DIABETICS AND DAILY CALORIES

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 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?

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

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.

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.

... Dr. Bernstein's book was basically where I learned everything I know. I had no insurance or regular medical care when when I was DX'ed, so once they booted me out of my severe DKA hospital stay, books were all I had. I actually am pretty sure I was better off reading Dr. Bernstein than in person with most of the doctors I have met since....

"What are the absolute best five foods one can eat to reverse diabetes?

Beans, Greens, Non-starchy vegetables, Nuts and seeds, Berries"

"What will readers be most surprised to learn from your book?

They will be most surprised to learn that not just type 2 diabetes, but heart attacks, strokes and even dementia can be almost totally prevented with a nutritarian diet. In other words, people have accepted that the typical risks, suffering, and premature death is normal or unavoidable and accepted that medical care is the answer to our health problems."

Diabetes Diet: New Book 'The End Of Diabetes' Highlights Ways To Prevent And Reverse The Disease
http://www.huffingtonpost.com/2013/01/18/diabetes-diet-prevention-the-end-of-diabetes-book_n_2478790.html

I am a T2 diabetic and have been struggling with my diagnosis and weight loss. I started out reading on diabetesforums.com about what diets work the best for T2's, and have been trying for low carb. Then I came here and starting reading, and thought, well lets try counting calories. Then I go to my CDE and she states that I should be eating 30 to 45 grams of carbs at each meal, 15 grams for a snack, but then tells me that I should only be eating 3 times a day. No snacking between meals, in order to give your blood sugar time to come down before you eat your next meal, so it won't be so high afterwards. I told her about diabetesforums.com and the low-carb, high fat diet. She just laughed and said "I can't make you eat like I have told you, but I am the one that is right".

I am so confused right now, I just don't know what to do anymore.

Some Low-Carb Studies:

"A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women"

"A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity"

"A low-carbohydrate, ketogenic diet to treat type 2 diabetes"

"Comparison of a High-Carbohydrate Diet with a High-Monounsaturated-Fat Diet in Patients with Non-Insulin-Dependent Diabetes Mellitus"

"The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus"

"Effect of a low-carbohydrate, ketogenic diet program compared to a low-fat diet on fasting lipoprotein subclasses"

"Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation"

"Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women"

"Lasting Improvement of Hyperglycaemia and Bodyweight: Low-carbohydrate Diet in Type 2 Diabetes. – A Brief Report"

"A Pilot Trial of a Low-Carbohydrate, Ketogenic Diet in Patients with Type 2 Diabetes"

"A Randomized Trial of a Low-Carbohydrate Diet for Obesity"

"Low-carbohydrate diets: an update on current research"

"Efficacy of low-carbohydrate diet in the treatment of obesity in adolescents"

"A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men"

Diabetes Diet Studies:

http://diabetes.diabetesjournals.org/content/41/10/1278.short
Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM.

“Compared with the low-carbohydrate diet, the high-carbohydrate diet caused a 27.5% increase in plasma triglycerides and a similar increase in VLDL-cholesterol levels; it also reduced levels of HDL cholesterol by 11%.”


http://www.annals.org/content/142/6/403.short
Effect of a Low-Carbohydrate Diet on Appetite, Blood Glucose Levels, and Insulin Resistance in Obese Patients with Type 2 Diabetes

“Mean 24-hour plasma profiles of glucose levels normalized, mean hemoglobin A1c decreased from 7.3% to 6.8%, and insulin sensitivity improved by approximately 75%. Mean plasma triglyceride and cholesterol levels decreased (change, −35% and −10%, respectively).”


http://diabetes.diabetesjournals.org/content/53/9/2375.short
Effect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2 Diabetes

“The mean 24-h integrated serum glucose at the end of the control and LoBAG diets was 198 and 126 mg/dl, respectively. The percentage of glycohemoglobin was 9.8 ± 0.5 and 7.6 ± 0.3, respectively. It was still decreasing at the end of the LoBAG diet. Thus, the final calculated glycohemoglobin was estimated to be ∼6.3–5.4%. Serum insulin was decreased, and plasma glucagon was increased.”

