Finding it difficult to limit carbs

LIFOtheparty

I was told by my doctor that I have prediabetes and that I should try to limit my carbs (i.e. have bread once a week max and eat meat, eggs, and vegetables only). I also want to lose around 100 lbs. I have tried keto off and on multiple times but I can't ever stick to it. I'm just finding it hard realistically to keep my carbs low. I feel very restricted and then when I inevitably eat carbs I feel like I've failed my body and my health.

Can anyone with prediabetes or blood sugar problems chime in on this? Is it really necessary to eat a low carb diet when you have prediabetes? I know for weight loss it's CICO, but surely I'm not doomed to a low-carb diet forever b/c of prediabetes?

kevont

I've good some bad news/good news for you here. Of course, your results may vary and you most certainly should follow your doctor's advice over that of internet strangers.

First the bad news. I was diagnosed with diabetes back in 2017. I was put on the low carb diet and yes I had to stick to it. It was hard but not impossible. It just takes a lot of planning at first but in a month or two it will be a lot easier since you will be more familiar with what you like and what you don't.

Now for the good news. I lost over 150 pounds since 2017 and my blood sugar has dropped so drastically that I don't even pay attention to my carbs any more. I've discussed this with my doctor and she is fine with it as long as my blood sugar doesn't go up. I still eat lower carbs than I did before being diagnosed with diabetes but then again, I eat lower everything since then.

Cahgetsfit

I don't know - I'm not a medical professional - but my dad had very high blood sugar too and his doctor told him to lay off the mega sugar laden stuff like ice cream but didn't say to not eat bread. He eats bread every day still. I think it's more a matter of swapping out to wholegrain stuff and reducing the quantities - not stopping altogether?

The first thing that came up on Google (I know - it's not a doctor.... ) https://lark.com/blog/2018/4/23/pre-diabetes-diet doesn't say to cut out bread, just says to choose wholegrain stuff. huh - I saw this after I wrote that in the paragraph above

cbihatt

Diabetes is no joke. If your doctor has directed you to limit carbs, you should follow that advice to the best of your ability. Did you get any guidelines for that? As in, how many carbs you should be aiming for? Personally, I would not jump on the keto train, but there are people who have some success with it. Maybe ask your doctor for a referral to a nutritionist?

rheddmobile

I’m a type 2 diabetic and I eat bread regularly. I can’t eat refined white bread without a blood glucose spike, but one or two slices of Dave’s seedy bread (can’t remember which exact variety I get) doesn’t spike me. Different diabetics have different tolerances, but having bread only once a week sounds unnecessary for most people and isn’t in line with ADA recommendations, for what that’s worth. My a1c is consistently under 5, controlled by diet and exercise, and I have never done keto - I eat about 150g net carbs daily. On days when I do long runs I can eat a bunch of carbs afterwards without raising my blood sugar.

With prediabetes, the main thing is to reverse the issues you’re having before they progress to full fledged diabetes. That means no binging on carbs, try to cut back on quick digesting carbs such as soda, juice, sweets, and refined flour, but most importantly lose the weight, and start exercising. Both cardio and strength training improve insulin resistance.

Hannahwalksfar

Listen to your doctor. If you find you lack self-control then get therapy to help you learn self-discipline. Your life is not worth bread.

corinasue1143

If you are still trying, you have not failed! You just hit a bump in the road. Use it as a learning experience. Do you eat more carbs when you are hungry? When you are tired? When you are stressed? Learn to manage it. When you want carbs, reach for something else instead. Take a deep breath. Ask yourself what you really want. Sleep? Dinner? An answer to problems?

LAT1963

What are you doing for exercise?

"Pre-diabetes" means you have "peripheral insulin resistance". You have been eating enough carbohydrate that your insulin level has been staying high. Because of the constant stimulus of insulin telling your muscles to uptake sugar, without corresponding burning off of the sugar they have soaked up, your muscles have down-regulated the number of insulin receptors they have, to 'turn down the noise' of the constant insulin level that resulted from a combination of over-eating and possibly of eating round-the-clock. There's some implication of high fructose corn syrup as well but that mechanism hasn't been worked out yet.

