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Saturday 25 January 2014

Why low carb is best for diabetics

By Dr. Katharine Morrison

Healthy people who don't have diabetes have hbaics of 5.7% or below. Risk of increased cardiovascular events start at even lower levels than this and microvascular complications increase above this level. Achieving strict glycaemic control has its challenges, but so does living with the complications of diabetes. The target hbaic should therefore be decided by the person with diabetes with informed guidance from their doctor. It should not be set at some arbitary standard that may be dangerous for some to achieve but at the same time hopelessly inadequate for others who seek to avoid or reverse complications.

Achieving normal blood sugars for diabetics is a straightforward procedure with choice points along the way. Restricting the amount and type of carbohydrate in the diet is the key intervention. Meticulous monitoring and medication adjustment is essential for safety in insulin users and those on oral hypoglycaemics. Of course, this option is not necessary or desirable for everyone.

My belief about the ACCORD study is that the results are not directly comparable with low carbing diabetics who get their blood sugars regularly far lower than in the ACCORD study.

In ACCORD a lot of drug and insulin therapies were used but the diet was the standard high carb/low fat. Thus people were vulnerable to the side effects of the drugs, higher blood sugar levels than ideal especially post prandially and also increased hyopoglycaemic events compared to the low carbing diabetics. There are higher cardiovascular mortality rates with gliclazide and certain glitazones compared to non users. Thus low carbers will automatically have lower post prandial blood sugars, lower rates of hypos, need less insulin and other drugs. All of these things are protective. Apart from these effects weight, blood pressure and insulin resistance are also lowered by a low carb diet.

Link to information here.



Anonymous said...

Informative :)

Anonymous said...

It is a reduction in carbs that have improved my HbA1c numbers following the usual recommendations I couldn't get below 8.0 now I'm in the 5.'s.