Officially diagnosed this morning and a little grumpy

[Burylancs]

I’m not sure which JBs you are using for that estimate @Burylancs, but the Bassets ones I use for hypo treatments are approx 5-6g of carbs each, so 4 jelly babies would be 20-24g of carbs for me which would raise my BG by approx 6-10mmol/L depending on the time of year.

I guess different people have different reactions to things, but 1mmol/L for 20g seems unusual to me.

I think you must be right. I remember years ago weighing 3, 4 and 5 JBs and calculating that 4 were about 15 grams of carb ( a Carb Portion for T2s according to X-Pert T2 Course). I was probably kidding myself. Nowadays I tend to use Dextro Energy tablets or buy a big bag of Freddos in a Cadbury outlet store. A Freddo is a T2 Carb Portion also.

 

[Bruce Stephens]

I think you must be right. I remember years ago weighing 3, 4 and 5 JBs and calculating that 4 were about 15 grams of carb ( a Carb Portion for T2s according to X-Pert T2 Course). I was probably kidding myself. Nowadays I tend to use Dextro Energy tablets or buy a big bag of Freddos in a Cadbury outlet store. A Freddo is a T2 Carb Portion also.

According to https://www.sainsburys.co.uk/gol-ui/product/all-sweets-/bassetts-jelly-babies-bag-190g 4 sweets is 21g, so 3 would be close to 15g. (I'm guessing they're just copying from what the manufacturer says, so it's likely correct.)

 

[everydayupsanddowns]

A Freddo is a T2 Carb Portion also.

Gotta love a Freddo! Not ideal as a hypo treatment sadly, because the fat in chocolate slows down the carbs too much for a hypo (though frustratingly they remain too speedy for general unhindered consumption!)

 

[Docb]

4. The ludicrous DiRECT study in 2017 of Roy Taylor claimed to have operated on 50% of calories from carbs, 10-20% from Protein and 20-30% from fats. Which means Taylor's guinea pigs were getting upto 20% of their calories from Fresh Air. His figures have 100 recommended combinations of carbs, protein and fats of which 99, Ninety-nine ! of them are mathematically impossible e.g. 50 +15+25 adds up to 90% not 100%. It's amazing that this stuff is taken so seriously especially by Diabetes UK, although they've ploughed £millions into it so feel that they have to keep plugging it.

You have me at a disadvantage because I have not looked at the detail of the direct trial - I am not inclined to set aside the several days it would need to gather together the information and even begin to understand it, let alone critique it.

I do however note that the authors (and there were an awful lot of them of which R Taylor was one) interpretation of the outcome of the trial was...

Our findings show that, at 12 months, almost half of participants achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care.

Are you suggesting that because some of the experimental detail looks a bit odd, that this overall interpretation is unjustified? If so then that seem to me to be a bit harsh.

Moderator Note: The conversation that unfolded about the division of macronutrients in the DIRECT trial has been split away here: https://forum.diabetes.org.uk/boar...cronutrient-divisions-in-direct-meals.106871/

 

[Martin.A]

Unfortunately, the colour of the carbohydrate has very little effect, as a BG meter will show. Whole grains or brown rice may make a very tiny difference, but really it's almost exactly the same carbs but with a little fibre and a minute amount of vitamin added.

I always thought that one of the reasons given for switching to wholegrain was that it's lower GI, since carbohydrates with a low GI value are digested, absorbed, and metabolized more slowly than their high-GI counterparts and cause a lower and slower rise in blood glucose. White rice is high GI, brown rice medium?

 

[ianf0ster]

I always thought that one of the reasons given for switching to wholegrain was that it's lower GI, since carbohydrates with a low GI value are digested, absorbed, and metabolized more slowly than their high-GI counterparts and cause a lower and slower rise in blood glucose. White rice is high GI, brown rice medium?

Three points about lower GI being better for T2D's.:
1. The total carbs digested matters as well as how fast they are digested, partly because slower digested carbs have an effect for longer, so they raise the background BG that a T2D starts their next meal at.
2.The effect of 'brown carbs' is actually smaller than the 'yesterday's pasta' effect (sorry don't know the official name). That's where the effect on BG from pasta cooked yesterday and kept cool in fridge overnight is much lower than that of freshly cooked pasta.
3. In all cases, the BG reduction from gram of carbs not eaten is greater than that from either switching to a brown carb or eating a leftover from yesterday.