In normal people insulin levels drop off overnight; you need to give your body an opportunity to do this for your muscles to have a chance to up-regulate the number of insulin receptors they have. So don't eat after 8 pm (water is okay). In addition you need to exercise daily to clear out all the glucose that your muscles have already pulled out of your blood (and stored internally as glycogen) so that your muscles 'want' to uptake more glucose again. Only by exercising daily can your muscles get the biological signal to regain sensitivity to insulin and start uptaking sugar at an appropriate rate when insulin levels are within the normal range instead of elevated as they are now.

So. Count calories. Eat only non-grain non-potato non-rice non-taro non-tapioca carbs (those all have a high glycemic index-quick absorption that spikes blood sugar followed by insulin). Regard corn syrup as a poison. Don't eat after 8 pm. And exercise like crazy.

PS: be suspicious of non-heirloom corn as well--modern eating corn has been bred to be extra sweet, and corn tends to do that by being high in fructose. There's some fructose in fruit too but nowhere near as much. "dose" matters.

brenn24179

keto is very restrictive for me but I do low carb, 100 gr or less and log my calories . If I can do it anyone can. A friend of mine did this and lost 160 lbs. You can have right many carbs for 100 gr

lemurcat2

I'd ask for a referral to a registered dietitian. I've never heard of keto being necessary for pre-diabetes, it's not even the default recommendation for actual T2D, and many people on MFP have controlled T2D without medication or gone into remission (not getting into the debate on that) by controlling carbs and sticking to moderate carbs eaten with fiber and protein, but not even going fully low carb.

I don't have IR or T2D, but I enjoy eating lowish carb from time to time (around 100 g to 120 g), and that did not require me to cut out fruit or starchy carbs, just watch portions.

mystgrl28

Maybe your doctor meant refined carbs? That is bad for diabetics. But I dont see a problem with low GI carbs. Following this post as I want to have a low carb, high protein diet as well and am struggling to keep my carbs low. Im a carb monster hahahahaha.

ConfidentRaven

Did the doctor say lower your carbs or do keto, they are two different things. I would ask them for a clarification and/or an appointment with a registered dietitian.

Hannahwalksfar

I’m just going to tell myself that all the woos mean the people love my advice

MikePTY

I am also not a doctor, but I'd recommend consulting a registered dietician, as your doctor seems to be not giving you generally accepted advice. The truth is just because someone is a doctor does not make them automatically an expert on all things medical.

The biggest thing you could probably do yourself, both for pre-diabetes and overall health, is lose weight. If you have 100 to lose, losing that would likely make a significant difference.

MikePTY

Hannahwalksfar wrote: »

Listen to your doctor. If you find you lack self-control then get therapy to help you learn self-discipline. Your life is not worth bread.

This is over the top. OP is not going to die from being pre-diabetic and having some bread. Rather than find themselves in therapy, they are better off finding a new doctor, or even better a registered dietician, who can give them more sensible diet advice.

lgfrie

Hannahwalksfar wrote: »

I’m just going to tell myself that all the woos mean the people love my advice

I have gotten woo'd every time I've suggested following a doctor's instructions or deferring to his/her expertise, as you did in this thread. It's just a thing here, I guess.

StatChicBayes

I was told I had pre-diabetes back in Feb (also have issues with high LDL cholesterol, but normal triglycerides and high HDL). I was working with a lipids specialist who recommended reduced carb (but not keto or Atkins) - recommendations were pretty close to 40% carb, 30% protein and 30% fat (the Mediterranean diet??) which translate to about 130g of carbs for me in a 1400 calorie diet. Carbs were supposed to be primarily low glycemic index fruits, vegetables, but pasta and bread on occasion were OK within the macros. Brown rice rather than white rice if possible, legumes for carbs, protein and fiber, steel cut oats, oat bran, etc. Wine was also OK. Healthy fats: avocado, olive oil, etc were fine, but should limit saturated fats (this is related to lipids more than the pre-diabetes) from meat/dairy. I tend to avoid processed foods and do most of my own cooking so find it easier to eliminate sugars or other added carbs.

With this I have been exercising (cardio +strength training and have lost 48 pounds so far - still a ways to go but getting there! It has been pretty easy to adhere to, and something that will work for me long term. Mostly it has been limiting the more refined carbs (pasta, pizza, fritos). Fortunately, I don't really like sweets so that has not been a problem :-)

Tests yesterday indicate that fasting blood glucose is now in the normal range. LDL cholesterol results tomorrow.

