Finding it difficult to limit carbs

13

Replies

  • LAT1963
    LAT1963 Posts: 1,375 Member
    edited August 2019
    psychod787 wrote: »
    LAT1963 wrote: »
    Wow. 12 Woos. Sorry for explaining physiology, geebus...

    Florida Man here. Yes ma'am you got woo's because your grasp of human physiology is well.... wrong...... report me....🤷‍♂️

    What parts about what I said about physiology are wrong?

    The way you tell your muscles to upregulate their insulin receptors is to crash your insulin levels on a regular basis (by avoiding high-glycemic-index carbs) and deplete the muscles of locally-stored glycogen by exercising. Use every tool in your arsenal to do those things and you can reverse 'pre-diabetes'.

    Don't believe me, look it up in Harrison's Principals of Internal Medicine.

    I'm a licensed physician. Bite me.
  • acpgee
    acpgee Posts: 7,931 Member
    https://www.bbc.co.uk/news/magazine-29629761

    Google "re-heat" with "resistant starch". A lot of carby foods will spike blood glucose much less if they are cooked in water, cooled and re-heated. This is a way of converting simple carbs into resistant starch which decreases digestibility of starchy foods. Pasta and rice can be simply cooled and re-heated. For bread, freeze and toast to get the same effect. I am not sure there is a similar technique for potatoes but try googling for studies.

    I would recommend confirming tests on yourself with a blood glucose monitoring kit. The kind where you can test blood glucose by pricking your finger tip. Available in drugstores.

  • psychod787
    psychod787 Posts: 4,099 Member
    acpgee wrote: »
    https://www.bbc.co.uk/news/magazine-29629761

    Google "re-heat" with "resistant starch". A lot of carby foods will spike blood glucose much less if they are cooked in water, cooled and re-heated. This is a way of converting simple carbs into resistant starch which decreases digestibility of starchy foods. Pasta and rice can be simply cooled and re-heated. For bread, freeze and toast to get the same effect. I am not sure there is a similar technique for potatoes but try googling for studies.

    I would recommend confirming tests on yourself with a blood glucose monitoring kit. The kind where you can test blood glucose by pricking your finger tip. Available in drugstores.

    Yup, they change the structure of the polysaccharide chains... you are good btw. Can I friend you?
  • anubis609
    anubis609 Posts: 3,966 Member
    lemurcat2 wrote: »
    Thank you everyone for your replies! To clear up a few things - my doctor did not specifically tell me to do keto, he simply said "eat mostly meat, vegetables, and eggs and limit bread to once a week". I had tried keto in the past and asked him if I should do that again - he said that would be fine. But I didn't really get any more specific guidance than that, which is honestly why I'm a little confused now.

    I thought you sounded a bit confused about how to implement the advice, which is why I think a referral to a registered dietitian would be a good idea if possible. It's usually covered by insurance if the doctor will refer you. That would give you a lot more guidance and let you talk through things that you think would be difficult for you.
    I have started to incorporate exercise into my lifestyle, which is apparently a good way to control high blood sugar.

    Yes, it is.
    In terms of food, I never really ate a ton of refined white carbs to begin with, so it's not really a matter of just switching to wheat bread or brown rice. But it sounds like limiting carbs to maybe 100g per day would be a good place to start? It would certainly be more sustainable for me than doing keto. Thank you all for your help - getting a diagnosis like this is scary and it's nice to hear from others who have had the same experience.

    There are others longtime posters here who have controlled T2D with diet (hope one shows up). It seems like it's common to work with a certified diabetes educator (your dietitian could be one of those).

    Anyway, I think there's some variation on what foods trigger you -- I have a friend with T2D, and he found white rice, even with fat and protein (maybe especially with fat) was one of the worst things for his blood sugar, he basically had to give up the Chinese take out he loved.

    That aside, as I understand it, it's about limiting carbs per meal and making sure that you get a good amount of fiber and also protein with it -- a mixed meal. If you can't get a referral, maybe something like that, so 100 g or so of carbs a day, about 30-40 g per meal? And for weight loss, are you using MFP to set a calorie goal and count cals? Weight loss alone often addresses insulin resistance.

    But I am not a doctor or an RD, and I think the dietitian option is the best one.

    I'm formerly T2D and was morbidly obese. Controlled both glucose and weight, among a variety of other severe cardiovascular health risks, with a calorie deficit and a focus on reduced carbs (around 50-150g/d).

