Is a low-carb diet a must?


#61

I am not on a pump and I don’t do MDI. I live off my one shot in the morning. I wait for my bg to drop down to 70. Then I eat enough to make it go up to 130. Then I wait for my bg to drop to down to 70. Then I eat enough to make it go up to 130. This goes on for a while. Typically after lunch my bg does not drop down to 70 anymore. This means that I am done with eating for the day. In other words, I am a diabetic only between breakfast and lunch. After lunch I start being a normal person and I don’t have to worry much about my diabetes.


#62

Give me some idea? 25g, 50g, 100g? You have such good control. I used to eat breakfast at a bagel store and always ate half a bagel and took the other half to go. I am itching to eat the whole thing. Tell me how I can do that while maintaining a good A1C.


#63

Sorry. I’ve been under a 5.0 a1c for several years now, and I eat as many carbs as I like. (I’ve sometiems gone through periods where I at A LOT of carbs.) Now, I’m not saying this is healthy (it definitely isn’t); I’m just saying you can eat a lot of carbs and still have a low a1c. Numbers: For a while, when I was getting a 4.5 a1c, I was eating about 300 carbs a day. Actually, maybe more (I’d get low and need to correct.)


#64

I was wrong when saying that low carb meals are a must to achieve low A1Cs. I was mislead by my own inability to achieve just that.


#65

Anna,

You’ve mentioned on several discussions taking huge amounts of insulin because of your fear of highs, having 100’s of seizures from lows (having lows in the single digits), being treated by paramedics for these lows, passing out in your tub & passing out on the street & breaking a bone from lows. I recall members being concerned about you over-doing doses.

Think you’re sending the wrong message here about eating as many carbs as you like & having a great A1c, if your A1c is the result of severe lows & taking large doses.


#66

Gerri …my humble observation , because I so agree with your observation …A1C is a number …how you arrive at it is another story …quality of life , living with diabetes is /should be important AND one can still eat carbs if the quotation " daily exercise " gets added .
There are also horror stories out there , due to LOWS ( an possibly a great A1C result ) .


#67

Nel,

Agree with you 100%. We get too focused on A1c numbers. Someone who’se BG is level is in much better shape than high/low swings which average out to a “good” A1c. I detest having lows!


#68

Yeah - I’m the same as you Gerri - I hate lows - so luckily for me - it’s a rarity - as I try to stay on an even keel with my blood sugars - but sometimes they go up when I’ve eaten a wee too much and not taken the right meds to cover it - but hey - who is perfect? Sometimes that slice of cake has my name engraved on it - and I dive into it head first!

Janet - On the subject here tho’ about attaining good A1C’s thru’ eating low carb diet - I don’t eat low carb. I try to average about 30-40g of carbs per main meal - and snacks vary from about 10-20g of carbs. I’ve been doing some research on low carb - as I have a friend who swears by it (she has a A1C of 5.1%) - it sounds expensive to me - as she has to buy low carb bread - something I can’t afford - or want to eat (I make my own bread). According to Atkins diet (I just got a cook book from the library this week) - it looks like a low carb diet is 50g of net carbs (they take away fibre) per day - but I am scratching my head at that trying to figure out how the heck a person does that - so maybe I’m misreading things.

Since going on to the pump from MDI - I’ve gone from an A1C of 7.0% to 5.7% - but during the process of being on the pump - I’ve gained weight - ugh - so while it’s nice to have lower A1C - don’t like the weight issue - as I’m not very tall (5’4"). I think because I didn’t have as tight control of my BG’s before - that the roller coaster ride I was on - made me burn off fat when I was high (there’s some sort of medical word for that - but can’t recall what it’s called).

Anna from Montreal http://www.diabetes1.org/blogs/Annas_Blog


#69

Wow Anna, that’s some excellent improvement since pumping!

Not preaching or trying to convince anyone, but I eat 30-40 carbs per day & it’s possible. I’m a shorty, too. Doesn’t have to be expensive. I don’t buy low carb packaged foods because they’re too expensive, full of chemicals & don’t taste good.


#70

I share the opinion that low A1C does not equal good bg control. Focusing on A1C is so tempting because A1C is easy to measure and easy to compare. None of my doctors ever asked to download data from my glucose meter. The most intrusive question that I was ever asked was “How often do you measure?”. My A1C is considered good enough and all questions stop there. A download of my glucose meter would have easily revealed that my bg variance was not all that great. Now I am lucky enough to have all the data that I could possibly want through my CGM. I have to have some goal, some number to keep me straight. I chose to switch from A1C to % of time spent within 71-130. I am trying to get this number as close to 100% as possible. The incentive to ‘improve’ my A1C through lows is gone and this might have a negative effect on my A1C. But A1C is no longer my number one priority. Keeping carbs per meal low definitely helps me with my new goal. I am not a low carb food eater. For me low carb equals portion control.