So do ask for more specifics - you can change this with reducing carbs and weight. Feel free to add me as friend.

Hannahwalksfar

It’s like doctors shouldn’t even exist according to the majority of posters here. Bit concerning really.

MikePTY

Hannahwalksfar wrote: »

It’s like doctors shouldn’t even exist according to the majority of posters here. Bit concerning really.

Not really. But what is concerning is people who think that doctor's words should be taken as gospel and everyone should follow them no questions asked.

Most doctors recieve very little nutritional training. Nutritional advice is not their areas of expertise. That is why we have registered dieticians. The truth is even with years of medical training, most areas of medicine are not any particular doctor's area of expertise, because the field of medicine is so vast. More than you think, doctors rely on Google like the rest of us.

And they also beleieve plenty of wrong information. My dad's endocrinologist told him he needed to stop drinking diet soda because "your body doesn't know how to process it and it all gets stored in your gut." That's not a real thing that happens. It's not true just because a doctor said it.

Medical errors are the third leading cause of death in America. The world is undoubtedly better off because it has doctors in it, but people would be bettter served by not putting their doctors on a pedestal, and questioning advice that seems suspect.

concordancia

Ask for a referral to a dietician.

In the meantime, look into something like the Mediterranean Diet, which has better long term compliance rates, as well as good results for diabetes.

If you have weight to lose, losing that weight will usually help pre-diabetes, no matter which diet you use to lose.

I have full on diabetes and I can manage it with exercise and a diet that includes occasional carbs. I eat a very keto like diet when I need to get my blood glucose into the normal range (like this week, since I went ahead and had the bread and the cobbler on Sunday), but can eat a few more carbs when I am stable. This also means that it can be helpful to use an upcoming occasion to stick to my plan. "Oh, I can't have any unplanned carbs this week, because I am going to Sunday brunch!"

Hannahwalksfar

MikePTY wrote: »

Hannahwalksfar wrote: »

It’s like doctors shouldn’t even exist according to the majority of posters here. Bit concerning really.

Not really. But what is concerning is people who think that doctor's words should be taken as gospel and everyone should follow them no questions asked.

Most doctors recieve very little nutritional training. Nutritional advice is not their areas of expertise. That is why we have registered dieticians. The truth is even with years of medical training, most areas of medicine are not any particular doctor's area of expertise, because the field of medicine is so vast. More than you think, doctors rely on Google like the rest of us.

And they also beleieve plenty of wrong information. My dad's endocrinologist told him he needed to stop drinking diet soda because "your body doesn't know how to process it and it all gets stored in your gut." That's not a real thing that happens. It's not true just because a doctor said it.

Medical errors are the third leading cause of death in America. The world is undoubtedly better off because it has doctors in it, but people would be bettter served by not putting their doctors on a pedestal, and questioning advice that seems suspect.

My doctor saved my life so I’ll trust doctors over internet people. Especially when it comes to potentially life-threatening issues like diabetes.

Cahgetsfit

StatChicBayes wrote: »

I was told I had pre-diabetes back in Feb (also have issues with high LDL cholesterol, but normal triglycerides and high HDL). I was working with a lipids specialist who recommended reduced carb (but not keto or Atkins) - recommendations were pretty close to 40% carb, 30% protein and 30% fat (the Mediterranean diet??) which translate to about 130g of carbs for me in a 1400 calorie diet. Carbs were supposed to be primarily low glycemic index fruits, vegetables, but pasta and bread on occasion were OK within the macros. Brown rice rather than white rice if possible, legumes for carbs, protein and fiber, steel cut oats, oat bran, etc. Wine was also OK. Healthy fats: avocado, olive oil, etc were fine, but should limit saturated fats (this is related to lipids more than the pre-diabetes) from meat/dairy. I tend to avoid processed foods and do most of my own cooking so find it easier to eliminate sugars or other added carbs.

With this I have been exercising (cardio +strength training and have lost 48 pounds so far - still a ways to go but getting there! It has been pretty easy to adhere to, and something that will work for me long term. Mostly it has been limiting the more refined carbs (pasta, pizza, fritos). Fortunately, I don't really like sweets so that has not been a problem :-)

Tests yesterday indicate that fasting blood glucose is now in the normal range. LDL cholesterol results tomorrow.

