Official diabetes diet misinformation - any candidates for the Darwin Awards?
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If it is accidentally and ignorantly withheld, then Doctors - just like us - need educating and re-educating. Some - like us - will willingly take counsel and change their route. Others - like us - may well be more difficult to persuade....
If it is wilfully and deliberately withheld, you can bet your bottom dollar, pound, euro, yen or Rand - it's a financial incentive sufficient in amount, offered and proffered (in all likelihood), by the pharma guys....1 -
I've mentioned my sister before and how stubborn she is to even attempt a single simple change even in baby steps.
For example, she drinks only regular soda and sweet tea and never water or anything unsweet or diet.
I simply suggest to switch to diet... "but it tastes bad". So I suggest mixing 75% regular to 25% diet and gradually get to all diet... "that's weird. And I just don't want to drink diet. It's gross!"...................... FFS!!!
Today I'm with her while we visit our Dad. This talk happens again after she says she refuses to take her metformin and won't even take the D3 and magnesium her doctor told her to take. I asked what will it take before you make even this 1 simple change? What has to happen? A heart attack? A stroke? Lose a foot? (Neuropathy is just starting btw) she shrugged her shoulders....
I told her husband that when they remove her foot to keep it in a jar next to a bottle of diet soda so she can be very clear as to which one is actually gross and also next to a bottle of regular soda so she's fully aware of what she bought with it!
I don't hold back anymore8 -
I'm going to defend doctors here. Just a little bit.
I'm a doctor. I'm also a type 2 diabetic. 12 years now. I gave myself DM2 by basically "living on sugar" for my entire life. When I finally got DM2 I tried to fight it with a calorie restricted low fat diet and exercise. I believed the ADA nonsense. I "poo-pood" Atkins. I was an educated (wrongly) idiot.
Last year I discovered Atkins and LCHF. Long story short. I'm at goal weight bad my blood sugars are totally normal.
Now I'll defend doctors.
When I go into a convenience store pretty much everything is off the menu with the exception of pork rinds, sour cream, nuts, and the sausages and hot dogs. In a grocery store only some of the food sold on the periphery is OK. Almost everything in the isles is off limits.
Restaurants, meetings, and parties are always a problem.
Most diabetic patients don't want to put in the work (LCHF + exercise). They want a pill (or a shot). They are surrounded by crappy food. All the time. This is the food environment in which most Americans live.
Only very few patients are able and WILLING to shun probably 95% of the food products available to them.
OK. That's my pathetic attempt to defend my colleagues.
@tsazani - I have to agree with you here, for the most part. Nutrition, particularly updated nutrition, is not a standard part of the medical curriculum. My understanding is that most folks get 1 class to make 1 semester worth of education in this arena. And that, as you said or implied, most patients are rarely compliant with doctor instruction, and it's far easier to get them medication compliant if you don't take away their favorite indulgences!!! It is sad but true.
But rather than label the patients as purely being unable and unwilling to do this, I think it helps to link back the neuro-chemical compulsion that is driven for dopamine, particularly when a food that has created a dopamine response previously is viewed, thought of, or even smelled. My understanding is that fat, carbs (sweet or starchy), and some level of sodium create the perfect trifecta of dopamine reaction - so french friends, some breads, doughnuts, cakes, etc. It is why even the mention of a food like this can be a downfall for most.
I know it has been said that keto can help with this, that abstaining from all starches, all sugars, and most sweet foods - artificial or otherwise, is required to break this connection, but there has to be something else. I know not everyone is wired this way - some avoid the dopamine issue altogether, but those of us susceptible - keto alone, sans sweeteners, was not enough for me. One major dopamine trigger and I began the slow fall to Hades.
And whenever someone has tried to avoid those foods, they became anxious or depressed or what-have-you, or absolutely unable to avoid them, so that has created a knee-jerk fear response for most patients. When they say, "I could never give up XYZ," it makes me wonder why. "It makes me sad..." "It is the only food that makes me happy..." or "every time I give it up, I get the shakes, get anxious, or get depressed," etc. I wonder if would couldn't add something, a supplement, a different food, or timing, etc., to blunt the edge of that for them to suddenly make things seem somehow possible???
Anyway, sorry to dump another rabbit hole idea here, but I strongly believe that it is fear and such within a patient and lack of compliance that drive doctors to not focus on nutrition because it has the least compliance and success within the average patient... So another chicken and the egg situation, no?8 -
KnitOrMiss wrote: »I'm going to defend doctors here. Just a little bit.
