carbs - how much?

[Sienna]

About a month ago I began testing blood and keeping a diary of BG numbers and diet. I'm T2. The easiest way Ive found to keep numbers low, is to cut out carbs almost entirely, especially early in the day. I can manage a small potato or some rice later on, but do best just filling up with protein and rabbit food.
Does it matter if carbs - I think I really mean STARCH, like rice, bread, pasta, potatoes - are cut out completely? Will anything go desperately wrong? (thinking total terminal constipation or something)

How could I get the numbers down a bit more please, because if I cant, in a couple of months "They" will put me on metformin. Someone posted about exercise soon after intake of food: I have a horrid feeling exercise (nasty stuff IMO) may be essential. Please tell me I am wrong?

Last thing at night I often test 6ish, then typically 7.5 or more when I wake up, so I'd love to know what's happening there too.

Northerner, I really have read the helpful passages you recommend and hope I haven't missed the answers to these questions.

 

[Northerner]

Hi Sienna, it's certainly possible to live on next to no carbs, several of our members have managed to control their levels well in this manner. Approximately how many carbs per day are you currently consuming? It would be worth having a look at the Dr Atkins diet as this details the pros and cons of following a reduced carb diet. It would also be worth discussing with your GP if you are on medication for anything in case there are any potential problems.

In answer to your question about the overnight rise - this is your liver releasing some of its stores of glucose as you wake in the morning (part of what is known as the cortisol cycle, or 'dawn phenomenon'). Your liver is constantly trickling out glucose in order to provide energy for your autonomic system - your heart, lungs and digestive system - and of course your brain whilst you are not eating. In the mornings it often releases extra to give you a boost to start the day and in some people this can be quite pronounced. A rise of 2 mmol/l or less is perfectly normal though 🙂

And, the good news and the bad news! Yes - exercise is a necessary part of blood glucose control 😱 The good news is that exercise makes your body more sensitive to the insulin your pancreas is producing so it can utilise the glucose in your blood. Your body's cells have something called 'insulin receptors' on them. These are like doorways for the glucose to enter the cell, and insulin is the key to unlock the door. In cases of insulin resistance there are either not many of these on the cell, or they are damaged - think of a key that doesn't quite fit or a broken lock - meaning that much of the glucose remains in the blood as it cannot enter the cells. When you exercise however, your cells grow extra receptors so they are much more able to take in the glucose. Regular exercise will maintain this situation, so in time your blood glucose levels become lower generally and more stable 🙂

So, do start exercising, even if it is only something like a regular walk - it doesn't have to be a painful endurance test down the gym, find something you can enjoy! There are lots of other benefits to exercise, not least the general feelings of well-being, better sleep, lots of lovely endorphins - brain chemicals that make you feel good, lifting your mood and spirits and encouraging you to do more! 🙂 Go for it!

 

[DebbyC]

Hi Sienna

I was diagnosed with type 2 about two months ago, but I haven't been given a glucose machine to test, I'm still working on that 🙂. I have started the NHS couch to 5k which my nurse told me about, I go about 3 nights a week. I'm on week 4 and it's great. I couldn't run for a minute before, now I'm running for 5 minute intervals. I also do zumba once a week, which I don't class as exercise as it's like dancing. I have been trying to cut the carbs, someone also told me that if you are eating some carbs try to eat them with some protein. For example toast with scrambled egg its helps to reduce the rise in glucose. I have learnt so much on this site, it has been a great help. Good luck

 

[Redkite]

Hi Sienna,

It was me who posted about exercising straight after a meal! It seems to make the insulin (which your body will produce when you eat) work harder. This is strictly based on anecdotal evidence - when my son does anything energetic after eating (and taking insulin), he needs less insulin than if he was going to sit around. Exercise makes a little insulin go a long way 🙂

You don't have to go crazy (I hate exercise too!). Maybe save errands like walking to the post box to do straight after lunch, things like that.

