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NHS Carb Level Advice for Pre-Diabetes

R

RM51

Member
Messages
5
Type of diabetes
Prediabetes
Treatment type
Diet only
Hi

I have been given a patient information sheet by my GP entitled 'basic dietary advice for newly diagnosed' from NHS West Suffolk. I am actually pre diabetic but GP wants me to reduce my levels. I was tested in May and October and my HbA1c level was both 44 both times.

The information sheet is telling me to aim for a minimum (not maximum) level of carbs per day of 130g (40g to 50g per meal).

I have been reading various posts and the consensus seems to be that individuals are aiming for around the 50g per day mark.

Am I missing something here with regards to carb levels? Is 130g about right or should it be lower?

Thanks
 
The best advice is to ignore NHS advice when it comes to eating for T2 diabetes. Restrict carbs to a maximum of 130g per day, and be prepared to go lower if necessary. I've found a blood glucose meter and a set of kitchen scales invaluable in helping to calculate what I can and can't eat (tolerate) and the kitchen scales are good for portion control - some people can get their BG under control by simply reducing the amount of carbs they eat, e.g., 20g of rice instead of 60g. Sadly, there are some foods that spike your BG no matter how small the portion, and they're the ones you need to take off your personal menu. We're all different when it comes to what we can and can't tolerate, and that's why a BG meter is essential.
 
The thing is, they keep touting a one-size-fits-all thing, and it really doesn't. Fit all, I mean. Even then, they are promoting more carbs than some other, more up-to-date nurses are handing out. So here's what you do: Get a meter. Test before your first bite and two hours after it. If your blood glucose is, at that point, more than 2.0 mmol/l higher than it was before you started, there were more carbs in the meal than you could process. If you're 2 or lower, the meal was spot-on. I couldn't get away with 130 grams a day... I kept halving my carb intake, and now I'm comfortably keto, at around 20 grams of carbs per day. Could well be, (better yet, it's very, very likely with a HbA1c of 44!!!) you need something much less rigorous though, to get into the normal range. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html might help some as well. You're not one of many. You're unique, and so is your insulin sensitivity. So time to figure out what suits you!

Just to make sure you know, it's a breeze getting from 44 back to the normal range. You might be able to get there just by cutting out spuds or bread, or soda's... Take a look at what you eat in a day and where there's room for improvement? Your doc'll be surprised at the next results.
 

The thing is that for a lot of people in your situation, that much would represent a considerable reduction in their carbohydrate intake. For those people, following that diet will reduce their HbA1c and almost certainly their waistline.

But if you are eating about that much, or less, then it won't help.
 
I have managed to maintain my hba1c in normal levels on approx 130g carbs per day.
 
I was given that diet sheet from NHS West Suffolk as well (I live in Lincolnshire) by my diabetes nurse and threw it in the bin. I felt guilty wasting the paper!
 
Around 130g/day is the minimum glucose your body needs. If you don't eat 130g/day, your body will manufacture the rest from stores - usually its liver stores first but once they're used up it will metabolise bodyfat. This is why many of us on low carb, as well as controlling our blood glucose levels, also lose weight.

The thing is we're all different. The level that works for me might not work for you. You need to find out what works for you - and for that a glucose meter is essential. Test before and two hours after eating. You are NOT testing to see "how high you go" - you are testing to see how well your insulin system coped with the glucose and carbs (if any) in the food you ate. So you are looking for the second reading to be within 2 mmol/l of the first, and not above 7.8. If that's the case, that meal, in that quantity and proportions, is OK for you.

I found that I needed to reduce my carbs to around 20g/day to maintain both blood glucose control and weight loss. Others manage on 50g or 100g.
 
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