Question regarding Type II and Diet

[Middle Aged Man]

Okay, I've mentioned going to this class a bunch of times. The dietician laid out a plan for me for taking in carbs and calories throughout the day.

To be honest, I'm having problems getting that many carbs into my system.

Am I doing the right thing being way low on carbs, or do I really need what they are saying? Why????

[ADE]

I think you should let your meter tells you how many carbs you could eat. You can start by following what the dietician tells you what to eat and, then, adjust the carb based on what your meter tells you. Take care.

[Peter Lee]

The dietician laid out a plan for me for taking in carbs and calories throughout the day.

I'm having problems getting that many carbs into my system.

.........or do I really need what they are saying? Why????
Probably, what you are seeing is the dietician trying to give you a balance of complex carbohydrates with calories.

The problem for Type 2s is that if you don't take enough carbohydrates, your liver pumps glucose. If you eat the wrong sort of carbs. then your blood glucose goes up anyway.

To control this you need to eat complex carbs. so that the release of glucose into the blood is slow enough for the medicines you are on to control, and yet be fast enough to stop the liver pumping.

I have had occasions when I have not eaten enough and seen my sugar readings go up due to liver action.

For Type 2's, it is not a simple matter of 'low carbs good, high carbs bad'. Use of glycemic index can be useful - and seems to work for me.

By the way, one of the actions of Metformin which is what a large number of Type 2s is on, is to depress liver pumping as well as helping counteract insulin resistance.

[valc3]

My dietician also gave me a sheet with a diet layed out. I felt the same as you did that it was way too many carbs. I went back to her and we worked out a diet that worked for me. It took some trial and error, but my bg is stable and I don't feel like all I do is eat.

[Lori M.]

Probably, what you are seeing is the dietician trying to give you a balance of complex carbohydrates with calories.

The problem for Type 2s is that if you don't take enough carbohydrates, your liver pumps glucose. If you eat the wrong sort of carbs. then your blood glucose goes up anyway.

To control this you need to eat complex carbs. so that the release of glucose into the blood is slow enough for the medicines you are on to control, and yet be fast enough to stop the liver pumping.

I have had occasions when I have not eaten enough and seen my sugar readings go up due to liver action.

For Type 2's, it is not a simple matter of 'low carbs good, high carbs bad'. Use of glycemic index can be useful - and seems to work for me.

By the way, one of the actions of Metformin which is what a large number of Type 2s is on, is to depress liver pumping as well as helping counteract insulin resistance.





I don't mean to sound like an idiot, but what are complex carbs? I've seen the term used alot but I really don't know what kinds of foods are complex carbs. :dancing2: :dontknow: :confused:

[jdstein11]

I think complex carbs are pasta, wheat bread, etc. These are carbs that are "better" for you than those in simple sugars, like chocolate, candy, and soda.

I think that if you use your judgment you should be able to decide which carbs come from healthier sources, and I believe that is the gist of "complex" vs. "simple" carbs.

[MarkMunday]

The problem for Type 2s is that if you don't take enough carbohydrates, your liver pumps glucose. If you eat the wrong sort of carbs. then your blood glucose goes up anyway.

To control this you need to eat complex carbs. so that the release of glucose into the blood is slow enough for the medicines you are on to control, and yet be fast enough to stop the liver pumping..
Peter,

Excuse me while I play deveils advocate here. With all due respect, I think you may be barking up the wrong tree. It is true that going for long periods of time without food prompts the liver to release glycogen into the bloodstream. But increasing carbs in the diet won't stop this.

The release of hepatic glycogen is common in the early hours of the morning. And it is usually the result of not having eaten since supper time. While a carby snack before bed often helps, a high protein snack is better. It digests more slowly, supplying glucose into the bloodstream over a longer period of time.

The effect is not peculiar to T2s, as you suggest in your post. T1s have an even bigger problem with it. Their beta cells don't produce any insulin. And they don't produce Amylin either. Amylin helps prevent post prandial hyperglycemia by slowing stomach emptying and inhibiting the release of hapatic glycogen. Or the liver pumping glucose into the bloodstream, as you refer to it.

If low-carbing didn't help control T2 diabetes, there would be so many t2s controling their diatbetes on low-carb diet and exercise alone. I realise that this is not possible for all t2s. But cutting down on carbohydrates definitely helps.

After all, diabetes is by definition the inability to properly process catbohydrates. Whether they are complex doesn't make much difference. The ADA and dieticians that follow their line still don't seem to have figured this out.

Cheers,

Mark

[Middle Aged Man]

Wow!!!! You guys please keep debating this! I am learning so much from you both!!!! Thank you!!!!!!!

[nomorecarbs]

life. I am a very well controlled type 2. I eat a very low carb diet (virtually none except for salad greens or berries and trace amounts in cheese and heavy whipping cream). I exercise daily as well.

I recommend all diabetics read Dr. Richard Bernstein's 'Dr. Bernstein's Diabetes Solution' for a lot of good information about treating diabetes. Dr. Bernstein has been a type I since 1946.

