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Was Told By A Doctor To Increase My Carbs

Discussion in 'Ask A Question' started by CrumblingWall, Jun 28, 2019.

  1. CrumblingWall

    CrumblingWall Don't have diabetes · Well-Known Member

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    I will supply a short TL;DR here so people don't have to read post history. 2017 December - googled my symptoms, thought it is diabetes and went low carb. 2 weeks later had an OGTT, which shown diabetic levels of sugar. Tested for antibodies for type1, normal hba1c and fasting. Endo said it is not diabetes and probably caused by insulin resistance due to low carb. c-peptide was below normal range at 0.68 ng/ml though ... onwards we go on low carb diet, to today.

    A week ago, I decided to go to a doctor for other issues, and her attention was peeked by this story. She mentioned that since I was not considered a diabetic, I should try to get out of low carbing. My c-peptide was re-tested at 1.0 ng/ml which is in normal range. Thing is, I did occasional tracking of my glucose. I noticed anything above 6.5 mmol/l after a meal makes me experience symptoms like: sweating, feeling hot, headache and face pressure (don't know how else to describe it), and feeling slightly thirsty. It always comes down but late, like 3 hours+ since food consumption. My doctor thinks this is still insulin resistance due to delayed glucose clearance, but I have lowish c-peptide for it to be resistance?!

    Essentially, was told to eat carbs that have GI < 60. I am thinking of buying a freestyle libre, put it on for a month and see if my pancreas will actually wake up and handle the carbs (that is doctor's and endo theory). Otherwise, it just do not see a need to put out much insulin on low carb....

    I am just afraid of taking this step because low carbing kind of works - my BG is normal, my weight is fine, not too much GI issues. I tried a few times to eat some complex carbs, went to 8-9 mmol/l which makes me feel ill. Thing is, I will not know if it is a pathology or physiology until I actually carb load myself and see what happens to BG curves. Normal people are expected to experience high BG for a few days until their metabolism switches to glucose burning, while people with diabetes will continue seeing high BGs all over the place....

    Feel quite alone in this. Should I consult a dietician or another endo? Problem is, my GP will never refer me to one because I don't exhibit diabetes symptoms...
     
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  2. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Go with what works for you.
     
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  3. Emile_the_rat

    Emile_the_rat Type 1.5 · Well-Known Member

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    To be honest I think it’s either just in your head, or that your problems are not blood sugar related. Because blood sugar above 6.5 mmol are completely normal and should not under any circrumstances cause symptoms, because it is normal. Also 8-9 mmol are NOT high, and it is normal for non diabetic to reach levels of 10-11 mmol if they eat something with high GI. If you had 20 mmol I understand if you felt ill, but 8-9 are really not high, and pretty normal for non diabetics when eating something with high GI.

    I think your discomfort have other causes and are not blood sugar related.
     
  4. Sapien

    Sapien Prediabetes · Well-Known Member

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    Isn’t a truly normal response to high GI (e.g. 75 grams of pure glucose) supposed to be to stay under 7.8 at all times? And below 6.1 at two hours?

    I would think that briefly going up to 6.5 wouldn’t be a cause for concern, but 10-11 for non-diabetics would be quite high. (Pre-diabetic levels are also high).
     
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  5. Brunneria

    Brunneria Other · Guru
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    Something I have noticed over the years is that the more my body gets used to a particular blood glucose range, the more uncomfortable it is to go above or below that range.

    For instance, there have been times when my bags were fluctuating between the 4s and the 12s. It all felt perfectly normal and unless I went down into a hypo, I didn’t have an awareness of what my bg was doing.

    However, once I have things under control, and my bg varies by less than 2 mmol/l (range of 5-7), then going up to 8, or down to 4 is noticeable and rather uncomfortable. Consistently so, and not a figment of an over active imagination.

    Our bodies do like the security of the familiar.

    I suspect this is what may be happening to you.

    Like @xfieldok I think you should do what feels best for you. I am unaware of any nutritional need that requires the reintroduction of carbs, so I am curious as to why your doc thought you should go back to eating them. Social pressure? A belief that you ‘need’ them?

