The March 7 issue of Diabetes Daily newsletter kicks off with a great article summarizing a research review of different diets and their effects on blood sugar and other cardiovascular health indicators in people with diabetes, recently published in Diabetes Care. Very edifying!
That's an interesting article. I'd add that I don't necessarily have "fruits and vegetables" which they mention as much as vegetables?
I had seen the original article earlier and while it contains a number of ongoing issues it is a step in the right direction. At least it notes clearly that improved glycemic control is observed when you decrease carbs and it is honest that lipids usually improve on low carb. We all too often hear dieticians and nutritionists claim the total opposite.
I don't necessarily agree with the summary of the results in Diabetes Daily, and beyond that the study itself simply summarized supposedly high quality studies (randomized controlled trials) and then often cherry picks various points. The authors of the study were unable to derive any overall conclusions.
One would hope that tiis would help drive some change at the ADA, but I am pessimistic. I think it was a hugely political step for the ADA to divest themselves of the whole nutrition mess into the American Dietetic Association (now called the (wait, don't laugh) Academy of Nutrition and Dietetics). Most of the old-line went with them. And it was hard for the ADA to admit that low carb worked for weight loss and they still don't suggest that low carb is an appropriate choice for glycemic management. But there are still people like Hope Warshaw who will never understand or accept the evidence that keeps the ADA in the dark ages.
I thought the article was a sell-out, really.
Every T2 diabetic on earth should know that carbs are what spike our blood glucose and that carbs need to be handled with as much care as a munitions expert shows when handling a bomb they're defusing.
The T2 people who can handle a higher-carb diet are doing one of three things:
-- squeaking by in the very early stages; or
-- exercising at a unusually vigorous pace for an unusually long duration several times per week (perhaps every day); or
-- eating a very restricted total number of calories (which masks the fact that they're eating "low carb" by default due to the restricted total calories.)
There isn't a full-blown T2 diabetic on earth who can lead a moderate-exercise lifestyle, eat a normal amount of daily calories for their height and weight, and eat a high percentage of calories from carbs (55% to 65%) without spiking several times per day, doing permanent damage to themselves -- damage that will become quite apparent in a few short years.
Most of them are also not testing their blood glucose often enough to realize how high and how frequently they're spiking -- because their doctors and insurance gate-keepers tell them that they shouldn't test "too much".
So they progress along, spiking to 175, then 190, then 225, then 275+ after meals -- for years -- doing permanent damage to their eyes, their nerves, their heart, their kidneys, their tendons and joints, until eventually they hit a brick wall and all the pills on earth can't hide the fact that they NEED insulin. Now. Then they're allowed to wallow around for a while longer on Lantus -- still spiking after meals, but perhaps not quite as much. Eventually they'll need short-acing insulin, too. It's a progressive disease and complications are progressing right along with the highs.
It's sickening, really, that the ADA doesn't have the courage to say to the medical community, "STOP. You're doing permanent damage to T2 diabetics with your enabling, misinformation, patronizing and lies."
I'm happy because as a type 1 people have an awful lot of opinions about what I should or shouldn't be eating.
"In the end, the diet that’s best is the one that works for you." I'll take that, keep counting carbs and just be done with all of this meddling. Thanks for sharing the link.
I think that part of the problem with analyzing diet and diabetes from our perspectives may be that doctors want patients to have "A" diet and don't really care what it is? The doctor wants to "know" (LMAO...) what the patient is eating because they assume that we are eating what we report to them, despite the acknowledged challenges of the LOATHESOME task of logging one's food. The doc asks "are you eating ok?" and the patient goes "uh huh" and the doc checks that off and moves onto the next thing. If you want to talk about food, well, off to the dietitian with you. Of course, if you report "I ate 2x jelly donuts and took 15U of Novolog and still crashed out?" the dietitian's answer is "don't eat jelly donuts" rather than getting to the real problem, which is balancing jelly donuts and insulin. Which can be done but requires a scientific approach. I had really good donut experiences on a vacation to Cape Cod a couple of summers ago but we were biking and marching around Provincetown and other relatively active things and the "fuel" worked. Although I prefer chocolate glazed to jelly donuts.
Well...not every diabetic has your cast-iron constitution, either.
I have done my fair share (!) of trying to use insulin to cover everything from tubs of ice cream to mountains of pasta. But I wouldn't expect a national diabetes organization to recommend that behavior as a healthy way of life?
A "national diabetes organization" talks to everyone, and not everyone can manage and solve the issues with balancing food, insulin and exercise.
It's easier and safer to say "do this, not that".
But as empowered patients, it's up to us to know ourself and tune the many parameters of diabetes on our ones.
I would like a "national diabetes organization" could at least inform that there are tips and ways to improve your quality of life, according to your specific diabetes and habits.
Inform, not rule, but I understand not everyone is able to customize the management of his own diabetes.
It is quite an interesting array of responses that people have posted to this article, and how easily the last sentence dissatisfied some of the group here.
I've managed Type 1 for 36years & I would never want someone to tell me what to do without giving me choices. I'm really not sure that "easier" is ever the simple answer to what anyone should do as it relates to what we eat...look at the result of our Fast Food Nation.
Health is a life long investment, whether a chronic condition is present or not. All research can do is offer information, not choices for THE best way to manage one's health. That narrow approach ignores the uniqueness of each person's biochemistry, and how each person responds to stress or food, or alcohol, or sleep, or lack of exercise.
It's ironic that some people say they just want to know what to do. But the body must be listened to, even when medications are in place. Drugs are not the answer, yet we've become so reliant on them, and have given all of our power to Drs, pharmaceuticals and this is about THEM making money while we remain unhealthy.
As an adult, part of one's responsibility is self-care. If you delegate it to someone else, you leave yourself at their mercy & quickly become the victim of "what's being done to you" instead of what you choose to do for yourself. Do you REALLY, honestly NEED someone to tell you how to eat a balanced meal? Or eat healthy foods? How to manage medications is a different horse, and sadly, there just are ZERO answers that work for EVERY single BODY. The drug companies KNOW this, just as the ADA KNOWS this, just as each individual KNOWS this.
In a perfect world, every body would be perfectly healthy. I suspect that some form of illness (disease) has plagued life since its inception. Medicine women or shamans were a vital part of clan life long ago, and even with their wisdom of plants & roots, nuts & berries they could not save every single person from every single thing.
Doing the best that we can with what we have means we must learn, and keep learning what works for us in OUR own body. "...not everyone is able to customize the management of his own diabetes." How true is that, really? Customizing's a choice we can make for ourselves. Or not. Doctors DO NOT know everything ~ they never did. We allowed ourselves to believe that they do.
There's no "like" button. I LIKE this comment, LaGuitariste.
I agree the article is a sell-out. Defending the ADA as not having an "official diet"--oh, please. Every day, PWD are instructed on what to eat by healthcare professionals schooled in the same approach. Tremendous gate-keeping & pressure to conform within the professional community. A dear friend is a dietian. A colleague was harassed & threatened with revocation of her license over a referenced article (not in a professional journal)that advised the use of butter over margarine. Imagine losing a license because she had the nerve to say margarine isn't healthy.
We're not given options or have alternatives presented. Everyone is different, eat what works for you. What a cop out.
The ADA isn't going to say anything to the medical community. They're proponents of higher than healthy A1c's. Under pressure, they revise this a bit over the years.