Diabetics appear to be very interested in low-carb eating

Back in March I was invited as a guest on the BBC Radio 4 consumer affairs programme You and Yours to discuss diabetes. Up against me was a spokesperson/dietician from Diabetes UK (the UK’s largest diabetes charity). My issue is that Diabetes UK gives diabetics incomplete and misleading information that is likely to make their blood sugar control harder and their risk of complications higher than they need be. I argued for a diet lower in carbohydrates that cause spikes in blood sugar, including many starchy carbohydrates. The Diabetes UK spokesperson trotted out the same, tired, nonsense about the essential nature of carbohydrate in the diet and the supposed hazards of ketosis (a natural state where fat is broken down to give rise to ‘ketone’ bodies which we can use for fuel – a process which probably occurs through the night in most of us, whether we’re on a diet or not). You can read more about these issues here.

The idea that each meal should include starchy carbohydrate (as Diabetes UK posits) is ridiculous and dangerous, in my opinion. When individuals eschew this advice and eat meals comprised of say meat, fish, eggs and non-starchy vegetables (e.g. green leafy vegetables) then their blood sugar control is usually very good. There are many diabetics who have proved this for themselves by self-testing blood sugar levels before and for a couple of hours, say, after eating. Individuals adopting a low-carb diet will also generally see an improvement in levels of HbA1c (also known as glycosylated haemoglobin) which is a marker of overall blood sugar control over the last 3 months or so. Many diabetics, with the right diet, are able to get their HbA1c level into what would be regarded as the normal range. Don’t be expecting such results by following the dietary advice dished out by Diabetes UK, though.

Recently, I came across what looks like a whole better on-line resource for individuals with diabetes known as diabetes.co.uk. Diabetes.co.uk (not to be confused with Dabetes UK) describes itself as: “your resource for diabetes, diabetics, diabetes research and education; the leading community website and forum for people with diabetes”.  On the homepage, it states: “Diabetes.co.uk is growing as a community of diabetics and non-diabetics alike, offering their own support and first hand knowledge.” I like this last bit, because I’m a great believer in listening to what people who have had success in controlling their diabetes have to say. I don’t have diabetes so I’m not in the best place to judge what works. However, I’ve seen countless individuals report excellent results on adopting a low-carb diet, and it’s these experiences (plus some science) which has led me to conclude this way of eating is, overall, the best for people with diabetes.

Like any website, I can’t say I endorse every piece of information on it. However, I did take a browse through the forum (which looks lively) and took this screenshot from it today. Under ‘Diet and Nutrition’ the site has areas for individuals who are and are not interested in low-carbohydrate diets for controlling their diabetes

Just look at the figures here: Activity in the low-carb section is many times greater than the non-low-carb area. Have a look in the low-carb area and you’ll find plenty of first-hand stories about success with lower-carb eating.

None of this proves anything of course. What it shows, though, is that there is considerable appetite for information on low-carb eating among diabetics, and many are discovering the benefits of this way of eating. As this happens, of course, more and more individuals will come to realise that conventional dietary advice for diabetics if often misleading and dangerous, and I think the people at Diabetes UK should take note.

33 Responses to Diabetics appear to be very interested in low-carb eating

  1. Frances K 23 May 2012 at 6:25 pm #

    When I was a student nurse in the mid 80′s, diabetic patients were given a diet that was restricted to 120g of carbohydrate a day. This was divided into 3 meals of 30g plus 3 snacks of 10g each. Latterly, this became simply “sugar-free”. When I developed gestational diabetes in 2005, I was given very little guidance on my diet but lots about how often to check my blood sugar. I decided to follow the diet I was familiar with from the 80′s. Apart from one reading of 10, all were within 5-8, including my fasting ones. I did not want to end up injecting insulin. In short, low carb stabilises blood sugars, but we all know that, don’t we? The funding that Diabetes UK receives from companies such as Kellogs cannot be disregarded. It’s deplorable that politics & profit are contributing to the obesity/diabetes epidemics.

  2. Lori 23 May 2012 at 7:18 pm #

    My brother is going to see a dietician for his diabetes in a few days. I told him she’d likely tell him he needs 120g of carbohydrate every day, and suggested he ask her how humans made it through a 100,000-year ice age if that was the case. I’m looking forward to her answer.