Blood sugar control is a dynamic, complex system. Your body is constantly adjusting through the day, raising or lowering it by a variety of means, usually within a small range for non-diabetics. I have found that through weight loss and good control of blood sugars, my insulin resistance has been greatly lowered. I can't even observe the dawn phenomienon on my meter anymore.

That this treatment works even though 180 degrees opposite from the mainstream authorities and such organizations as the ADA and Joslin Institute, reflects poorly on those organizations and the biases of their managements.

[MarkMunday]

The case for low carbohydrate diets in diabetes management
Surender K Arora and Samy I McFarlane

Nutrition & Metabolism 2005, 2:16 doi:10.1186/1743-7075-2-16

Published 14 July 2005

Abstract (provisional)

A low fat, high carbohydrate diet in combination with regular exercise is the traditional recommendation for treating diabetes. Compliance with these lifestyle modifications is less than satisfactory, however, and a high carbohydrate diet raises postprandial plasma glucose and insulin secretion, thereby increasing risk of CVD, hypertension, dyslipidemia, obesity and diabetes. Moreover, the current epidemic of diabetes and obesity has been, over the past three decades, accompanied by a significant decrease in fat consumption and an increase in carbohydrate consumption.

This apparent failure of the traditional diet, from a public health point of view, indicates that alternative dietary approaches are needed. Because carbohydrate is the major secretagogue of insulin, some form of carbohydrate restriction is a prima facie candidate for dietary control of diabetes. Evidence from various randomized controlled trials in recent years has convinced us that such diets are safe and effective, at least in short-term.

These data show low carbohydrate diets to be comparable or better than traditional low fat high carbohydrate diets for weight reduction, improvement in the dyslipidemia of diabetes and metabolic syndrome as well as control of blood pressure, postprandial glycemia and insulin secretion. Furthermore, the ability of low carbohydrate diets to reduce triglycerides and to increase HDL is of particular importance.

Resistance to such strategies has been due, in part, to equating it with the popular Atkins diet. However, there are many variations and room for individual physician planning. Some form of low carbohydrate diet, in combination with exercise, is a viable option for patients with diabetes. However, the extreme reduction of carbohydrate of popular diets (<30g/day) cannot be recommended for a diabetic population at this time without further study.

On the other hand, the dire objections continually raised in the literature appear to have very little scientific basis. Whereas it is traditional to say that more work needs to be done, the same is true of the assumed standard low fat diets which have an ambiguous record at best. We see current trends in the national dietary recommendations as a positive sign and an appropriate move in the right direction.

For trhe full article, go to :

http://www.nutritionandmetabolism.com/content/pdf/1743-7075-2-16.pdf

Mark

[mg_2204]

Hello Middle Aged Man,

I too think the dieticians should update their approach. It has helped me to go see one... but the management of my BG is up to me. The best way is to test often and keep a little dietary journal for a while. See what works (and doesn't!) for you. A low carb didn't agree with me. I had fantastic BG readings but cholesterol went up on the stratosphere. What I do now is following this principle but with a twist : eat like a king in the morning, like a prince at lunch time, and eat like a beggar at supper time. I have most of my carbs in the morning. I just wouldn't have the energy to do the kind of work I do if I didn't anyway. I also have 2 snacks, one in the morning and one in the afternoon and they mainly consist of cheese and a fruit. Sometimes a few nuts if I have especially worked hard that day. BG is stable, the average being 5.9 mmol/L. Ok, Glucophage SR helps too. I have found what works for me through reading from others in this wonderful forum and also through trial and error. I don't believe there is one recipe to good control... there are many. I hope you find yours quickly. Nothing like smooth sailing :)

[Harold]

One must remember, when getting a diet from a dietician in class, the dietician must come up with a diet for more people than yourself in a short time. They usually start with a generic diet determined by height, weight, sex, and if your lucky age. This diet should only be taken as a starting diet. They should have given you the tools in class to change it to fit your needs and still have a healthy diet. True they usually recomend too many carbs to start with for most people, but they treat everyone as if they are running over two hundred and have weak kidneys. While it's true we can supplement vitamines and minerals there are enzymes in vegatables that you will not get any where else. Some of these enzymes will help in digesting meat which also contains different enzymes and some of them help in digesting veggies. Enzymes from both sources helps your metabolism perform other necessary functions as well. Too many carbs, cut your starches and eat your veggies. There are some veggies that are more bulk than carbs and help you to feel full.

On the note of complex carbs being better for you than simple carbs from things made with suger, it's true. Not that it's better for your glucose control, but because they have vitamins and minerals that candy and pastries don't have. Some foods with complex carbs can be even worse than sugar for glucose control. This happens when they are cooked, especially overcooked, because the heat breaks down the complex carbs into simple carbs. Which is why cutting back on starches becomes a first choice and lighty steaming veggies and tubers comes highly recomended.