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Published today in Practical Diabetes -A low carb approach in General Practice

Southport GP

Well-Known Member
Verified HCP
Here is the abstract of my piece - I am hoping to get you all a link to the full 3,000 word article but its not on-line yet, the paper form is first out. My idea is to give you something to show your Health care professionals that the approach is gaining ground, also it includes a suggested diet sheet for discussion with your Doctor, nurse or dietician,

Abstract

Patients with diabetes have long been exhorted to give up sugar, encouraged instead to take in fuel as complex carbohydrate such as the starch found in bread, rice or pasta (especially if ‘wholemeal’). However, bread has a higher glycaemic index than table sugar itself. There are no essential nutrients in starchy foods and diabetics struggle to deal with the glycaemic load they bring. The authors question why carbohydrate need form a major part of the diet at all? The central goal of achieving substantial weight loss has tended to be overlooked. The current pilot study explores the results of a low carbohydrate diet for a case series of 19 type 2 diabetics and pre-diabetics over an 8 month period in a suburban general practice.

A low carbohydrate diet was observed to bring about major benefits. Blood glucose control improved (HbA1c 51±14 to 40±4mmol/mol; p<0.001).By the end of the study period only 2 patients remained with an abnormal HbAic (>42mmol/mol), even these two had seen an average drop of 23.9mmol/mol. Weight fell from 100.2±16.4 to 91.0±17.1kg (p<0.0001) and waist circumference decreased from 120.2±9.6 to 105.6±11.5cm (p<0.0001). Simultaneously, blood pressure improved (systolic 148±17 to 133±15; p<0.005; and diastolic 91±8 to 83±11 mmHg; p<0.05). Serum gamma GT decreased from 75.2±54.7 to 40.6±29.2 U/l (p<0.005). Total serum cholesterol decreased from 5.5±1.0 to 4.7±1.2mmol/l (p<0.01). This approach is easy to implement in general practice, brings rapid weight loss and improvement in HbA1c. The great majority of patients find a low carbohydrate diet easy to live with.
 
Thank you GP......Wish I'd had that info this morning when I spoke with my DN. She thinks I'm eating far too few carbs and apparently "anything less than a reading of 10 is fine" for t2 ID BG.
 
Thommothebear said:
I think on the original thread Southport GP said the diet was based on Dr Briffa's low carb diet.


Sent from the Diabetes Forum App
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Here is the sheet we used -notice it includes a mention of you all on here !!

So what should I eat to control Type 2 Diabetes? ,For discussion with Health Care Professional

Reduce starchy carbs a lot, if possible cut out the ‘White Stuff’ like bread, pasta, rice --though porridge, new potatoes and oat cakes in moderation may be fine. Sugar -cut it out altogether, although it will be in the blueberries strawberries and raspberries you are allowed to eat freely. Cakes and biscuits are a mixture of sugar and starch that make it almost impossible to avoid food cravings; -they just make you hungrier!! Increase healthy fats as they keep you full for longer and are fuel.

All green veg/salads are fine- eat as much as you can, So that you still eat a good big dinner try substituting veg such as broccoli ,courgettes or green beans for your mash pasta or rice- still covering them with your gravy ,bolognaise or curry ! Tip try home-made soup it can be taken to work for lunch and microwaved. Mushrooms, tomatoes, and onions can be included in this.

Fruit is trickier; some have too much sugar in and can set those carb cravings off. All berries are great and can be eaten freely; blueberries, raspberries, strawberries, apples & pears too, but not tropical fruits like bananas, oranges, grapes, mangoes or pineapples.

Proteins such as in meat, eggs, fish- particularly oily fish such as salmon, mackerel or tuna are fine and can be eaten freely. Plain full fat yoghurt makes a good breakfast with the berries. Processed meats such as bacon, ham, sausages or salami are not as healthy and should only be eaten in moderation

Fats (yes some fats can be fine in moderation) olive oil is very useful, butter may be tastier than margarine and could be better for you!, coconut oil - great for stir fries. Four essential vitamins A, D, E&K are only found in some fats or oils. Try full-fat mayo or pesto. Avoid margarine, corn oil and vegetable oils.

Cheese only in moderation- it’s a very calorific mixture of fat, carbs and protein.

Snacks Avoid, but un-salted nuts such as almonds or walnuts are great to stave off hunger. A hard-boiled egg is another idea. The occasional treat of strong dark chocolate 70% or more in small quantity is allowed
EATING LOTS OF VEG WITH PROTEIN AND FATS LEAVES YOU PROPERLY FULL in a way that lasts.

