Starchy Carbohydrates

KBradz said:

Diagnosed type 2 late last year and went to a "diabetes day " organised by my local NHS Trust. The dietitian at this event informed us, myself and other diabetics, that we should eat starchy carbohydrates 3 times a day. The research I have done points to the fact that this is wrong and is bad advice and I wrote to the Trust to infrom them of my concerns. They have replied stating that the dietary advice given on the day is in line with NICE guidelines. Has anyone else had this sort of experience? I get the impression that they are keen to diagnose Type 2 Diabetes but do not fully undertand the condition. My HbA1c level at the time was 5.7%,

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Hi and welcome to the forums @KBradz ,

I assure you that you are not alone, I'm also sure that some other T2's will weigh in here.

Welcome to Type 2 treatment on the NHS.. lots of HCP's trot out the guidelines that the Eatwell plate is what Type 2's should eat although this is dietary advice for the "healthy" population.
I am being kind by saying they are mistaken... a lot of us view Type 2 as carbohydrate intolerance so carbs are best avoided.
If you cut the majority of carbs out of your diet your blood sugars come down and your HCP's are completely amazed that you have stopped this "chronic and progressive" condition in its tracks.. sometimes they think they must have misdiagnosed you because "this can't happen". There are a few shining lights in the medical world but they are few and far between. Best educate yourself by reading round the forum threads there is a goldmine of helpful info here .. especially the success stories thread where you can read what other have done to control their condition.
I'll tag @daisy1 for the intro to how to do this..
Welcome and good luck!

The response from the Trust is correct - the advice is in line with NICE guidelines. It's just that NICE guidelines are wrong. There are thousand upon thousand of people with T2 who can attest to that from their own experience, but that's only anecdote, apparently. And there are studies, including a randomised controlled trial showing a low carb diet to be superior to the ADA diet (very similar to NICE guidelines) for weight loss, glycemic control and everything else they measured. But for some reason, that doesn't count.

But you've found this forum, so you can rescue your own health from the well-intended misinformation you were given on that day.

@KBradz
Hello and welcome to the Forum Here is the Basic Information which we give to new Members. In it you will find a lot about Low Carbing and a link to the Low Carb Forum which you could join. I agree that carbs should be limited. I hope this Information will be useful to you and that you will ask questions when you need to and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS



Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 147,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.

Because that is the NHS guidelines and that is all they are a guide we then have to tailor things to suit us. It will be a long time before they will change it.. if ever.. because in the huge scale of things LCHF being best way for diabetics is not the world wide medical opinion and the number of diabetics who do it is just a drop in the ocean compared to the thousands and thousands of diabetics in the world so most countries will have the same guidelines as we do in the UK. We choose to do something different as in LCHF but we can't say it is the right way and guidelines should be changed because there is no one way suits all the only right way is what works for us personally

Well done for getting here @KBradz and welcome

Also, on the assumption that you have been told that Type 2s 'don't need to test', if you don't already have a meter, please do yourself a huge favour and buy yourself a glucose monitor so that you can test.

This is the only way you can tell which foods your body doesn't deal with so well and therefore you can avoid them.

Test strips are the on-going cost so advise is to consider meters which use the less costly test strips. These two are considered the best value and seem to be reliable

Tee2 meter (Free) and Test strips £7.75/50 at http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
SDCodeFree £11.99, Test Strips £7.69 at https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

There are many other meters on the market, of course, but not as good value for money, perhaps

KBradz said:

Diagnosed type 2 late last year and went to a "diabetes day " organised by my local NHS Trust. The dietitian at this event informed us, myself and other diabetics, that we should eat starchy carbohydrates 3 times a day. The research I have done points to the fact that this is wrong and is bad advice and I wrote to the Trust to infrom them of my concerns. They have replied stating that the dietary advice given on the day is in line with NICE guidelines. Has anyone else had this sort of experience? I get the impression that they are keen to diagnose Type 2 Diabetes but do not fully undertand the condition. My HbA1c level at the time was 5.7%,

Click to expand...

Are you sure that your HbA1c was 5.7% (39mmol/mol) at the time of diagnosis as you have stated? This does not indicate diabetes (GT 48 or 6.5%) or even prediabetes or at risk (42-48 or 6.0 to 6.5%). It places you in the normal, healthy range.

Agree that NHS dietary advice is potentially harmful, however think that for many people a reduction in carbs is sufficient and lchf unnecessary. I have dropped blood glucose levels to normal range with a little exercise and cutting carbs to 100-130g/day.

Pinkorchid said:

We choose to do something different as in LCHF but we can't say it is the right way and guidelines should be changed because there is no one way suits all the only right way is what works for us personally

Click to expand...

Hmm.... well if LCHF is better for the majority of people with diabetes - which it is- then there would be a better hit rate if it was the standard advice. Or, at the very least, LCHF should be offered as an option, instead of grudgingly accepted if you're lucky.

midnightrider said:

Are you sure that your HbA1c was 5.7% (39mmol/mol) at the time of diagnosis as you have stated? This does not indicate diabetes (GT 48 or 6.5%) or even prediabetes or at risk (42-48 or 6.0 to 6.5%). It places you in the normal, healthy range.

