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Opinions on low carb diets

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luisa

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Type 2
Hi all,

My name is Luisa, I am a dietitian and I have been doing a course in Diabetes.

I have consistently seen patients on low carb diets have good results and I am looking at journal articles with varying degrees of evidence at the moment but, I feel any essay on the pros and cons of a low carb diet would be incomplete without the comments of those who have done them, or are doing them.

I am looking for comments good and bad with as much detail as possible - energy levels, weight, bowels etc

Please PM me or reply on here.

Thank you,

Luisa
 
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Hi Luisa have you mailed admin before you put this on the forum, usually not too keen on you given out your email address for all to see,so maybe use the PM(private mail) facility... 🙂

Sorry if im doing a mods/admins job here dnt wanna step on anyones toes.
 
I really wan to do a low carb diet , to loose some weight :(
 
Thanks Steff,

Hi Jenny sorry I wouldn't be keen to give any advice on low carb diets as the position statement from Diabetes UK remains that there is still inadequate evidence but I do have an interest and so would like to hear from those who have tried them.

Thanks,

Luisa
 
Hi Luisa, as long as you are just looking for anecdotal evidence, I don't see any problem with you asking for responses here about people's experiences with low, or shall we say 'controlled', carb diets. Personally, I don't consciously restrict the carbs in my diet although I do tend to avoid snacking on carbs so that I don't have to have extra injections of insulin. I probably have somewhere in the region of 140-180g carbs per day. 🙂

Really, it is a trade off for people I think. People need to discover how much carbohydrate they can consume in a meal or snack without raising their blood sugar levels too much. If they find that this amount is too low and represents too great a restriction then medication can allow for a more flexible diet. Some people are happy to restrict carbs to a very low level. We're all different! For me personally, lower carb content of meals means smaller amounts to inject, which also tends to mean better blood sugar control. 🙂
 
Hi Luisa,
firstly you need to tell everyone what you consider a low carb diet 🙂
There does seem to a rather wide veriation on what people consider low carb.
 
I would personally find it difficult to eat enough calories on a low carb diet. I've tried lowering my carbs lately and am often falling short of my calorie targets.

The only solution would be more cheesecake.🙄

As a T1, it isn't such a necessity to cut carbs unless research shows health benefits. I'm pleased it's being looked at, as long as it's done scientifically.🙂

Rob
 
Hi Luisa,

Low carb diet is something that I have read about mainly from this forum and I get the opinion from type 2's that it can be really helpful for blood sugar control but dieticians I have spoken too don't recommend it and instead say we should stick to a balanced diet including plenty of carbs for energy.

Personally I eat a reasonable amount of carbs but find that if I eat to much long lasting carbs like pasta or pizza this can make my sugar levels very hard to control even by using carb counting and insulin injections to compensate. I stick to medium amounts of carbs (under 90g carbs at a time which is high for some people).

The only time I have found low carb diet helpful is in the morning. I have dawn phenomenon where the liver outputs sugar in the morning. As a result I have high insulin resistance and need a high insulin to carb ratio in the morning. By cutting down my carbs to only 12 g and incresing the no carb foods (I have poached egg, tomatoes, mushrooms) in my breakfast I have been able to drop my insulin dose significantly and no longer suffer from spikes after breakfast, I feel better in terms of energy levels and there is the added bonus that I don't get hungry so quickly so I snack less.

Basically, low carb, and low GI diets can really help a lot of people and work like yours looking in to the pros and cons is really needed so that people can make a better informed choice of which diet to follow. People also need to know of any risks of a low carb diet before deciding.
 
Speaking purely personally, I generally match my insulin dose to carbohydrate content of food, which is connected with things like physical activity, infection, weather etc. However, it is a pleasure to have a carb free snack or meal once in a while - a meal with no associated injection.

There was also an incident a few years ago when my partner and I were stuck on the wrong side of a Andean meltwater stream for 2 days (alternative was a 2 day walk over a 2000m pass, then bus back to city, then boat trip to reach the same border post), so we had to limit ourselves to 1 bowl of porridge a day, keeping other rations, dried apricots and muesli bars, for the 20km walk once we crossed the stream, left Argentina via a border post and walk towards Chile. We had a bonus of mugs of hot chocolate sold by Argentinean border post officers and apples and blackberries collected from roadside. Then we had to hope that our dried apricots wouldn't be confiscated as illegal imports into Chile. Obviously, in that situation, the ability to adapt MDI regime to just one bolus dose per day was pretty vital!
 
Pumper_Sue said:
Hi Luisa,
firstly you need to tell everyone what you consider a low carb diet 🙂
There does seem to a rather wide veriation on what people consider low carb.
Click to expand...

I echo these sentiments. Some people think that because they have lowered their carbs slightly from the recommendations that they are low carbing. I would like to know what you consider the ratio of carbs and fats necessary to be a low carber.. Some extreme low carbers, 30-50gms per day, insist that you have to up your fat intake considerably.
 
Thanks for the responses so far, they are all very useful.

I see many Type 1s have been in touch and I think compared to Type 2s your knowledge on carbs tends to be better because it is repeated so often and if you are testing you BG levels regularly you can't help but be aware that what you eat will have an effect on your results.