    The horribly oversimplified explanation is that your fat cells are nearing their capacity to store fatty acids and your pancreas is having trouble signaling more insulin to meter those fatty acids in a controlled manner. Insulin is also responsible for shuttling glucose for use or storage, so fast-digesting carbs create more glucose than your insulin can handle since it's busy trying to keep fatty acids in check. Hence, insulin resistance.

    You would need to be mindful of carbs and their quality to control glucose, but you don't need to do keto unless you want to. Your doctor giving the okay for keto is probably more along the lines of "if you think you might have trouble controlling carb intake, then eliminating it completely may just be easier, mentally." Not that I'm a doctor, but it seems logical to me why you may not have heard anything else beyond that.

    Just keep your diet simple. Place a priority on protein, nutrient dense fibrous sources of carbs, reduce hyperpalatable refined carbs within your calculated calorie deficit, and exercise (emphasis on strength training, though any activity is better than none). As you lose fat and stimulate muscle for growth, your body becomes more efficient at shuttling incoming food to their proper place and you should see better lab readings.
  • mmapags
    mmapags Posts: 8,934 Member
    anubis609 wrote: »
    lemurcat2 wrote: »
    Thank you everyone for your replies! To clear up a few things - my doctor did not specifically tell me to do keto, he simply said "eat mostly meat, vegetables, and eggs and limit bread to once a week". I had tried keto in the past and asked him if I should do that again - he said that would be fine. But I didn't really get any more specific guidance than that, which is honestly why I'm a little confused now.

    I thought you sounded a bit confused about how to implement the advice, which is why I think a referral to a registered dietitian would be a good idea if possible. It's usually covered by insurance if the doctor will refer you. That would give you a lot more guidance and let you talk through things that you think would be difficult for you.
    I have started to incorporate exercise into my lifestyle, which is apparently a good way to control high blood sugar.

    Yes, it is.
    In terms of food, I never really ate a ton of refined white carbs to begin with, so it's not really a matter of just switching to wheat bread or brown rice. But it sounds like limiting carbs to maybe 100g per day would be a good place to start? It would certainly be more sustainable for me than doing keto. Thank you all for your help - getting a diagnosis like this is scary and it's nice to hear from others who have had the same experience.

    There are others longtime posters here who have controlled T2D with diet (hope one shows up). It seems like it's common to work with a certified diabetes educator (your dietitian could be one of those).

    Anyway, I think there's some variation on what foods trigger you -- I have a friend with T2D, and he found white rice, even with fat and protein (maybe especially with fat) was one of the worst things for his blood sugar, he basically had to give up the Chinese take out he loved.

    That aside, as I understand it, it's about limiting carbs per meal and making sure that you get a good amount of fiber and also protein with it -- a mixed meal. If you can't get a referral, maybe something like that, so 100 g or so of carbs a day, about 30-40 g per meal? And for weight loss, are you using MFP to set a calorie goal and count cals? Weight loss alone often addresses insulin resistance.

    But I am not a doctor or an RD, and I think the dietitian option is the best one.

    I'm formerly T2D and was morbidly obese. Controlled both glucose and weight, among a variety of other severe cardiovascular health risks, with a calorie deficit and a focus on reduced carbs (around 50-150g/d).

    The horribly oversimplified explanation is that your fat cells are nearing their capacity to store fatty acids and your pancreas is having trouble signaling more insulin to meter those fatty acids in a controlled manner. Insulin is also responsible for shuttling glucose for use or storage, so fast-digesting carbs create more glucose than your insulin can handle since it's busy trying to keep fatty acids in check. Hence, insulin resistance.

    You would need to be mindful of carbs and their quality to control glucose, but you don't need to do keto unless you want to. Your doctor giving the okay for keto is probably more along the lines of "if you think you might have trouble controlling carb intake, then eliminating it completely may just be easier, mentally." Not that I'm a doctor, but it seems logical to me why you may not have heard anything else beyond that.

    Just keep your diet simple. Place a priority on protein, nutrient dense fibrous sources of carbs, reduce hyperpalatable refined carbs within your calculated calorie deficit, and exercise (emphasis on strength training, though any activity is better than none). As you lose fat and stimulate muscle for growth, your body becomes more efficient at shuttling incoming food to their proper place and you should see better lab readings.

    This^^! I was diagnosed prediabetic 3.5 years ago. I reduced carbs to the 100gr to 150gr range, ramped up vigorous exercise and lost 20 lbs. All numbers dropped into healthy ranges and have been there ever since. Not only my A1c and BG numbers but all my bloodwork, cholesterol, triglycerides, ratios, everything.