I'm a doctor. I'm also a type 2 diabetic. 12 years now. I gave myself DM2 by basically "living on sugar" for my entire life. When I finally got DM2 I tried to fight it with a calorie restricted low fat diet and exercise. I believed the ADA nonsense. I "poo-pood" Atkins. I was an educated (wrongly) idiot.
Last year I discovered Atkins and LCHF. Long story short. I'm at goal weight bad my blood sugars are totally normal.
Now I'll defend doctors.
When I go into a convenience store pretty much everything is off the menu with the exception of pork rinds, sour cream, nuts, and the sausages and hot dogs. In a grocery store only some of the food sold on the periphery is OK. Almost everything in the isles is off limits.
Restaurants, meetings, and parties are always a problem.
Most diabetic patients don't want to put in the work (LCHF + exercise). They want a pill (or a shot). They are surrounded by crappy food. All the time. This is the food environment in which most Americans live.
Only very few patients are able and WILLING to shun probably 95% of the food products available to them.
OK. That's my pathetic attempt to defend my colleagues.
@tsazani - I have to agree with you here, for the most part. Nutrition, particularly updated nutrition, is not a standard part of the medical curriculum. My understanding is that most folks get 1 class to make 1 semester worth of education in this arena. And that, as you said or implied, most patients are rarely compliant with doctor instruction, and it's far easier to get them medication compliant if you don't take away their favorite indulgences!!! It is sad but true.
But rather than label the patients as purely being unable and unwilling to do this, I think it helps to link back the neuro-chemical compulsion that is driven for dopamine, particularly when a food that has created a dopamine response previously is viewed, thought of, or even smelled. My understanding is that fat, carbs (sweet or starchy), and some level of sodium create the perfect trifecta of dopamine reaction - so french friends, some breads, doughnuts, cakes, etc. It is why even the mention of a food like this can be a downfall for most.
I know it has been said that keto can help with this, that abstaining from all starches, all sugars, and most sweet foods - artificial or otherwise, is required to break this connection, but there has to be something else. I know not everyone is wired this way - some avoid the dopamine issue altogether, but those of us susceptible - keto alone, sans sweeteners, was not enough for me. One major dopamine trigger and I began the slow fall to Hades.
And whenever someone has tried to avoid those foods, they became anxious or depressed or what-have-you, or absolutely unable to avoid them, so that has created a knee-jerk fear response for most patients. When they say, "I could never give up XYZ," it makes me wonder why. "It makes me sad..." "It is the only food that makes me happy..." or "every time I give it up, I get the shakes, get anxious, or get depressed," etc. I wonder if would couldn't add something, a supplement, a different food, or timing, etc., to blunt the edge of that for them to suddenly make things seem somehow possible???
Anyway, sorry to dump another rabbit hole idea here, but I strongly believe that it is fear and such within a patient and lack of compliance that drive doctors to not focus on nutrition because it has the least compliance and success within the average patient... So another chicken and the egg situation, no?
Yes!
But... (yes, here it comes), there are some medications that can help with cravings (such as Victoza and Symlin).0 -
Victoza (like Trulicity) seems to work by causing the pancreas to release more insulin to help lower blood sugar when it is high. The problem with that is that if you are insulin resistant, this creates a feedback loop of excess hunger with starvation and nutrient deficiencies and all that. Since most diabetics are IR first...??? I just don't see how burning out your pancreas to produce more when your body is massively inefficient at using what is in the body helps...
Reading Symlin is scary! It stops the liver from releasing glycogen, so your body can't self-regulate glucose...it slows digestion - which while it allows the body to absorb more from the food can also cause other digestive issues...and it messes with your brain to have you eat less. So you're eating less, but it's taking longer to digest, and the body can't release glycogen to help??? Major all caps underlined risks of hypoglycemia. Showing that it MUST be used with insulin, in a very specific way. and that each time you use it, you must have at least 30 grams of carbs and 400 calories or something... That's a whole lot of scary, easy to go wrong stuff...
But I guess the realities of living with diabetes is scary too. I just don't like anything messing with the few things my body might be doing right or reasonably well... Is it less scary to you than that? I mean, I know everything has risks, but sheesh. @midwesterner851 -
Symlin (amylin) does not stop the liver from releasing glycogen. It decreases the amount of glycogen released, but does not stop it altogether.
It slows stomach emptying, but the biggest reason it decreases hunger is its effect on GLP-1 receptors.
Within the family of incretin mimetics, Symlin works most quickly and is on the 'short-term' side. Let's say I know that I always over-eat if I go to X restaurant. If I take Symlin before I eat at X, then I'll eat less.
