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Wednesday 17 August 2011

Lowcarbing still a mystery to most Healthcare Professionals !

I just had my most recent check up with the hospital diabetic clinic. It was interesting, but probably in the wrong ways. Still at an HbA1c of 6.2% (slightly annoyingly). Which in new money is 44 (as I remember). 5.2% (my target) is 33. What was interesting was the very nice nurse was saying it was such a relief to see a Type 1 with good 'sugars' as most that she sees have 'a terrible time of it'

The consultant who spent quite a lot of time with me couldn't really get to grips with a low-carb diet. He said you are probably losing weight because you are cutting down on everything. I just had said to him that I was low carbing, and he also assumed that because I was eating less fat (which I'm most certainly not) that was why my triglycerides were so low (!). I didn't really have the heart to tell him I was mainly eating protein and fat. He also asked me if I were low carbing just to lose weight; the blood sugar control didn't seem to register with him.

He had not heard of the idea that losing weight could increase LDL, that general use of metformin could deplete B12 levels in the blood, that statins had effects on memory, indeed he felt that statins had very low side effect rates and were a good thing to take, even though when we got down to it he acknowledged that only 2% of people who take them will see a benefit (!) He didn't push the point though about me going back on them. He also thought the DAFNE course would be helpful for me because then I 'could then eat anything I wanted'

It's all a bit depressing; you have to be really steeled to this stuff to get out of there without abandoning the one thing that is helping one's health and glucose levels; low carbing.

Dillinger

18 comments:

Anonymous said...

Dillinger, as you may have read recently elsewhere, my very supportive but clearly baffled GP look at my latest results and actually said;

"I wonder if you're cured?"

I told her if that was the case, let me share it with you and the Lancet and see if we can cure other diabetics. We'd make a fortune.

wiflib

Anonymous said...

Goodness me!
Firstly well done Dillinger I think 6.2 is very good and many diabetics would be pleased to have this result.
Secondly, it is sad and very worrying that a lot of HCP do not appear to have any grasp of low carbing. We must all keep 'banging our heads against a brick wall' and keep talking about the great news low carbing is.
With a low carb diet, which I consider to be 30 to 50 carbs each day, means meds can be kept to a minimum. The less meds the better - less risk of side effects etc.
As has been said before we must all keep spreading the news, if it results in only one person a day recognising and understanding that a reduction in sugars and starchy carbohydrates means their health is greatly improved and that person then goes on to spread the news it has a snowball effect ...... the quest goes on to unlock "the mystery of lowcarbing" not only to healthcare professionals be they nurses, doctors, consultants, dietiticians etc. but to the many ordinary folk too who have yet to discover the huge benefits a low carb life style brings.

Once again well done on your result.

Anne

Anonymous said...

Dillinger I suspect the nice nurse was referring the consultants compliant patients when she said about those having 'a terrible time of it'.


Graham

Anonymous said...

Well done Dillinger, agree its a damn shame there are not more wised up health care people out there.

Joe

Anonymous said...

Thanks all.

The other thing that the consultant said, which I forgot to mention above, is that he thought DAFNE was a great improvement over the way people used to eat with diabetes 'in the '50's' where they would avoid carbohydrates because that meant that they would eat lots of fat which 'obviously' meant that their risk of CVD 'went through the roof'.

I asked if there were any studies to show that and he said no; because it's not something you can do double blind with a placebo.

As I said he was very nice, very concerned for his patients but was stuck totally in the fat/heart disease philosophy - so couldn't conceive of advising people to eat fat because then they would have heart attacks, and thereby couldn't conceive of eating low carb.

That Ancel Keys has a lot to answer for...

Dillinger

Anonymous said...

Great results Dillinger. When I see results like these I wonder why forum members are not beating a path to your door?

John

Anonymous said...

Thanks John, although like my school reports used to say; 'could do better'...

I've found that as a Type 1 I'm also insulin resistant so am now taking Metformin which is helping. Fingers crossed for the next set of bloods.

Other members are beating a path to my door - unfortunately though the member is Ka-Mon and he's brought his axe...

Dillinger

Anonymous said...

Hi Dillinger,
I think your consultant has his fa(c)Ts wrong regarding high fat in the 50's this was never the case. I am living proof of this and if you do some research you will also find all cookery books were carb and fat retricted.

I limit my carb intake to 150 carbs per day and within this amount I eat a well balanced diet. Using 19.5 units of insulin a day, I also have no weight issues or complications. Over the last 10 years My Aic average works out at 5.8%.

I like many others would be interested in a break down of how much insulin you use and your carb ratio's so we can put it into prospective.

Many thanks

Janet Johnson

Anonymous said...

"I've found that as a Type 1 I'm also insulin resistant so am now taking Metformin which is helping."

As A type 1, you do need to remember your diabetes is not metabolic as is a type 2's.
Perhaps if you took a different approach to your diet than the type 2's on this blog you would then have a much better response to your insulin?

