Need help with Diabetes Type II food

this is not accurate. Its no less than 30g Carb per meal for diabetes.

That's a disastrous amount for ANY diabetic regardless of Type I or Type II. Many physicians that specialize in treatment of diabetes are now recommending getting control by eating no more 30g of CHO per day.

Having that much carbohydrate at a meal will cause a Type II's blood-sugar to skyrocket into unhealthy levels. A Type I will need to take a great deal of insulin to counter-act it, which increases the risk of hypoglycemic episodes.

The actual meal amounts will vary person to person, based off calorie needs. at 1250 you are looking at about 140g Carb per day which is about 45g per meal, or if you have 15g snacks you can do 30g at each meal with a 15g AM, PM and bedtime snack. that is not many carbs though and most women average about 45g at lunch and dinner.

Although this is the standard line touted by many dieticians, the ADA and many pharmaceutical companies, it's NOT based in sound medical science and is completely opposite of what should happen.

Diabetes is an impairment in CHO (carbohydrate) metabolism - again, regardless of Type I or Type II (although the methodology in the two types differs, the result is the same - carbohydrate causes blood glucose to rise to unhealthy levels.)

As medical professionals we'd never tell people with celiac disease to eat more gluten ... why on EARTH would we tell people with diabetes to eat more carbohydrate? Especially when we KNOW from all nutritional and biochemical standpoints there is NO dietary need for carbohydrate? It makes no sense.

What DOES makes sense is a reduction in carbohydrate. Period. This will not only normalize blood glucose levels, but prevents progression of the disease (it doesn't HAVE to be progressive, folks) and in many cases (especially for Type II's), reverses the symptoms of the condition.

There's a reason that 90% of diabetics fail to control their blood glucose levels - it's because of horrible advice like "no less than 30g Carb per meal" ... No offense to the poster of that, but that advice is only going to make their condition progressively worse.

I'm sorry but as a type 1 diabetic, a registered Dietitian, a certified diabetes educator, and someone who works with endos on a daily basis I have to disagree. Diabetes is not an impairment on CHO metabolism its an impairment on Insulin production. CHO is metabolized the same in a diabetic as it is in a non diabetic, the only difference is Diabetics (type 1 or 2) cannot use it due to not enough or no insulin. As for CHO intake MANY studies have shown that the average person diabetic or not needs 120g CHO throughout their day for proper brain function. CHO is the fuel source for your body and you need carbs to function properly. Carbs are used in the production of many different things in our bodies and unfortunately despite what you think we do need carbs for dietary and health purposes.

You do not want to tell a type 1 diabetic to be ketotic because they are at higher risk to slip into DKA more easily at lower numbers since they would be producing ketones already. A reduction in Carbs is partially correct as many newly diagnosed patients are eating way too many carbs, however the key is not reduction but balance and consistency. the same number of carbs at about the same time each day. I know many diabetics who eat 30-45g CHO for breakfast & 60-75g CHO for lunch and dinner and still have perfect A1Cs without medications. Many that have great A1Cs with medications. If you really think 90% of diabetics are uncontrolled than you are horribly incorrect. 90% of my practices patients are in perfect control with 30-60g CHO intake per meal. I'm sorry you feel that my advice is "horrible" but it is what research is showing and is what ENDOs are practicing. and they are the diabetes experts in the medical field.

You do not want to tell a type 1 diabetic to be ketotic because they are at higher risk to slip into DKA more easily at lower numbers since they would be producing ketones already. A reduction in Carbs is partially correct as many newly diagnosed patients are eating way too many carbs, however the key is not reduction but balance and consistency. the same number of carbs at about the same time each day. I know many diabetics who eat 30-45g CHO for breakfast & 60-75g CHO for lunch and dinner and still have perfect A1Cs without medications. Many that have great A1Cs with medications. If you really think 90% of diabetics are uncontrolled than you are horribly incorrect. 90% of my practices patients are in perfect control with 30-60g CHO intake per meal. I'm sorry you feel that my advice is "horrible" but it is what research is showing and is what ENDOs are practicing. and they are the diabetes experts in the medical field.

(clipped for brevity)

Just curious...what are the target Fasting and PP BG's you recommend for your T2D clients?

this is not accurate. Its no less than 30g Carb per meal for diabetes.

That's a disastrous amount for ANY diabetic regardless of Type I or Type II. Many physicians that specialize in treatment of diabetes are now recommending getting control by eating no more 30g of CHO per day.

Having that much carbohydrate at a meal will cause a Type II's blood-sugar to skyrocket into unhealthy levels. A Type I will need to take a great deal of insulin to counter-act it, which increases the risk of hypoglycemic episodes.

The actual meal amounts will vary person to person, based off calorie needs. at 1250 you are looking at about 140g Carb per day which is about 45g per meal, or if you have 15g snacks you can do 30g at each meal with a 15g AM, PM and bedtime snack. that is not many carbs though and most women average about 45g at lunch and dinner.

Although this is the standard line touted by many dieticians, the ADA and many pharmaceutical companies, it's NOT based in sound medical science and is completely opposite of what should happen.

Diabetes is an impairment in CHO (carbohydrate) metabolism - again, regardless of Type I or Type II (although the methodology in the two types differs, the result is the same - carbohydrate causes blood glucose to rise to unhealthy levels.)

As medical professionals we'd never tell people with celiac disease to eat more gluten ... why on EARTH would we tell people with diabetes to eat more carbohydrate? Especially when we KNOW from all nutritional and biochemical standpoints there is NO dietary need for carbohydrate? It makes no sense.

What DOES makes sense is a reduction in carbohydrate. Period. This will not only normalize blood glucose levels, but prevents progression of the disease (it doesn't HAVE to be progressive, folks) and in many cases (especially for Type II's), reverses the symptoms of the condition.

