To Low Carb or Not to Low carb

Celtic - you are doing very well I have to say.

the problem is that we also need to make a distinction between types of carbs - avoiding the obvious high sugar foods also means you cut the bad fats too and the excess calories!

I agree ally. There's nothing beneficial in coke, burgers etc.
There are lots of beneficial things in vegetables and fruit however, and any diet that says these must be avoided at all costs just seems a little odd to me.

Which diet told you to avoid vegetables at all cost, Celtic.Piskie?

Celtic.Piskie said:

If people wish to eat low carb, fine. But please, don't tell me it's killing me when i am in very good health, and always have been.

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In very good health, apart from being a Type 1 diabetic...

As Type 1's we cannot hope to 'eat normally' and match the very tight control of blood sugars that non diabetics maintain; so we have to look at the best possible way to maintain good control. We need to up our metabolism by doing exercise, we need to reduce foods that cause fast (or any) blood sugar spikes and we need to try and limit how much insulin we take. The best way to do that is, with respect, reducing (sometimes drastically) our carbohyrdate intake.

As you know from being a Type 1 for so long the day to day management of diabetes is not the problem; it is the long term aggragation of debilitating conditions that result directly from failing to closely maintain blood sugars at optimum levels. It's not a question of fitness, it's a question of not making an enemy of our future.

You are saying that you are getting good HbA1c's but don't say what they are; on the assumption that they are between 6.5% and 7.5% (i.e. within the 'good control' required by NICE and our GP's), there is a problem that this is still much higher than a non-diabetic and the aim should not be these higher levels but to reduce our HbA1c's to non-diabetic levels. That's no easy thing, but it's what we should be shooting for. A large number of people on this site have found that the best way to do that is to drastically reduce their carbohyrdate intake. Read the success stories and the various debates here about that and about the benefits to be had from that approach.

As an alternative check out this statistic; this is from a study on average HbA1c's done by Liverpool University relating to Type 1 diabetics (Source; Fergus) - "Over 11 years, the total mean HbA1c was 9.19% . Only 3.4% of patients achieved an average HbA1c of <7% during the study period, and 80% of patients had average HbA1c levels of >8% ." I'll put money on the majority of those diabetics following the 'eat plenty of carbohyrdate' strategy. And it is literally killing them.

I know it is difficult and odd to be told the exact opposite of what your health care people have been saying but this is not a fad, or a craze it is a clearly thought out, logical and demonstrable way of improving our diabetic control and extending our lives. If you are getting good results now, just think what you could be getting if you drop the pizza and the pasta...

Dillinger

See, that is what i object to.

I have had three hb1c's above 7.
One when i was pregnant, and two when i was ill. Mostly, they are in the 5 region.

Wht do you assume that i must be unhealthy?
I don't assuume to know your medical history.

That study doesn't include any data on diet. So you could very well loose your money, as there is no way for you to back up your claims that they are killing themselves.
Those statistics include low carbers too.
The human body normally has some glucose spikes. A 'normal' human body doesn't restrict their insulin use, there are no penalties for using more.

I'm glad that you have a diet that is working for you.
I have one that works for me. Don't say it's killing me unless you have any proof at all.

Dillinger, this may be your way but to quote the oft mentioned mantra we are all different. I don't eat pizza very often because it is difficult to bolus for but I do eat other carbs (about 150 worth a day, some days far less, occasionally more) I adjust my insulin and don't take huge amounts and like Celtic Piskie, I take care to exercise, this improves insulin sensitivity, on the odd occasion when I have misjudged my bolus, if possible I don't correct with more insulin, I get on the treadmill. I'm not young but I keep it up.
Here are a weeks average levels, it was smaller than the daily graph but I assure you there are no huge peaks. The after lunch level is a bit higher than perhaps I've been in the past but my specialist asked me to try cutting my lunchtime ratio and basal to avoid dropping too low before lunch and dinner. (Basal now 10.2u a day boluses between 9 and 14)

Celtic.Piskie said:

A 'normal' human body doesn't restrict their insulin use, there are no penalties for using more.

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Celtic.Piskie - that's the point ; there are many many penalties for using more; hyperinsulinemia for instance; lot's of carbohydrate plus lots of insulin leads to lots of problems. Have a look at this post as well - viewtopic.php?f=1&t=8508&p=79558#p79548 with details of the other consequences of elevated serum insulin.