The majority of type 1's have to count 1/2 the fat as carbs as well as protein. The problem with blood sugar rises hit many hours later. (Up to 8 for some people)
Thus eating mainly fat and protein does your insulin reduction no good at all.
Modern day insulin's also have a short duration so can not cope with extra fat and protein.

Try eating a few more carbs and cutting back on your fat and protein amounts. By a few more I do not mean increasing by silly amounts. Each person has an upper limit as to where they can go before control is compromised. 50 carbs per meal is my limit others are less others are more.
I am hopeful that you are able to take this on board and are able to improve your control to live a long and as happy a life as I have with diabetes for over 6 decades.

All the very best
Janet Johnson.

ailz said...

I only started low carbing in May of this year - hadn't heard of it before then for diabetics. I'm a type 2, in May my Hba1c was 7.5%, in August 5.9%. My doctor is really pleased and although the nurse didn't like my low carbing he's told me to carry on with it and ignore her.

Well done Dillinger.

Anonymous said...

Hi Janet,

Those are fantastic results - I envy you.

I think the consultant wasn't really looking past the 'fat is bad' veil. Saying that my trigs had come down due to (presumed) less fat in my diet, for instance, is just incorrect; the reason that one has elevated triglycerides is because of elevated carb consumption.

In terms of insulin/carb ratios it has slightly changed recently but it's about 1 unit novorapid to 1.5 grams of carbohydrate, maybe 2 grams of carb.

So, I was using about 6-8 units per meal dependent on what I ate but would not eat more than 25-30 grams of carb a day. Now, the fast acting is more in the 5 units per meal and still on 25-30 grams of carb a day; so 6-8 carbs a meal.

To put that into perspective the DAFNE course suggests the starting ratio is 1 unit / 10 grams of carb.

My basal insulin (levemir) has gone down from 24 units (split) to 18 units (split) since going onto 2,000 mg Metformin a day (also split).

This morning I had some of the low carb microwave bread from Mitch's recipe page which is fantastic stuff as toast, but took 5 units of insulin to cover it. That turned out to be slightly too much as I'm a bit low at the moment (3.8). Bodes well for future breakfasts though...

Best

Dillinger

Lowcarb team member said...

H ailz

Thanks for your comment. The difference of 7.5 and 5.9 in the medium/long term is huge in regards to warding off complications. Especially when achieved with life style changes rather than intensive multiple med. regimes.

Very well done and keep up the good work.

Regards Eddie

Brian said...

Stress can be a danger factor towards one's health. it is always better to consult a Healthcare Professionals for health advice.

Anonymous said...

Dear Brian,

Healthcare Professionals!!! I'm afraid their advice for diabetics would induce stress rather than alleviate it.

By the way are you on commission from valiMedix?

Geordie

Anonymous said...

Dear Geordie,

If you give my a fiver, I can tell you to eat more carbs and less fat, and then in 10 years or so, I'll help cut your feet off.

Stephen

Anonymous said...

Come on now Stephen why should he pay you a fiver when that advice is freely available from noblehead, phoenix, jopar et al at DCUK.

Graham

Anonymous said...

Hi.
My husband many yrs ago was diagnosed as prediabetic and for him to change his diet and exercise. He did at first change then slipped back into the life style again. But just shy under mo. ago he went back to the dr due to symptoms he was having. He was then diagnosis as Diabetic II. He was giving Metformin 500mg / 2 day & Pravastatin 40mg/ 1 day for cholesterol. And was told to change his diet and exercise. Well I set him up with an appointment w/nutrition (who uses the form of organic/natural view). She told him not to take those drugs and told him to take Alpha Lipoic Acid 600mg/twice day for blood sugar and Red Yeast Rice 600 mg W/Co Q-10 60 mg. for cholesterol. Of course he also takes B-complex & multi vit. Also changed diet to no carbs for now (only what he gets naturally thru Veg) and been fast pace walking 30 min approx 5-6 days wk. Within wk time he felt better and had more energy. Couple times in morning his sugar ran 122 give or take. I got back in touch with the nutrition and she said for him to eat something small such as boiled egg, chicken, raw almond butter on slice celery before he goes to bed. He has tried boiled egg and the next morning be around 104-107. She claims that your body heals its self if you mainly eat organic meat, green veg. much as you can raw. Then once sugar is normalized then you can gradually add certain grains w/o gluten and one piece of fruit day. You can not go back to the American diet like before & if you do you will be back to square one. She says you have to find your body’s point. You might be a person that can indulge once week or every other wk. She has a friend that indulgence the first day of mo. and eats what she wants. But if she has a celebration such as wedding, party, etc. she exchanges that first day to that day. And that has worked for her. My husband has slipped few times but he isn't where he wants to be but sure isn't where he use to be. He goes back couple mo for follow up at the dr. and she said that the dr. will be so surprised. She has turned many insulin diabetics to normal if they follow what she says. But it does take time. She says you didn't get this way over night and you want be fixed over night.

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