DIABETICS AND DAILY CALORIES

LauraDotts

On a 1470 calorie diet, 5-10% of my calories come from carbohydrates. That is about 20 net carbs a day. I have been on that diet since the beginning of May 2012. I lowered my A1c from 8.3 to 5.1 without medication. I firmly believe that had I followed the ADA's recommendation of 45-60 grams of carbs per meal I would be on insulin right now.

DonnaLeeCattes

bump

albertabeefy

I noticed that you are a medical researcher. Would you know what factors it would take for a diabetic to rebuild insulin receptors?

If we're talking actual "damage" to the insulin receptors - there is no research to suggest this is currently reversible. If we're talking insulin-resistance, there are many factors that influence it.

1) Excess adipose tissue (ie: body fat), but especially visceral (in/around the organs) adipose tissue, has a very large role to play here. Studies universally show that reducing visceral adiposity (even for subjects that have little reduction in subcutaneous adipose tissue) improves insulin sensitivity. Unfortunately we cannot target where we lose bodyfat first (with the exception of liposuction, but that's not done for subcutaneous adipose tissue, not visceral adipose tissue) when we lose weight - as such some subjects lose visceral adipose tissue first, others lose subcutaneous tissue first. Some lose all-over at a very similar rate.

2) Exercise, but especially HIIT (high intensity interval training) improves insulin sensitivity. The exact mechanism is unknown, but recent medical research is clear that HIIT is superior to steady-state cardio (IE: walking/jogging at a moderate pace continuously) for insulin-sensitivity.

3) Metformin, even the $4 a month generic version, improves insulin-sensitivity. I still consider Metformin the #1 diabetes medication ever. (Insulin technically isn't a medication - it's a naturally occurring hormone.)

Some that believe they are (and have even been diagnosed as being) insulin-resistant are actually hypoinsulinemic. It's not so much that they're resistant but that they have reduced amounts of serum insulin levels. When this occurs it's usually a result of damaged/impaired β cell function, and is not currently reversible. This most commonly happens either through autoimmune disease (IE: Type I diabetes and LADA - Latent Autoimmune Diabetes in Adult) or through long-term elevated blood glucose in a state of insulin-resistance/hyperinsulinemia that apparently burns out pancreatic β cells.

DrBorkBork

I'm diabetic too. Make sure you're replacing those reduced carbs with healthy fats. Not only will they help you meet your daily cal requirements, but fat can help slow insulin spikes as well.

doctorwhome

bump...for later.

CJ_Holmes

In response to your original post, I would recommend upping your fat intake. I'm a Type I diabetic, and try to keep my fat at 50%, protein at 30%, and carbs at 20% of my calories. A couple of tablespoons of coconut oil in your coffee would boost you up 250 calories! Yum!

I used to eat very low carb, but love more variety in my diet. I do think that the ketogenic diet would probably be the best for sugar control, and I just haven't been able to bring myself to give up fruit. I have a feeling as I get older, if something else doesn't change, I will eventually give in to what I already know!

JaceyMarieS

image from here: http://www.healthy-eating-politics.com/american-diabetes-association.html

One of the best sources of information on diabetes, especially Type II, is Blood Sugar 101: www.bloodsugar101.com ... The site is run by author Jenny Ruhl, herself a diabetic - and includes mountains of clinical research outlined in an easy-to-research format.

The best book on controlling diabetes (whether Type1 or TypeII) I know of is Dr. Richard K. Bernstein's "Diabetes Solution", who is both an MD and a Type I diabetic. Much of his book is free online if you google it.


Sorry for the vast-amounts of information being thrown out here, and for the 'soap-box' speech, but people are dying because of bad advice being given - and they have the ability to turn it around.

I can 2nd, 3rd and 4th (and on and on) both of these reading recommendations. And the suggestion of a much lower carb, much higher fat diet than is recommended by most nutritionists/dieticians. It has made a huge difference in my overall health

mikejholmes

Bump to read later -- this seems very interesting!!!

retiree2006

Interesting read. Thanks.

PolacaFL

This is so contrary to what I’ve always believed. I grew up thinking that we are built to be vegetarians and that that is the spiritual way of eating (Buddhism/Hinduism). Plus I was concerned about what they fed the animals and what hormones was given to them.

I’ve been on a low-carb diet and even though it’s odd to me I’m trying to keep an open mind about it and I have kept at it because I’m losing the weight and I don’t crave foods.