  3. Dave P 23 May 2012 at 7:46 pm #

    I used to frequent Diabetes.co.uk during my courtship with Lo Carb. There used to be a results spot where you could show progress etc. Today i am still Lo Carb and thankfully more knowledgeable than i was. The other side of this, i recently joined a new surgery and had my 6month check with Spec Nurse. I got a pat on the back for an Hba1c of 6.2 and no progressive neuropathy and no eye problems and stable weight. I then told her how i do it, the reply was Oh Well if it works for you !. Which is really the point, it isnt just me and my time on this website and others tells me so. Not to mention whats going in in the Nordic Countries at present.
    I have no expectation that the Authorities will accede any time soon, but at some point they must surely see the elephant in the room ? or how can they claim to be evidence based ??

  4. Forumite 23 May 2012 at 8:39 pm #

    It’s more an indictment of a dysfunctional forum.
    The two forums have been in existence for different amounts of time.The low carb forum came first, then the non low carb forum, both in an attempt to prevent arguments. You can see by the very first post on the non low carb forum a locked post entitled Bernstein that two forums didn’t stop the animosity. Its very hard to define someone as ‘non low carb’ so people don’t tend to post there. Arguments continue but in one of the other sections.
    Many people get fed up with the arguments and migrate to one of the other UK forums including the one sponsored by Diabetes UK.
    http://www.diabetessupport.co.uk/boards/

  5. Agricola 23 May 2012 at 8:50 pm #

    when I was diagnosed with type II diabetes several years ago, I embarked on a crash course of self learning about the disease and diet. I quickly came to Dr. Richard Bernstein. If you have not read any of his books, you should. The various diabetic associations, nutritionists, and doctors should as well.

  6. John 23 May 2012 at 10:51 pm #

    Don’t forget, HbA1c levels give you a general idea of how much overall glycosilation is occurring. Why is this important?? Let’s say you eat a lot of carbohydrates and you have a lot of serum glucose from the carbohydrates while your liver converts the glucose to triglycerides and then small LDL is formed. Since small LDL is not recognized by the LDL receptors it will continue circulating in the blood stream increasing it’s chances of oxidation. The oxidized small LDL will then undergo glycosilation during the periods of high serum glucose, and then the glycosilated small LDL will attach itself to an artery. Surprise, you now have the beginnings (or continuation) of heart disease. Even non-diabetics should get their HbA1c levels checked.

  7. PhilT 23 May 2012 at 11:01 pm #

    Excellent, like an opinion poll by proxy. I played with Diabetes UK’s meal planner and it proposed a breakfast that was almost entirely carbohydrate – fruit juice, toast, cereal, milk etc. Disaster.

  8. Diane Smith 24 May 2012 at 12:25 pm #

    This is what it says on Diabetes UK: “Why does my body need carbohydrate?
    Carbohydrate is the body’s preferred source of energy in the diet. All carbohydrates are broken down into glucose, which is essential fuel for the body – especially the brain. High-fibre carbohydrates such as wholegrains and fruit play an important role in the health of the gut.”

    As someone who has been eating no grains and about 20g of carbohydrate a day for 2 years now and in that time every aspect of my health has improved, I am wondering how this can be true!

    I am certain that a low carb diet is the best way to manage Type 2 diabetes but I would be really interested to know if eating low carb could help Type 1 diabetics manage their condition.

  9. Edwardia 24 May 2012 at 8:26 pm #

    I have Type II diabetes, and first thing I’d like to say is that I hate being called a diabetic, especially to my face. With the notable exception of my GP, most healthcare professionals are appallingly patronising to people with diabetes. We get treated as if it’s a self-inflicted disease and we’re therefore wasting valuable NHS resources. When I tell them that I’m an ex-chef who was reared on the low fat diet, had my own organic allotment and never ate ready meals they look at me as if I’m lying.

    I found low carb by Googling two years ago. I got my HbA1c down from 13% to 8.5% in the first three months on a max of 100g carbs a day. In December, wanting to reduce my weight yet further, I cut that to 50g. My latest Hb1Ac two weeks ago was 6.5% and I’ve lost four inches off my waist. I’m now size 16, which I haven’t been since 1996.

    I’ve just starting reading Escape The Diet Trap today so can’t comment yet, but even though it’s aimed at men, Waist Disposal is great !

    The problem for doctors contracted to the NHS is that they can’t go against NHS policy and recommend low carb for people with diabetes so thousands of people continue on the road to further ill health. Diabetes UK is in bed with cereal manufacturers and consequently doesn’t advocate low carb either, which makes me furious.

  10. Bruce 24 May 2012 at 9:23 pm #

    It’s how to safely attenuate food sugars with less injection and drug complications.