    I also think that if ‘normal’ involves blood glucose fluctuations that affect my body enough to feel grotty, then ‘normal’ or not, I would want none of it.
     
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  6. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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    Well, you could eat some carbs like leafy greens if you wanted to eat more carbs and stay away from processed refined carbs like bread, pasta, rice and all those high insulin demanding processed foods. :D

    Bread is often full of seed oils that are also not healthy.

    If you are doing well on your current LC diet and happy with it, then why change it? Yes, low carb requires less insulin output. Do what you feel is right. Personally, I don't see any sense in eating high carb foods that will most likely elevate your glucose levels.

    Edit: No one, including doctors can decide for you what you eat.It's your choice, it can't be forced on you.
     
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  7. JoKalsbeek

    JoKalsbeek I reversed my Type 2 · Well-Known Member

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    Good morning!

    Is this diet working for you personally? Do you feel alright on it? Then I don't see why you'd have to splash out on a Freestyle just so you can have and check carbs you don't actually want. And for the record, if my bloodglucose hits 8 or nine, I feel it too. Normally I stay under 6,5 (and if I do get a rise it's either dawn phenomenon, illness or a steroid shot, so those are all all liver dumps). But if someone decides to serve me a salad with unlisted honey and apple in it (it was lovely, but oh, ****!), and my BS goes up to 7-something? I get wobbly in my legs, a little nausiated and very cranky. Not to mention palpatations and whatnot. Kindof the same response I'd have to a hypo. So it's not between your ears. Like @Brunneria said, our bodies like keeping things on an even keel and protests some when anything changes.

    You don't actually need carbs. I know I don't, and I hover around a max of 20 grams a day. I know people who eat even less of them than I do, (actually zero carbs a day!) right here on the forum. And they haven't dropped dead yet either. So you do what you feel is right for you. If that's carby eating with a freestyle to monitor what's going on, do it, if it's seeing a dietician, do... But you could also save that money and have a nice weekend out.

    Do whatever you feel is right. Good luck!:)
    Jo
     
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    #7 JoKalsbeek, Jun 29, 2019 at 6:01 AM
    Last edited: Jun 29, 2019
  8. Listlad

    Listlad Prediabetes · BANNED

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    For non diabetics I suspect the Eatwell plan, if adhered too, is adequate. But it is so easy to stray away and overindulge with carbs.
     
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  9. Emile_the_rat

    Emile_the_rat Type 1.5 · Well-Known Member

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    No, it is a truly normal respons to food with high GI for non diabetics.

    I think healthy people with normal blood sugar should stop making an illness out of it, and rather be thankful for having a pancreas and body that manage to keep blood sugar within normal range. To be honest I think it a little bit offending ovenfor diabetics that really struggles with their blood sugar to complain about blood sugar less than 11.2, and act like it makes them sick.

    An OGTT with 75g carbs have these markers:

    Non diabetic 4.0 - 7.7 mmol after 2 hours.
    Pre-diabetic are 7.8 - 11.1 mmol after 2 hours.
    Diabetic is 11.2 or greater after 2 hours.
    All these values are after 2 hours, so non diabetics can still reach 11 mmol after 15-30 min when the blood sugar are at its highest.

    So well, it is a myth, and wrong that non diabetics always has blood sugar under 7.8 mmol at all times. I have many friends that have tried to measure their blood sugar 15-30 min after eating, and well I’ve seen many of them reaching almost 11, and they are not diabetics. The difference are that the blood sugar either continue to raise, or use longer time before falling in diabetics.

    Having a random reading of 10 mmol does not mean anyting.

    If your blood sugar are either less than 7.8 after 2 hour, or you never had several reading above 11.2 mmol you are completely healthy and not diabetic.
     
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  10. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    @CrumblingWall , my position would be to firstly ask whether the prospect of eaating more carbs appeals to you, or whether it's somewhere you would rather not go.

    Assuming, for argument's sake, you increased the carbs, dose your doctor intend to conducting any other investigations, or is it just she doesn't really get, or go with the LC lifestyle?

