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

Food
62

First and foremost, I was shocked to learn that the original post was back in June 2015. Today’s date: 9 February 2016. (Or the date I am responding rather…)

A complete change of subject, but the conversation seemed to have lost it’s path from the topics of Carbs to the topic of a specific participant not being able to afford insulin.

So, to get back to the original topic: Perhaps the site has changed a bit since then because I am fairly new to the site and have not read anything on Carbs. Personally, I would graze the topic and simply not take it to heart. Why? I will not lie. I am a Carb Junkie!!!

First thing I grab from the Thanksgiving table (last year it was on my Birthday) are the potatos. (Preferably mashed with half & half and butter.) If I had extra cash for the movies, I would get Nachos & cheese and a huge Diet Coke.

There, that wasn’t so hard to read about…was it?

1 Like
65

That’s the ticket. What works for your. It’s the art and science of managing your diabetes! Best to you!!

Jo

1 Like
66

thank you, me i thought maybe it time, to try something new,.

67

I gather one of the main points of this discussion is that people’s reactions to a particular diet differ. Maybe one or more of you can give me some useful advice about how I can best learn how I react.

I realized very recently that I’m prediabetic and need to do something about it. Basically I’m a completely novice regarding diabetes, and I joined TuDiabetes today because of this thread. After surfing the web this morning for hours looking for information I can use, and getting pretty frustrated by conflicting information, I stumbled on this thread and liked the feeling and intelligence and personal experience you all bring to bear, even though there’s fighting amongst you.

Here’s how I fit into the low carb picture. Without thinking at all about my prediabetic condition, I’ve recently been on a low (or slow) carb, high fat diet (pretty much Tim Ferriss’s version of the paleo diet). A few days ago, I got back blood test results that included a higher HbA1c: 6.1; one year ago it was 5.8. I gather 5.8 was itself a prediabetic indicator but my internist wasn’t fazed by it so I paid no attention at the time. Estimated Average Glucose (these are fasting) went from 120 to 128. Plus this year I got back much higher LDL results (e.g., Apo B went from excellent at 69 to moderately bad at 117).

My internist remains unfazed by my HbA1c number, I’m not sure why, and has no suggestions for dietary modifications to deal with it, but he seems to be mystified by the increase, in part because from year to year I lost eight pounds, almost all of which was body fat, no doubt as a result of the lchf diet. I started out pretty fit, and now I’m fitter, with body fat below 12%, yet the metabolic numbers worsened.

As for the LDL increases, he thinks they are entirely caused by the increased saturated fat intake and can be easily reversed by going back to my previous intake of saturated fat. I don’t think he has a theory about the insulin resistance. Today, as I did web searches on lchf and LDL and diabetes, the first thing that jumped out at me on the diabetes front was the massive disagreement between ADA/traditional dieticians and Bernstein/paleo dieticians, which I gather is reflected on these forums in general. That inspired me to make an appointment with an endocrinologist who specializes in diabetes (I think based on something I read of his that he might be halfway between these factions) but I can’t get in for a month.

On the lchf and LDL front, I found out that perhaps 1/3 of people who go on low carb high fat diets have big LDL increases like mine. Some paleo folks say don’t worry about such increases in LDL; don’t cut back on saturated fats. I think I’ll not take that chance, because those with more academic expertise are saying not to take that risk.

But how to arrest and reverse the prediabetes? I’m not seeing the same sort of expert consensus. I see that increased exercise should lower the HbA1c number, other things being equal, but I already do a lot of exercise.

That leaves me with changes in diet. If I’m learning anything from this group, I guess I need to do some experimenting. I guess I need to equip myself (equipment suggestions welcome, if they are permitted) and check my blood glucose after each ingestion of food or drink, until I figure out the patterns. Is that right?

68

Without writing about my own bias toward low carb high fat, I would suggest that you adopt a tactic called, “eat to your meter.” It’s simple enough. Get a blood glucose meter and a few hundred test strips. Test right before eating and then about two hours after eating. Record what you eat and how much you eat. Try to calculate the amount of carbs in grams, since that is the primary driver of post meal blood glucose. You can use an online program like Calorie King to help. Calorie King gives you the macronutrient breakdown in a standardized label. It would help to also get a digital scale to weigh your portions.

Then just observe the correlation between what you eat and your post meal (sometimes called postprandial) blood glucose. This will be the best education you can get on your individual metabolism. A healthy non-diabetic metabolism will not often go above 140 mg/dl and if it does it will not stay there very long. It will hang out most of the time between 70-90 mg/dl. You can also test upon waking and should expect numbers in the 70-90 mg/dl range.

I know this looks daunting and inconvenient, but by learning about your metabolism and taking counteractive measures, if needed, you will be doing your long-term health a huge favor.

3 Likes
69

{begin soapbox}

IMHOP (and this is another topic that ignites . . . uh, let us say, “enthusiastic” debate), there is no such thing as “pre-diabetes”. It’s a made-up word that is false to fact. Either the body can control its blood glucose without outside help, or it can’t. No such thing as “a little bit pregnant” and no such thing as “pre” diabetes. Either you got it or you ain’t.

. . . which is not to say that cases don’t blanket the spectrum from so severe as to be almost unmanageable, to so mild as to require only the very slightest adjustment to achieve stability. But that’s NOT the same thing.

What “pre diabetes” really is, is an easy cop-out for doctors: “This is only pre-diabetes, so I don’t need to spend much of my precious, overworked time on it until such time as it becomes really serious.” Which, of course, is what most often happens.

An ounce of prevention is worth a pound of cure.

{end soapbox}

Now, to the meat of the matter. There are a number of topics in the diabetes world that trigger passionate, even incendiary, conversations. LCHF isn’t even the worst one. A good deal of this comes from that basic piece of human nature which dictates that you can’t tell a mother her baby is ugly. People sometimes get so invested pro or con in a particular therapy or technique—either because they have experienced spectacular success, or spectacular failure—that they react strongly when it’s praised or challenged.

Starting a firestorm accomplishes nothing, aside from allowing the participants to blow off steam. The real bottom line with advice, whether from an “expert” or a peer, is David’s Rule #1: take what you can use and leave the rest.

When I switched to LCHF, my lipids dropped like a stone. But my experience is my own, not anyone else’s. People can and do have results similar to yours. Physiology is uncomprehendibly complex and each case is individual. That’s why effective diabetes management is empirically based. You have to determine what works for you, and the only way to really know that is experimentally and experientially. LCHF isn’t for everyone. NOTHING is for everyone!

One specfic question you raise is, how often to test. The basic rule of thumb is as follows:

To determine your response to food, test before eating, 1 hour after, and 2 hours after. On average, the BG peak is reached somewhere within shouting distance of the one hour mark. In a normal, nondiabetic, nonpregnant, nonobese individual, BG should be close to normal again around the 2 hour mark. Understanding how you deviate from that basic pattern is essential prerequisite knowledge for developing an effective treatment or management plan.

And don’t do the test just once. One meal can always be a statistical outlier. Do it for every meal for at least a couple of days to be confident you know the real pattern.

3 Likes
70

The triglycerides HDL ratio and number that tell how much is the bad small LDL is more important than total cholesterol and LDL,

get a copy of your blood test and look at the results

as said ‘eat to your meter’ but If you cut wheat, for a prediabetic should be enough
also losing weight can mess you up

71

I am very grateful for the useful and thoughtful responses.