to 'low carb' or not to low carb!

[lahdida]

HI all!
I was recently admitted to A and E as I had an foot infection and high sugars . My diabetes was poorly controlled but slowly improving since I began seeing a new endo a few months ago . When I was in hospital I was speaking to a new dietician and diabetis nurse specialist who told me my diet was wrong , that I required more carbs for the insulin to 'work ' on even though my blood sugar is mostly high at levels ranging from 13- 19(at times) . I am also conscious of my weight and at 5'10 and 10 stone I would rather not gain any weight ,the dietician and diabetic nurse felt that it would be better for me to eat more carbs take more insulin and that I could 'afford' to go up to 12stone . I know myself tough that I would be very unhappy to gain 2 stone !
can anyone please give me some dietary advice as I dont see where I am going wrong as I thought I ate a healthy diet .

Current diet
Breakfast : Apple with natural yogurt
Lunch : soup with 3 Ryvita topped with turley slices and cheese or a salad with kidney beans and tuna and ryvita
Dinner : usually something like , meat carrots and salad or curry with chickpeas instead or rice .
.I would snack on meat and cheese and peanuts

the diet recomended for my by the dietician however , roughly consisted of the following
Breakfast : 3 weatabix and toast,
Lunch : roll or soup and a sandwich
Dinner : meat, veg , large portions of pasta ,rice or potato
snack before bed of toast or something with high carb content!


hope someone can advise me ,
Thank you

 

[CarbsRok]

y

 

[Lezzles]

Hi Lahdida,

im Certainly no expert on this as im still learning myself but i think the diet you have been recommended is far to high in carbs.
The reason that the docs etc don't promote a low carb diet in the UK is that there hasn't been as much research done on it like there has been in america.

when i saw my dietician when i was first diagnosed 6 years ago i was told that 3 weetabix was far to much and i had to cut it to one with one slice of toast.......totally different to what you were told.

first thing in the morning i have to have very little carbs as my body can't process it very well and i find that m high for a very long time, an apple would be no use to me instead i will have eggs and then if i feel i need something carby i have a snack mid morning like a slice of nimble bread toasted.

diabetes is different for everyone and i think you need to do a lot of testing and experimenting with food so you know what is right for you. keep a diary so you can use it for reference, this has worked for me, write what you eat, what dose you took and test results.
don't let the nurses and docs make you do things that you don't feel comfortable with, if you don't want to risk putting on more weight then make sure they know that.

Lesli x

 

[noblehead]

Ialdida,

I would say that if you are happy with your 'current diet' than stick with it. As Carbsrock says, you need to adjust your insulin better to work with the foods you eat, those bg readings are high and need to be addressed, so obviously you need talk with your DSN to establish a more suitable insulin ratio for your meals, rather than increase carbs/insulin. Just remember to test before eating, and then 1, 2 and 4 hours after eating to establish your bg control.

Regards

Nigel

 

[hanadr]

lahdida
It seems all wrong to me that any diabetic, nowadays, should be advised to "eat Up to" their insulin.
that is a certain route to weight gain.[although I have heard of it several times lately ]
As written in a previous post, learning to carb count and varying your doses to match your meals would get round that problem. However 10 stone at 5 feet 10 is definitely slim. Check out your BMI.
Controlling carbs is a way chosen by many of us, and I've yet to hear of any harm coming to anyone from it. AND it doesn't cause weight gain.
I did a rough estimate of your BMI and it comes out around 20, which is safely in the healthy zone
Hana

 

[ally5555]

Right a view from the dark side - yes I am a Dietitian

You need more info - eat plenty of carbs is useless!

You need to dose adjust and know exactly how much CHO you are taking at each meal. Diabetics who attend Dafne courses can mange their BS without low carbing - ask your team for some details.

 

[Beav]

**** you dont eat much! Where is the morning/afternoon snacks! :?

 

[hanadr]

Question fo Ally 555 if she's there
Regarding carbs. Do dieticians regard cellulose as carbohydrate in a diet sense? I know they are in terms of organic chemisstry.
Hana

 

[jopar]

CarbRok and Noblehead are correct it sounds as though you need to learn how to adjust your insulin to the carbs you eat, I would ask your team to attending a carb counting course such as DAFNE or similar

There are in reality only a few dieabtics who choose extreme low carbing to control there diabetes and in the main most of these are T2 diabetics on oral medication or diet alone... A high percentage of these actually do stuggle with the diet and regularly fall of the wagon..

Most of us T1's who also have sucessfull control actually eat carbs and near normal diet, but we tend to keep our daily carb amount to moderate amounts, which for most seems to be around the 150g-200g mark some slightly higher some lower more often than not, we chose foods that have a low G.I value, such as wholemeal breads, pasta etc

 

[cugila]

**** you dont eat much! Where is the morning/afternoon snacks! :?

I'm a bit puzzled here.......why does everybody have to have snacks ? If they are well controlled and not hungry, their meds and Bg levels are fine.....what is the point ? :?

Ken

 

[Debloubed]

**** you dont eat much! Where is the morning/afternoon snacks! :?

I'm a bit puzzled here.......why does everybody have to have snacks ? If they are well controlled and not hungry, their meds and Bg levels are fine.....what is the point ? :?

Ken

I don't think Beav was suggesting that you must have snacks, but if you are feeling peckish, then why not?! I had some sliced strawberries this afternoon, they taste better when sliced and eaten with a fork, not sure why! :lol: I myself, find it hard to get from lunch to dinner without a little nibble on something :twisted:

 

[cugila]

DB
Beav is a weight trainer and posts that advice in other posts here. That differs from many of the posts made by T1's I have seen before who advocate 3 meals a day, very little, if any snacking.
However, if you want to snack, eat between meals.......sounds fine to me.