  11. Swimmer2 24 May 2012 at 11:40 pm #

    Glad to see the diabetes.co.uk forum get a mention, as it’s such a welcoming and truly helpful place. HBA1C day tomorrow – 10% in January, 7.2 in March, hoping for a low 6 this time – all as a result of a reduced carb diet and a determination to eat to my meter.

  12. Steve 25 May 2012 at 12:24 am #

    Dr Briffa

    So glad you have finally found us all on the diabetes.co.uk site. I was diagnosed T2 5 months ago and using the low carb info and friends I now have on the site I have reduced my hBA1c from 11.3% to 5.3% in 3 months, lowered by cholesterol down to 3.8 while upping my good cholesterol, reduced my blood pressure so it averages around 115/70 and have lost over 3 stone (20kg) in that same period. When will Diabetes UK and the NHS sit up and take notice of results like that! They are not atypical of the results that many T2′s who find us achieve. My DSN and GP appeared initially very sceptical of my low carb approach but once they have seen the results they have both sat down with me to find out how I achieved my good results so hopefully they can now help other T2′s in my part of the world. Apart from a low carb diet the most important tool I and other similarly successful T2′s use is a meter and strips which of course most of us have had to fund ourselves because “TESTING SENDS YOU MAD”, strange T1′s aren’t all insane then isn’t it? . While I don’t agree to a blanket prescription of strips for T2 for those who show a serious effort to want to control their condition they should be prescribed especially to start with when the newly diagnosed is working out what is safe and not safe to eat. How else are we supposed to work this stuff out? The membership of diabetes.co.uk is at present considering a campaign called “Eat to your meter” which while it doesn’t prescribe any particular dietary regime (low carb, low GL/GI, portion control or whatever) does encourage T2′s to meet the NICE 2 hour post prandial target of 8.5 (or even better the slightly lower IDF recommendation of 7.8) for the vast majority of time. Meeting this target is seen as essential for minimising future risks of diabetic complications and therefore not only aids the diabetic but will ultimately save the NHS millions of pounds if it were adopted more widely. It is easily achievable by most T2′s so long as they adopt an appropriate dietary regime. Hope to see you lurking more or better still why not join us and give us some extra expert opinion you would be made most welcome!

  13. Lori 25 May 2012 at 12:41 am #

    @Diane Smith, assuming your question isn’t rhetorical, what Diabetes UK et al conveniently forget to mention is that glucose is needed in your blood, not your stomach. Your liver can make glucose out of protein in a process called gluconeogenisis. (That’s how humans don’t die of hypoglycemia on a low-carb diet.) When they say carbohydrate is “preferred,” it means that your body burns carb (glucose) before it burns fat. Too much glucose is toxic. This also means that when you’re burning enough glucose, you’re not burning fat. As to fruit and grains, humans have gotten along for millions of years without grains and without year-round fruit. Suddenly, these foods are “important”?

    I like to imagine that people who spout the nonsense you mentioned are more stupid than evil.

    And yes, LC helps T1 diabetics.

  14. Ian Day 25 May 2012 at 12:46 am #

    I learned low carbing from a type 1 who had his results published in the “Sweet” magazine for diabetics (now discontinued.) I scanned his article, & gave my experience. D UK, of course, commented in effect: “Don’t try this at home…”

    May 29, I will be addressing the Hounslow Cardiac/Diabetes Support Group on my experience. See the forum & search for Hounslow for more details. I post as IanD.

  15. Dr Jay Wortman 25 May 2012 at 5:38 pm #

    Things appear to have improved at diabetes.co.uk. It was not always thus, however, and some vestiges of earlier discord still remain. I have blogged about my own experience there which resulted in some changes for the better: http://www.drjaywortman.com/blog/wordpress/2011/07/

    For a somewhat amusing take on the ongoing battle between the died-in-the wool low-carbers and the “low-carb antis” see: http://thelowcarbdiabetic.blogspot.ca/

  16. Scott 25 May 2012 at 7:59 pm #

    Have you seen Diabetes UK’s latest ‘position statement’ on the consumption of carbohydrate in people with diabetes? They seem to be slightly softening their approach. But their own review of the evidence seems to take an even more positive view. It says:

    The low-fat “strategy for weight loss is promoted by all major diabetes organisations [41,42] but evidence is emerging that alternative dietary methods may be as effective, including the Mediterranean diet [43], low carbohydrate diets [44] and meal replacements [45].” (p9-10)

    And…

    “Low-carbohydrate diets have created some controversy, but both a recent review and meta- analysis suggest that they are associated with significant reductions in body weight and improvements in glycaemic control [121, 135]. It has been shown that the main mode of action of low carbohydrate diets is simply a reduction in energy intake due to carbohydrate restriction [136]. Systematic reviews have reported that although these diets may be more effective than comparison diets over the short-term, there is little published evidence from studies in people without diabetes showing benefit over the longer term [44, 137]. Concern has been expressed about the potential adverse effects of these diets, especially on cardiovascular risk, but there remains no evidence of harm over the short term [137].” (p17)

    Perhaps you should write to them with a summary of the research they should consider in their next review?

