My Sad, but Funny, History With Carbs


In one chapter of my book (published in March, 2010) I recalled several things from the history of diabetes. One paragraph from that chapter is given here:

"There were two schools of thought in the 17'th century. One theory proposed replacing the sugar lost in the urine by following a diet high in carbohydrates. The second school believed that carbohydrates should be restricted to reduce excess sugar. Eureka!!! That may have been the first time excessive carbohydrates was considered to be detrimental to diabetics. The first theory seemed to be much more popular, and the idea of restricting carbohydrates seems to have been lost for the next few centuries. I say that because treatments being proposed in the late 1800's included bleeding, blistering and doping, with no further reference to restriction of carbohydrates. What a shame!!! If the second school of thought had become the popular one, that may have accelerated the advancements in the years that followed."

In 1945, the year of my diagnosis, carbohydrates were never mentioned. I did not know about the effect of carbohydrates until the late 1980's. That was about 300 years after the initial proposal that carbohydrates should be limited in a diabetic's diet.

Why was the initial theory ignored for so long? I used to think about that a lot, and it made me angry!

There are many things that my doctors never told me and one of them was that I should follow a low carb diet. I found that tidbit in a magazine. My doctor assumed I already knew that, but I didn't. I am so fortunate to have avoided complications for more than 40 years while eating hundreds of carbs every day. I avoided sugar, but ate many, many carbs. Avoiding sugar was the only advice I was given for so many years.

In modern times, with all the technology that is now available, and all that is known about proper diabetes care, it is much easier to avoid complications. My attitude about my diabetes and the mishaps that happen, has changed. I can now laugh at things that used to make me mad. A sense of humor has totally replaced my former bitterness. That sense of humor has helped me so many times, in so many ways. I can now laugh about the carbs I should not have eaten, and I can laugh about the things I should have been told. Laughter is the best medicine I know!


Views: 107

Comment by Tim on July 30, 2010 at 5:21am
I was diagnosed in the very early 80's and after a stretch of just doing urine testing and the ADA exchange diet, I got hooked up with the pediatric endos at the state research hospital and they turned me on to home bg testing and carb counting. Then 4-5 years after that I went away to college and figured out MDI on my own. That's really the first time I felt I had any real control of my bg's.

My opinion, today 30 years later, is that carbs are obviously very important but I have been finding that "simple" carb counting misses out on a lot of fundamental things. Non-carboydrate foods have fundamental effects on my bg's that are not accounted for by the simplistic "carbs are the only things that affect bg's" selling of carb-counting that has become increasingly popular in recent years especially the obsession with "spiking" after meals.

The ADA exchange diet includes carb counting (after all, that's what the starch exchanges are, they are exactly translatable to grams of carbs) even if you were never told about it. But it also allows a reasonable way of thinking about fats and proteins, and how they not only modify the absorption of carbs, but also turn into carbs hours after the meal through gluconeogenesis. Everything old is new again, maybe!
Comment by Doris D on July 30, 2010 at 7:42pm
You know I never knew about the carbs for MANY years. The Drs always told me to count my calories. Weird huh?
Comment by Richard157 on July 31, 2010 at 11:42am
Tim and Doris, those are interesting replies. thanks!
Comment by Anthony Holko on August 2, 2010 at 12:40am
Winning washes away all sin.
Comment by Jag1 on August 3, 2010 at 9:46am
I don't think your history is correct. In fact it was well known prior to the discovery of insulin that excluding sugar and other carbs could sometimes keep T1's alive longer than a normal diet. But it was a miserable existance and didn't last long (a few years at best). Here a sample reference from the Nobel prize web site: CLICK HERE : "Doctors knew that sugar worsened the condition of diabetic patients and that the most effective treatment was to put the patients on very strict diets where sugar intake was kept to a minimum. At best, this treatment could buy patients a few extra years, but it never saved them."

When I was diagnosed in the 70's I was told about carbohydrate (not just sugar) and its effect on my BG. This was in the days of one injection of NPH a day, and I was told to limit the amount of carb at each meal to keep my BG from going high after the meal. I wasn't told to strictly limit carbs to the miniscule amounts that Bernstein does, but I was certainly informed about controlling the amount of carbs that I ate.
Comment by Mike Ratrie on August 3, 2010 at 11:49am
Richard,

When I was diagnosed in 1973, I remember my internist making sure we got the ADA booklets that described the (dreaded) exchange diet, but he promoted counting calories by measuring carb, protein and fat grams and then multiplying by 4, 4, and 9 respectively. Oh, and NO SUGAR - EVER!

My mother had this huge notebook where she recorded all the data from a variety of meals. My doctor had me on 4,000 calories/day. I can remember eating two large bowls of puffed rice cereal for breakfast and then eating a small, disgusting organic peanut butter sandwich @ 10AM. Most of the rest is lost in the recesses of my mind.

Thanks for getting me to drag up those memories, I think(?)

Fair Winds,
Mike
Comment by Richard157 on August 3, 2010 at 2:27pm
Jag, I posted that in the 17'th century, researchers had found that a low carb diet would help diabetics. Despite that fact, I did not know that I should eat low carb until 1988. No doctor ever told me. You are lucky that you found out in 1973. I wish I had know then.
Comment by Jag1 on August 4, 2010 at 11:52am
You also said this: "treatments being proposed in the late 1800's included bleeding, blistering and doping, with no further reference to restriction of carbohydrates. What a shame!!". That is what I was responding to about being historically inaccurate. A type 1 in the late 1800's would die since they didn't have any insulin production, regardless of how much carb they ate. But it was known in the late 1800's that eating very low or no carb would prolong the life of a Type 1 by possibly a few years (as shown in my citation) and my understanding is that this was the standard treatment in that day.

Unlike Mike, I wasn't told to eat low carb as much as I was told to eat the amount of carb that would keep my BG from going low or high to match my one injection a day. Back then the amount of insulin you took was very easy to manage (since it was always exactly the same as the day before), but you were always eating to your injection - very frustrating if you were hungry when your BG was high or visa versa. I assume you remember those days better than I since you've had a few more years of them.

As I recall it wasn't until MDI became the standard approach that this advice was modified to allow ever greater amounts of carb - on the belief that they could be balanced by injecting the correct amount of fast-acting insulin. I've never had a doctor recommend low-carb (ala Bernstein) to me - but he has always been out of the mainstream.
Comment by Jag1 on August 4, 2010 at 12:13pm
Yikes, sorry I missed that you were diagnosed in 1945. Then you have a *lot* more than a few years with NPH than I do (diagnosed in 1975). Was one injection a day of NPH the standard treatment in 1945 - or was that before the invention of (relatively) long-acting insulins?
Comment by Richard157 on August 4, 2010 at 12:26pm
Jag, I was on one injection per day at diagnosis in 1945. It was that way until the 1990s when I used the N and R insulins.

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