So do ask for more specifics - you can change this with reducing carbs and weight. Feel free to add me as friend.

this is pretty much what the doctor told my dad. Dad walks more as exercise now (coz of high blood pressure too) and has just swapped some things out in his diet like white rice for brown and the white (even though mainly sourdough) bread for grainy/rye other types of bread. No more chocolates and ice cream all the time, but he eats yoghurt in moderation for his sweet tooth, as well as fruit.

Cahgetsfit

MikePTY wrote: »

Hannahwalksfar wrote: »

It’s like doctors shouldn’t even exist according to the majority of posters here. Bit concerning really.

Not really. But what is concerning is people who think that doctor's words should be taken as gospel and everyone should follow them no questions asked.

Most doctors recieve very little nutritional training. Nutritional advice is not their areas of expertise. That is why we have registered dieticians. The truth is even with years of medical training, most areas of medicine are not any particular doctor's area of expertise, because the field of medicine is so vast. More than you think, doctors rely on Google like the rest of us.

And they also beleieve plenty of wrong information. My dad's endocrinologist told him he needed to stop drinking diet soda because "your body doesn't know how to process it and it all gets stored in your gut." That's not a real thing that happens. It's not true just because a doctor said it.

Medical errors are the third leading cause of death in America. The world is undoubtedly better off because it has doctors in it, but people would be bettter served by not putting their doctors on a pedestal, and questioning advice that seems suspect.

I agree re the doctors thing. I've had heaps of instances where doctors gave me or people I know crap advice. For example, husband had kidney stones, Dr told him to just take paracetamol. Daughter had a freaking bee sting, dr wanted to give her antibiotics (instead of anti-inflammatory), I had IBS - pretty bad IBS - dr wanted to cut out half my guts and have me live off cortisone for the rest of my life. I fixed IBS with diet/herbs. Dr when I was fatter telling me what to eat to lose weight - peanut butter on toast for breakfast - me - SURE! never having actually weighed out a tablespoon of peanut butter, which we all know is NOT 20g, no wonder I wasn't losing weight considering i was eating "healthy" food and peanut butter on toast for breakfast, but just HOW MUCH OF IT was I actually eating?! Way more than necessary.

Nothing wrong with OP looking into second opinions from other doctors/nutritionists/etc.

It's great that the dr found the pre-diabetes condition - wonderful - now OP just needs to look around and ask teh questions and research exactly how much and what type of carbs can she eat? Good job OP for asking the question.

LKArgh

deleting - double post

LKArgh

No, you do not need low carb, you need to count carbs and distribute them throughout the day. This is just an assumption from my part, but I assume your dr said to limit carbs and not to eliminate carbs? Even a diabetic can eat bread daily, as in have a sluce of bread with cheese for breakfast, but not have the entire loaf of bread for breakfast, and not have also bread as snack, at lunch and at dinner.

The usual plan is something like one small serving of carbs per meal/snack, paired with protein. So even though a peach is definitely good for you and you should eat, diabetic or not, do not eat 10 peaches at once, but eat 1 peach and pair it with a plain yoghurt or a cup of milk to have a snack, and not with more carbs. Similarly at main meals, eat one serving of rice or whole grain pasta or bread or beans etc with meat and a green salad, but do not eat a serving of beans and a serving of potatoes and a couple of slices of bread. Of course you need to figure out what a serving is per food, your dr should provide resources, otherwise the American Diabetes Association has a lot of info.

Usually several servings of fruit, vegetables and grains are encouraged for diabetics, and reducing overall fat is also encouraged. You can check here: https://www.diabetes.org/nutrition/meal-planning , there is a lot of detail. It requires some reading, but it looks very close to what my local hospital advises diabetics and prediabetics.
Also keep in mind that losing weight and adding exercise (walks are good, you do not need to find anything more complicated) are key to controlling and even reversing diabetes.[/quote]

Lillymoo01

I have only glanced through some of these comments but I wonder whether you clarified with the doctor what he/she meant by low carb. Low carb can be anything under 150 grams of carbs a day by definition and does not have to be keto. If that is the only information you got then I'd be seeking further advice, either from the doctor or better yet, a trained dietician who specialises in diabetes.

amusedmonkey

"Cut carbs" doesn't mean keto by default. For a prediabetic it most likely means "watch the carbs". It could mean reducing them, not necessarily to keto levels, or just regulating them paying attention to carbs per meal and types.

