime" is when one diabetic attacks the regime of another as effectively you are attacking how that person is controlling the condition and the attacker risks undermining the long term stability of people whose dietary regime is being attacked. The bottom line is there are many ways to control the condition each is entirely valid for the person who is using it assuming it does actually work of course.

Most people who VLC do low carb high fat not low carb high protein (as you stated) because they recognise that high protein diets aren't particularly good for kidney function. Note that in other countries notably Sweden which, if you ignore Luxemborg, has the 2nd lowest Type 2 diabetes rate in the industrialised nations (Iceland is first) low carb high fat dietary regimes are recommended to it populace and VLC is an accepted way of treating T2 (so long as its monitored by HCP's). Restricted carb routines are the defacto advice given to T2 diabetics. The classic diet in Iceland is also low carb high fat in nature. Even the ADA has a 130g / day carbohydrate recommendation in their position statements for the last few years and recommends a "quarter plate" attitude to carbs rather than the half a plate advocated here.

So, you are saying that both people are diabetic since the 'curves' are not representative of a bog standard non-diabetic. So I am not 'diabetic resolved' after all then.

I don't think you will find I attacked anyone. Also I have no idea if you know the other person just because you say you do. I published a comparison and said "The main point is, I think, the overall similarity in 'benefit' in terms of bGs and weight loss." That is what I call a comparison. I have not made any comments as to why they are similar. It is you and others who are 'attacking' it.. Any suggestion that I am attacking anyone is ludicrous and I am sure others who read this blog will agree.

It's a sad day for this site if a person's success is treated with such disdain.

 

[anna29]

Well, Gezzathorpe is the only one of these two people who is here talking directly about his own experience, and we can't really assume the other story by proxy. What matters is that each person has his or her own strategies which work for them, for now at least. No two people will have identical metabolisms, energy requirements, or even predisposing risk factors. Not everyone chooses the LFHC way of eating. Some people can and do opt for a moderate carb intake and can get their numbers under control.

Being brutally honest here, it's not always down to diet, is it? There's exercise, medication, significant weight loss—and all weight loss comes about through consuming fewer kcal than is expended, regardless of how this is achieved. No-one can say it's all down to one type of diet if other parameters have also been changed at the same time. Everyone's physiological make up, is different too. The important thing is what works for the individual.


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Excellent valid points here - we are all unique and individually different :thumbup:
Thanks for sharing these well balanced points janeecee .

 

[xyzzy]

Being brutally honest here, it's not always down to diet, is it? There's exercise, medication, significant weight loss—and all weight loss comes about through consuming fewer kcal than is expended, regardless of how this is achieved. No-one can say it's all down to one type of diet if other parameters have also been changed at the same time. Everyone's physiological make up, is different too. The important thing is what works for the individual.


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Exactly my point. What's important is what works for the individual. Assuming a method works no one method is better than any other. People should be happy that others have found successful ways of dealing with the condition whatever that way is.

 

[Anonymous]

Being brutally honest here, it's not always down to diet, is it? There's exercise, medication, significant weight loss—and all weight loss comes about through consuming fewer kcal than is expended, regardless of how this is achieved. No-one can say it's all down to one type of diet if other parameters have also been changed at the same time. Everyone's physiological make up, is different too. The important thing is what works for the individual.


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Exactly my point. What's important is what works for the individual. Assuming a method works no one method is better than any other. People should be happy that others have found successful ways of dealing with the condition whatever that way is.

I agree. No one should be advocating their approach to anyone since it can only apply to themselves. It is particularly important when dealing with newly-diagnosed' people. The latter would do well to understand how their own, current diet is affecting them before embarking on a particular plan

 

[xyzzy]

So here is some of OGTT tests a group of us done a few months ago. I have taken the legend off to keep people anonymous.

The non diabetic is the pale green line at the bottom. As you can see at no time does their BG exceed 8 at any point over the 2 hour period. The next best line (orange) is that of a T1 using a pump which shows how effective pumps can be. Mine is the bright red line. I certainly don't think I am "diabetic resolved" compared to the non diabetic line even though I ended up under the value for any diagnosis. However on the day before I took the test I WOULD have been diagnosed full T2 based on my FBG reading. My FBG's had risen during the days before taking the test because I had to "carb up" to over 150g / day for more than 3 days to make the test valid.

Other lines. The black and dark green lines are both people who VLC at sub 50g / day. Likewise the pale blue line is another significant low carber (they'll recognise their line and I will happily correct if I'm wrong and they PM me). As you can see all the lines have unique profiles and differ regardless of the fact they essentially do similar dietary regimes

 

[anna29]

Being brutally honest here, it's not always down to diet, is it? There's exercise, medication, significant weight loss—and all weight loss comes about through consuming fewer kcal than is expended, regardless of how this is achieved. No-one can say it's all down to one type of diet if other parameters have also been changed at the same time. Everyone's physiological make up, is different too. The important thing is what works for the individual.


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Exactly my point. What's important is what works for the individual. Assuming a method works no one method is better than any other. People should be happy that others have found successful ways of dealing with the condition whatever that way is.

And other people should be happy others have found a successful way they are happy/wish to use
to deal/cope/maintain their condition with

Be happy for other persons - who are happy to do - what they are happy with doing

Anna .

 

[janeecee]

These terms like "reversed" and "resolved" don't mean the same as "the same as a non-diabetic with a fully functioning pancreas and no insulin resistance". They are more like categories used for the benefit of healthcare professionals to establish treatment protocols and frequency of reviews. I think we all know that.