P.S. I'd be so happy if my type 1 son went to bed on 6 and woke up on 7.5 every night! Sounds like you're doing a pretty good job 🙂

 

[Northerner]

Hi Sienna,

It was me who posted about exercising straight after a meal! It seems to make the insulin (which your body will produce when you eat) work harder. This is strictly based on anecdotal evidence - when my son does anything energetic after eating (and taking insulin), he needs less insulin than if he was going to sit around. Exercise makes a little insulin go a long way 🙂

You don't have to go crazy (I hate exercise too!). Maybe save errands like walking to the post box to do straight after lunch, things like that.

P.S. I'd be so happy if my type 1 son went to bed on 6 and woke up on 7.5 every night! Sounds like you're doing a pretty good job 🙂

Injected insulin is likely to be absorbed more quickly if exercising as the blood reaches into the capilliaries more, so this can also be a factor - even more so if injected near to a muscle that is in use during the exercise e.g. legs during walking/running. However, for someone not injecting this factor will not come into play 🙂

 

[yorksman]

Doing without carbs is possible but there may be long term health problems, ie ten years or more. You need other nutrients, vitamins, fibre. It's OK people saying Inuuit eat lots of carb free foods but they also eat raw seal liver, which is a very good source of vitamin C. If one is honest, we'd admit to skipping that here. Plus, Inuuit have one of the lowest longevity rates in the Americas.

If you must cut right down, eat some carbs in fruit and veg. I like brown rice and rye bread which are both complex carbs and I'll even eat a two or three new boiled potatoes. It is important that you keep the diet balanced. You need things like calcium and vitamin D to stop you getting things like osteoporosis later in life. Elements like potassium will help prevent muscle cramps and the best source is a banana. Fish, fruit and veg, olives, some cheeses and some wholegrain products will be well balanced with a low level of carbs.

 

[yorksman]

Someone posted about exercise soon after intake of food: I have a horrid feeling exercise (nasty stuff IMO) may be essential. Please tell me I am wrong?

I exercise one hour after meals. I used to do it three times a day for 10 mins, though I had to work up to that. I now find it more convenient to do 2 x 15 mins per day.

It doesn't really matter what you do, a walk which includes a small hill would suffice but swimming, cycling, dancing would all work. I fancy doing some of that taiko drumming. It looks fun. You don't have to jog for an hour or pump iron in the gym. Short regular daily sessions are better than going down the gym for a big session 3 times per week.

"all individuals with type 2 diabetes should be encouraged to minimally engage in greater daily movement to better manage their diabetes and body weight. In addition, engaging in physical activity of any intensity (including low-intensity ones) likely positively impacts insulin action and blood glucose control acutely."

Physical activity: the forgotten tool for type 2 diabetes management.
Colberg SR.

The benefits of improved general fitness, weight loss and improvements to heart and lungs are often what springs to mind when exercise is mentioned, but simple movement releases hormones which trigger the production of enzymes to do with digestion which also interact with insulin sensitivity. These peak at 12 hours but decline after 24 hours so short and sweet is best.

 

[DeusXM]

. It is important that you keep the diet balanced. You need things like calcium and vitamin D to stop you getting things like osteoporosis later in life. Elements like potassium will help prevent muscle cramps and the best source is a banana.

But all of these elements are easily found in non- or very low-carb sources.

100g of a standard bell pepper contains double the RDA of vitamin C in just 4g of carbs.

Calcium is easily available from cheese and natural yoghurt, Vitamin D isn't actually found naturally in starchy foods at all, it's added to breakfast cereals and bread, but there's loads of it in eggs and oily fish. Plus, you can get all the vitamin D you need simply by standing in the sun. As for potassium, spinach and chard are full of the stuff. They're also reasonably good sources of vitamin C.

Every important nutrient that supposedly makes carbs essential for long term health is easily found somewhere else. There is simply no biological need to eat carbohydrate at all - certainly there is no need to eat rice or potatoes or bread and I'm going to suggest pretty strongly that you don't really need fruit either.

