Replies to This Discussion

Permalink Reply by BadMoonT2 on February 13, 2012 at 11:27am

Sarah, well you have received the standard criticism of low carb. Your diabetes nurse and dietician are trying to help you according to what they have been taught.

I work in IT (as does onesaint, I believe) so I can tell you my brain is still functioning just fine after 2.5 years of no more than 50g/day of carbs, believe me there would be no way to fake it, on the job, if this were not true. But the anecdotal evidence from a folks on a diabetes forum will do you no good in discussing this with your health care professionals, as you say, they view it a dangerous fad diet.

Luckily we have actual scientific evidence that they are wrong. I would highly recommend the book, already recommended by Ralph, The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable by Stephen D. Phinney and Jeff S. Volek This book is good because it is written by scientists and medical professionals who have actually published papers in peer reviewed journals, as well as having worked in the field for years. The book was actually written for medical professionals although I found it quit readable, their conclusions are supported by actual studies. Gary Taubes books are also excellent and contain copious references to studies supporting his conclusions.

Here's a link to the bloodsugar101 website that quotes studies affirming the safety of low carb. Here's a link to another study

In regards to the risks to the heart of saturated fats it seems that the deadly combination is saturated fats in the presence of high carbs and the resulting high insulin levels needed to deal with them.

This puts you in a very difficult position as I don't really think it's a good idea not to be totally honest with your health care team, I know you are about to start pump training so it will be difficult to fudge the amount of carbs you are eating. Throwing in a couple of avocados probably won't satisfy them. Your best course might be to print out some of these studies and ask them to evaluate them.

This whole thing can have a positive outcome. I discovered low carbing after the standard diabetic diet resulted in unacceptable spikes. I read the applicable studies and had no concerns about safety. As a T2 it was really easy to see this was the way to go. I had a follow up visit with my doc after diagnosis and I was really dreading it after reading about the resistance many have gotten from their health team. My doc said nothing pro or con, I really don't know what he thought, perhaps he thought I wouldn't stick to it. In subsequent visits he expressed surprise about how well I was doing. Finally on my last visit he said he had learned a lot from me. I am so grateful I didn't have to get in a big fight with him, dealing with diabetes is hard enough!

Here's a link to an excellent site by a member of tuD who is a registered dietician and CDE. Her blog is excellent and is always well researched with footnotes at the end of each post.

Finally a good place to look is in the archives of this group. Most of the issues you are facing have been discussed extensively here.

Good luck here's wishing you a smooth path forward and and awesome A1C, we're all pulling for you!

Permalink Reply by Ralph on February 13, 2012 at 5:11am

I think I have written about bad official dietary advice before on these pages but in reply to your trouble with your dietician I can only repeat that when I saw my dietician she advised the ADA type (high carb) diet etc but also said to check my blood sugar before bed and if it was 7 (126) or less to have a sandwich and glass of milk before going to sleep! Using Dr B I try to stay at 4.61 (83). If my CGMS shows 5 (90) I check with a fingerstick and if >90 take 1/2U rapid (I carry a syringe which I load up with a few units a day and take throughout the day to tweak things (if needed) rather than a pump (I have a separate syringe of human insulin to cover meals (slower insulin for low carb meals as per Dr B)). When told to check if I got to 7 (126) my wife sitting next to me felt my back stiffen and worried that there was about to be a low carb outburst but I managed not to say anything this time as the dietician was only doing what she believed was right and I have been thru this many times with her before. My wife was relieved not to have to go thru it all again!
Another time when she saw my CGMS trace (prev flatlines posted on this site before) the dietician was impressed despite herself then said "oh no, you are running at average of 4.6 (83) that's far too low, please run it around 7 - to be safe!!!" She has also in the past told me there is no way low carb is sustainable, that it will kill me, that I will miss nutrients / have no energy etc etc. It is amazingly hard to get thru to them how correct Dr B is even with the CGMS / lab tests evidence.
My doctor/endo is much happier with it. He sees me every 4 months as I think he originally felt at some stage I am not going to be able to manage to continue on such low carbs but as time has gone on he looks less surprised. He used to call me "an experiment in progress" but now says "whatever you are eating, on all your lab tests you are doing great so do carry on (see you in 4 months!)" so there are some people open to this approach or at lease accepting of it which is great.
Basically don't worry when lots of professionals (especially non diabetics) tell you low carbing is wrong - lots of people here have been doing it for years and it is a case of the lesser evil - even were low carbs bad (and I don't think they are) I am quite sure high sugars and a high HbA1c are worse so I choose to avoid that. Avoid hypos (by law of small numbers) and keep regular eye on your labs (thyroid HbA1c lipids etc) to get feedback that you are doing the right thing. (Re lipids, mine did just what Dr B said: my LDL went up for first 3 months then down and down, my triglycerides plummeted and my HDL has gone way high - great. Further reassurance when he accurately predicts what will happen versus people who tell you what to do despite this clearly immediately worsening things as shown by your meter).

