Search
Search titles only
By:
Search titles only
By:
Home
Forums
New posts
Search forums
What's new
New posts
New profile posts
Latest activity
Members
Current visitors
New profile posts
Search profile posts
Log in
Register
Search
Search titles only
By:
Search titles only
By:
New posts
Search forums
Menu
Install the app
Install
Reply to Thread
Guest, we'd love to know what you think about the forum! Take the
Diabetes Forum Survey 2024 »
Home
Forums
Diabetes Discussion
Diabetes Discussions
The NHS T2 Treatment Regime
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Message
<blockquote data-quote="The_Health_Therapist" data-source="post: 1433752" data-attributes="member: 393964"><p>Hi I agree completely that treatment programmes need to be individualised. </p><p></p><p>Meal glycemic load is important too if a meal has too high a glycemic load your insulin dose will struggle to keep up with the dramatic rise in blood sugar. Glycemic load is glycemic index * available carbohydrate g in the food eaten / 100</p><p></p><p>Glycemic load is rarely discussed as there are few foods for which a GL has been calculated, however if you look at the foods that have a GL and do a multiple linear regression you can estimate GL based on macronutrient (protein, fat, carb, fibre & sugar) content this equation can further be simplified for meals with a GL above 2 as approximately equal to 2+(0.5*available carbs)+(0.25*sugar) where available carbs is total carbs less fibre, all of these amounts are g per meal. low GL is <10 high above 20 but in my opinion many T2 diabetics (dependent on INDIVIDUAL insulin sensitivity) may have to have meals less than 16. This means lower carb as opposed to low carb per say but on an individual basis which can be estimated as outlined below:</p><p></p><p>The NHS does not believe there is any science supporting glycemic load modification in diets for diabetes, but they do acknowledge that glycemic index (an inferior measure of how a food raises blood sugar) does. What they fail to realise is the reason there is little evidence is there's been no/very little research rather than that there has been lots of research showing no effect. They also fail to realise that as individuals have different rates of insulin sensitivity the affect of glycemic load will be different from one individual to the next. Ideally, what should be done is following a meal plan with different GL meals and measuring blood sugar one day then the next day having meals with the same GL, but in a different order (to take account of the effect of time of day), whilst keeping all other factors constant e.g. exercise, medication etc. this will then allow for a comparison of the effect on an individual of high, low and moderate GL meals and figuring out the relationship between increase in GL and blood sugar for an individual it is then easy to give GL meal targets for that individual. The downside of course is that it still requires carb counting and using databases/back of the packet information to meal plan or lookup a food's nutritional (*carb, fibre, sugar) content, but unlike the NHS approach would allow you flexibility in your meals- doesn't assume you have the same meals every day. Eating out still provides a problem as if a food isn't listed in a database knowing the sugar content is hard especially regarding added sugar (e.g. sugar in sauces). </p><p></p><p>I'm working on a points based system developed from the diabetic exchange lists that in combination with a dynamic plate model would make estimating what's in an unknown food a little easier, but again this would be a more rough estimate than if you actually knew exactly what had been added to the food. Personally I think not only should restaurants have to post kcal fat protein, carb but also fibre and sugar content of food, especially if they are above a certain size. </p><p></p><p>*The role of protein and fat in reducing a meals GL is present but seems quite minor compared to these.</p><p></p><p>Anyway these are my thoughts on a preliminary 'new system' for an individualised approach as I say all the equations are new and will provide rough estimates only and don't apply to GLs below 2 (the longer form equation does). Ive used a 100 items to come up with these equations from a variety of different food groups but this falls short of true validity testing.</p></blockquote><p></p>
[QUOTE="The_Health_Therapist, post: 1433752, member: 393964"] Hi I agree completely that treatment programmes need to be individualised. Meal glycemic load is important too if a meal has too high a glycemic load your insulin dose will struggle to keep up with the dramatic rise in blood sugar. Glycemic load is glycemic index * available carbohydrate g in the food eaten / 100 Glycemic load is rarely discussed as there are few foods for which a GL has been calculated, however if you look at the foods that have a GL and do a multiple linear regression you can estimate GL based on macronutrient (protein, fat, carb, fibre & sugar) content this equation can further be simplified for meals with a GL above 2 as approximately equal to 2+(0.5*available carbs)+(0.25*sugar) where available carbs is total carbs less fibre, all of these amounts are g per meal. low GL is <10 high above 20 but in my opinion many T2 diabetics (dependent on INDIVIDUAL insulin sensitivity) may have to have meals less than 16. This means lower carb as opposed to low carb per say but on an individual basis which can be estimated as outlined below: The NHS does not believe there is any science supporting glycemic load modification in diets for diabetes, but they do acknowledge that glycemic index (an inferior measure of how a food raises blood sugar) does. What they fail to realise is the reason there is little evidence is there's been no/very little research rather than that there has been lots of research showing no effect. They also fail to realise that as individuals have different rates of insulin sensitivity the affect of glycemic load will be different from one individual to the next. Ideally, what should be done is following a meal plan with different GL meals and measuring blood sugar one day then the next day having meals with the same GL, but in a different order (to take account of the effect of time of day), whilst keeping all other factors constant e.g. exercise, medication etc. this will then allow for a comparison of the effect on an individual of high, low and moderate GL meals and figuring out the relationship between increase in GL and blood sugar for an individual it is then easy to give GL meal targets for that individual. The downside of course is that it still requires carb counting and using databases/back of the packet information to meal plan or lookup a food's nutritional (*carb, fibre, sugar) content, but unlike the NHS approach would allow you flexibility in your meals- doesn't assume you have the same meals every day. Eating out still provides a problem as if a food isn't listed in a database knowing the sugar content is hard especially regarding added sugar (e.g. sugar in sauces). I'm working on a points based system developed from the diabetic exchange lists that in combination with a dynamic plate model would make estimating what's in an unknown food a little easier, but again this would be a more rough estimate than if you actually knew exactly what had been added to the food. Personally I think not only should restaurants have to post kcal fat protein, carb but also fibre and sugar content of food, especially if they are above a certain size. *The role of protein and fat in reducing a meals GL is present but seems quite minor compared to these. Anyway these are my thoughts on a preliminary 'new system' for an individualised approach as I say all the equations are new and will provide rough estimates only and don't apply to GLs below 2 (the longer form equation does). Ive used a 100 items to come up with these equations from a variety of different food groups but this falls short of true validity testing. [/QUOTE]
Verification
Post Reply
Home
Forums
Diabetes Discussion
Diabetes Discussions
The NHS T2 Treatment Regime
Top
Bottom
Find support, ask questions and share your experiences. Ad free.
Join the community »
This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies.
Accept
Learn More.…