I had prediabetes, and I was dangerously close to official diabetes, meaning, I was diabetic by some measures and pre-diabetic by others. Completely limiting carbs did not feel like something I could keep up long term, and since health is an ongoing management effort, imperfect but sustainable is way better than perfect but unsustainable. What I did was regulate carbs, not cut them down drastically. I made sure to spread them evenly over the day, which allowed me to eat carbs, but not too many carbs in one sitting. I also made sure to eat balanced meals with protein and fat because that produces a less steep blood sugar spike. This helped regulate my blood sugar short term as evidenced by my glucose meter. Becoming more active also helped. What ultimately helped me long term was losing weight. I'm no longer prediabetic because I lost a lot of weight. I wouldn't have lost the weight nor improved my blood sugar long term had I attempted an unsustainable program.

glassyo

Hannahwalksfar wrote: »

I’m just going to tell myself that all the woos mean the people love my advice

I didn't woo you but my life is DEFINITELY worth bread.

lemurcat2

Hannahwalksfar wrote: »

MikePTY wrote: »

Hannahwalksfar wrote: »

It’s like doctors shouldn’t even exist according to the majority of posters here. Bit concerning really.

Not really. But what is concerning is people who think that doctor's words should be taken as gospel and everyone should follow them no questions asked.

Most doctors recieve very little nutritional training. Nutritional advice is not their areas of expertise. That is why we have registered dieticians. The truth is even with years of medical training, most areas of medicine are not any particular doctor's area of expertise, because the field of medicine is so vast. More than you think, doctors rely on Google like the rest of us.

And they also beleieve plenty of wrong information. My dad's endocrinologist told him he needed to stop drinking diet soda because "your body doesn't know how to process it and it all gets stored in your gut." That's not a real thing that happens. It's not true just because a doctor said it.

Medical errors are the third leading cause of death in America. The world is undoubtedly better off because it has doctors in it, but people would be bettter served by not putting their doctors on a pedestal, and questioning advice that seems suspect.

My doctor saved my life so I’ll trust doctors over internet people. Especially when it comes to potentially life-threatening issues like diabetes.

Getting a few woos for advice that includes a lot more than "follow your doctor's advice" does not mean "the majority of people here say doctors should not exist." (I did not woo you, btw.) That's a really over-the-top reaction than makes it seem like you aren't even reading what other posters are saying.

Pre-diabetes is not diabetes, it's not even a well-established diagnosis. It's basically a risk factor for developing T2D. For those who think it would be very hard to deal with, there are many other more typically recommended dietary responses. Most T2Ds do fine with fruit, which is healthy, so having to give that up, for example, is a pretty drastic response to prediabetes when other options, like simple weight loss and moderate carb, have not even been tried.

Keto is not the currently ADA recommended treatment for T2D. It can be a viable one, especially for those who can't control it in other ways.

Most significantly, saying "get a referral to a registered dietitian" is not saying "ignore your doctor." It's saying "have your doctor refer you to someone who specializes in nutrition, and especially nutrition/weight loss approaches to treating medical issues. Pretty much any doctor will concede that doctors are not experts in nutrition and that they normally will refer to RDs for significant nutritional/weight loss issues if the person needs help. I suspect the RD will give way more (and more sensible) options than the doctor, but if there really is a medical need to do keto (however unlikely that seems) the RD will support the doctor's recommendation and help the person struggle less in implementing that.

Suggesting there's some harm in this advice or that we are telling OP to ignore the doctor and follow "internet advice" is absurd.

lemurcat2

Oh, also, keto isn't even just eat meat and eggs and veg, and have bread once a week (jumping out of ketosis once a week isn't a great idea, and there are a variety of other foods one should also eat for good health on keto), so it doesn't really sound like a prescribed diet. It sounds like the doctor or someone the doctor knows has lost weight that way and the doctor is trying to give weight loss advice. REAL medical treatment with a dietary component would be more specific, include handouts, and usually be supported by an option to see an RD.

Hannahwalksfar

I think they should just listen to their doctor. You disagree. And so the world turns. Each to their own. Peace