 

[Leadinglights]

Three points about lower GI being better for T2D's.:
1. The total carbs digested matters as well as how fast they are digested, partly because slower digested carbs have an effect for longer, so they raise the background BG that a T2D starts their next meal at.
2.The effect of 'brown carbs' is actually smaller than the 'yesterday's pasta' effect (sorry don't know the official name). That's where the effect on BG from pasta cooked yesterday and kept cool in fridge overnight is much lower than that of freshly cooked pasta.
3. In all cases, the BG reduction from gram of carbs not eaten is greater than that from either switching to a brown carb or eating a leftover from yesterday.

My understanding is that the GI of a food is determined by laboratory analysis which is rather different to how an individual handles the foods because of their gut bacterial flora and of course everybody's gut flora is different. By adding fats and proteins to the high GI food it can be converted into lower GI.

 

[ianf0ster]

My understanding is that the GI of a food is determined by laboratory analysis which is rather different to how an individual handles the foods because of their gut bacterial flora and of course everybody's gut flora is different. By adding fats and proteins to the high GI food it can be converted into lower GI.

Correct in meaning (though not in terminology), we T2D's aren't all the same. Our genetics and gut microbiome means that the way an individual processes carbohydrates is unique to that individual. Hence the usefulness of BG monitors.
However since GI is lab determined, although the 'effective GI' can be changed, the GI itself has to remain the same!

 

[Leadinglights]

Correct in meaning (though not in terminology), we T2D's aren't all the same. Our genetics and gut microbiome means that the way an individual processes carbohydrates is unique to that individual. Hence the usefulness of BG monitors.
However since GI is lab determined, although the 'effective GI' can be changed, the GI itself has to remain the same!

Yes that's what I meant, It's effect on the individual.

 

[Martin.A]

Three points about lower GI being better for T2D's.:
1. The total carbs digested matters as well as how fast they are digested, partly because slower digested carbs have an effect for longer, so they raise the background BG that a T2D starts their next meal at.
2.The effect of 'brown carbs' is actually smaller than the 'yesterday's pasta' effect (sorry don't know the official name). That's where the effect on BG from pasta cooked yesterday and kept cool in fridge overnight is much lower than that of freshly cooked pasta.
3. In all cases, the BG reduction from gram of carbs not eaten is greater than that from either switching to a brown carb or eating a leftover from yesterday.

I'm sure the advice usually comes with a caveat that you reduce portion size at the same time, which is guess is where GL comes in. Personally I've gone for alternatives, like cauliflower rice or other kinds of pasta.

 

[everydayupsanddowns]

My understanding is that the GI of a food is determined by laboratory analysis which is rather different to how an individual handles the foods because of their gut bacterial flora and of course everybody's gut flora is different.

I dont believe that is right. I think it was a university in Aus (Sydney?) that used to be quite heavily involved in this. From memory 100 volunteer subjects were given 50g in carbs from a thing in isolation, and the effect on their Bg levels was measured at intervals over the next so many hours, and compared against pure glucose (GI 100). The 100 results were then averaged out to try to take account for the individual variance you mention

By adding fats and proteins to the high GI food it can be converted into lower GI.

This is also a weakness of GI as a measure. Things are rarely if ever eaten completely in isolation. And also you don’t always eat 50g in carbs of everything.

There was an adjusted measure called Glycaemic Load, which tried to factor in likely portion size.

About – Glycemic Index

glycemicindex.com

EDIT: the website says ‘10 or more’ people, rather than my memory of 100

 

[Leadinglights]

I dont believe that is right. I think it was a university in Aus (Sydney?) that used to be quite heavily involved in this. From memory 100 volunteer subjects were given 50g in carbs from a thing in isolation, and the effect on their Bg levels was measured at intervals over the next so many hours, and compared against pure glucose (GI 100). The 100 results were then averaged out to try to take account for the individual variance you mention


This is also a weakness of GI as a measure. Things are rarely if ever eaten completely in isolation. And also you don’t always eat 50g in carbs of everything.

There was an adjusted measure called Glycaemic Load, which tried to factor in likely portion size.

About – Glycemic Index

glycemicindex.com

EDIT: the website says ‘10 or more’ people, rather than my memory of 100

I stand corrected, I have just looked up the detail in my food science nutrition text book. It also suggests as you do portion size is the issue as to have the same amount of glucose for each food is unrealistic in terms of the portion needed e.g. 1 pound of carrots hence glycaemic load.