Further reading might help when you get adverse messages from dieticians/professionals. If interested as well as possibly adding Gary Taubes Good fat bad fat/the diet delusion to your reading there are many others on Amazon: look up Barry Groves' books, Uve Ravnskov on cholesterol, the book "The art and Science of Low carbohydrate living" - which has plenty of medical advice to show your dietician / doctors - and lots of info on the internet if you don't want to buy/read lots of books: try http://yourlighterside.com/ for low carb recipes (one of many), Jimmy Moore's livin La Vida Low Carb for regular podcasts, Dr B podcast each month (access via http://www.diabetes-book.com/), lots of blogs (Hyperlipid, http://www.phlaunt.com/diabetes/ (you must try this site it is fantastic info) Dr Mike Eades/protein power blog (as per link recommended by Onesaint above - intersting article onesaint, thanks for that), Marksdailyapple, etc etc). There are sites advising about low carb flu (lack of salt when starting low carbing etc) so lots of advice out there.

Basically eating meat, fish and green veg, eggs and cheese, (ie low carbs), exercise (again read Dr B for advice re this) and some of the above reading to balance the unintentionally bad medical advice you might (often will!) get plus feedback from meter, CGMS (continuous glucose monitor) minute to minute plus lab results, visiting places like this site and spreading the low carb approach word is my present approach. (Many thanks to all on this site too for advice and support).Thinking back Dr B's book cost me £17 I think from Amazon - best money I ever spent or I would still be on the rollercoaster following the ADA diet. Good luck!

Permalink Reply by Sarah Emily on February 13, 2012 at 6:19pm

Well thank you so much for letting me in on this. I find it funny how most of the endo's, nurses etc don't actually have diabetes and when they tell you how to control it they (seem to) think they know much more that we (the people who have diabetes) do. Come on, I mean we have to live with diabetes everyday of our lives.. give us a little credit will you doc?? I sometimes feel like telling them they really have no idea.

And well done on such great control, I hope that I can get there soon to. My results have already improved a great deal over the past few weeks since going low carb. And if I were going low-carb as some fad diet to look good, then I don't know if I would be able to keep it up, but I think its actually very different when you are doing it to improve your quality of life. I want to be able to enjoy my life, I don't care if what I eat isn't the most exciting (plus I am actually enjoying my food alot more now, since I am not worrying about my blood sugars spiking up so high after I eat) :)

I have odered Dr B's book off amazon and can't wait to start reading aswell.

Permalink Reply by Ralph on February 15, 2012 at 4:18am

Re control: should add the description above is what i aim for rather than what necessarily happens - I often don't make it! As onesaint says there is plenty of time to adjust things slowly to find best way for yourself. As they often say YMMV (your milage may vary - i.e. we all have different responses to different approaches / diets etc). I personally find the CGMS helps me keep an eye on things (I feel lost without it) tho my friends (all medical) banter that it makes me OCD about my blood sugars (which I freely admit too!).
Interestingly have just got the first cold (man flu I mean!) I have had for several years - doubled my insulin requirements (basal levemir 5.5-6 units twice day instead of the usual 3U twice day) amazing how it does that...
Best wishes

Permalink Reply by Sarah Emily on February 15, 2012 at 12:29pm

Wow, yes. I'm guessing you are on a pump? I would love to try out a CGMS, but I don't think that is avail to me at the moment without a huge extra cost. Thats okay though because I don't mind testing frequently, but I would really love to try one out if I got the opportunity!

Damn, no good to hear about the cold! I think the extra insulin is something to do with the release of other hormones that make us less sensitive to insulin... I just did a paper on impaired body function as I am studying nursing. Hope you feel better soon!

Permalink Reply by onesaint on February 13, 2012 at 12:08pm

There is some fantastic advice above from BadMoon and Ralph (and lots of reading to come).

Don't get too overwhelmed and take it one study / book / change in D at a time. It took me about a year of studying and meeting with my local biology teacher (a T1D friend) to get a semi decent understanding of what goes on and how low carb works. So, take your time. A chronic disease takes a chronic solution.

Keep us posted and best of luck.

Permalink Reply by Sarah Emily on February 13, 2012 at 6:19pm

Cheers onesaint!!! =)

Permalink Reply by Sarah Emily on February 13, 2012 at 8:39pm

Hey im just curious: Does anyone know anything/seen any studies about the long term effects of low-carb/high-fat on health?

Permalink Reply by onesaint on February 14, 2012 at 9:46pm

This is a two year study done at Temple University. It says low carb is just as healthy as any other eating plan.

There are a few long term studies (10 years) not directly focused on low carb, but carb density and what not (like this one) that are often sited and speculated on for one side of the other (ie. carbs are bad / carbs are good).

If you pardon the source, about.com gives a simple explanation for these studies and their finding is no increase in CVD for long term low carb.

BSC and BadMoon can site studies all day long (their both volumes of information). But, I again would suggest just googling "long term low carb" and see what comes up. No doubt you'll find arguments on both sides of the fence. Only bare in mind your looking at things from a PWD perspective which adds the factor of higher A1Cs lead to CVD.

Permalink Reply by Sarah Emily on February 15, 2012 at 12:09am

Cheers onesaint! You are very helpful!

Permalink Reply by muleman on February 14, 2012 at 4:42am

Hi Sarah and Welcome. This site is made up of a lot of smart people who just happen to be diabetic! They are so up front so if they say it works for them, I know it does! Sadly for me, and for some reason I'm still not sure of my wild T2 is still wild on low carb? So one thing is sure not everyone is the same, but thank God for those who are! I wish you every success in finding a brighter future and a diet that works for you!

Permalink Reply by LAB on August 30, 2012 at 6:13pm

Sarah,

How did the Bernstein diet work for you?

Lisa Ann

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