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Nurse telling me to increase carbs

N

Nif

Newbie
I'm newly diagnosed and went low carb.. my diabetic nurse is trying to get me to introduce carbs and I'm worried it's the wrong advice. She did not even ask about what I'm eating or look at my food diary.
I'm really struggling to lose weight and on gliclicide already which doesn't help.
I'm active and do 5 x high intensity gym classes a week.
Feeling super low and in tears after this mornings call - they will not even see me in person it's all been done over the phone.

Does anyone have any helpful advice on reading materials/good places to get information/help
 
Nif said:
I'm newly diagnosed and went low carb.. my diabetic nurse is trying to get me to introduce carbs and I'm worried it's the wrong advice. She did not even ask about what I'm eating or look at my food diary.
I'm really struggling to lose weight and on gliclicide already which doesn't help.
I'm active and do 5 x high intensity gym classes a week.
Feeling super low and in tears after this mornings call - they will not even see me in person it's all been done over the phone.

Does anyone have any helpful advice on reading materials/good places to get information/help
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Hello, @Nif , and welcome.
If the nurse is trying to get you to introduce carbs has she / he taken into consideration any blood glucose readings? Or are you not even encouraged to take BG readings?
With your food and exercise diary, BG readings could give you good indications of how your diet and exercise are impacting your diabetes control.
It does seem counterproductive to be on medication to reduce blood glucose, but have to then eat the foods that will increase it. Though we don’t advise people to go against the advice of their HCPs, in your position I would be asking for another consulation, or even a consultation with a different HCP, and go to that armed with evidence from my own testing and diaries.
If you want to continue with the Low carb regime, you could consider the Low carb programme.
https://www.diabetes.co.uk/news/202...weeks-put-type-2-diabetes-into-remission.html
In some areas this is available on NHS.
 
Your nurse gets to go home at night and forget about her advice. Meanwhile you have to live with the consequences of it. We can't offer medical opinion but my advice would be to take hers under advisement and ignore it unless any of the following applies.
  1. You are having hypoglycaemic events (in which case she should reduce your medicine).
  2. You feel better with more carbs (not uncommon).
If neither of those two things are true then her pearls of wisdom are unfounded and best filed under "complete claptrap."
 
yes I'm Type 2 - initially HBA1C of 102 - down to 92 in a month, now testing bloods minimum 4 times a day and mainly between 5.5 - 7.5 after 2 weeks on meds combined with diet. Carbs and Fruit make me spike and feel dreadful so have been sticking to only carbs from vegetables plus protein and fats.
 
The nurse needs to go back for re-training. Virtually no-one needs to increase their Carbs unless they are starving themselves. If you are T2 then typically you need to reduce the carbs to reduce weight. If you are stick thin and have high blood sugar then these is good chance you are LADA and must avoid too many carbs as the body can't metabolise them.
 
Nif said:
yes I'm Type 2 - initially HBA1C of 102 - down to 92 in a month, now testing bloods minimum 4 times a day and mainly between 5.5 - 7.5 after 2 weeks on meds combined with diet.
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That's an amazing turn around in 2 weeks.
Become your own practitioner, many professionals are still reading from a decades old script, wholegrains, brown rice & all that rubbish.
Stay your course & amaze her in 3 months, then nod politely as you completely ignore her advice.
 
Did this fountain of wisdom (please read the sarcasm) have any explanation for why she says to increase carbs? Or was it a random unevidenced proclamation? Plenty of real wisdom in the comments above mine.
 
Nif said:
yes I'm Type 2 - initially HBA1C of 102 - down to 92 in a month, now testing bloods minimum 4 times a day and mainly between 5.5 - 7.5 after 2 weeks on meds combined with diet. Carbs and Fruit make me spike and feel dreadful so have been sticking to only carbs from vegetables plus protein and fats.
Click to expand...
There is some evidence that improving HbA1c too quickly can increase diabetic retinopathy. Some people advise not reducing HbA1c by more than about 30 mmol/mol in a year. This phenomenon has usually been noted after several years of known poor diabetic control. However, people with type 2 diabetes can often have had undiagnosed diabetes for several years so may also be at risk. In that case, it might be better to aim for the upper end of low carb rather than the keto end of low carb in order to make slow and steady improvement in HbA1c.
http://www.diabeticretinopathy.org.uk/retinopathyprogression.htm
 
Dark Horse said:
There is some evidence that improving HbA1c too quickly can increase diabetic retinopathy. Some people advise not reducing HbA1c by more than about 30 mmol/mol in a year. This phenomenon has usually been noted after several years of known poor diabetic control. However, people with type 2 diabetes can often have had undiagnosed diabetes for several years so may also be at risk. In that case, it might be better to aim for the upper end of low carb rather than the keto end of low carb in order to make slow and steady improvement in HbA1c.
http://www.diabeticretinopathy.org.uk/retinopathyprogression.htm
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I may be wrong but I’m sure in the past I’ve seen data that this is vastly more of a concern when lowered by insulin rather than by diet? None of the information in the link you provide (or it’s onward links which largely don’t work) defines how control is achieved or even type of diabetes being discussed. Whilst they may indeed not be relevant it seems a glaring omission and yet another example of how assumptions are made how a type 2 can achieve good control (ie diet ignored and based on medicated outcomes alone)

edit: it seems at least one has had the same eye issues via the diet pathway so I may indeed be wrong. I guess if your levels are very high meaning you have the potential for large drops steady may be the way to go. Less of an issue if your levels aren’t sky high to start with as they simply can’t change so drastically
 
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Hi.
I was diagnosed with type 2 in late November 2021. I went into complete panic mode and significantly reduced carbs right away as well as taking metformin and glicizide. I reduced my Hb1ac from 128 to 59 in 10 weeks but boy did I suffer. I had frequent hypos and suffered from horrendous peripheral neuropathy, muscle pain numbness the lot. Was told by consultant endocrinologist that my body had undergone huge metabolic changes too quickly. I am also menopausal.
No one had advised me to gradually cut back allowing my body to adjust.
Anyway that was my experience.
 
HSSS said:
I may be wrong but I’m sure in the past I’ve seen data that this is vastly more of a concern when lowered by insulin rather than by diet? None of the information in the link you provide (or it’s onward links which largely don’t work) defines how control is achieved or even type of diabetes being discussed. Whilst they may indeed not be relevant it seems a glaring omission and yet another example of how assumptions are made how a type 2 can achieve good control (ie diet ignored and based on medicated outcomes alone)
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Don't disagree in principle but speaking from personal experience I can confirm that aggressively lowering glucose through diet completely torpedoed my vision from mild retinopathy to full-blown macular oedema in both eyes.
 
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I went cold turkey on carbs, not realising the potential problems, and had no problems at all. This was after the hospital I was in for something else started injecting me with insulin without telling me I was diabetic or that the injections were insulin. So I say this just to underline that we are all different, and in my instance, cutting down carbs worked from the get-go. BUT as a lifetime dieter and nutrition geek, I hadn't eaten that much in the way of carbs anyway. So it's different for all of us - the vital thing is to listen to our bodies, and to learn as much as we can, because we can't rely on the medics.
 
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