Harking back to the Newcastle Diet study, the condition was considered "resolved" if they no longer met the diagnostic criteria for diabetes based on standard methods of testing—but we all know that once someone's Hba1c goes below 6.0% it doesn't mean permanently cured forever, but it did mean management without medication. Diet and lifestyle, and more crucially preventing weight gain, was the keystone of continuing success for the participants. No specific diet or amount of exercise was mandatory following the initial eight week programme.


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[xyzzy]

There have been a range of results of people doing the Newcastle diet who have posted their progress here. Some have essentially "resolved" their diabetes as in they would produce an OGTT graph similar to say mine while others have fully "reversed" their condition to the extent they could eat a pretty normal level of carbs without spiking. The reason for the difference is most likely how much beta cell loss they had suffered at the point they did the regime. If their issue was more one of insulin resistance than beta cell loss then losing weight meant they could essentially fully reverse however if it turned out they had significant beta cell loss then even though they could normalise their BG's they found they still couldn't cope with a normal level of carbs. Of course as a c-peptide test is hardly ever offered to newly diagnosed T2's (so that you can see how much beta cell damage you have) lots of people never find out until completing the regime where they stand.

The bottom line is I do not (and there are many like me) think I am "resolved" because we cannot process a normal level of carbs because of significant beta cell loss. Patently I and others could take stronger meds to allow extra carb consumption but then because we are then on meds we wouldn't be "resolved" either. In that regard in my mind using a diet is no different than electing to use meds to control the condition.

 

[janeecee]

It seems that people in the earlier stages fare better on the Newcastle Diet, and I suppose that applies to other regimes. Some people never progress from the pre- stage to a diagnosis of T2 but that would also depend on finding out early enough to make the appropriate changes.


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[Anonymous]

So here is some of OGTT tests a group of us done a few months ago. I have taken the legend off to keep people anonymous.

The non diabetic is the pale green line at the bottom. As you can see at no time does their BG exceed 8 at any point over the 2 hour period. The next best line (orange) is that of a T1 using a pump which shows how effective pumps can be. Mine is the bright red line. I certainly don't think I am "diabetic resolved" compared to the non diabetic line even though I ended up under the value for any diagnosis. However on the day before I took the test I WOULD have been diagnosed full T2 based on my FBG reading. My FBG's had risen during the days before taking the test because I had to "carb up" to over 150g / day for more than 3 days to make the test valid.

Other lines. The black and dark green lines are both people who VLC at sub 50g / day. Likewise the pale blue line is another significant low carber (they'll recognise their line and I will happily correct if I'm wrong and they PM me). As you can see all the lines have unique profiles and differ regardless of the fact they essentially do similar dietary regimes

This is a very confusing graph because not everyone followed the same protocol. Some people recorded every 15 minutes, some recorded a mixture of 15 minute and 30 minute readings, some 30 minutes only, some stopped at 2 hours, some at 2.5 hours and some at 3.

 

[xyzzy]

This is a very confusing graph because not everyone followed the same protocol.

Yes its called living in the real world where some people who were genuinely wanting to add to the communities knowledge could only afford to use a limited number of their scarce test strips.

It doesn't alter the fact that people using similar dietary regimes produced widely varying shaped graphs within the official 2 hour period and that therefore the similarity in shape between your graph and Person X is completely coincidental in my opinion. Effectively you are attempting to compare two N=1 data sets which is meaningless because your physiology and Person X's are uniquely individual.

All diabetics are individuals and should be entitled to the support of the wider community regardless of what dietary method or medication regime they have found works for them.

 

[janeecee]

Would that also apply to someone who controls their condition with only with exercise and a diet which is neither very low carb nor high in fat? I think people deserve respect and support even when they choose not to follow a VLC or LFHC regime.

There are question marks over the long term implications of any diet although I'm sure that for some people the benefits outweigh the risks. It seems to me that it is long term weight loss that produces the benefits for the majority of T2s who are overweight or heavier than they used to be. Also, physical activity plays a part so for someone going from couch potato at diagnosis to going to the gym 3 times a week. No-one is advocating a diet of mars bars and Lucozade, are they?


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[xyzzy]

Would that also apply to someone who controls their condition with only with exercise and a diet which is neither very low carb nor high in fat? I think people deserve respect and support even when they choose not to follow a VLC or LFHC regime.

I entirely agree and that is the philosophy behind "eat to your meter" i.e whatever regime you choose be it dietary or through medication then you should receive the support of the entire community. Experienced people will obviously explain to newly diagnosed ones how they achieved good control to defeat (or at least hold at bay) the progression of the disease. I will obviously explain an LC (not VLC as I don't VLC) approach as that is what I have experience of but others will equally explain their own entirely valid ways that they have used be that through different dietary regimes, exercise, medication or whatever. In my opinion adult debate and friendly discussion between the different ways is a good thing but when that debate crosses the line and becomes a criticism of other peoples means to control then you are essentially undermining the very newly diagnosed people that need help the most.

 

[Sid Bonkers]

It doesn't alter the fact that people using similar dietary regimes produced widely varying shaped graphs within the official 2 hour period

Reinforcing once again that we are all different.

 

[xyzzy]

It doesn't alter the fact that people using similar dietary regimes produced widely varying shaped graphs within the official 2 hour period

Reinforcing once again that we are all different.

Totally agree Sid. I've tended to find that people who disagree with that view point are those who for whatever reason only believe their own and often narrow experience should apply to everyone.