    Consumption of carbohydrate in people with diabetes
    http://www.diabetes.org.uk/About_us/Our_Views/Position_statements/Consumption-of-carbohydrate-in-people-with-diabetes/

    Evidence-based nutrition guidelines for the prevention and management of diabetes (May 2011)
    http://www.diabetes.org.uk/Documents/Reports/Nutritional_guidelines200911.pdf

  17. Ian Day 25 May 2012 at 10:39 pm #

    That “Evidence-based nutrition guidelines for the prevention and management of diabetes” is well hidden in the DUK website. I don’t think the people who write their leaflets are aware of it.

    But I hope I’m wrong – I shall quote the document next Tuesday.

  18. Geoff Hetherington 26 May 2012 at 4:30 am #

    Folks:
    Can we stop the low carb talk – it is more rightly low to no processed carbs – Vegetables, especially the green leafy and less starchy ones along with prudent fruit intake achieves these results. it is the overly processed sugar / HFCS / transfat filled carbs that are continuing to do the damge to all who have not woken up.
    Low carb is too broad a brush to use – let’s try to get the real culprits in everyone sights – processes carbs.

  19. Xenia 26 May 2012 at 7:20 am #

    Low carb rules. Of course, not low carb “products” where carbs have been artificially removed – but low carb REAL food. If it’s organic, so much the better. It is encouraging to see that such a huge number of people on this diabetes forum is interested in low carb! The word is spreading. But if you are a diabetic and you happen to slip once in a while, there are two interesting ways to bring you blood sugar down very quickly after the meal.

    The first is a 1-minute exercise called Hoe Downs (by Teresa Tapp, the inventor of T-Tapp workout). It is performed standing in place but it raises the heart rate nevertheless. It lowers the glucose significantly in just 10 minutes post workout, stimulates lymphatic flow, increases mental clarity and improves neurokinetic conenction (because it sort of exercises the brain as well).

    It takes a few minutes to learn (because posture and linear alignment are very important and because in most people, left side and right side of their brain are not in sync). Here is the link, please read also the explanation under this YouTube video.

    http://www.youtube.com/watch?v=lsURicKB_G8

    All it takes is one minute!

    The second method is even simpler: eat 1-3 tablespoons of virgin expeller pressed, non-refined organic coconut oil immediately after the meal. In just 30 minutes, the blood glucose should return to normal. According to dr. Bruce Fife, coconut oil works in several ways, of which I am listing just a few:

    * It slows down the absorption of carbs into blood
    * Helps pancreas secreting insulin
    * Improves insulin sensitivity of cells (so you need less to achieve more) which also helps reverse insulin resistance
    * Improves the circulation (plus feeling in numb limbs returns)
    * Is heart healthy and helps manage cholesterol (the more non-compromised saturated fats you eat, the better your cholesterol levels will be)
    * Improves thyroid function, etc.

  20. JustMEinT 26 May 2012 at 8:00 am #

    http://www.proteinpower.com/banting/index.php?page=7

    A great read on early low carbing (some things will not ‘gel’ with the modern approach) but it is worth reading

  21. JustMEinT 26 May 2012 at 8:02 am #

    http://www.lowcarb.ca/corpulence/corpulence_1.html this maybe an easier read of Bantings original letter on corpulence

  22. Dr John Briffa 26 May 2012 at 5:47 pm #

    Geoff

    You make good points, I think. My sense is that many people use ‘low-carb’ as short-hand for the sort of diet you mention (one largely devoid of processes carbs).

    However, I would add that I am reticent about using the term ‘low-carb’ myself, at least in part because the word ‘low’ suggests this way of eating constains insufficent carbohydrate. The problem is ‘appropriate-carb’ doesn’t roll of the tongue so easily…

  23. Keith Taylor 28 May 2012 at 10:35 am #

    As a type 2 diabetic diagnosed two years ago I can confirm that a low carb diet does indeed provide good control. My latest HbA1c was 40mmol/mol. My morning blood glucose has been around 5 to 5.5. My weight is steadily dropping and my blood pressure too. My GP practice nurse (new on the job) was keen to listen about my diet and agreed that high fat, low carb seems to be gaining ground. Now we just need to divest the medics of the desire to force statins down the throats of diabetics.