    I am 68 , at a healthy body weight and exercise regularly and still eat the same way. It's become my habit now and the way I prefer to eat.
  • acpgee
    acpgee Posts: 7,931 Member
    I used to be a full blown type 2 diabetic with an HBA1C of 10+. After losing weight I got my HBA1C to down to 4 which is the bottom of the normal range and have stopped all medication.

    Have a look at this study which essentially says that insulin insensitivity from normal Type 2 (not adult onset Type 1) can be reversed by losing belly fat surrounding liver and pancreas.

    https://www.ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation

    Vigorous exercise, especially high intensity interval training reduces glycogen in the muscles which will also suck glucose from blood into glycogen stores. Google "high intensity training" with "blood glucose" for more information.



  • psychod787
    psychod787 Posts: 4,099 Member
    T2 dm here as well....
  • Hannahwalksfar
    Hannahwalksfar Posts: 572 Member
    WinoGelato wrote: »
    WinoGelato wrote: »
    I’m just going to tell myself that all the woos mean the people love my advice

    More likely people are reacting to your sensational and unwarranted comment that the OP’s life is not worth bread...

    I see. To clarify I meant that the op’slifeisnt worth risking eating bread and making themselve’s sick. So their life is much more valuable than the bread they want to consume.

    Still overly dramatic for the situation....

    Ok. 😊
  • LAT1963
    LAT1963 Posts: 1,375 Member
    you can tweek the food around to reach a diet that you can stick to and lose weight, but if you neglect the exercise the chances of fixing the insulin resistance component are much lower.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    In fact all this hoopla over a single fasting reading - NOT an a1c which tracks glucose over several months - seems a little loopy to me - since a minor illness or stress or slow digesting meal or just a funny strip could easily cause a reading of 103. For goodness sake, a study found the accuracy of all available blood glucose testing strips was only within tolerances of between 10 and 15% which would mean 103 could really be a perfectly normal 93!

    Good point.

    My guess is the doctor was more focusing on the weight loss and had anecdotal awareness or personal knowledge with low carb success, plus current demonization of carbs, plus assuming that someone overweight has a poor diet and eats lots of refined carbs (usually with fat too) -- which OP has said is not actually the case.

    Given all this, although I still think a visit to a registered dietitian could be helpful if possible, I think the main thing is finding a sustainable way to eat for weight loss and increasing activity/exercise (which OP has also mentioned doing already).
  • psychod787
    psychod787 Posts: 4,099 Member
    lemurcat2 wrote: »
    In fact all this hoopla over a single fasting reading - NOT an a1c which tracks glucose over several months - seems a little loopy to me - since a minor illness or stress or slow digesting meal or just a funny strip could easily cause a reading of 103. For goodness sake, a study found the accuracy of all available blood glucose testing strips was only within tolerances of between 10 and 15% which would mean 103 could really be a perfectly normal 93!

    Good point.

    My guess is the doctor was more focusing on the weight loss and had anecdotal awareness or personal knowledge with low carb success, plus current demonization of carbs, plus assuming that someone overweight has a poor diet and eats lots of refined carbs (usually with fat too) -- which OP has said is not actually the case.

    Given all this, although I still think a visit to a registered dietitian could be helpful if possible, I think the main thing is finding a sustainable way to eat for weight loss and increasing activity/exercise (which OP has also mentioned doing already).

    Funnily enough, my doctor actually told me I didn't need to lose weight and that I was perfect the way I was - I only needed to limit carbs for blood sugar purposes. I'm not sure if he was just afraid of hurting my feelings or what, but as a 250 lb female at 5'7", I hardly think I'm perfect the way I am. I almost wish he had stressed the importance of losing weight. In fact, I wish someone had helped me years ago when I wasn't as bad off as I am now.

    With all due respect, that is really bad advice on the part of your doctor which would make me look for a new one.

    At your height and weight, you have a BMI of 39, class 2 obesity, and are only 6 pounds from being morbidly obese. The top end of healthy BMI for you is 159 lbs. There are very real health risks from being that overweight, and unless you haven’t mentioned that you are a massively muscular bodybuilder, your doctor’s advice is not just misguided but dangerous.

    I agree, but disagree. OP, if you lose about 10% of your BM, about 25lbs and can maintain it easy enough, you will get much of the maximal health rewards out of it statistically. I recently went to a T.O.P.S. meeting. Know what I notice? All had weight loss, not a SINGLE one lean. All overweight to low OB, but guess what? They were all happier and HEALTHIER! OP find the balance, I am as well. Best of luck OP!
  • cbihatt
    cbihatt Posts: 319 Member
    acpgee wrote: »
    aokoye wrote: »
    MikePTY 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.