What if we ate a high veggie diet with legumes and no refined carbs?

cubbies77

Some that believe they are (and have even been diagnosed as being) insulin-resistant are actually hypoinsulinemic. It's not so much that they're resistant but that they have reduced amounts of serum insulin levels. When this occurs it's usually a result of damaged/impaired β cell function, and is not currently reversible. This most commonly happens either through autoimmune disease (IE: Type I diabetes and LADA - Latent Autoimmune Diabetes in Adult) or through long-term elevated blood glucose in a state of insulin-resistance/hyperinsulinemia that apparently burns out pancreatic β cells.

This piqued my interest. I have PCOS, and I was diagnosed with insulin resistance last July. My 12-hour fasting insulin level was approx 63 "somethings". (I'm not sure of the units, as I don't have my paperwork with me.) Regardless, it was 2-3x the normal range.

My doctor put me on 500 mg of extended-release metformin and instructed me to eat 100 carbs (or fewer) per day. He said to eat like a diabetic, since the diets are so similar. He suggested low-carb, high-protein, and low-glycemic fruit and fiber. He added that "linking" protein with carbs can help the carbs digest slower, as you mentioned in regard to fiber. He said that would help prevent insulin spikes but added (as you did) that it doesn't change the total number of carbs; it just keeps me from spiking. I imagine preventing the insulin spike is the key, since I'm not actually diabetic.

My last A1C (before metformin and the new diet) was 5.8. Is there any way to tell if I'm truly insulin resistant or hypoinsulinemic? Is there a way to test for that? I'm eager to get my new numbers, now that I've lost weight and have been taking medication.

albertabeefy

In response to your original post, I would recommend upping your fat intake. I'm a Type I diabetic, and try to keep my fat at 50%, protein at 30%, and carbs at 20% of my calories. A couple of tablespoons of coconut oil in your coffee would boost you up 250 calories! Yum!

I used to eat very low carb, but love more variety in my diet. I do think that the ketogenic diet would probably be the best for sugar control, and I just haven't been able to bring myself to give up fruit. I have a feeling as I get older, if something else doesn't change, I will eventually give in to what I already know!

For most Type I's the macros you suggest may actually work quite well, if there's not too much 'guessing' on their bolus insulin requirements.

For Type II's though - the vast majority are insulin-resistant, and as such the ketogenic ratio of < 10% carbs and > 65% fat will provide for better control - and much less work on the pancreas.

Interestingly, over the past few decades as the amount of refined sugars/carbohydrates have gradually but greatly increased in our diets, so has insulin-resistance started to manifest in Type I diabetics, especially those that didn't restrict carbohydrate and just attempted to eat anything they want and just 'bolus it' .... It would seem that even Type I's that over-indulge in refined carbohydrate are experiencing the same insulin-resistance that normally only manifested in Type II's.

albertabeefy

This is so contrary to what I’ve always believed. I grew up thinking that we are built to be vegetarians and that that is the spiritual way of eating (Buddhism/Hinduism). Plus I was concerned about what they fed the animals and what hormones was given to them.

I’ve been on a low-carb diet and even though it’s odd to me I’m trying to keep an open mind about it and I have kept at it because I’m losing the weight and I don’t crave foods.

What if we ate a high veggie diet with legumes and no refined carbs?

First, eliminating refined carbohydrate seems to universally improve glycemic control and insulin-sensitivity regardless of what type of diet a person is on, including vegetarian and vegan diets.

I must admit I've only done limited research on a vegetarian approach to treating diabetes - most that are successful, however, are either ovo/lacto/pesco-vegetarians who are also restricting carbohydrate.

If you visit www.diabetesforum.com you'll find several vegetarians that are actually eating a ketogenic diet.

As for vegans - I've yet to see any vegan study even control diabetes, let-alone reverse it like a low-carb ketogenic diet can.

albertabeefy

My last A1C (before metformin and the new diet) was 5.8. Is there any way to tell if I'm truly insulin resistant or hypoinsulinemic? Is there a way to test for that? I'm eager to get my new numbers, now that I've lost weight and have been taking medication.

First, congratulations on the 5.8% ... that's what I'd consider "well-controlled" though not yet what is considered "normal". (Normal is really 4.6 to 5.4%)

As for testing: the most common is to start with a C-Peptide test. C-Peptide levels are lower in those with autoimmune diabetes (ie: decreased pancreatic β cell function) than those with no pancreatic impairment. C-Peptide is often used in PCOS diagnoses simply to determine the level of insulin-resistance. It's most commonly elevated due to the hyperinsulinemia normally associated with PCOS.