  24. Chris 28 May 2012 at 12:14 pm #

    Yes, Dr Briffa, theis low-carb movement is considered as ‘counter-culture’ and ‘pseudo-scientific’ by the establishment. But .. ..

    .. .. Life for the diabetic gets a lot easier when it is realised neither saturated fat nor cholesterol play any causal part in the advance of heart disease.

    Then, in the face of all the advice and influences that set are minds against saturated fat and in favour of low-fat foods, it gets easier if the mind can come to appreciate something that is actually quite simple, and it is thus:

    The levels of reactivity of fats rise with the degree of ‘unsaturation’.

    Polyunsaturated fats as a class are more reactive than the saturated fats. To put it another way Saturated fats are the more stable. Now it should be possible to ‘see the sense in the systemic’.

    Saturated fats can make for a good source of fuel – because on the way to being used as fuel they are not so likely either to become damaged or to do damaged themselves.

    Fats with higher levels of unsaturation, like the polyunsaturated fats, can make for good ‘messenger molecules’ because there level of reactivity (and their degree of diversity of form) means they can carry a message and signal the message in a contextual ‘reaction’. As they are a diverse group they can signal alternate messages. So the bodies marvellous physiology picks up on this and utilises polyunsaturated fats to build signalling molecules called ‘prostaglandins’, who are each tasked with important messages and roles. Polyunsaturated fats are good and healthy but only while supply meets with a fairly modest requirement of demand. Get too much, and get too much of a particular sub-class, the omega-6 group, and your storing up trouble. Polyunsaturated fats don’t make for good fuel especially, because on the way to being utilised as fuel they are likely to become damaged, or oxidised, and interfere with what can be a delicate, and delicately balanced, state of affairs.

    Simple! Now why didn’t I see things that way sooner? (666″£££$$$%%%” — !!!)

    Symptoms of type-2 diabetes definitely ease if the supply of fast and processed carbs is restricted. And why shouldn’t we replace these carbs with saturated fat? No reason, save for the matter that Dr Ancel Keys and the dogma that has followed hasn’t half pulled the wool over our eyes.

    Long before I knew quite so succinctly why I found cutting back on over-supply of sources rich in polyunsaturated fats also significantly eased the symptoms of muscle lethargy that can accompany poor diabetic management. Somewhat later I learned that ‘Earthing’ also helps restore ‘the spring in the step’, and this would seem to be because each of these protocols address underlying chronic inflammation that may well cause diabetes in the first place.

    Even factions in establishment circles are uttering something about the part oxidative stress and chronic inflammation may have in the cause of heart disease and atherosclerosis. If that’s the case what is becoming ‘oxidised’, in all probability?

    But don’t take me at my word, as I’m mostly qualified to drive a truck.

    .. Long live counter-culture, for it may be the antidote for ‘pseudo-science’ within the establishment.

  25. JustMEinT 29 May 2012 at 12:38 am #

    far be it from me to throw a spanner in the works BUT (grin) Dr. Briffa and many other doctors are now questioining the LDL measurement in the blood as the best indicator of plaques and blockages and heart risk etc… and now here we have some who are questioning the A1c’s as the best measurement of diabetes control. This is worth viewing me thinks. Makes a lot of sense. Could it possibly be a B1/thiamin deficiency?

    http://www.youtube.com/watch?v=UNRaFjdeuZk

  26. Heather Hill 29 May 2012 at 5:58 pm #

    I have glucose intolerance and gestational diabetes. I recently visited my Gp to explain that I was having no luck on diets and that I had been reading about low carbohydrate diets and asked could they help me. My GP told me that weight loss was a simple equation – less calories in, more calories expended = weight loss everytime. He said study after study in a controlled environment had proved that people using this equation lost weight every time and refused to believe I had been following calorie controlled diets to the letter and had no loss. Made me feel like a liar actually. He also referred to no carb diets as ‘faddy’ and the information as “just something people are spouting (dangerously in his opinion) to sell diet books.”
    My father was a late onset diabetic and died, overweight, from a stroke in his 50′s after trying hard to follow the diet guidelines given to him by healthcare professionals at the time. I remember he was always hungry and struggled enormously to stick to the low fat diet plans given to him. I can’t help thinking after ignoring my doctors advice and following Dr Briffas recommendations for two months now and never feeling better, that Dad’s quality of life and possibly lifespan may have been improved if he knew what I knew today. It is time for Diabetes UK and indeed, diabetes health care professionals to sit up and take notice of this approach. It is in my opinion dangerous for them to ignore it.
    To further argue this case, I also have an insulin dependant son in his late teens who went on a Diabetes UK recommended DAFNE course (Dose-Altered-Food-Nutrition-Estimation) and came home believing he can eat as much as he likes and just alter his insulin dose to manage his blood sugars. His control is appalling and his ever increasing apetite as a growing lad – no regularly eating things which Dr Briffa points out in his book induce further hunger/less satiety means he binges on high carb, white flour foods all the time, believing it does him no harm. As he’s 19 I have a hard time convincing him how much damage all this rubbish is going to do him in the long term. Dangerous! And if I’d listened to my GP I’d probably be insulin dependant myself in a couple of years too. It is shocking to think that such an influential organisation won’t sit up and take notice of the facts here.

  27. paulc 30 May 2012 at 12:59 pm #

    Recently diagnosed T2 controlled by diet alone…

    I broached the low GL diet in the non-low-carb diet forum of diabetes.co.uk and promptly found myself besieged by low-carb carb-counting evangelists… very unhappy with them.

    What I like about the low GL diet is that there’s no counting involved… just stick to the simple rules in the GL Diet For Dummies book and the weight rolls off… and the rest of the family can join as well as the diet is very healthy

  28. Edwardia 31 May 2012 at 5:43 pm #

    I tried GI when first diagnosed with diabetes in 2007 and it did nothing for me. When I cut carbs to max 100g a day within 3 months my HbA1c was down 6%. Now I do 50g a day it’s NORMAL. GI/GL may well be healthiER than the standard Western diet and work for some people but it won’t work for all.

  29. Ian Day 31 May 2012 at 6:21 pm #

    This was my presentation at the Hounslow meeting – about 50 people were present, & the reaction was positive.

    My experience with a low carbohydrate diet.
    Ian Day May 29, 2012

    I was diagnosed type 2 diabetic in 2000 when I was 61. On diagnosis my Dr. told me all the complications could expect – foot amputation, blindness, stroke, heart attack, etc, & helpfully computed my heart attack probability as 25% within 10 years. She also advised me of the NHS help available.My Dr warned me of the consequences of uncontrolled diabetes & referred me to West Middlesex Hospital for a one day basic course by nurse, dietitian, pharmacist & podiatrist.. There I was told to base my diet around whole grain carbohydrates & generally follow a low sugar; low fat; low salt diet & maintain an active lifestyle. That diet was basically as recommended by Diabetes UK. I was also warned that diabetes was progressive, & I would progress from diet to tablets to insulin, while suffering health deterioration.

    My principle diabetes symptom was a numb sensation in my right thigh, which my Dr diagnosed as diabetic neuropathy.
    At diagnosis, my HbA1c was 8.7, cholesterol 7.6 & weight 13 st 7 lb (86 Kg)

    I was in a state of shock for some months, & was careful to comply with the advice. I was already playing tennis & getting plenty of exercise, & was have been health conscious all my adult life. I included cholesterol reducing margarine & oat bran to help reduce cholesterol.

    I got on well at first, & after two years I felt I had diabetes under control.
    My HbA1c was 6.5, cholesterol 5.4 & weight 12 st 5 lb. (78.5 Kg.) My heart attack risk dropped to 15%. I was very happy with Diabetes UK diet recommendations which I understood as:
    Low sugar, low fat/oil, low salt ;
    30-40% in the diet of carbohydrates, particularly multigrain bread, basmati rice, pasta;
    Plenty of vegetables & fruit.

    I even recommended the D UK diet in a radio phone-in in 2002.

    My condition progressed slowly, as predicted. In 2003 I started taking metformin & then they wanted to reduce my cholesterol below 4.0 so I was given simvastatin. Simvastatin caused serious muscle pain & I have been unable to take any cholesterol medication.

    Complications began to set in: chronic tiredness, muscle pain & the beginning of retina damage.

    In April 2008 muscle pain was so serious I feared becoming disabled. It could take 5 minutes to get out of bed. Stairs were a struggle. My active life seemed to be over. My HbA1c was considered acceptable at 6.7. My overnight BG averaged about 7. My Dr suggested hospital investigation.

    At that time I joined the http://www.diabetes.co.uk/ forum. Thousands of people with diabetes ask questions, note news items & contribute from experience. Many contributors had found from experience that a low carbohydrate diet was very beneficial. I had nothing to lose, so immediately cut right down on carbs. My overnight BG dropped to an average less than 6. Within 3 months I was playing tennis again & I was completely out of pain. My weight dropped to about 12 st (76 Kg.)

