Questioning Carbohydrate Restriction in Diabetes Management
From Diabetes in Control www.diabetesincontrol.com http://www.diabetesincontrol.com/index.php?option=com_content&v....
Patients with type 2 diabetes are usually advised to keep a low-fat diet. Now, a study shows that food with a lot of fat and few carbohydrates could have a better effect on blood sugar levels and blood lipids.
Sixty-one patients were included in the study of type 2, or adult-onset diabetes. They were randomized into two groups, where they followed either a low-carbohydrate (high fat) diet or a low-fat diet.
In both groups, the participants lost approximately 4 kg on average. In addition, a clear improvement in the glycemic control was seen in the low-carbohydrate group after six months. Their average blood sugar level dropped from 7.5 to 7.0A1c (58.5 to 53.7 mmol/mol). This means that the intensity of the treatment for diabetes could also be reduced, and the amounts of insulin were lowered by 30%.
Despite the increased fat intake with a larger portion of saturated fatty acids, their lipoproteins did not get worse. Quite the contrary -- the HDL, or 'good' cholesterol, content increased on the high fat diet.
No statistically certain improvements, either of the glycemic controls or the lipoproteins, were seen in the low-fat group, despite the weight loss.
Dr. Fredrik Nyström, who was part of the study, said, "You could ask yourself if it really is good to recommend a low-fat diet to patients with diabetes, if despite their weight loss they get neither better lipoproteins nor blood glucose levels."
In the low-carbohydrate diet, 50% of the energy came from fat, 20% from carbohydrates, and 30% from protein. For the low-fat group the distribution was 30% from fat, 55-60% from carbohydrates, and 10-15% from protein, which corresponds to the diet recommended by the Swedish National Food Agency.
The participants were recruited from two primary health care centers and met for four group meetings during the first year of the study. All 61 participants remained in the study for the follow-up.
Dr. Hans Guldbrand who was also part of the study says, "In contrast to most other studies of this type, we lost no patients at all, which vouches for the good quality of our data."
The results of a two-year dietary study led by Hans Guldbrand, general practitioner, and Fredrik Nyström, professor of Internal Medicine, Diabetologia, May 2012
Gerri: Thank you for this link.
Heartily agree with your comment above. Extremely hurtful for T2 to be constantly referred to as a lifestyle disease. Knife in my chest when I see that on Tu.
A convenient, easy answer that lays the blame on the victim for an extremely complex metabolic disease. Victims are typically blamed for their situation because it deflects the issue from the real cause, whether it's illness, poverty, unemployment. What a chicken & egg dilemma regarding which came first--weight gain or insulin resistance, & a terrible struggle for those T2s who have weight problems.
Quote " Patients with type 2 diabetes are usually advised to keep a low-fat diet. Now, a study shows that food with a lot of fat and few carbohydrates could have a better effect on blood sugar levels and blood lipids." ...is this not called a life style change; if not what is it called ??? Show me , where I used the word " lifestyle disease " and I will change my wording .
I see that many posts have been deleted including all the posts by MountainCat. It seems that Mountaincat and his partner have left TuD entirely? As a fellow Canadian and a T2 let me say that I certainly mourn his loss. I can only hope that he deleted himself. This happens far too often on this site where T2s are baited and then removed from the site when they react in anger. It is very lonely on this site for a T2 who does not use insulin.
At the risk of being deleted myself, let me say this.... It is NOT okay to post images which mock Type 2 diabetics. It is NOT okay to continue to bait a Type 1 who comes to the defense of his T2 partner. It is NOT okay for a T1 to post stories of their weight gain and weight loss when they will never be punished through treatment options and finances for that weight gain as are all T2 Canadians are whether they have ever been overweight or not. It is especially NOT okay to continue to bait and mock with comments about weight when the poster has been absolutely clear that there are NO weight issues involved!
It seems to me that the offensive links should have been deleted long ago.
I think they would contact you re a notion of deleting you, unless you were particularly horrible in attacking someone personally. I have been friends w/ Nel for a while and don't think that she ought to be attacked for posting a link with the word "lifestyle" in it. I don't see any images mocking T2 in there either. Medical science is often dead wrong about all kinds of diabetes so any "medical link" posted may have some potential to contain things that may be interpreted as offensive.
