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Monday 7 May 2012

Never over-estimate a lowcarb anti !


Normally I would advise the opposite, never under-estimate your opponent, but I believe I have wasted too much time with these individuals. They may be good at ruining threads and intelligent debate. They are good at getting threads locked and posts deleted, but as for the good control of diabetes, they are pretty poor. Most of the lowcarb anti propaganda comes from type ones, but not all. Very often using pumps, good healthcare professionals and all the tools for good control. Do they get good control ? Well the NHS stats say no. The sad truth is, the majority never get close to a safe HbA1c.


NHS Statistics for 2008 2009: 
Percentage of Type 1 diabetics with HbA1c greater than 7.5 per cent = 71.4 per cent. 
Percentage of Type 2 diabetics with HbA1c greater than 7.5 per cent = 33.4 per cent. 
Percentage of Type 1 diabetics with HbA1c greater than 10.0 per cent = 33.6 per cent. 
Percentage of Type 2 diabetics with HbA1c greater than 10.0 per cent = 14.3 per cent. 
These results are very similar to those found in 2006 – 2007 and 2007 – 2008. 


To combat the good news we see regarding lowcarbing, the seasoned anti relies on long dismissed by the wise, ridiculous myths. Dropping potatoes can lead to scurvy, too much protein will wreck kidneys, a high fat diet will lead to heart disease, the list is long. What seems to escape the anti, is the fact proteins and fats are essential to good health and life, carbs are not. See what I mean about not over-estimating the knowledge of the average anti, they don’t even understand the basics. Our diet they tell us is dangerous, and cannot be maintained in the long term. So, a diet based on a wide range of non starchy vegetables, low carb fruit, good quality fats, protein, seeds and nuts is dangerous, they are wrong again. Let’s look at it from the antis stand point. We up the carbs to the average anti type level, and what the likes of Hope Warshaw recommend as a balanced diet for a diabetic, i.e 40 to 60% of diet consisting of carbs. Hope tells us lowcarbing is the old dogma, and carbs and drugs are the way forward. Again, that’s not what the stats tell us.


Well, if you are an insulin user, your insulin requirement will be higher with a high carb diet. Many type one diabetics know, the lower the carbs the lower the insulin required. The lower the insulin, the more predictable BG numbers become. Dr. Richard Bernstein a world renowned BG  and diabetes expert, calls this the power of small numbers.


If you are a non insulin user, and believe Hope is correct, stand by for double figure BG numbers permanently. You might get lucky with type two drugs, Actos, Avandia or the pancreas wrecking Gliclazide, maybe some of the other drugs that come with black box cancer warnings are more your thing. Maybe try with a whole bunch of drugs, as was tried in the ACCORD study. As most know, that trial was abandoned due to the very high death rates of the participants. Many using Actos and Avandia by the way now banned in many countries. The reality in the real world, if you are a non insulin using diabetic, nothing will work with a high carb intake, other than injected insulin to control BG numbers. Experienced and well controlled diabetics using insulin, know insulin is not a get out of jail free card. It takes a great deal of discipline, knowledge and skill to hold safe BG numbers and stay safe. Diabetics should not fear insulin, but it must be respected, and for many, used as a last resort, save insulin if the day comes you have no choice.


So, the safe and intelligent choice for the majority of type two diabetics, who are the majority of diabetics, is reduce the carbs in the diet until safe BG numbers are obtained. Some can use 150 carbs a day and hold non diabetic numbers, for the majority of med free diabetics or metformin users, 50 is very often the norm, some can use only thirty to keep to a healthy weight and meds free. I guess most reading this know all this. That being the case, the lowcarb antis cannot know this, if they did, surely they would not have spent four years telling us otherwise. As I said earlier, never over-estimate a lowcarb anti. They either know that their information and recommendations are dross,  and will lead others to the gates of the poorly controlled and high risk of complications, as demonstrated by the abysmal NHS stats. Or they do not know. I’m in a mellow mood today and will give the antis the benefit of the doubt, and accept they don’t have a clue what they are talking about.


Eddie

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