There's a reason that 90% of diabetics fail to control their blood glucose levels - it's because of horrible advice like "no less than 30g Carb per meal" ... No offense to the poster of that, but that advice is only going to make their condition progressively worse.

I'm sorry but as a type 1 diabetic, a registered Dietitian, a certified diabetes educator, and someone who works with endos on a daily basis I have to disagree. Diabetes is not an impairment on CHO metabolism its an impairment on Insulin production. CHO is metabolized the same in a diabetic as it is in a non diabetic, the only difference is Diabetics (type 1 or 2) cannot use it due to not enough or no insulin. As for CHO intake MANY studies have shown that the average person diabetic or not needs 120g CHO throughout their day for proper brain function. CHO is the fuel source for your body and you need carbs to function properly. Carbs are used in the production of many different things in our bodies and unfortunately despite what you think we do need carbs for dietary and health purposes.

You do not want to tell a type 1 diabetic to be ketotic because they are at higher risk to slip into DKA more easily at lower numbers since they would be producing ketones already. A reduction in Carbs is partially correct as many newly diagnosed patients are eating way too many carbs, however the key is not reduction but balance and consistency. the same number of carbs at about the same time each day. I know many diabetics who eat 30-45g CHO for breakfast & 60-75g CHO for lunch and dinner and still have perfect A1Cs without medications. Many that have great A1Cs with medications. If you really think 90% of diabetics are uncontrolled than you are horribly incorrect. 90% of my practices patients are in perfect control with 30-60g CHO intake per meal. I'm sorry you feel that my advice is "horrible" but it is what research is showing and is what ENDOs are practicing. and they are the diabetes experts in the medical field.

That's not really true. It is true that the body needs about 120g of carbohydrates per day. However, it does not need to come from dietary carbohydrates. Most of the body can run on ketones, and the brain can run on a combination of ketones and glucose. This reduced need allows the liver to provide all of the necessary glucose through gluconeogenesis.

And actually, many studies conclude that the body can handle itself just fine on even zero carbohydrates, provided there is adequate fat in the diet to provide a substrate for gluconeogenesis. It's only when carbs and fat are restricted that the body starts to have problems. The evidence also points to ketones as a more stable fuel for the brain and nervous system, thereby preventing and mitigating a number of neurological issues, including not only epilepsy (for which the ketogenic diet was originally created and has been used for the better part of the past century), but also for Alzheimer's, Parkinson's, migraines, and others, in addition to the aforementioned uses for both Type I and Type II Diabetes (which I already posted numerous links to studies regarding). Finally, while reduced calorie, low-glycemic diets are effective, the evidence points to ketogenic diets being more effective for blood glucose control in diabetics.

Also, the WHO disagrees with your assertion that Diabetes is not a carbohydrate metabolism disorder -- http://www.who.int/diabetes/action_online/basics/en/

Of course, post some of the studies that you know of that say that the body requires 120g of dietary carbohydrates per day, by all means. I know I'd love to read the research you have for us.

http://ajcn.nutrition.org/content/75/5/951.2.full
http://ajcn.nutrition.org/content/86/2/276.full
http://www.medscape.com/viewarticle/706139

You do not want to tell a type 1 diabetic to be ketotic because they are at higher risk to slip into DKA more easily at lower numbers since they would be producing ketones already. A reduction in Carbs is partially correct as many newly diagnosed patients are eating way too many carbs, however the key is not reduction but balance and consistency. the same number of carbs at about the same time each day. I know many diabetics who eat 30-45g CHO for breakfast & 60-75g CHO for lunch and dinner and still have perfect A1Cs without medications. Many that have great A1Cs with medications. If you really think 90% of diabetics are uncontrolled than you are horribly incorrect. 90% of my practices patients are in perfect control with 30-60g CHO intake per meal. I'm sorry you feel that my advice is "horrible" but it is what research is showing and is what ENDOs are practicing. and they are the diabetes experts in the medical field.

(clipped for brevity)

Just curious...what are the target Fasting and PP BG's you recommend for your T2D clients?

Our fasting goals are 70-100, 2 hr PP 70-140

This is very interesting. As it is not within range of what my Endo recommended to me. Hence I don't listen to him much :laugh:
But seriously, what happens when a T2D cannot meet those goals with just diet & exercise with the recommended amount of approx 120g of carbs per day?

edited to add the amt. of carb

You do not want to tell a type 1 diabetic to be ketotic because they are at higher risk to slip into DKA more easily at lower numbers since they would be producing ketones already. A reduction in Carbs is partially correct as many newly diagnosed patients are eating way too many carbs, however the key is not reduction but balance and consistency. the same number of carbs at about the same time each day. I know many diabetics who eat 30-45g CHO for breakfast & 60-75g CHO for lunch and dinner and still have perfect A1Cs without medications. Many that have great A1Cs with medications. If you really think 90% of diabetics are uncontrolled than you are horribly incorrect. 90% of my practices patients are in perfect control with 30-60g CHO intake per meal. I'm sorry you feel that my advice is "horrible" but it is what research is showing and is what ENDOs are practicing. and they are the diabetes experts in the medical field.

(clipped for brevity)

Just curious...what are the target Fasting and PP BG's you recommend for your T2D clients?

Our fasting goals are 70-100, 2 hr PP 70-140

This is very interesting. As it is not within range of what my Endo recommended to me. Hence I don't listen to him much :laugh:
But seriously, what happens when a T2D cannot meet those goals with just diet & exercise with the recommended amount of approx 120g of carbs per day?

edited to add the amt. of carb

it all depends on the person and what their BGs are running. If they are running a little higher but overall have an A1C of 6.5% or lower then usually we just monitor it and if it increases to much higher numbers then medications are the next step.