Looking back at Nel's posts, since MC has left the building (I recall looking at it and thinking "what is going on here?" and deciding that it wasn't really worth it to get involved...but I like Nel), it looks like Nel is advocating participating in a survey with the potentia to guide future policy which seems 1) very reasonable and 2) very much in keeping with her general "activism" [ed. I look at activism as a good thing!] and participation in events, organizations and overall teambuilding activities 3) a golden opportunity for all PWD in Canada to work to flood the health organization with the idea to use low-carb strategies to improve people's health. I would think that it would be an "easy sell" to the administrators if only because, other than talking, and talk is relatively cheap, it doesn't cost much in terms of $$$ to adjust one's eating habits to a lower carb approach.
I don't see Nel as being inclined to "bait" people and I don't think there's any of that going on in this thread? I'm sad to see Mountain Cat go too but I am not sure how the community can work better than it already does to protect peoples' sensitivities to the issues to which you are referring while we are engaged with discussing our shared and diverse health issues.
AR: I don't think this is a matter of liking or not liking anyone. You spoke up to me and that's absolutely okay. MountainCat took offense to the links which have now changed somewhat. The problem began when he referred to Nel as a "diabetes advocate" and objected to the images of overweight individuals. The thread is somewhat tangled and, as responses have been deleted, it really doesn't make sense. As Nel often refers to the CDA in terms of "we", it stands to reason that some believe that they are speaking to an organization rather than an individual. As I have now been on this site for a year, I understand that Nel is an individual and yet she does represent the CDA?
When the links were posted, they didn't really add to the topic at hand. Everyone could see the storm brewing and tried to intervene. I still stand by what I have said. If the links had been removed at the time, it would probably have prevented the arguments which seem to have occurred because MountainCat referred to Nel as a "diabetes advocate".
I don't personally dislike anyone here nor do I wish to attack. I think it's time for you to add some of your humour AR.
I was like "OMG" when I saw the "My big, fat diet" headline on the one article too but then I realized that the doc/ study was talking about eating fat to get skinny which I've come to agree with. The ignorant charge of "lifestyleism" leveled by critics and health people misses the boat but us fighting amongst ourselves doesn't help. We should fight the people on the other side of the barbed wire!
GERRI & BADMOON I just came across a 2008 post by Saundra Barragan where she stated her theory of the causes of T1 and T2. I posted it as a discussion so as not to further hijack this thread. Joanne
I'll read it. Miss Saundra:(
Notwithstanding a few knotheads who are always determined to prove the wrong thing; I consider as others have here the insulting term "lifestyle" disease as ones own fault as useless, hurtful, misleading and overlooking key facts.
a) science bears as much blame for all the new refined foods, improved grains and production techniques in its quest to keep a evergrowing bulk of the world's population fed.
b) science has created all sorts of labor saving devices from cars, lap tops, video games - couch potato tools and entertainment vastly reducing the energy burn.
c) I grew up as a child when steam engines in early 50's were being used to pull trains and computers had just barely shifted from tubes to solid state. Lap tops - good luck there.
d) As a child I was never taught, led, advised about need for energy balance in human hunter gatherer system as well as watching out for not overloading body on reduced exercise and refined foods and corn starch converted to sugars by science on pennies on the ton.
To turn around and blame my lifestyle as the fault for this mess and success by science on other quarters preposterus.
Once one learns about food, how the body actualy works and why ones need to balance energy carefully and then storms ahead regardless, maybe then admonishment.
I see this more of : Your Life style sure as hades did not cause your type 2 diabetes but on the other breath, one may have to modify one's lifestyle to cope with all this modern changes and improvements in our diet, foodstuffs and exercise on an ancient body.
Excellent points, jims.
JIMS: I am originally from Toronto and my grandfather was one of the first to participate in Banting's trials. He passed in the late 60's at the grand old age of 84. His diet was low carb for sure! When, like you, I arrived on the scene in the 50's, he was allowed his first slice of bread.... cracked wheat. He was also allowed oatmeal but it was a thin,watery gruel. I never ever saw him eat more than that one slice of bread a day. He never ate rice, pasta, or potatoes and absolutely no sugar! He did not have complications.
My theory is that this gradual reintroduction of carbs into the diets for diabetics was the beginning of the end. I'm thinking that, with the advent of fast-acting insulin, it was determined that everyone could now eat carbs. They seem to have forgotten the weight issues which also seem to plague some T1s.
They also seem to have forgotten that Metformin, which works well in some to stop the liver dump, is no bolus! One cannot simply pop a metformin and eat what you like. The other T2 drugs are worse as they seem to lead to a never-ending cycle of too much of one's own insulin...liver dumps... increase the insulin...more liver dumps. The action of these pills cannot be determined by the PWD hence no carb counting and once again, no bolus.