Does this mean you should cut carbs out of your diet? That's up to the individual. I personally like certain fruits like blueberries which are low in carbs but packed with vitamins. I also enjoy bread as well so I don't really feel the need to cut carbs out of my diet. But the idea that eliminating bread and other starchy carbs will lead to long term health problems simply doesn't stack up when you look at the science. In fact, I'd suggest a low- to no-carb diet could in fact be beneficial for most people's health precisely because it forces them to eat a wider range of foods. If you're in the mindset you 'need' carbs then you're also probably likely to stick to quite a limited range of foods. For instance, if you believe you need carbs, you probably eat a sandwich for lunch, every single day. Whereas if you're low- to no-carbing, maybe one day you have a salad. Another you have a soup. Or an omelette.

Going low-carb really forces you out of your comfort zone and makes you explore more foods, because you have to. I eat a whole new range of things that I wouldn't have even imagined eating had I stuck to the idea I need carbs. It also then encourages you to make better food choices overall. If you're worried about your potassium, maybe you'd eat a sandwich and then a banana for your lunch. If you're low-carbing, that's not an option. So instead you go for a leafy green salad with onions, tomatoes and sliced peppers. Not only is it lower calorie, but it'll also probably give you MORE potassium than the banana alone - plus you won't be filling yourself with fructose (that has to be converted to fat before you can metabolise it) and glucose.

You can quite easily cut out carbs from your diet. Whether you want to is a separate matter, but let's not pretend everyone who avoids spuds or bread is setting themselves up for long term health problems. Any problems from supposed vitamin deficiencies from cutting out carbs pale in comparison with the consequences of fluctuating blood sugars caused by eating them.

 

[yorksman]

But all of these elements are easily found in non- or very low-carb sources.

I didn't indicate otherwise. What I said was,

"It is important that you keep the diet balanced. You need things like calcium and vitamin D to stop you getting things like osteoporosis later in life."

There is nothing there to indicate that one must eat starchy foods to obtain it. Calcium and vitamin D are just examples of the many things one needs. There's no need to post an exhaustive list including the differences between salt and iodised salt and the dangers of goitre years down the line.

The problem about an unqualified adherance is to a term such as Low Carb is outlined in Low-Carbohydrate Diets and All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies 2013

Objective : Low-carbohydrate diets and their combination with high-protein diets have been gaining widespread popularity to control weight. In addition to weight loss, they may have favorable short-term effects on the risk factors of cardiovascular disease (CVD). Our objective was to elucidate their long-term effects on mortality and CVD incidence.


The term Low Carb Diet is not specific and means different things to different people: low carb high fat, low carb low fat, how low is low, how high is high, are the fats animal, dairy, fish or vegetable fats, how much fibre does one take, soluable or insoluable and so on. There are many studies which warn against the dangers of concentrating on the low carb element whilst not devoting attention to what foods should supplement it.

"CONCLUSION: A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates."
[Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. 2010]

"CONCLUSION: Low-carbohydrate, low-GI, Mediterranean, and high-protein diets are effective in improving various markers of cardiovascular risk in people with diabetes and should be considered in the overall strategy of diabetes management."
[Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. 2013]

Any problems from supposed vitamin deficiencies from cutting out carbs pale in comparison with the consequences of fluctuating blood sugars caused by eating them.

The point is that you don't need to choose one at the cost of the other.

 

[everydayupsanddowns]

Do you have a reference for that first conclusion Yorksman?

 

[yorksman]

Do you have a reference for that first conclusion Yorksman?

Do you mean this one?

"CONCLUSION: A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates."


Yes, I gave the reference:

Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies.

It's in Fung et al. 2010

I'm not endorsing any particular diet, merely pointing out that there are many studies which have views on what one should supplement a 'low carb diet' with. The main focus of the research appears to be the longer term risk of cardio vascular disease, not because of the low carb element, but because of the substituted foods.

 

[everydayupsanddowns]

Great - Fung et al 2010 was what I was after. Just wanted to look it up.