Indeed Sue - what is a low carb diet? Well I may be as baffled as you! Many of the studies which look at a low carb diet state it as being 30-40% of the total intake which isn't really a big reduction on the recommended 55-60%.

I would be interested in those who have followed an Atkins or Paleo or DUKAN diet as these are particularly low carbohydrate. Interestingly they also advise that you reduce your alcohol intake. So, with so many variables are they really that easy to follow? But if you do, are the results worth it?

I should hasten to add that all the studies I have looked at have been with overweight or obese individuals and have resulted in weight loss therefore a very low carb diet (e.g Atkins etc) is unlikely to be useful in a normal weight person with Type 2 Diabetes.

Any more queries, please feel free to ask.

This is not a study just looking for opinions. Anything I use will give the 'jist' of what was said and no names.

Luisa
 
luisa said:
...I should hasten to add that all the studies I have looked at have been with overweight or obese individuals and have resulted in weight loss therefore a very low carb diet (e.g Atkins etc) is unlikely to be useful in a normal weight person with Type 2 Diabetes.
...Luisa
Click to expand...

I think you will find that there are a lot of 'normal weight' people who do follow a very low carb diet, so that they can reduce their dependency on medications to control their blood sugar levels 🙂
 
There's a snag with everything though isn't there Luisa? - for instance, if you are gonna do Atkins properly, you need to take quite a lot of supplements.

I eat approx 130g of Carb a day. I did before I was diagnosed - they asked what I ate typically, I told them, they said it was fine and balanced and enough calories, then told me what injection would cover all that (one jab a day then!!!) I ate 130g a day, because that was 'normal' for me pre diabetes, within my 1500-ish cals, it kept my weight at 8st 6lbs, it kept me satisfied and why would I want any more?

I wish dietitians would stop telling people we NEED carbs. We don't.

(We may WANT them though .....)
 
Personal view from me, as a type 1 for 47 years using an insulin pump.

Carbs are counted and restricted to no more than 50 carbs per meal.
If I eat more then my control goes wonky. If I lower carbs to far or just have fat and protein then I need almost twice as much insulin as I would for a carb meal. Pasta, rice, pizza, are never on the menu. ( I don't like them).

So you could say I am very carb aware and as I have aged my consumption of carbs has reduced greatly 🙂
 
I also think that in the case of Type2's there is not enough education being handed out as to why we need to control, the amount of carbs we eat. That is why forums like these are the best for Type2's as we are talking to other diabetics who understand. We don't necessarily have to be extreme but if all Type2's were given a meter and test strips then we could educate ourselves as to the amount that is suitable for us on an individual basis.

I am an underweight Type2 and can manage 130 gms per day but any more than that and my levels are raised. I do not take medication, although there may come a day when I have to. I am never hungry because I eat plenty of fresh veggies and balance my meals throughout the day. It is very rare for me to have a snack.
 
Hahaha! Tophywench you do make me smile. I feel that as a dietitian I need to use the evidence available to me to the best of my ability whilst supporting what my atient wants because ultimately it is your body and your Diabetes. Patients will do what they want and I want to facilitate that in a safe environment that takes what they want to do into account.

Also, yes Atkins and Paleo diets all suggest supplements which is an issue all of its own as some suggest mega-dosing which if you look at the studies can have links to cancer.

This is a very contentious issue, which I think is probably why I wanted to study it. I don't think there can be a conclusion with the current evidence just a need for more studies.

Northerner, yes definately I agree many 'normal' weight people do follow a much lower carb diet. I suspect when they see me in clinic they may tell me what they think I want to hear!
 
luisa said:
Northerner, yes definately I agree many 'normal' weight people do follow a much lower carb diet. I suspect when they see me in clinic they may tell me what they think I want to hear!
Click to expand...

Lol there's plenty of evidence about people doing this on all forums.
With the attitude of some dietitions it's hardly surprising though.
 
I have never felt I was lacking in carbs - often I seem to be having more spuds than everyone else.

It therefore surprised me to read in various places that the typical 120 - 160g I have is considered 'moderate' by some and 'low' by others.

Although I can happily eat upwards of 100g in a single meal if it's something I am used to and have worked out a suitable split-dose system for I am a believer in small numbers:small mistakes / big numbers:big mistakes

The higher the carb load the greater significance of the inaccuracy in my usual guesswork (say 10-15%)... Additionally large boluses just do not behave as reliably (well in my experience anyway) as small ones. Much over 7 or 8u for me and the results just don't play out as I would expect - something to to with surface area:volume of the insulin according to a poster on another forum.
 
Cherryie brilliant I am delighted for you and pleased that you have such good control.

We do try to have people within a normal weight range however if you have always been slightly underweight then I wouldn't have a problem with it, because as you describe you seem to have a healthy and varied diet.

I get the feeling that perhaps Dietitians can be a bit hard on people with Diabetes sometimes, or certainly come across as being that way but I honestly believe that is for us as profession to change.

My next wee project is patient satisfaction questionnaires but I daresay that is for a different forum!!!

Back to low carb experiences please :D
 
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