“Potentially, this could be a patient-empowering way to ameliorate hyperglycemia without pharmacological intervention.”


http://www.nejm.org/doi/full/10.1056/NEJMoa022637
A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity

“Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost.”


http://www.annals.org/content/140/10/778.short
The Effects of Low-Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One-Year Follow-up of a Randomized Trial

“Participants on a low-carbohydrate diet had more favorable overall outcomes at 1 year than did those on a conventional diet. Weight loss was similar between groups, but effects on atherogenic dyslipidemia and glycemic control were still more favorable with a low-carbohydrate diet after adjustment for differences in weight loss.”


http://www.nejm.org/doi/full/10.1056/NEJMoa022207
A Randomized Trial of a Low-Carbohydrate Diet for Obesity

“The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease.”


http://jcem.endojournals.org/content/88/4/1617.short
A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women

“Based on these data, a very low carbohydrate diet is more effective than a low fat diet for short-term weight loss and, over 6 months, is not associated with deleterious effects on important cardiovascular risk factors in healthy women.”


http://www.biomedcentral.com/content/pdf/1743-7075-2-34.pdf
A low-carbohydrate, ketogenic diet to treat type 2 diabetes

“In summary, the LCKD had positive effects on body weight, waist measurement, serum triglycerides, and glycemic control in a cohort of 21 participants with type 2 diabetes. Most impressive is that improvement in hemoglobin A1c was observed despite a small sample size and short duration of follow-up, and this improvement in glycemic control occurred while diabetes medications were reduced substantially in many participants.”


http://www.biomedcentral.com/1743-7075/2/16
The case for low carbohydrate diets in diabetes management

“Low carbohydrate diet compares more favorably … to traditional low fat for improving glycemic control, insulin sensitivity and dyslipidemia of diabetes with reduction in triglycerides, increase in HDL cholesterol and modification of LDL to less atherogenic form. The need of the hour is to accept the benefits of carbohydrate restriction…”

Well, since Fuhrman advocates vegetarian or vegan diets, and is a member of known animal-activist groups, I'll take what he says with a grain of salt, and stick to the scientific studies on diabetes, rather than what a vegan animal-activist tells the Huffington Post.

Nope. But you're welcome to document your assertions. Just once will do, I take it.

The chief feature that makes a vegetarian diet beneficial compared to more conventional ways of eating is that a person following a vegetarian diet is likelier to be consuming more high nutrient produce that contains protective fibers and antioxidant nutrients.

To achieve optimal health, we require a significant exposure to a full symphony of antioxidants and phytochemicals in unprocessed plant matter. Minimizing or removing animal products from the diet leaves more calories that can be derived from plant foods. Also, since animal products contain no fiber, they remain in the digestive tract longer than plant foods, slowing digestive transit time and allowing heightened exposure to toxic compounds.

This diet will naturally be lower in saturated fat, which is an accepted risk factor for both heart disease and cancer.

The American Medical Association (AMA), which actually represents the medical profession, has called PCRM a “fringe organization” that uses “unethical tactics” and is “interested in perverting medical science.”

PCRM is a font of medical disinformation. The group has argued, with a straight face, that experiments involving animal subjects “interfere with new drug development.” PCRM even rejects the consensus of the respectable medical community by claiming that animal experimentation “leads AIDS research astray.”

[PCRM president Neal] Barnard has co-signed letters, on PCRM letterhead, with the leader of Stop Huntingdon Animal Cruelty, an animal-rights group the Department of Justice calls a “domestic terrorist threat.” PCRM also has ties to People for the Ethical Treatment of Animals. An agency called the foundation to Support Animal Protection has distributed money from PETA to PCRM in the past and, until very recently, did both groups’ books. Barnard and PETA head Ingrid Newkirk are both on the foundation’s board.

They are neither responsible nor are they physicians.”

The AMA finds the recommendations of PCRM irresponsible and potentially dangerous to the health and welfare of Americans. [PRCM is] blatantly misleading Americans on a health matter and concealing its true purpose as an animal ‘rights’ organization.