Low Carb vs Not Low Carb - let's stop the vitriol

Everyone’s body is different and we can all learn from one another. I went low-carb for a few months and the results were very mixed. My blood sugars were certainly better, but I started to feel sick to my stomach and didn’t want to live like that on a daily basis. So I have settled on a moderately low-carb diet on most days.

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For several years I’ve been of the opinion that the carb debate here at tudiabetes equals the still ongoing debate about abortion or not in vitriol, emotions, and aggressiveness. Personally I have had very good experiences combining low GI carbs and regular after meal walking, but whenever I have brought that up I end up getting flamed by the low or no carb gurus at this site. So I stopped bringing it up, and they have succeeded in flaming me out of the nutrition debate.

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I was just diagnosed on Thanksgiving Day.I was already upset about being in the hospital (thanks to massive DVT) when it was noted that I was running high sugars in the mornings. Of course an A1C was done and found to be 9.6. Endocrine was consulted and when they walked into the room, their first comment was that I looked like Cushing. I am asthmatic so they assumed I was taking steroids.

I must interject here that I had been an ICU nurse for 20 years a knew well the negatives associated with long term steroids and had rejected using them in favor of breathing exercises and albuterol. I actually knew I had adrenal disease. It had been diagnosed since 2001. But the catch is the wrong or rather the complete diagnoses was not made. Long story short, my endo doctors never looked at the actual C-T so missed the nodule that is most likely pumping out tons of steroids literally killing the beta cells of my pancreas. Just once, I wish doctors would listen to me when I say something is wrong.

Back to diabetes. I am so surprised buy what I didn’t know. And admittedly I am still going through the stages of grief. Anger is really holding on. But I know that everyone with a chronic disease has two choices. They can control the disease or the disease controls them.

In the American culture, food defines us. There is not a single celebration that food is not the centerpiece. When one is told that they have a disease that by its nature makes one feel like an outsider, or worse punished, it is easy to allow the disease to control you. When I say that, to me, for the disease to be in control, the individual will suffer the consequences of its progression, blindness, heart disease, vascular disease necessitating amputations, renal disease and the horrors of dialysis

For one to control the disease none of the adverse complications spoil your health but one must also enjoy life to the fullest and that means feeling in control. So people gain that feeling by counting every gram that enters their mouth whether it be fat, protein or carb. Some limit their carbs because for them it demonstrates control over the portion of our diet responsible for increasing blood sugar levels. Some make minimal adjustments to the diet but control their glucose with insulin.

I guess the point I am making is that Diabetes is like Christianity. One basic doctrine - a belief in the Christ - but many churches.

What is my strategy, well, I can only afford to eat one meal a day as eating three times a day would require me to use more insulin. I am on disability and I have no idea how I am going to afford my insulin when I fall into the hole in February. I also refuse to give up potatoes, macaroni and cheese or rice. After all I am from Texas and rice is a major crop. I have found that Humalog does not begin working for at least an hour after taking and since my meal contains foods with a high glycemic index, I don’t start eating until my finger stick BG is around 100. I do eat protein and fat first and save the carbs for dessert. For me it works. I am keeping my sugars less than 130 with no bounces, I don’t feel punished. In fact, I feel in control. I did not get there overnight. I was sent home on 20 of Lantus and 8 of Humalog before meals. I have been home 26 days. I have increased my Lantus to 40 units and will most likely go up an additional 5 units on Monday and I have discovered that I require 1 unit of Humalog for every two carbs. So if I eat the suggested carb ratio of the 1800 ADA diet I would require over 2,000 units of Humalog a month.

How does anyone afford insulin. I am caught where I make just enough that I get no assistance, but not enough to live given the cost of meds.

Well, that’s my story and I’m sticking to it. I have no family and friends live quite a distance away. So, I am hoping to find support on this site as well as the experience of those who have lived with this disease and found acceptance.