JaceyMarieS

What if we ate a high veggie diet with legumes and no refined carbs?

I can't answer for "we" - only "me". Legumes are on my severely restricted list. I love them (except peanuts - intolerance), but can only eat 1/8-1/4 cup before my blood sugar is adversely affected. I severely restrict fruit for the same reason.

It's really a good idea for Type 2 diabetics to rely less on the standard GI Index and more on a personal GI Index that they create themselves using their meter as a guide.

RamoZimm

Very informative. Must look into this more.

cubbies77

My last A1C (before metformin and the new diet) was 5.8. Is there any way to tell if I'm truly insulin resistant or hypoinsulinemic? Is there a way to test for that? I'm eager to get my new numbers, now that I've lost weight and have been taking medication.

First, congratulations on the 5.8% ... that's what I'd consider "well-controlled" though not yet what is considered "normal". (Normal is really 4.6 to 5.4%)

As for testing: the most common is to start with a C-Peptide test. C-Peptide levels are lower in those with autoimmune diabetes (ie: decreased pancreatic β cell function) than those with no pancreatic impairment. C-Peptide is often used in PCOS diagnoses simply to determine the level of insulin-resistance. It's most commonly elevated due to the hyperinsulinemia normally associated with PCOS.

Wow. Thank you so much! This is incredibly helpful. I'll go through my lab results when I get home and see if that was included in my blood work (we did a huge round of tests, including hormone levels, thyroid, etc). I'll ask my doctor about it at my next appointment too.

albertabeefy

What if we ate a high veggie diet with legumes and no refined carbs?

I can't answer for "we" - only "me". Legumes are on my severely restricted list. I love them (except peanuts - intolerance), but can only eat 1/8-1/4 cup before my blood sugar is adversely affected. I severely restrict fruit for the same reason.

It's really a good idea for Type 2 diabetics to rely less on the standard GI Index and more on a personal GI Index that they create themselves using their meter as a guide.

^ This.

So very true. When it comes to diabetes there really is no "one size fits all" with the exception of low-carb universally being a better overall approach.

Which carb sources will spike each individual vary wildly.

I have a friend who can eat all the beans they want - even highly processed canned pork and beans, etc., and NEVER see any kind of spike or long periods of elevation in glucose. On the other hand - I haven't found a bean yet that my body tolerates.

Fruit is another example of this - some diabetics spike up the wazoo (that's a serious medical term, LOL) with pears or bananas, some tolerate it quite well. For me, the only fruits I tolerate well are berries (especially blackberries and raspberries), cherries and granny smith apples (though I only have 1/2 an apple as a serving.)

Every diabetic should test foods with their meter, so they know what does and doesn't spike their glucose (or in the absence of a spike, what causes long periods of elevation.)

LauraDotts

I can tolerate beans in controlled quantities. I can have 1/4 cup of hummus or a couple tablespoons of refried beans. But I cannot eat fruit at all... none. Only after losing 90+ pounds can I now eat tomato again (in limited quantities) without spiking.

polarsjewel

Hi everyone. My name is jewel and I am a Type2 Diabetic (voices replying "Hi Jewel")

Seriously though, I was diagnosed as Type2 Diabetic 7 or 8 years ago, after having gestational diabetes with both of my pregnancies. I have been on Metformin and Victoza since August of last year and am only now starting to see results. The diabetic education and nutritional counselling that I received from my local hospital was vague at best. I was eating about 1500 calories a day and walking almost 5km everyday at lunch, and not losing any weight and still seeing numbers in the mid to high teens *ducks* At Christmas, I spoke to a friend of mine (also diabetic) because I had spiked at 22. She was able to give me more relavant information that either the diabetic educator or nuritionist was able to. Since Christmas I have brought my A1C down to 7.2 and have lost 16 pounds.

My doctor's advice to me was to eat at about 10 x my IDEAL body weight in calories to lose some of the extra weight. For me that is 1,350 calories. I have been eating at this level since Feb. Lately, my sugars have been climbing again (due to me going "xx is okay this time, and then having whatever it is daily)

Albertabeefy has posted a lot of information which I am going to read later, but I just wanted to share how I have been treating my diabetes since Christmas.

Cheers,
jewel

ETA - Feel free to add me as a friend :flowerforyou: