I've been reading a lot of the threads here and see a lot about a low carb diet. However, I have a question or series of questions. First let me start out on this premise: Let's say I am a type 1 diabetic (how about that, I am!) and I know my I:C ratio is 1:20 as an example. As long as I give myself proper insulin for the carbs I don't have a problem with my BG being out of control after meals regardless of whether I have 200 carbs a meal or 60. In this type of situation, what is the benefit to me as a diabetic, not just general health benefits anyone could get, from being on a low-carb diet? In essence, I'm doing what my pancreas would normally do and dose for the meal (although my pancreas was much more efficient and precise of course).
If this is a hot-button issue here then forgive me, I don't intend to open up a can of worms. My books from Dr. Bernstein and 'Think Like a Pancreas' are still on their way, so maybe they will answer this question. I've just seen a few people here who seem to feel very guilty that they were still "living like they didn't have diabetes and dosing for the meal." If you're BG's are in check and your otherwise healthy and doing okay, why is this a problem? Again, we're discounting the benefits anyone could get, and focusing on why it's beneficial specifically for diabetics.
NOTE: I DO count my carbs religiously (I don't see how that could be optional as a T1) and try, in general, to eat fewer than I did before I was diagnosed. Also, the ratios and scenario above do not fit me, they are just setting the stage for the discussion.
Totally agree Zoe. I've said it so many times you must be nauseous LOL I don't think either is really as worthwhile without the other.
I don't low-carb, though I've been trying (without much success) to reduce them a bit. The reason is this: post-prandial highs. At my last endo appointment, he told me that those PPD high blood sugars are what makes my A1C higher than I'd like. If I could smooth, or even eliminate, that spike, I'd be better overall.
As for the weight issue, I could actually afford to PUT ON a few pounds! I'm not quite sure how to go about doing that. Fatty, unhealthy stuff doesn't seem quite right, nor does a low-carb diet.
Scott, post-prandial highs were what made me decide to go on insulin. My BG would go up after a meal and just hang out there for hours. If I ate while my BG was high, it just went higher and then stayed up there, instead. Waiting around for my BG to come back down was really interfering in the rest of my life and I felt powerless in general because the spikes were happening despite eating less than 6g of carb for breakfast and 12g for lunch and dinner. My endo put me on bolus insulin only, reasoning that my overall BG level would come down on its own if I could avoid spiking it. I've been on Humalog for three months now and I'm doing really, really well. My fasting BG is around 4.6 mmol/L (83 mg/ml) every morning. I only use Humalog for meals and corrections and I'm finding that I don't need to correct very often at all these days. This may change in time, but right now it's working very well for me and I feel good! Of course, YMMV, but you might talk to your doctor about it if you're interested.
I have read this discussion with interest, because I low carb, sort of. I try to watch my carbs by not intentionally eating carbed foods, and snacking on protein rich foods, such as nuts and meat. I have virtually eliminated breads and starches. What it has done for me is eliminated the need for high doses of insulin at meal time, and increased energy levels and endurance. I have seen a dramatic improvement in my A1-c as well.
I don't know that it's really possible to define with one number. I eat around 30 carbs a day (works for me), but I think that's the lower end of the low carb scale. I found this from a study (not about D)
... in 1973, the average daily carbohydrate consumption in America was 400 grams. Nearly three decades later, the average carbs consumed each day jumped to 500 grams. (here).
So, if 500 (!) is average where do we start saying carb consumption is low?
I hear what you're saying about it being cultish; I think that's because Bernstein's 'number' is 30 carbs. So if someone is 'doing' Bernstein, 30 carbs=low carb. Personally though, I think that's just (as I said above) the bottom of the low carb scale. I just don't know that there's a rule for what the top end is.
Based on 500 carbs being the average American carb consumption per day, there's lots of wiggle room for what I'd call low. I guess IRL it's anything significantly lower than what one ate before 'going LC'? Individual, as is everything with D.
In regards to the issue of what constitutes low carb I am influence a lot by Dr. Steve Phinney. He says that your metabolism changes when you go below 70 grams in that fat becomes your body's preferred fuel. He terms this state being ketoadapted. Here's a link to a discussion at the Bernstein group that has links to a couple of interviews with Phinney. He is a published scientist so his concepts carry extra weight with me.
I'm somewhat puzzled that you think of the low carbers around here as cultish. I guess it's because Bernstein's name comes up so often when folks ask for advice about how to improve their numbers. I seldom fail to mention his book when a new T2 asks for advice, so I guess I'm guilty as charged. I have also noticed that many who have been influenced by his ideas, including myself, do not adhere slavishly to the 30 gram rule. The concept that carbs are the problem and restriction is the solution is the key concept IMHO. Since this runs counter to the advice most have been given by the ADA or their health care professionals, perhaps this does make us a cult in the eyes of some.
The first time I remember interacting with you, acidrock, was in an epic flame war concerning low carb. We were on different sides and it got ugly. I think the culture here at tuD has evolved considerably since then, most post's seem to be along the lines of, this is what works for me in case you find it useful, not my way is the only way. Respect for each others choices is the most important value. Since our individual carb consumption is at the heart of what we do to deal with our condition, of course an individuals choice along these lines be it 30 or 300 needs to be included in many posts, to put them in context. I must admit I don't understand when someone feels threatened by the fact that a person is consuming 30 grams/day and is happy with their control. This is useful information and readers are free to make use of it or not.
Agreed. Your assertions at the end there make sense. There's no reason to feel threatened by someone on either end of the spectrum.
The info you provided by Dr. Phinney is good information to have. The fact that my body may change at <70 carbs/day to use fat instead is an incentive to me. Might clear up those "problem" areas, but then I wonder where I'd inject! What seems key here is that people are presented with the information, or sources to get the information they need to make a decision about what will best the them manage their diabetes. Yes, we all have the same condition, but it's also unique to each of us. Kinda like cars on the highway traveling north. Sure, they're all going north, but some are going faster, and there's a myriad of different cars on the road.
Plus a couple in the ditch.
It's always useful to remember that we've all spent time in the ditch:)