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i am not on insulin, but my bg can go to diabetic levels if i eat as much as i want of what i want. i have 2 parents with diabetes, so the genes are there. one thing i got that has helped a lot is an old schwinn exercise bike that is in good condition. i think i paid $40 for it. it’s in my basement with a tv and dvd player. i was going all out on the bike, but i was hurting my knees. so now i go at a gentler pace for like 20 minutes and my bg can drop like 30 to 40 points. my bg can start creeping up again as my body digests carbs that are released slowly cuz i’m eating them with protein and fat. but anyway, that bike is really important to me and easy on my body.

my problems with eating carbs, which i love, is i am going to be hungry two hours later. we have yummy carbs i cooked for christmas, and i said to myself that i would only have small portions on christmas day, but but- we have left overs and i am eating that stuff every day!!! if you have a way to eat all those yummy carbs that i love too, like rice, macaroni and cheese, mashed white potatoes, mashed sweet potatoes, etc, and not get hungry again 2 hours later, you are luckier than me. i will still eat that stuff, but in the future i will only make enough for one day and eat it maybe once a month.

i would like to understand more about what’s happening with healthcare in this country. my mom passed 2 years ago, but when she was alive she lived with us. i heard from her about the donut hole and how she wasn’t going to take a certain pill because the daily dose was so expensive. her doctors had to help her by getting some medication from a Canadian pharmacy. could you tell me when someone reaches the donut hole and how much insulin costs when you get to that point?

you may find some help here
http://www.tudiabetes.org/diabetes-patient-assistance-resources/

and welcome to our community here @TexasDeedster, we are glad you’ve joined us!

just in case you or someone else reading this topic might have not read our values statement, here’s a link

we value diversity and respect here, and strive for a positive environment where our members support each other.

Join any topics that interest you, and let us know if you have questions about diabetes in general or our community and how things work. I’ve been here for 8 years and I’ve found a wealth of support, friendship and information here.

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marieb, i looked at the link to the suggestions for using the walmart insulins. i know everyone was trying their best to give good advice based on their experience, but it was very confusing.

ideally something simplified, but still accurate would be what i would want if i had to use those insulins in an emergency situation. i would want to know in easy step by step language how to gage how much i would need. also, guidelines about the most crucial times to use test strips would be useful as people who use the walmart insulin are using it because they need to save money.

i think my suggestion would require people who have used these insulins to be willing to work together to reach some consensus on basic, easy too understand guidelines.

I think the issue is often discussed from an emotional “It’s my body and I’ll do what I want to do” position than a clinical and factual position.

If TuDiabetes has a low-carb slant perhaps it’s because people with diabetes may finally has access to data about diabetes management and diet that improve outcomes. In some ways t’s like saying a local networking group that used to have a lot of smoker has developed a “nonsmoking” slant because some members promote quitting.

After reading a few research papers it would seem there is significant benefit to people with diabetes in adopting a low-carb diet. You can do your research and then an informed make a choice. Whatever the choice may be, it’s yours and you alone will be responsible for the consequences of that choice.

Research paper Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome

While low carbohydrate diets may not be appropriate for everyone, choices should be left to individual physicians and patients. Key points that bear on the assessment of benefit vs. risk of carbohydrate restriction are presented below. The discussion focuses on type 2 diabetes but many of the principles will apply to metabolic syndrome and possibly to type 1 as well.

  • Carbohydrate restriction improves glycemic control, the primary target of nutritional therapy and reduces insulin fluctuations.

  • Carbohydrate-restricted diets are at least as effective for weight loss as low-fat diets.

  • Substitution of fat for carbohydrate is generally beneficial for markers for and incidence of CVD.

  • Carbohydrate restriction improves the features of metabolic syndrome.

  • Beneficial effects of carbohydrate restriction do not require weight loss.

The recommendation of the research paper above is three definions of low-carb:

  • Low-carb ketogenic diet (LCKD): less than 50g carbs and 10% calories daily
  • Low-carb diet (LCD): 50-130g carbs daily and between 10-26% of calories
  • Moderate-carb diet (MCD): 130-225g carbs daily and between 26-45% of calories

The American Diabetes Association conducted a study as well:

There is no consistent definition of “low- (or high-) carbohydrate diets” throughout the literature. Based on the studies in this systematic review, the following defini- tions are used:

  • very-low-carbohydrate diet: 21–70 g/day of carbohydrate
  • moderately low–carbohydrate diet: 30 to ,40% of kcal as carbohydrate
  • moderate-carbohydrate diet: 40–65% of kcal as carbohydrate
  • high-carbohydrate diet: .65% of kcal as carbohydrate

But then according to WebMD:

However, not surprisingly, most people exceed this daily amount. Depending on age, the IOM says that men typically eat about 200 to 330 grams of carbs a day while women eat around 180 to 230 grams daily.