I've been reading bits and pieces over the last year or so that have failed to find much problem with saturated fats and CHD and was interested because it mentions 'animal sources' 🙂

 

[everydayupsanddowns]

Was interested (and a bit ) to read this:

In addition, these diets can be high in red meat and low in fruits, vegetables, and whole grains which has been shown to increase risk of chronic diseases

Whole grains I understand completely and fruit to some extent... but why would these diets tend to be low in veg?

They also seem to assume that the animal protein versions will be heavily loaded toward red and processed meats, rather than a mix of poultry/fish etc. Something to do with the study being Harvard/US based perhaps?

I guess the message is that if you choose to go low/low-ish carb for the sake of your BGs then make sure you eat sources of veg protein/pulses and aren't just eating burgers and bacon. 🙄

 

[yorksman]

I guess the message is that if you choose to go low/low-ish carb for the sake of your BGs then make sure you eat sources of veg protein/pulses and aren't just eating burgers and bacon. 🙄

I think this goes back to the early 1980s when people spoke of a Protein Only Diet, no carbs at all but bacon and egg fried in butter with cream was fine. You couldn't eat even a single tomato. The idea was that you only did it for 3 periods of 10 days and it did induce rapid weight loss, but it was not a long term thing and made you feel quite ill towards the end.

But, people are people and nothing will stop them making up their own minds on what does them good. My father told of his grandfather slitting the throat of a pig and drinking it's warm blood, "I feel a touch of TB coming on".

I am more persuaded by a frenchman's view that the softer the fat, the better it is healthwise. You can cook with olive oil but you make candles with lamb's fat.

 

[Sienna]

P.S. I'd be so happy if my type 1 son went to bed on 6 and woke up on 7.5 every night! Sounds like you're doing a pretty good job 🙂

-------------
Redkite, I am grateful that so many people here take the time to help someone like me who's not too badly diabetic (I hope) - I am really lucky. Hope with all my heart your son goes on splendidly. It sounds like you are the one doing a good job.

Everyone else, thank you for all the advice. Say what you will about stinky diabetes, it is altogether Interesting! Who wd have thought an egg or a slice of bread was as full of content, potential and menace as a speech by Kim Jong-Un.
On Friday I have a place on a Desmond Course to learn how to be diabetic. I'm very curious.

 

[Northerner]

On Friday I have a place on a Desmond Course to learn how to be diabetic. I'm very curious.

Good luck with the course Sienna! Be sure to let the others know about the forum 😉

 

[yorksman]

On Friday I have a place on a Desmond Course to learn how to be diabetic. I'm very curious.

It was fun when I went because it was snowing and there was a good crowd in a cheery mood. The talks on what diabetes is were interesting and told me stuff that I didn't know, the plastic models of a fried egg and slice of bacon were a bit primary school. There will be something for everyone but do ask questions to make sure you get something out of it too.

 

[avantgardaclue]

Potatoes are a big no no for me, and oh how I miss pasta and rice. However all is not lost. Tried quinoa which is OKish, but the real winner for me is wholemeal couscous. A fraction of the carbs of spuds or rice, and low GI too and it fills you out.

10 mins cook time, splash in some toasted sesame seed oil to add flavour and you have an accompaniment food for all meals*

* My view and opinion that is.

 

[yorksman]

Potatoes are a big no no for me, and oh how I miss pasta and rice. However all is not lost. Tried quinoa which is OKish, but the real winner for me is wholemeal couscous. A fraction of the carbs of spuds or rice, and low GI too and it fills you out.

Morrisons brown rice is a parboiled rice like Uncle Ben's converted rice. It has a low GI. It has very little effect on me. If you can eat wholemeal couscous, which is a coarse semolina made from durum wheat, you will be able to eat wholemeal pasta, which is made from the same stuff. The problem in the UK is that wholemeal is legally vague but a brand like Buitoni has a stricter definition. If you can eat wholemeal couscous, you should try Buitoni wholemeal pasta.

Barley too is worth trying. It's great in stews like lamb and barley.

 

[DeusXM]

And before Dory gets here, you can use cauliflower to make zero-carb rice....