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I doubt the original poster was invited to a diabetes day if all their levels were completly normal.

A number of doctors have suggested a change in the guidelines for prediabetes as has been reported by members of the forum recently although not seen anything official yet

KBradz said:

Diagnosed type 2 late last year and went to a "diabetes day " organised by my local NHS Trust. The dietitian at this event informed us, myself and other diabetics, that we should eat starchy carbohydrates 3 times a day. The research I have done points to the fact that this is wrong and is bad advice and I wrote to the Trust to infrom them of my concerns. They have replied stating that the dietary advice given on the day is in line with NICE guidelines. Has anyone else had this sort of experience? I get the impression that they are keen to diagnose Type 2 Diabetes but do not fully undertand the condition. My HbA1c level at the time was 5.7%,

Click to expand...

Hi @KBradz .. and welcome
I think you'll find that many folk here have shared your experience with the "advice" that they have been given by their HCPs. I have my first meeting with my DN tomorrow (Mar 6th) and I have expressed my concerns about this - see post: First Meeting with DN From the replies that I have received to this post, I have developed a new mantra to add to my "Managing My Diabetes" mindset ...

.. Nod
.. Smile and say Thanks
.. Ignore

There must be a tipping point when negligence comes into play?

Robkww said:

There must be a tipping point when negligence comes into play?

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Indeed and that is why in the states especially there is such a huge opposition to low carb.. can you imagine the class action suit if the American Diabetes Association had to say that their advice for the past 40 years was wrong and indeed harmful to people with Type 2? That is what LCHF is up against.. also why in other places doctors like Tim Noakes and Gary Fettkes are undergoing needless persecution for daring to spread the low carb message.

Hi. Once you realise that the Eatwell Plate was designed and approved by the food industry with virtually no input from the NHS you become aware that NHS and most government diet advice is driven by the food industry lobby who want to sell and highly profitable carbs. It's a disgrace but a fact which is why many of us on this forum advise posters to ignore diet advice from their surgery or dieticians unless they wish to make their diabetes worse.

BarbaraG said:

Hmm.... well if LCHF is better for the majority of people with diabetes - which it is- then there would be a better hit rate if it was the standard advice. Or, at the very least, LCHF should be offered as an option, instead of grudgingly accepted if you're lucky.

Click to expand...

.It takes years of research and many studies and trials to change something in the medical world and they will certainly want to know what the long term effects of LCHF will be years down the line. Maybe they are already doing all this we don't know. We are just a very tiny minority of diabetics that follow LCHF and I am afraid a minority is not enough to change the world so no point in us getting in a strop about it, all we can do is go on doing what we think is best for us

KBradz said:

Diagnosed type 2 late last year and went to a "diabetes day " organised by my local NHS Trust. The dietitian at this event informed us, myself and other diabetics, that we should eat starchy carbohydrates 3 times a day. The research I have done points to the fact that this is wrong and is bad advice and I wrote to the Trust to infrom them of my concerns. They have replied stating that the dietary advice given on the day is in line with NICE guidelines. Has anyone else had this sort of experience? I get the impression that they are keen to diagnose Type 2 Diabetes but do not fully undertand the condition. My HbA1c level at the time was 5.7%,

Click to expand...

Yes. You are correct unfortunately

bulkbiker said:

Welcome to Type 2 treatment on the NHS.. lots of HCP's trot out the guidelines that the Eatwell plate is what Type 2's should eat although this is dietary advice for the "healthy" population.
I am being kind by saying they are mistaken... a lot of us view Type 2 as carbohydrate intolerance so carbs are best avoided.
If you cut the majority of carbs out of your diet your blood sugars come down and your HCP's are completely amazed that you have stopped this "chronic and progressive" condition in its tracks.. sometimes they think they must have misdiagnosed you because "this can't happen". There are a few shining lights in the medical world but they are few and far between. Best educate yourself by reading round the forum threads there is a goldmine of helpful info here .. especially the success stories thread where you can read what other have done to control their condition.
I'll tag @daisy1 for the intro to how to do this..
Welcome and good luck!

Click to expand...

Agree with every word.

KBradz said:

Diagnosed type 2 late last year and went to a "diabetes day " organised by my local NHS Trust. The dietitian at this event informed us, myself and other diabetics, that we should eat starchy carbohydrates 3 times a day. The research I have done points to the fact that this is wrong and is bad advice and I wrote to the Trust to infrom them of my concerns. They have replied stating that the dietary advice given on the day is in line with NICE guidelines. Has anyone else had this sort of experience? I get the impression that they are keen to diagnose Type 2 Diabetes but do not fully undertand the condition. My HbA1c level at the time was 5.7%,

Click to expand...

"The ADA advice to eat wholegrain bread is guaranteed to kill diabetics", Dr Richard Bernstein.

Until around 1980 advice was based around restricting intake of carbohydrate-rich foods but research suggested that the restriction should be around broader energy intake. This has been translated into eating 'slow-release' carb foods regularly and restricting sugar and fats. Note that the old advice did not actually contradict the later research (leaving aside the question as to whether this was actually correct), so remains as valid, and most here seem to find it is an easier and more successful approach to take.