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Tuesday 8 September 2015

Are diabetics being given diet advice that just makes their problems WORSE?

  • Each day, 400 people in Britain are given a diagnosis of type 2 diabetes
  • Research indicates weight loss may be incredibly effective
  • Yet many are not getting the lifestyle guidance they need
  • Encouraged to eat balanced diet 'applicable to the general population'
  • 'Some carbs rapidly turn into glucose in your blood and should be avoided'
There are more than three million people in this country living with type 2 diabetes and a further five million thought to be at risk of developing the disease. Diabetes UK has warned that the cost of treating patients 'could bankrupt the NHS'. In the second part of our series, we reveal the latest thinking on managing the complex condition.

When mother of three Sarah Gibbs was diagnosed with type 2 diabetes in May 2014, a nurse told her that her blood sugar levels were too high, gave her a prescription for medication to help reduce them - 'and that was it'.

Sarah, 42, from Newport, Gwent, went home, read about the complications she was likely to suffer if she couldn't control her blood sugar and panicked. 'I felt my life was finished,' she says.

Each day, 400 people in Britain such as Sarah are given a diagnosis of type 2 diabetes - a disorder where blood sugar levels can become dangerously high unless they are managed effectively.

For the 3.3 million people in this country diagnosed with diabetes, working out how to lead your life with the condition can be bewildering and, as Sarah recognised, getting it wrong can have disastrous implications.

Two out of every three people diagnosed with type 2 diabetes do not manage to keep their blood glucose levels within healthy limits, according to statistics published by the charity Diabetes UK last month. It's as a direct result of this that 200,000 people every year develop severe diabetes-related complications: kidney and heart failure, nerve damage, blindness, heart attacks and strokes.

Yet how do you get that blood sugar control and why are so many people getting it wrong?

Medication can help, but increasingly research indicates that the most effective way for people to hold this disorder in check is for them to lose weight by changing their diet and becoming more active. Yet, as Sarah discovered, many are not getting the lifestyle guidance they need. The urgent need for this is underlined by new statistics from Public Health England showing that eight out of ten people with type 2 diabetes in England are both obese (ie with a BMI of 30 or more) and have unhealthy levels of inactivity.

Furthermore, there is evidence that, far from helping, the advice most frequently offered about diet may actually be making it harder for type 2 diabetics to keep their condition in check.

Type 2 diabetes normally occurs when fat clogs the liver, which regulates the supply of glucose to feed the body, and the pancreas, the tiny gland behind the stomach that produces the hormone insulin that takes glucose out of the blood stream and into cells.

But this fat can be eliminated, enabling normal insulin production to resume, by losing around 15 per cent of body weight (on average 2½ st). This means blood glucose levels return to normal immediately, an effect that lasts at least two years.

'We now know that once people with type 2 diabetes successfully lose weight and go below their personal fat threshold, the diabetes will disappear,' explains Professor Roy Taylor of Newcastle University.

'This knowledge is gold dust to many folk with type 2 diabetes. If I had the disorder, I would do this,' he says.

Guidelines from the National Institute for Health and Care Excellence (Nice), the NHS watchdog, recommend loss of up to 10 per cent of body weight. But the dietary advice on how to get there may do more harm than good, say some experts. According to Nice, anyone with type 2 diabetes should be encouraged to eat 'a healthy, balanced diet that's applicable to the general population' - in other words, meals containing a balance of protein, vegetables and, crucially, plenty of starchy carbohydrates including bread, rice and pasta.

However, some experts now insist that such a diet can actually contribute to type 2 diabetes.

'We know that type 2 diabetes develops when blood glucose rises above a certain level - and whether it's sugar, rice, bread or potatoes, these carbohydrates rapidly turn into glucose in your bloodstream and so should be avoided,' says Dr David Cavan, formerly a consultant physician at Bournemouth Diabetes and Endocrine Centre and now Director of Policy and Programmes at the International Diabetes Federation and author of Reverse Your Diabetes.

It's not just Nice which says type 2 diabetics can continue to eat carbo- hydrates or sugary foods. The charity Diabetes UK reassures visitors to its website ( that having diabetes 'doesn't mean you have to cut sugar out of your diet completely. We all enjoy eating sugary foods occasionally, and there's no problem including them as a treat in a healthy balanced diet'.

However, Dr Aseem Malhotra, consultant clinical associate to the Academy of Royal Colleges, last month challenged the charity to explain why it continues to recommend 'carbo- hydrates known to promote fat storage and hunger' to a group of people most of whom urgently need to lose weight.

He said: 'Given that type 2 diabetes is a condition related to an intolerance to metabolise carbohydrates, it is puzzling why Diabetes UK recommends as part of a "healthy balanced diet" the consumption of plenty of starchy carbohydrates and modest amounts of sugary food and drinks including cakes and biscuits.'

The best long-term intervention for type 2 diabetes, says Dr Cavan, is to restrict carbohydrates by cutting back on sugar and starch and replacing it with non-starchy (green) veg, with some fatty foods such as cheese and full-fat, unsweetened yogurt along with calorie-dense protein.

Read more:

I know the diet advice given by DUK and the NHS would make my problem worse, a blood sugar monitor and HbA1c will confirm that. 



Tara said...

I'm surprised how many people in the U.S. get little or no information when newly diagnosed. I was lucky 23 years ago, I got a lot of nutrition counseling and information on how to manage my glucose levels. Turns out, I am a type I and take insulin. Limited carbohydrate has been the way I keep my weight and my blood glucose in check.

Linda said...

As wife of a diabetic, I get frustrated by mainstream advice in the US. Last year I attended one of my husband's doctor appointments and asked the doctor about diet. He said, "We find that most patients won't make lifestyle changes but they will take medication."

Well, it's true of my husband. But my aunt was told to cut out sweets when she had diabetes 20-something years ago. She lost weight and brought her blood sugar under control. It can work.

Cheryl said...

So interesting. I watched a programme last week about young people with type 2.
The elderly were also included. It was diet based, mainly around sugar.
When my father was diagnosed he was given tablets and told not to eat sugary foods. That is as far as the advice went. I tried to help my father with his diet but because I am not medically qualified he said 'Best I do what the doctors tell me'
People put a lot of faith in doctors and the medical profession and of course they do a wonderful job in many cases. I do feel that diet and lifestyle are rarely included.......things need to change.

chris c said...

I was told ever since early childhood that all my symptoms were either psychiatric or completely made up. Strange that they never noticed that all the symptoms I was making up just happened to be symptoms of diabetes and conditions that are "common in diabetics". FIFTY years later and I was finally told I "just have a touch of prediabetes". I was given a diet leaflet listing exactly the same high carb low fat diet I had been given verbally previously, and which had left me semipermanently exhausted, constantly hungry and with WORSE lipids than before, and which caused me to gain 15kg quite rapidly and worsened my blood pressure. I was also told on no account to test my blood.

It didn't take long online to realise I should do the EXACT OPPOSITE of what I was told, which reduced and eliminated ALL the symptoms, lost me the weight even faster than I had put it on, and returned my BG and lipids to pretty much normal and even reduced my BP.

After ten years of this I was recently told I was not only not diabetic, I had never been prediabetic. Gee thanks!