Like insulin, amylin is a hormone normally made in the pancreatic beta cells. Unlike most people, I do not have these cells and do not make this hormone on my own. Nonetheless, GLP-1 agonists can (and do) help those who are not type 1's. Symlin could be a good match for type 2's; and I'll agree it isn't ideal for non-diabetics.
Symlin isn't scary to me, but it is clear to me that the 30g of carbs suggested is to prevent hypoglycemia. Since I am so carb-sensitive these days, I think there is some benefit (for me) with a much smaller dose of carbs. It's tough for a drug manufacturer individualize something like that, though.
Among GLP-1 agonists, Saxenda is the same drug as Victoza except it is prescribed for non-diabetics and in higher doses.4 -
@midwesterner85 - Thanks for the explanation. The main website I visited for it said that it did stop the liver from releasing glycogen, which is a red flag for me, but I absolutely will take "on the ground" experience far and above what some piece of paper says. It sounds like a fantastic option for you to employ!
And yes, the 30 grams of carbs/calorie suggestion is absolutely related to preventing hypoglycemia, and I understand that for the "average user" that is probably a really good marker. I'm glad to know that you can adjust the dosage better to yourself...
Do you credit the exercise or diet more for helping you re-sensitize to carbs?0 -
KnitOrMiss wrote: »@midwesterner85 - Thanks for the explanation. The main website I visited for it said that it did stop the liver from releasing glycogen, which is a red flag for me, but I absolutely will take "on the ground" experience far and above what some piece of paper says. It sounds like a fantastic option for you to employ!
And yes, the 30 grams of carbs/calorie suggestion is absolutely related to preventing hypoglycemia, and I understand that for the "average user" that is probably a really good marker. I'm glad to know that you can adjust the dosage better to yourself...
Do you credit the exercise or diet more for helping you re-sensitize to carbs?
It's all diet. When I say I'm carb sensitive, I mean that carbs have more of an impact on BG than in the past. It isn't something I see as a benefit.1 -
LCHF first. Exercise second. Generic metformin third. Brand name Glucophage fourth. Additional meds fifth.
If you know what you are doing, medical cannabis can be an incredible tool to lower IR. Stress and poor sleep will increase you IR. Improving stress and sleep are forgotten contributions to lower IR.
Bupropion (generic wellbutrin) can be a great med to curb carbs cravings.
1. Any idea as to which generics are best tolerated?
2. Any carb-addicted T2Ds you would not recommend try wellbutrin?0 -
How (not) to drink when you're diabetic.
As you might guess, there's a lot of folksy "wisdom" out there on how to do booze and diabetes in the same lifetime.
"Ideally, you should drink with meal or snacks. Some snacks that are good include popcorn, vegetable/fruit salad, and fat free yogurt."
http://healthyone.org/alcohol-and-type-2-diabetes/
"It is not easy to recommend one type of alcohol instead of another, but American Diabetes Association
informs that beer and dry wine have lesser carbohydrate content, fewer calories, and lesser alcohol content and may be better for diabetics."
http://healthyone.org/diabetes-and-alcohol-moderation-and-caution-is-required/
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Beer? Ooookay. 1 -
LOL
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That's what I was thinking too.
But since alcohol inhibits glycogen release by the liver, the argument is somehow that the extra carb intake doesn't matter? As long as it is just beer instead of sugar mixed with liquor? But then lower alcohol content along with lower carb content = WTF?!1 -
midwesterner85 wrote: »
That's what I was thinking too.
But since alcohol inhibits glycogen release by the liver, the argument is somehow that the extra carb intake doesn't matter? As long as it is just beer instead of sugar mixed with liquor? But then lower alcohol content along with lower carb content = WTF?!
Well put, old chap!0 -
??? Who wrote that crap anyhow? Obviously someone who knows nothing about the science of alcohol. Sheeesh.2
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canadjineh wrote: »??? Who wrote that crap anyhow? Obviously someone who knows nothing about the science of alcohol. Sheeesh.
Hear, hear! I'm guessing someone who gets paid by the ounce for piles of *kitten*1 -
canadjineh wrote: »??? Who wrote that crap anyhow? Obviously someone who knows nothing about the science of alcohol. Sheeesh.
Hear, hear! I'm guessing someone who gets paid by the ounce Beer-crate for piles of *kitten*
Fixed that for ya....
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canadjineh wrote: »??? Who wrote that crap anyhow? Obviously someone who knows nothing about the science of alcohol. Sheeesh.
Ya know, if someone were to set about dispensing the worst advice on how diabetics should swig their alcohol, I have to wonder how dissimilar it would actually be from the dog's breakfasts the ADA mantra-mumblers routinely puke up for public consumption ....0