#71

I’m not sure how I could feed V enough if he went low carb… He typically has about 130 carbs for breakfast (cereal, fruit, toast, juice), 70 for lunch (sandwich, fruit, yogurt) and 45 for dinner (pasta, grains, or potatoes, wine) Unless we eat out (rare) his control is pretty good, except for occasional, unexplained lows (40 - 50) an hour after breakfast.

I keep reading that low carb is good…

Then I read that carbs are necessary for overall health…

Isn’t just a balanced diet of healthy, natural foods the best? No processed stuff, minimum pre-prepared and no excesses?

Or am I just trying too hard to not change our lifestyle - we both love to cook and eat…

Of course, there is always the exception… He hauled four loads of firewood the other day and got to eat two fruit and nut cereal bars just to stay around 80… He thinks that should be his new job…


#72

I hope that some day control of bg variance as you do is part of the clinical standard, not just A1C. As many friends here have pointed out, way too many dangerous lows occur (and highs) when A1C is the only target. Of course, it’s much easier to gather the kind of data you’ve amassed when a CGM is available.

The question on whether low carb, moderate carb, high carb is better has some relation to the type of diabetes. With type 1, the dietary concerns are less to do with insulin resistance (although type 1s can have IR). With type 2, battling insulin resistance and high blood glucose are (nearly) always part of the problem.

One problem dietitians often have with low carb eating (considered under 140 grams a day) is that people compensate with too much saturated fat (some people; others are more versed in good nutrition and seek healthy proteins/fats such as tofu and nuts instead of red meat). Too much saturated fat is associated with heart disease risk and may actually worsen insulin resistance.

When it comes to weight loss, the message is pretty clear: calorie (of any sort) reduction. For some, low carb works, for others low fat. But, overall, it’s fewer calories (through intake or by burning them off, but reducing intake seems to have the edge).

I think Helmuts statement is a very sensible approach: “I am not a low carb food eater. For me low carb equals portion control.” But, as always with D, your mileage may vary. Thanks for the interesting discussion, y’all!


#73

Thanks for sharing. This is pretty important info to know to be able to assess your comments and try to apply any takeaways to my own regime.

Yours is quite an unusual system and unlikely to work for a type 1 who makes no insulin and wants to eat 3 meals a day and no snacks (me).


#74

Well-said, Nel!


#75

Hi Katie, Low carb is one method, medium carb, 100 to 130 gm per day, works for me with oral meds. No, carbs do not appear to be an absolute requirement but they sure help to add variety. I do tend to agree balanced is the correct way, just I am not sure defining balanced as an absolute is possible. I also tend to agree that the foods closer to how nature made them is the better option.


#76

Swings in blood glucose (glucose variability) are believed to cause complications. It is very important to try to lower post-prandial spikes. However, if you are using a so-called “rapid” insulin, such as Novolog or Humalog, and it takes 4.5 to 5 hours to leave your system, as it does for my niece (for a lot of people it takes 3 hours), you have a problem. Your blood sugars may look something like this: 250 @ hour 1; 200 @ hour 2; 150 @ hour 3; 127 @ hour 4 and 100 at hour 5. (Not reading off the numbers exactly, just guestimating). Alternative is, aside from prebolusing, to give more insulin than needed for the food, then when blood sugar gets to 130, check insulin on board and cover that before you drop. The insulin is largely to blame and perhaps Apidra will help. An A1c of 6 or below is great, providing you do not have too many lows. Lows skew the results. If you bolus to cover ANY number of carbs (a high carb load), the insulin needed to cover it will not use the same ICR as one for a lower carb meal. Seven units of insulin is a lot stronger than four units. And insulin simply does not match a lot of foods very well. Can easily be seen on the cgms. Can go low, then high. Can go high, then low. Or any variation thereof. Glycemic index notwithstanding. We are always “feeding the insulin” around this house and that is insane giving that it is so-called “rapid acting” insulin. Add to that certain foods need more insulin to cover them. Other foods need a lot less to cover them. ICR is just a baseline. Every time you eat carbs you have to watch until the insulin is gone from your system. This does not mean you have to go low carb to have good control. But if you want to, you can. I like the way the Minimed Rep we met soon after my niece’s diagnosis handled it. Lower carbish breakfast, lower carbish lunch. For dinner, he ate everything he wanted, including desert. He would then only have the one spike per day.


#77

A hand clap to you, Dear Kelly, for writing it!!!

God Bless,
Brunetta


#78

Dear Rainbowgoddess.

Good for you if you do not have a great amount of insulin resistance then you can eat more carbs.


#79

Dear Gerri.

In my case of 1 if I ate as much as Anna I would need 200 300 units per day and would be so hungry that I would end up weighting 500 lb or death whichever came first.

Dear Helmut

Same here.


#80

A1c is the only number my Endo looks at. I tried to show him a histogram which was a niece normal curve, he was not interested and he is our cities best.