Finally about sweeteners and what to drink –sweeteners have been proven to tease your brain into being even more hungry making weight loss almost impossible -drink tea, coffee, and water or herb teas. I'm afraid alcoholic drinks are full of carbohydrate- for example beer is almost 'liquid toast' hence the beer belly!! Perhaps the odd glass of red wine wouldn't be too bad if it doesn't make you get hungry afterwards- or just plain water with a slice of lemon.

Where to get more info ?
A book – ‘Escape the diet trap’ by Dr John Briffa - Well researched and easy to read.
Internet - Google 'about.com low carb diet' for loads more info and recipes or look into the closely related PALEO DIET, also Google ‘diabetes.co.uk forum low carb’ for contact, recipes and hints
 
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Looks like you moving closer to Scandinavian LCHF all though this is usually grain free and dares to recommend higher fat intake and in some versions more restrictive in carb intake. Read about diabetes type 2 now considering them-self type 0, since they've been able to come off all meds also metformin. Regarding cheese usually more mature cheese are very low in carbs and babybel cheese is a handy snack when travelling. If anyone interested in the Scandinavian LCHF - http://www.dietdoctor.com/lchf
 
Hi, I've been Insulin Dependant Diabetic for 50 years. Use 4 injections per day, 3 pre-meal & 1 evening long-acting 'background' insulin.

I am well-controlled & fit & active with minimal signs of retinopathy. My average is blood glucose is 6.2mm (not sure how this equates to figures in the 50's or so!).

My 'however' is that I am overweight & do have hypertension for which I have to take medication.

I have made an appointment with my GP to discuss the low-carb diet & wonder if any 'type 1' can share their experience of making the switch to a low-carb diet.

I may well download Dr. Bernstein's book to check out his research. However, having a Doctorate (in psychotherapy practice) I am rather sceptical of those making claims!

Thanks,

Roger
 
You probably know then that Dr Bernstein is Type 1 and has been since a child. It's a good book and well worth the read.
 
Agreed! Dr Bernstein is a very credible source and there is no need to be skeptical of his teachings(That he has practiced himself for decades) IMO.
 
I was really wanting to read about a Type 1 diabetic's experience of making the switch to low-carbs. Had a brief foray into Dr B's book & first thoughts are it is very basic , talking about meters & test-strips & how to get blood spots of clothing. I have been managing my diabetes for 50 years pretty well. Wonder whether there is a book or a blog that explores the switch in a practical way?

For instance I have 4 units of Actrapid for muesli & a slice of toast. Suppose I could try extra walnuts in my muesli, skip the toast & just have 2 iu. & measure the results. I was hoping to learn from others experience if possible.
 

I know a Type 1 person (diabetic for 28 years) who has switched to the LCHF diet with good results.
You may read about her experience on her pinterest page: http://www.pinterest.com/solestar1000/
She's also very often in our Facebook group: https://www.facebook.com/groups/116102965097116/

I hope this helps.
 
Thank you very much. That's great. Having eaten an LGI diet with CHO for years it seems a bit spooky to change to low-carb.
Thanks again,
Roger
 
DrRogerRam said:
Thank you very much. That's great. Having eaten an LGI diet with CHO for years it seems a bit spooky to change to low-carb.
Thanks again,
Roger
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I completely understand.
Being vegetarian I was living on whole grains and pulses, thinking I was eating the best for my body.
Then I was diagnosed with diabetes and, against my GP's advice, I bought a glucose meter. Oh, the horror.
Grains and pulses were supposed to be my friends, so why were they spiking my glucose with so much gusto?
The GP told me not to worry, as any reading below 12 was good enough, but I didn't want "good enough", I wanted "good".
I did some research and I came across the LCHF regime. I worked out a vegetarian version, and that's what I'm having now.
I feel healthy and full of energy, whilst my readings have stabilised considerably.
Also, gone the hunger, the cravings, the headaches, the feeling bloated, which I had experienced my whole life.
I don't mean to sound evangelical about LCHF, but it really made a big difference for me.
 
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Southport GP said:
So what should I eat to control Type 2 Diabetes? ,
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But, but, but, you missed the chilli, ginger, tomato, garlic, corriander, cumin, fenugreek, cinammon, garam massala, and all those things that turn otherwise boring vegetables into a mega tasting meal

Chilli garlic mushrooms, great comfort food whilst watching TV.
 
Good point !
 
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