I just wondered if there is some reason for that. Is it peculiar to someone who does weight training or is it advice given to all T1's ? Of course if you feel 'peckish' there is nothing wrong with a snack between meals, I don't recall ever saying it wasn't ??? That would be ridiculous in the extreme.

As I stated in my post I am puzzled and just curious as to the reason that's all. Maybe Beav will tell us why he prefers that regime ? What it's benefits may be. Might help others including myself to understand things a little better. I have a great thirst for knowledge, we can all do with more, always learning and dialogue has to be a great way to learn.....don't you think ? I am sure we can all do with some additional knowledge at times, the more information we have, the better. Save making mistakes. I am sure you would agree with that ?

Ken

 

[Beav]

Well eating small and often increases metabolic rate making it easier to stay lean or get lean in my case Aparently its how everyone is meant to eat but noone can stick with it. Break/dinner/ tea are propper meals and the snacks in between can be 1 hand full of nuts or a banana so its not alot really and most people would get away with eating that amount without a jab

 

[cugila]

Hi Beav, thanks for answering.
Was the advice to eat this way from a dietician skilled in advising Diabetic's or from a weight trainer ?

What sort of Bg levels do you have throughout the day, I seem to recall you posted on another thread about quite low Bg levels....am I mistaken ? I actually warned you that losing hypo awareness and running at hypo levels would disqualify you from holding or obtaining a UK Driving Licence, did you see that ?

You see I have seen that advice around here but not as a sort of mainstream thing. Most people are usually advised to eat regular meals, try and avoid eating between meals and generally just eat a well balanced and varied diet.

Surely it must be a bit of a pain having to snack all the time, does this interfere with work, home life ? When I was working I don't think the bosses would have taken too kindly to me eating every few hours.

You mention Banana's ......there are those around here who have difficulty with them, high in carbs and fairly quickly bump up the Bg levels. Possibly you don't get that because you are young and your metabolism is burning up the fuel, because you are very active. Not sure if that advice would be so suitable for say a 60 yr old Diabetic. Type 1 or not.

Personally I think the three square meals a day is what works for most, but of course if it works for you......who am I to disagree. :wink:

Ken

 

[ally5555]

Hi

To ans hana - yes cellulose is technically a carb but indigestable so really only provides fibre - I am curious why do you ask.

Snacks are a personal thing - I do not think they are required for everyone - but people are different and may be needed to get enough energy (calories). I hate to see diabetics encouraged to eat digestives and tons of fruit .! Kids and those doing alot of exercise/manual work may need to!

I am a dietitian and do not eat snacks - I eat 3 meals a day like ken and do not get hungry between!

Allyx

 

[CarbsRok]

y

 

[Debloubed]

I don't eat the same every day, I like to mix it up! Some days I eat 3 meals and no snacks, other days I eat 2 or 3 smaller meals with a snack or 2, it depends on where I am, what I am doing, etc, etc. Isn't that normal?! I thought it was so apologies if I am on my own with that thinking :? Basically, I eat if I am hungry which most days will be in the morning, at lunchtime(ish) and in the evening, but then my body has probably been conditioned to feel hungry at those times. Some days, I am not able to sit down and eat a balanced meal at 12.30 for my lunch! but if that isn't the case, I don't stress, I grab something on the go and make sure my tummy isn't rumbling

As for bananas, I barely bolus for those as time and time again I have gone hypo when bolusing the 'correct' amount for the carbs, they are just one of those foods which I can eat with little insulin - which is a good job as I love 'em! :lol:

 

[phoenix]

I rarely snack, all the diabetes 'education' here emphasised regular meals and no snacks.
In general snacking is not part of the traditional culture, it's hard to buy food in bars and restaurants outside set mealtimes and very few people eat in the street. The message not to snack forms part of the antiobesity campaign. All publicity for manufactured foods containing added salt or sugar have to include one of five healthy eating slogans, avoid snacking between meals is one of them.

 

[Beav]

Hi Beav, thanks for answering.
Was the advice to eat this way from a dietician skilled in advising Diabetic's or from a weight trainer ?

What sort of Bg levels do you have throughout the day,
Ken

Im around 6-8 most of the time I eat regular because it is important for me to eat alot of protein. I eat alot of chicken which is good as that is low in carbs meaning I don't need a jab aswell. When I eat betweel the 3 meals a day I try to have no carbs or very little so that I do not need to jab but yet I get enough protein

 

[iHs]

For people using pumps it's fairly easy to manipulate insulin to work exactly as you want it, but for people using MDI (basal/bolus) it's a lot harder. Not everyone is able to use a 1:10 ratio all day long. They have to take into account the action of the basal insulin on bg levels as well as the effect of what the bolus is doing.

The deciding factor as to whether to snack or not depends what the bg levels are 2hrs after giving a bolus. People have also got to remember how much carb they ate and how much bolus they injected. If someone was following targets and wanted to try to be on 6 before they ate and then 2hrs later to be on 8 then unless they were hardly injecting any bolus due to low carb, they would need to use whatever amount of bolus it would take to get them that target. It might be a lot more than 1:10 or it could be something different.

My hospital clinic has issued a very easy to understand leaflet all about counting carb and advises that people eat a snack of 5-10g carb if their bg levels are below 9 two hours after the previous bolus. This is so that no one finds themselves going hypo.

As for putting on weight, I have remained a size 10-12 for all my diabetic life and have also eaten regularly.