    In your shoes, I could be inclined to have a couple of Libre, to view my peaks and troughs under usual living. Testing at 1 hour, two hours or even longer will never show the whole picture in a way that the 24/7 x 14 days, reading every 15 minutes.

    My A1cs have been dancing around 30 for the last 5 years and prior to using Libre, I was confident in what my body did, and how it reacted to various things - not just dietary, but sleep, stress, being under the weather and so on. I learned a great deal from the Libre and consider any sensors I have used to be an investment in my long term wellbeing.

    Of course, that said, I did have a definite Type 2 diagnosis.

    I can't suggest what you do. It's more complex than a few carbs I think.
     
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  11. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    Did you follow the guidelines for the glucose tolerance test by eating the required amount of carbs during the days before the test?
     
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  12. Squire Fulwood

    Squire Fulwood Type 2 · Expert

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    Isn't that what the OGTT is for. What were the actual results?
     
  13. CrumblingWall

    CrumblingWall Don't have diabetes · Well-Known Member

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    14.2 mmol/l after 2 hours.

    With regards to others questioning the advice of carbs restriction...I currently live in an unknown, no doctor told me I am diabetic and I do not know what my BG will do after adding more carbs. I basically survive on this diet but am wondering if not taking endocrinology advice and simply getting back to normal diet is me being arrogant about knowing better. I have no proof that reintroduced carbs will always keep me spiking. If I found by experience that spikes keep reoccurring, then it means I am somewhat diabetic and should go back to low carb to avoid damaging glucose spikes.

    I am glad others also feel unwell being out of range, even if in non diabetic range. Our bodies tell us when we divert from normal, same for blood pressure, anything 20 points above regular highs at rest makes people have splitting headaches and chest pain. I honestly am tired of doctors claiming I should not feel the deviations. If I feed them 1kg of cake and we measure the glucose, I wonder they would feel.
     
  14. CrumblingWall

    CrumblingWall Don't have diabetes · Well-Known Member

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    And how do these friends spiking towards those values feel? Sleepy, carb coma? Any sweating or feeling weird? It depends on your standards. Do you want to heed advice of science that claim above 7.8 starts inflicting damage and keep inflicting it? Or do you analyse the data and see what satisfies your targets? Occasional spikes to 11 is not harmful. But every day will start adding up.

    Also, if it makes one feel really ******, then why keep feeling ******? Why not use this knowledge and control the bgs such that one feels okay most of the time?

    There is a documentary from Japanese scientists somewhere on YouTube if you search glucose spikes Japanese documentary, they tell you research shows how damaging those spikes are. They give advice for people to eat low gi foods and do a short walk after lunch.

    Overall, I want to find out what is the real state of the pancreas. I think libre would give me that info

     
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  15. Emile_the_rat

    Emile_the_rat Type 1.5 · Well-Known Member

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    All the friends that «tested» my meter and got «high» values didn’t feel anything unusual. And I think I speak for most diabetic, you do not get diabetic symtoms with only 10-11 mmol in blood sugar, and definitly not anything with just 7-8 mmol. Also sweating are not a symptom of high, but of low blood sugar.

    I think it lays more in your head, and that you do overanalyse things, really. And no, 11 mmol are not harmful, most type 1 diabetics experience often 11 mmol without suffering any complications. I would agree with you if you said 15-20 mmol are dangerous on long term. But 10-11 mmol are pretty normal, most people, if not anyone would get those values shortly after a high glycemic meal.

    If you can’t get your mind at ease you should get help for it, and talk about your concern with your GP, so you can feel more calm.

    Keeping track of blood sugar, or getting hung up on it when you’re health are not good for you, and won’t help you. I think you should let this go for your own sake. Take care :)

    I see your video, but in all honest I trust my gp and diabetes team more, when I say there is nothing wrong based on the values you posted here.

    Edited by moderator to remove medical advice
     
    #15 Emile_the_rat, Jun 29, 2019 at 9:48 PM
    Last edited by a moderator: Jun 29, 2019
  16. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    In my personal experience, what people do and don't feel is very personal indeed, and not necessarily the same through their journey with diabetes, or other metabolic dysfuntionality.