Those averages from the Liverpool Study are no good - there is a clearly elevated risk with higher HbA1c's, so yes having 80% of a population of diabetics with HbA1c's above 8% means that they are risking their health, 'killing themselves' may be a bit harsh, but how else would you describe it? We don't have to have those sorts of levels; and if we do have them we can improve them and as so many have discovered the way to do that is to low carb.

You have great HbA1c's but I would suggest that you (and Phoenix) are getting these despite your pizza and pasta not because of it?

I made no comment on your health or otherwise; I'm talking about long term complications from diabetes. And as the Liverpool Study shows what may work for you surely doesn't work for most.

Dillinger

i think it is all about finding a level of carb intake that suits you.i have yet to come across anyone posting that they can eat as many carbs as they want.as far as i can see everyone advises to cut down on carbs to some degree.i think that there has to be a bit more tolerance of each others views.to an extent we all low carb,its just the level that we do it that is different.i feel that people need to find out what works for them, and to feel that they have options, if one way doesnt work for them ,then they have alternatives.there are some people posting and trying to score points against each other.this isnt helpful to any newbies.i think the advice should be to cut carbs but to find a level that you are happy with .be it 50 carbs per day ,or 150 or somewhere inbetween.i think some people like having an arguement ,so why dont we have a ,to quote mrs merton "lets have a heated debate" forum. maybe not.thanks for reading

dermot

Thank you Mullaneder, I don't quite know how many times this has been written in different ways but what you say is true!!
And yes,I think some people do just like an argument! :twisted:

Th point is, if i can eat carbs and still keep a good level of control, then obviously a low/no carb diet isn't the ONLY way to control diabetes.

The liverpool study is fairly useless. Most people need a better diet. Not just diabetic, most people.
Since there isn't any data on what the diabetics were eating, you can't say that the ones with bad control were eating loads of carbs. They could just as easily have been eating a low/no carb diet.
If i am getting good control, am eating healthily, enjoying my food, why is all this pressure to insist that the carbs are 'bad' and i need a 'better' diet?

Diabetics, like everyone, need to work towards a healthy, balanced diet, adjusting their carbs and meds to meet their needs.
No diet is a one size-fits all solution.

Pixie - that is an understatement - most people need a better diet! I despair sometimes - I saw 2 patients today with awful control and they just didnt care - one was even putting 2 teaspoons of sugar in tea and drinking loads of mugs a day. I don't think they will change any thing ahhhhh!

Ally

one of the things the Exeter study has shown is that the low carbers migrated upwards so compliance was an issue. Also the higher carb control group had very similar results.

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Was the higher carb group using the DUK/NHS guidelines, if so I find it hard to believe they had similar results even those on Low GI would have problems.

If low GI works why are you so against it.

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I have never stated I am against low GI diets only that Low Carb is a better option.

We are seeing more and more newbies joining the forum and many are telling the same story of being refused test strips, and in some cases only having an annual HbA1c regardless of Nice guidelines. Would you advise them to follow a Low GI diet, as many T2s are carb intolerant can you say it would be a safe option.

Graham

Graham- you should feel happy that people are getting good results and encourage them.
Many of the low carbers on here are eating very poor diets and it will be interesting to see if they can sustain it. I sometimes despair when I see the meal plans posted on the low carb forum.

In the exeter study i think that they were mainly overweight diabetics and were using a calculated calorie restriction - so the diets were individually calculated. So yes is the ans.

I use a low GI approach , yawn , as I have said so many times and pts find it easy to follow and it works. However there are still many who will not follow any advice - that is life but frustrating for HP.

Dillinger said:

Celtic.Piskie said:

A 'normal' human body doesn't restrict their insulin use, there are no penalties for using more.

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Celtic.Piskie - that's the point ; there are many many penalties for using more; hyperinsulinemia for instance; lot's of carbohydrate plus lots of insulin leads to lots of problems. Have a look at this post as well - viewtopic.php?f=1&t=8508&p=79558#p79548 with details of the other consequences of elevated serum insulin.
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Dillinger

