Terry, I agree that the carb discussions have been constructive. I know I'm not nearly as combative in these threads as I once was and I think that's true for a lot of us.
LOL. What a marvelous analogy.
Yes, we really do share more than we differ. Glad to hear that you don't feel as polarized. I don't.
I found The Art and Science of Low Carbohydrate Living as a free e-book and also free kindle software to read it.
The problem seems to be that many PWDs don't understand the difference between ketosis and ketoacidosis. Ketosis is something anyone, including non-diabetics, who isn't getting much in the way of carbs experiences. DKA is something that only T1s and very few T2s experience, and it is, indeed an emergency. And it's due to not enough insulin, rather than not consuming carbs. But the medical establishment doesn't usually bother to make that distinction to people, and so they don't know.
It's amazing that the body can restore that much kidney function given a more "normal" BG environment. I seem to remember the DCCT findings that showed some diabetic complications could be arrested and in some cases reversed with better BG control. I'm hoping for similar results with my autonomic neuropathy/gastroparesis. Good for you, Baby Tee.
So true, Natalie. The confusion between those two terms is disconcertingly common. And worrisome, since one is a genuine emergency and the other isn't.
The body's ability to repair itself given half a chance is nothing short of amazing, sometimes.
Life is better in the 50-75 Cho grams per day for me as far as control.
I would like to see Gary's proof that protein is used for energy. My research suggests that protein is used as an energy source only as a last resort and that endurance athletes or starving folks are the only ones able to trigger the body's ability to process protein for energy. And then, only when their carb and fat resources are depleted.
My feeling on carb intake is that everyone needs some carbs. The argument seems to revolve on how many. I tend to subscribe to Dr. Fuhrman'sapproach. A high nutrient, low refined carb Calorie diet just makes a lot of sense to me. That approach is also supported by proponents of the "paleo diet" which has been found to be beneficial to just about anyone who wants to restore or maintain optimal health. I think most people today take in way too many carbs, but I'm not sure where we should draw the line. 100 grams seems a bit too low for someone as active as me. I think that if more people were aware of their Calorie expenditure, they would be able to fine tune their intake requirements more effectively.
As I’ve written elsewhere on this board, I believe that we, as people with diabetes, have an intolerance for carbohydrates. Each of us has an individual carb sensitivity threshold, beyond which we board the glucose roller coaster.
David Eddy, it appears that your carb threshold is similar to mine. I limit my daily carbs to about 50 grams. My BG average is about 110, my SD about 30, and my last A1c is 5.9%. This framework of understanding the role of carbs in my life has enabled many sustained metabolic benefits. While your diabetes may vary from mine, I think we share more than we differ. We are all carb intolerant!
I used to use a minimal carb diet when on Lantus+Humalin; as you say any carbs were a potential disaster area, avoiding *all* carbs was the only way to make MDI work. The only way I could do this was because my wife, who does the food preparation, decided it was a good idea and rigorously followed that protocol when preparing food.
About +1 year ago, however, I moved to the Omnipod pump and *everything* changed. Now I can bolus small amounts of insulin (0.05IU increments) at any time and I can eat carbs without my BS going through the roof.
Of course I still can't eat the standard staples (wheat, rice, potatoes) in any significant amount because even Humalin delivered through the Omnipod can't keep up unless those carbs are diluted in some way, but I can (just about) deal with maybe 90g total carbohydrate at one meal (this is not typical, it is an upper limit.)
I do count protein as well as carb, but very approximately - if there is a lot of protein I do an extended (2 hour) bolus for it.
I can also eat in restaurants - I might do a pre-emptive bolus (only if I know the restaurant really well) but mainly I do incremental boluses at each dish. That's what I did on MDI too, but it didn't work - there's too much of an unpredictable delay with MDI, with the Omnipod I know the delay is consistent (after a few hours of a new pod.)
I believe you are correct about the BS high problem, but that's a feature of MDI which is simply too imprecise to work with modern short-acting insulin. Pumps fix that problem, but without a pump I don't see how it can work.
John Bowler
Sigh... rarely agreed with Gary, blatantly has some definite bias in some tangible areas.
If your approach is working ignore him.
Terry, I am curious is 50g daily low enough to put your body into ketogenic state?
The art and science of Low Carbohydrate Living says that only 25% of diabetics are carb tolerant. These are the ones that tell me to eat carbs, shoot up and be happy. Unfortunately, it doesn't work for me, with or without a pump.
Dr Bernstein didn't pick 30g of carbs per day out of thin air. I did daily tests with the Abbott Precision Xtra Glucometer and found it quite difficult to stay ketogenic. I think that he is correct with his 30g limit. I have seen ketones as high as 2.8 mmol (red zone) but with a completely normal BG.
Like everything with this disease, we have to find what works for us. Read, educate, experiment, refine. If somebody thinks they can show me how to eat carbs without my BG shooting through the roof, I will pay for their airfare and hotel to fly out here and show me how. That includes Gary S.
Fine, but make the payment contingent on results.
I forgot that.
I don't know for certain. I did run some blood ketone tests at home with a fingerstick meter. The results usually fell in the middle range, 0.6-1.5 mmol/L for beta-hydroxybutyrate, one of the blood ketones. This suggests ketosis but I don't have access to enough strips to monitor regularly.
I do know that I lost significant weight in the first few months of this level of carb consumption. My weight, however, has held steady for the last year.
Seems likely but I see how you can't be certain. For sure your energy source is more fats than carbs. As long as you maintain weight and feel good, it doesn't really matter!
Yes, they are doing it based on some sort of calculation. The problem is that it's a textbook one size fits all approach. But that doesn't work. Different people, no matter what their type, have varying degrees of carb tolerance. If you are very insulin sensitive, then you may well have a great carb tolerance, but not always and not everyone. Being athletic, and spending a lot of time on that bike (I love your picture) can certainly improve your carb uptake as well. But not everyone can do that. So I figure everyone should do what works for them. But accurate carb counting, and dosing is surely a fundamental skill that everyone can work on, regardless of how many carbs they're taking in.