    For instance, when I was diagnosed, in 2013, with a fasting plasma glucose of 15.6, then an HbA1c to confirm the diagnosis of 73. I was completely asymptomatic.

    In 2017, I did a home OGTT, and reached my peak at 30 minutes, at 9.4. At 9.4, I felt sluggish, but unsettled, although I will say part of that could have been the discomfiture at seeing a leading 9 on my meter as it'd been a long time since the last one.

    My 2 hour point of that OGTT was 3.3, and I felt absolutely fine. I often run well into the 3s and feel tip-top.

    At the point of my diabetes diagnosis, I could eat toast, or sandwiches and feel fine. Now if I eat gluten, it takes me a couple of weeks to get over it. I'll spare you the detail. It's not pleasant.

    On that basis, I wouldn't ever challenge anyone saying they feel x, y or z at any blood glucose number. Depending on the circumstances, I might not always consider it to be diabetes causing their discomfiture. In my view it's just all too personal for that.
     
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    #16 DCUKMod, Jun 29, 2019 at 10:10 PM
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  17. Brunneria

    Brunneria Other · Guru
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    Emile,
    You are not addressing a type 1 diabetic on insulin. Type 1s have an autoimmune condition that means their beta cells are being (or have been) killed off by their own immune system. Therefore, raised blood glucose is not going to do more damage to beta cells than their own body is already doing with its own immune system. Therefore, higher than normal blood glucose has (in some ways) a different effect for type 1s than for people with high numbers of beta cells.

    For those of us with non-autoimmune diabetes, pre-diabetes, or no diabetes, then the preservation of our existing beta cells is very important, and there is significant evidence that beta cells and organs can be cumulatively damaged by blood glucose levels above 7.8mmol/l
    For more information on this, the www.bloodsugar101.com website (which is aimed at type 2 diabetics) has an overview and explanation of this research.
    https://www.bloodsugar101.com/organ-damage-and-blood-sugar-level

    The same website, has some very informative information on what is truly normal blood glucose for non-diabetics.
    https://www.bloodsugar101.com/what-is-a-normal-blood-sugar

    People whose blood glucose does not fit these profiles (and there are many, many people eating the modern diet who do not fit these profiles) are at increased risk of metabolic syndrome, heart disease and type 2 diabetes.
    https://www.sciencedaily.com/releases/2018/11/181128115045.htm
    People may have blood glucose readings of 10 or 11 but that does not make it healthy.
     
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  18. CrumblingWall

    CrumblingWall Don't have diabetes · Well-Known Member

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    I do not want to trash on that website, but I honestly heard doctors mention it is bunk. The studies cited their are highly contested. However, that website is playing on safe side - it has high standards for normal glucose levels and I think is very right.

    My own doctor mentioned that non-diabetics don't really spike above 8.5 mmol/l even after lots of cake. But then, CGMs studies are sparse on non-diabetics. We do not know what is really normal. So many people have metabolic syndrome and glucose variability is very large. They could be moved to a normal bracket when in reality they suffer from a beginning disease. It is all very complicated ....

    Motivated people, or obsessed like me, educated themselves on current research. It looks like it really depends on people standards. Do you agree with people like Bernstein, or do you think a1c of 5.7% is ok? Or are you more strict and go for high 4s?

    Decisions you make right now could influence your health in your 40s. People live normal lives and then, bam, diabetes out of nowhere. But foundations have been laid for decades for that to happen. You did not wake up with significant beta cells damage one day. It was a slow process.

    https://kresserinstitute.com/normal-blood-sugar-isnt-normal-part-2/
     
    #18 CrumblingWall, Jun 30, 2019 at 10:02 AM
    Last edited: Jun 30, 2019
  19. Brunneria

    Brunneria Other · Guru
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    Thanks for the Kressler link. He and Bloodsugar101 seem broadly on the same page about raised bgs for 'normal' people being an indication of problems to come.