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Of course it is possible for a type 1 to eat too much, need to take too much insulin and to subsequently develop high insulin resistance. (in otherwords double diabetes). I've seen it happen with some people who continue to eat a diet of junk food and 'cover' them with large quantities of insulin. This doesn't happen as a result of eating normal levels of carbohydrates and appropriate insulin.
Its usually said that a healthy, non diabetic person produces about .5u of insulin per kilo of bodyweight. thus a normal total daily dose of insulin for a 60k person with no insulin production of their own would be 30u. Needing to take a lot more than this probably suggests some resistance , much less suggests sensitivity or some remaining insulin production. (obviously this is a bit of a rough guide since insulin types vary a lot, I've cut my own dosage by almost a third since changing from rapid and basal to just rapid in a pump)
I'm sure you like me you have seen people on forums needing to take massive doses, many in the 100s of units in one case I've seen over 900u a day this is the result of resistance caused by beta cell failure caused by hyperinsulinemia. Incidently there is some evidence that people who eat wholegrains are less likely to develop insulin resistance.
I don't think that eating 'normal' quantities of carbs, fat and protein coupled with sufficient exercise will cause high insuin resistance without some sort of genetic predisposition. As I've reached 57 and at least since I had children, tried to cook and eat balanced meals including some starches at most meals. I doubt if its going to change now.

What's the matter with everybody here ? Can't you people just get on with your lives and do what suits you best. Who cares if somebody can eat spuds and pasta. Great, wish I could but I don't go round telling everybody this is what is best. You low carbies, ease up folks. We don't need lectures, we 'aint at school now. The non low carbies are just as bad. Why do you always want to pick an argument with everybody who says something you don't like ? Seems every time somebody says something they are all over here from that dfl place. We got them and then the lc peeps keep coming here to argue and fight. Why dont you all just stick in your own places and leave all the newbies and the rest of us to get all the info we need.
That mullaneder is dead right and Sue babe, I don't know how you and the rest of your pals put up with this lot bickering all the time. I got warned a while back for something I said. You should kick the lot of these troublemakers out. Make for a much better place. Respect. Sue and mullanedr.

D.

It does seem a bit like the Big Enders and Little Enders from Gulliver's Travels who went to war over which end of the egg should be opened first.

Seems to me that the real 'enemy' is not the two factions on this forum, but a combination of the establishment who are so wedded to their recommended guidelines and the many apathetic diabetics who don't take their condition seriously and aren't willing to take on board that they need to make lifestyle changes to give themselves a chance. I have come across lots of those people at random, one woman the other day in the vet's who blithely said to me that she had been diagnosed last year but couldn't be bothered to take the medication. :shock:

My diabetic nurse was telling me yesterday that very few diabetics she sees are able or willing to make the changes they need to get their sugars and Hba1C down to non-diabetic levels, so nagging them constantly and putting them under pressure to achieve targets that are beyond their ability will only cause stress on both parts, so perhaps this has some bearing on why the NHS stick to their guidelines.

Maybe that will change in time, as they were very keen to know how I had achieved my good results, at 5.9 yesterday down from 11.5 in March, and said I ought to go to the education meetings to talk to newly diagnosed peeps.

I would say that anyone who turns up here and sticks around is probably willing to take responsibility for themselves and find out what works for them, as clearly it's different for everyone.

I would say that anyone who turns up here and sticks around is probably willing to take responsibility for themselves and find out what works for them, as clearly it's different for everyone.

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This is the point.There has been a lot said on here about non compliant diabetics in general in the community.The difference on here is that members were interested enough to find this forum ,and others ,and start to do something to control their diabetes.Therefore the members here are not exactly your average diabetic. Find what works for you and live life to the full.

Imagine if the establishment was to actually tell folk to try cutting carbs; to see if that gives them more control?

Piskie
I'm not saying anything about your health personally, but a recent study showed that non-diabetics with HbA1c in the upper part of the normal range Ie above 5% have a tendency to develop conditions which are usually thought of as "diabetic complications". The Average non-diabetic HbA1c is 5.1%, but the ideal is probably as low as 4.5%. Some writers are now recommending 4.2% as an appropriate target. Puts us 5 club members on our mettle. and makes a "nonsense" of the< 7% target.

dipsticky said:

What's the matter with everybody here ? Can't you people just get on with your lives and do what suits you best. Who cares if somebody can eat spuds and pasta. Great, wish I could but I don't go round telling everybody this is what is best. You low carbies, ease up folks. We don't need lectures, we 'aint at school now. The non low carbies are just as bad. Why do you always want to pick an argument with everybody who says something you don't like ? Seems every time somebody says something they are all over here from that dfl place. We got them and then the lc peeps keep coming here to argue and fight. Why dont you all just stick in your own places and leave all the newbies and the rest of us to get all the info we need.
That mullaneder is dead right and Sue babe, I don't know how you and the rest of your pals put up with this lot bickering all the time. I got warned a while back for something I said. You should kick the lot of these troublemakers out. Make for a much better place. Respect. Sue and mullanedr.

D.

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I agree with the dipstick as long as we all are healthy and have good bloods what's the problem??!!