    I have continued a low carb diet ever since. Four years on, I am well & active, playing tennis & table tennis at club standard. I have cooperated with several heart/diabetes research projects, including Imperial College’s long term SABRE & Ealing Hospital’s LOLIPOP. There is no indication from these projects that my low carb diet is causing any adverse effects.

    One blood measurement that my Dr is watching is kidney function, which is slightly low but completely stable since before my change of diet.

    What do I eat? Is it complicated or straightforward? Are there problems with eating out, or with friends?

    Basically all I do is avoid the obvious carbs – bread, potato, rice, pasta. I have developed some special low-carb recipes.

    ## I showed my healthy eating plate at this point. ##

    Also I make a bread/cake & a porridge based on ground almonds. I snack on cheese & nuts. My friends are used to me refusing biscuits & cakes & savouries. Sweet dishes include jelly flavoured with NAS squash & topped with yoghurt or cream.
    A very serious question for D UK is raised by their booklet “Eating well with Type 2 Diabetes” where they assert:
    Why is carbohydrate important?
    All carbohydrate is converted into glucose and will have an impact on blood glucose levels. As this is the case, some people with diabetes wonder if it would be better not to have any carbohydrate in their diet to keep their glucose levels under control. This is not recommended as:
    • glucose from carbohydrate is essential to the body, especially the brain
    • high fibre carbohydrates, such as wholegrains and fruit, also play an important role in the health of the gut
    • some carbohydrates may help you to feel fuller for longer after eating.

    How much do I need?
    The actual amount of carbohydrate that the body needs varies depending on your age, weight and activity levels, but it should make up about half of what you eat and drink. For good health most of this should be from starchy carbohydrate, fruits and some dairy foods, with no more than one fifth of your total carbohydrate to come from added sugar or table sugar.

    These assertions by D UK appear to be totally without foundation. I have reported to them the benefits to me of low carbohydrate diet & asked for research references. All I get is “if it works for you, keep it up, but we cannot change our diet recommendations.”

    I came across the July/August 2003 “Balance”, which had an article “investigating the truth behind a low carb diet.”

    I won’t bore you with warnings of the dangers of “breakdown of vital muscle & body tissues” or “increased risk of heart disease, cancers & bowel disorders” or “the risk of kidney disease.” Such a diet may be “suitable … with medical supervision & with guidance from a state-registered dietitian.”

    A key paragraph is: “Research into the long-term effects of low-carb diets is now required. And in response to this, Diabetes UK is funding such research.”

    Eight years on we have the 2011 D UK “Position Statement” where we read:
    “More research is needed to assess the effectiveness of varying degrees of low-carbohydrate diet on weight, glycaemic control, hypertension and lipid profile in people with Type 2 diabetes as well as to investigate the long term effects of these diets.”

    I can’t wait for yet more long term studies – I’ve too much to lose. I followed their “healthy diet” for 7 years & was crippled by the complications. My low-carb diet started in May 2008. The complications disappeared in 3 months. Four years on I am well & active. There is no hint of any adverse effects in my experience, nor in the SABRE & LOLIPOP studies. My Drs are happy with my level of health & all my blood test results.

    D uk state in their “Position Statement” on low carb diets, warn that “there is a lack of evidence related to long-term safety and benefit of following this diet.”

    I know of two long term studies:
    A 44 month Swedish study, (citation 13 in D UK Position Statement) which states: “ the present high-carbohydrate dietary advice resulting in unnecessary hyperglycemia and insulin resistance seems difficult to support and for diabetes patients, current dietary recommendations seem to be a major part of their problem rather than being part of the solution. Carbohydrate restriction, however, reverses or neutralises all aspects of the metabolic syndrome.”

    Dr. Mark Daly, Consultant diabetologist, the MacLeod Diabetes and Endocrine Centre, Exeter responded to my query:
    “We have presented our results at 3 national and 1 international meetings. We found no serious adverse effects over 2 years but not everyone is as good at sticking to low carbohydrate diets as you.”

    D UK freely publish leaflets for general distribution that recommend a diet comprising 45-60% carbohydrates. e.g. “Eating well with type 2 diabetes.”
    Further, they warn diabetics against cutting out carbohydrates, as doing so will have harmful effects.

    We are NOT talking about cutting out carbohydrates, only reducing them. The harmful effects of a high carbohydrate diet are evident – diabetes is progressive & results in complications.