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there’s several discussions here on using the walmart insulins, you can search for them by using the little magnifying glass in the upper right. here’s one

Please be aware that Humulin N is NPH insulin which is NOT equivalent to Lantus or Levemir (which are long-acting basal insulins.) NPH is an intermediate-acting insulin and is a whole different ball game. Do your research before making this switch!

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I too live on a low pension. I find that low carb equals less medication equals less outlay of money, plus I hope to keep expensive complications at bay this way. Pragmatic choices when needs must.

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http://www.isletsofhope.com/diabetes/state-law/state-prescription-laws.html

Thanks for you kind thought. Already keyed in on the exercise. My insurance will only pay for approximately one month of insulin before I am in the hole. A set of quikpens runs around $500.00 and I take two kinds of insulin at least until February. The pharmaceutical companies have assistance programs but both require me to pay out of pocket for drugs 5% of my income before they will furnish me with insulin. Money I simply don’t have. I am currently painting a sign ---- Disabled Diabetic, in the hole, help me buy my insulin. I could tape it to the front of my walker and walk the highway corners for that extra exercise.

You think I’m kidding, sadly, I’m not.

are you researching the walmart insulins? its very confusing, but maybe you could start very low dose to experiment, letting yourself run higher at night until you get a feel for using them. lots of people here (not me though) have experience using the walmart insulins and could answer specific questions. i hope you’re doing ok. i recently also had a setback that is weighing on me, but all we can do is take it step by step and keep moving forward.

Thanks Melissa for your post.

I agree with you. Diabetes self-management is an art.

BTW (I am ready to be told off for the following statement as I am not living with T2DM. I simply work with people who are living with T2DM).

However, those who feel that there is a one-size fits all approach fail to remember that the human body is dynamic and from day to day it changes and over time our physiological needs change in terms of percentages of macronutrients. What was considered an appropriate amount of carbohydrates when I was 25 and teaching 20 hours of fitness is not the same at 50 when I am not teaching 25 hours of fitness per week. Would I say that my diet (even though I haven’t been diagnosed with T2DM) is LC. No. My carbohydrate intake is proportionate to my metabolic needs.

Take for example the recent news of William (Refrigerator) Perry’s health.

http://sports.yahoo.com/blogs/nfl-shutdown-corner/bears-legend-william--refrigerator--perry-hospitalized-in-chicago-154602942.html

I am in no way suggesting the cause of his T2DM is associated with the amount of carbohydrate he consumes. I am simply highlighting that overtime our nutritional needs change. He is no longer a professional football player. Hence dogmaticism regarding what works from a nutritional perspective regarding what is and isn’t effective isn’t absolute. It is relative to where are stand in the aging continuum. There is even more variability when one uses insulin.

Personally, I am all for the guidelines. And it must be remembered they are only guidelines. It give people like myself a framework from what do help people design (the art) a self-management approach that is individualized and that works for them.

Great conversation, great comments.

Thanks for listening.

It’s beyond dispute that nutritional needs change. Everything in physiology changes. That’s one reason I could never be a doctor. I could not spend my entire working life chasing moving targets.

However . . . one minor addition: physiology is not the only thing that changes over time. Knowledge does, too.

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Thank you, David. I was only responding according to the context of the discussion. I am ever seeking knowledge pertaining to diabetes. It’s my area of research. Even though I haven’t been diagnosed with diabetes, I am completely invested in learning as much as I can about the condition and doing my part to educate those who don’t have sufficient education and access to education to successfully manage their condition. Thanks so much for responding.

One of the things every diabetic learns sooner or later that has yet to register with the public and media–and yes, sadly, the majority of health care professionals–is that no two cases follow the same script. We even have an acronym for it: YDMV (Your Diabetes May Vary). Every physiology responds individually and every case is individual. “One size fits all” rules simply aren’t relevant to diabetes. It’s a perceptual barrier we struggle with every single day.

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@David_dns, bad news, you’re a PWD - you already spend your life chasing moving targets!

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Yes, but only one, and I know it intimately. Not dozens or hundreds of others, beyond my control, that I only see once every few months or years.

for me low carb, is the way to go for me,
i did read this topic, over & over, my A1C results are getting better,.