    Trusting doctors unconditionally is a really bad plan. While I have had a lot of very good doctors, there was also one who could have killed me on accident had it not been for a pharmacist who questioned what he had prescribed. And yes, the doctor had a full and up to date list of all of my meds. As a result of that unfortunate decision on the doctor's end as well as various other doctor related blunders, I ended up with a very nasty kidney infection to go along with the bladder infection and needed IV fluids (because I couldn't keep anything down, water included) along with IV antibiotics.

    Better that than a potentially deadly drug interaction though.

    I've had some great doctor's but I also have two friends who had parents were accidentally killed by their GP.

    In one case my friend's mom called the GP requesting a house visit because she felt so poorly. He advised her to take an aspirin and call in the morning. A few hours later a daughter, also a medical doctor, came to visit and noticed her mom was jaundiced. She rushed her mom to hospital but she died a few hours later of blood poisoning. Mom had a liver infection but it was the aspirin that actually killed her.

    In another case a friend's dad had drawn attention to a strange mole several times but his family doctor said there was nothing to worry about. When he was in hospital due to an unrelated accident, the emergency room doctor noticed the mole and immediately biopsied it and had it removed the same day. He died a few weeks later because his skin cancer had already spread.

    I visited a GP once that almost killed me too. I went to the GP feeling ill and the trainee doctor told to go home and rest because I had the flu. Around dinner time I felt so poorly I called an ambulance to take me to accidents and emergency. Good thing, because within 15 hours I was on life support in intensive care because swine flu had become viral pneumonia and acute respiratory distress. I spent 6 months in hospital that year including 2 months in intensive care. If I had waited until morning to return to the GP I probably wouldn't be around now.

    While these situations are terrible, it isn’t really fair to say the doctors involved caused (or nearly caused) the patients’ deaths. Doctors are human, and that makes them imperfect. Yes, they can misdiagnose a patient which may exacerbate an existing issue, but to blame a doctor for a death from a disease is a bit extreme, IMO. The doctor didn’t cause the liver condition or the cancer or the flu.

    I mean no offense by this. I just have sympathy for those in certain professions who I feel get less respect than they deserve, sometimes.
  • deannalfisher
    deannalfisher Posts: 5,600 Member
    cbihatt wrote: »
    acpgee wrote: »
    aokoye wrote: »
    MikePTY 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.

    Trusting doctors unconditionally is a really bad plan. While I have had a lot of very good doctors, there was also one who could have killed me on accident had it not been for a pharmacist who questioned what he had prescribed. And yes, the doctor had a full and up to date list of all of my meds. As a result of that unfortunate decision on the doctor's end as well as various other doctor related blunders, I ended up with a very nasty kidney infection to go along with the bladder infection and needed IV fluids (because I couldn't keep anything down, water included) along with IV antibiotics.

    Better that than a potentially deadly drug interaction though.

    I've had some great doctor's but I also have two friends who had parents were accidentally killed by their GP.

    In one case my friend's mom called the GP requesting a house visit because she felt so poorly. He advised her to take an aspirin and call in the morning. A few hours later a daughter, also a medical doctor, came to visit and noticed her mom was jaundiced. She rushed her mom to hospital but she died a few hours later of blood poisoning. Mom had a liver infection but it was the aspirin that actually killed her.

    In another case a friend's dad had drawn attention to a strange mole several times but his family doctor said there was nothing to worry about. When he was in hospital due to an unrelated accident, the emergency room doctor noticed the mole and immediately biopsied it and had it removed the same day. He died a few weeks later because his skin cancer had already spread.

    I visited a GP once that almost killed me too. I went to the GP feeling ill and the trainee doctor told to go home and rest because I had the flu. Around dinner time I felt so poorly I called an ambulance to take me to accidents and emergency. Good thing, because within 15 hours I was on life support in intensive care because swine flu had become viral pneumonia and acute respiratory distress. I spent 6 months in hospital that year including 2 months in intensive care. If I had waited until morning to return to the GP I probably wouldn't be around now.

    While these situations are terrible, it isn’t really fair to say the doctors involved caused (or nearly caused) the patients’ deaths. Doctors are human, and that makes them imperfect. Yes, they can misdiagnose a patient which may exacerbate an existing issue, but to blame a doctor for a death from a disease is a bit extreme, IMO. The doctor didn’t cause the liver condition or the cancer or the flu.

    I mean no offense by this. I just have sympathy for those in certain professions who I feel get less respect than they deserve, sometimes.

    may not have caused but failing to diagnose lead to the seemingly preventable deaths of these individuals