    The supposed harmful effects of low carbohydrate are not documented.

    Deep in their website is a link to a comprehensive “Evidence-based nutrition guidelines” document which includes on P. 17:
    “Low-carbohydrate diets have created some controversy, but both a recent review and meta-analysis suggest that they are associated with significant reductions in body weight and improvements in glycaemic control…….
    Concern has been expressed about the potential adverse effects of these diets, especially on cardiovascular risk, but there remains no evidence of harm over the short term.”

    What is the Diabetes uk objection to informing the diabetic public of their “Evidence-based nutrition guidelines” with a simple recommendation to restrict carbohydrate foods, & the provision of a revised diet leaflet?

    I challenge Diabetes uk to produce ANY evidence to:
    (a) support their warnings of the dangers of low carbohydrate diets, &
    (b) to justify their recommendation for T1 & T2 diabetics that carbohydrate should make up about half of what you eat and drink.

    I have prepared a low carb diet Sensible Eating with T2 Diabetes. leaflet based on the D UK leaflet: “Eating well with T2 Diabetes.”

    See the http://www.diabetes.co.uk/forum for discussion

  30. Edwardia 31 May 2012 at 9:07 pm #

    Well done Ian !! I wish Diabetes UK was the solution not part of the problem. Go to their website http://www.diabetes.org.uk and you’ll be able to find that besides several drug companies. corporate sponsors listed include Kellogg’s and Shredded Wheat. None of these companies are interested in people low carbing to improve their health because it would mean fewer sales for them.

    I would ask every person with diabetes who low carbs to contact Diabetes UK and tell their own story. If Diabetes UK was really representing everyone with diabetes they would include us too and they don’t !

  31. Aimee 7 October 2012 at 5:46 pm #

    This is my first time on this sight. I found by googling. I’m always looking on the internet, we are so fortunate to have communities of open minded Doctors and knowledgible diabetics. I was diagnosed with type 1 diabetes, 41 years ago. I now, and for many years manage my diabetes on my own. I have eaten organic foods for nearly 35 years and have been working to heal naturally for many, many years. I am presently on a farm to table, ketogenic, low carb (not over 20 carbs a day) diet. Nothing out of a package, all my food comes from farmers feeding their animals grass and farm raised produce as well. I just did my HbA1c and it was 5.1, which may be different in the UK, but it is very good & I am very happy. The diet is very easy and delicious. I eat very high animal fat, saturated fat which is really the best and very satisfying. My percentages are 5% carbs, 15 % protein and 80% fat. This is considered a ketogenic diet able to heal or improve many diseases, epillepsy , ALS, type 2 diabetes, etc.
    My meals are like this, breakfast farm raised 2-3 eggs, and 3 slices farm bacon. Lunch one 4 oz grass fed burger and greens of some sort. Then supper is actually 2 oz grass fed raw butter with hey protein, grass fed and raw with 6 brazil nuts. This is very satisfying , and I take only 18 units of insulin a day. I’d say the low carb diet works very well for type 1 diabetics.

  32. Suzy 26 July 2013 at 1:52 pm #

    My son has type 1 diabetes , aged 13. We all eat a low carb diet. No processed food. Only my cooking. I can make almost anything low carb: cookies, cakes, waffles, brownies, pasta from zucchini, rice from cauliflower, cheesecake, chocolate mousse. It is so delicious, and best of all
    tasty because it contains healthy fats.

    HIS BG’S are always normal if he eats my cooking, His HbA1c is 5.5, and apparently the only patient his paediatrician has with these numbers. He also exercises regularly and spends time in the sun to synthesise vitamin D. I research every week about true nutrition and physiology. The health benefits from eating low carb are substantial and it is honestly very easy to keep my son healthy this way. And yes, I was told NOT to put my son on a low carb diet by his diabetes educator.

  33. Leo Brown 2 November 2013 at 11:43 pm #

    From across the pond, thank you for furthering the conversation around dietary recommendations for people with diabetes. I have eschewed the advice of my doctors and the American Diabetes Association and achieved splendid HbA1C levels by limiting my carbohydrate intake. I eat many non-starchy vegetables and not too much protein or saturated fat. Ketosis has thus far treated me well, though I do harbor concerns about what might be its long-term impact.

    I’ve written a story about my experience and approach to HbA1C management, which at last count measured in at 5.6%. Hope it makes for an interesting read.

    Cheers!

    Why I Gave Up Peanut Butter Cups Forever http://www.huffingtonpost.com/leo-brown/diabetes-management_b_3956387.html

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