    My issue with the bloodsugar101 webpage isn't the info on it, but rather the age of the studies. It is an excellent and accessible site to offer people as an alternate way of thinking from the standard info they are given by their health care professionals, but the studies on it are getting a bit old now. Admittedly a good and informative study is still a good and informative study whether it was published in 2008 or 2015, but there is new info coming out all the time, and the bs101 site doesn't publish the new stuff.

    I totally agree with you about looking in the long term. People with metabolic syndrome, raised fasting blood glucose, and higher than usual post prandial readings may be fine now, but they probably have decades ahead, and those things are markers of problems in the future, if they don't take things in hand now. Kraft's insulin assays have shown that very clearly, where heart disease and insulinaemia go hand in hand for decades before either type 2 diabetes or heart attacks arrive.

    The time people spend with raised blood glucose is at least as important as the numbers that they clock at the top of the curve.

    As for Bernstein... I am in the position where I have a huge respect for him, but my body is one that insists on raised fasting readings and a steady rate of insulin resistance (which continues despite drasting dietary changes). So Bernstein's targets would only be achievable with the addition of exogenus insulin, or significant medication, and those are not steps I am willing to take at this point. I do think that moderm medicine has an inaccurate view of what 'normal' is in many ways - largely because the diet we currently eat is not the diet we evolved to eat. Whether true normal is where Bernstein thinks it is, is something I cannot really judge.
     
  20. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @CrumblingWall, ifrom my personal experience with diabetes, not as medical advice or opinion: I am surprised that the endocrinilogist opining that your OGTT result was due to having a low carb diet would not have suggested a repeat test with following a usual 3 to 4 day higher carb intake lead up ( if you had not done that the first time?
    14.2 mmol/l is high and in diabetic range going on usual acceotable ranges of BSL ( such as on Home Page , Living With Diabetes and far left column under that title.
    The particular conditions for undertaking an OGTT does limit its utility.
    Others have suggested you try out a continuous glucosecmonitoring device in associated with a glucosecmeter as a check on the spaccuracy of the monitoring device.
    A very sensible if expensive exercise. Unless you could hire such a monitoring device perhaps.
    The glucose monitoring devices can provide a great amount of data with which to better sort out what is happening to you.

    I personally find fault with the GI/GL diet studies - they are on non-diabetics and the value figures one is given for each food varies not only where we eat mixed meals wishing mixed up the overall prediction anyway, but the values are averages. You as an individual might find these average values apply well to you, but the next person can have a different resukt because they happen to react more in bsl rise or less because there is that range. Finally research has shown that an individual's responses to a single food at a time depends on the bugs in their gut, or gut biome as itvis calked. These bugs afect hiw sensitiveviur bidy is to insulin. These gut biomes seem to be the elephant in the room when it comes tobthe GI/GL paradigm.
    See https://wis-wander.weizmann.ac.il/lifesciences/blood-sugar-levels-response-foods-are-highly-variable
    Having said that many if us note that adding fat to a meal, or choosing full fat yoghurt over low fat yoghurt can reduce the peak in blood sugar level after eating.

    Of course on a low carb diet using fresh unproceesed food GI/GL can be pretty irrelevant.
    Why do low carb or even keto diet? There are recommendatios for type 2 diabetics for weight loss ( recent ADAguidelines), athletes in various sports like cricket, athletics etc, some diabetics on insulin injection use it.
    For variuos reasons dietitians are divided on its use and the food industry and pharamacupeutical industry see such diets as a threat. Lower breakfast cereal sales, diabetics improving their bsl cintrol and stopping medication. There has been a lot of false advertisinng and maligning of these diets and false science and flawed, manipulated statistics proferred to attack them.
    But we know that lapplanders, Inuit and other indigenous tribes lived healthily and well on a zero carb food diet.
    And looking at the Fat Emporer podcast E 25 the effect of thecWestern diet on indigenous people and others in the past 50 to 100 years has been mighty deleterious.
    This all would suggest you have made a wise choice in diet and it will take a while for health professions to fully come out from under the influence of the big three: Food, Pharmaceuticals and Medical Devices.
    I wish all the best in yiur endevours and hope the answers from all the people on this site have helped.
     
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