2

votes

Dietary advice for diabetics

Answered on September 12, 2014
Created September 22, 2011 at 11:08 AM

I am in a nursing program right now, and I deal with a lot of diabetics while working my clinical rotations. We recently started into the nutrition portion of our education, and I was (as I expected) very disappointed with the dietary model we are working with. We are taught that low fat diets are the best choice, and that grains should account for the bulk of your feeding. Our teachings for diabetics are questionably heavy on carbs as well (even though we advise them to limit carbs?)

So my question is simple, but I feel important: what dietary advice SHOULD diabetics get? Cite sources ifbyou can pkease I've heard reports of diabetics on Atkins and Paleo going completely off their meds and controlling their condition through diet, but I can't find any of those studies for citation.

(To be clear, I know there are two types of diabetes, and I would like this thread to contain info on both types, but I work with a lot more type 2 diabetics, so I would prefer resources for type 2.)

Medium avatar

(10611)

on September 26, 2011
at 03:00 AM

I usually waited 1-2 hours to see the full blood glucose effect on the meter. My T2 was diagnosed because my numbers did not go down with fasting, so for a while I ran pre and post meal tests. I went through a lot of strips. The meter is good for running N=1 experiments....your pancakes and syrup example ought to give them a shock...

078b14042d995aa2ad3cf31a4dcde988

(613)

on September 23, 2011
at 03:17 PM

Andre: To be clear, I do not disagree with you. But there are diabetics, perhaps those at early stages post-DX, who seem to be able to manage their disease with at least some conventional wisdom. The truth of their meters says they can eat toast, or whatever. So they're not just scared or misinformed; they are experiencing different results that reinforce their beliefs. This is why I (and you) say: it's all about your meter, your labs, taking ownership, collecting your own evidence from the lab of your body.

Medium avatar

(10611)

on September 23, 2011
at 01:55 PM

Namby do you have D2? In my case there was no such diagnostic trail. It showed up in my annual blood test. I had two dr visits afterwards and was left on my own with a meter, a book, an appointment with a dietician. I figured it out, but I daresay most type 2's never even see the dr to have it diagnosed. No insurance leads to no diagnosis.

Medium avatar

(10611)

on September 23, 2011
at 01:48 PM

Starches are the worst for diabetics because they're 100% glucose. And they're not distinguished by being sweet, which makes them seem innocuous.

Medium avatar

(10611)

on September 23, 2011
at 01:39 PM

Amen Sara. You don't know until you have it, and even then everybody's unique. I backed in to paleo after I had gotten mine under control, when I came to realize that paleo could accomplish the same thing as exchange counting and glycemic index had already done for me. And I can't overemphasize the help that my doctor was. He gave me the meter, the book and the blood test. But he also did one other thing. With a clinical demeanor he inspected my feet for holes. That got my attention. High blood sugar and A1C scared me, but not as much as the idea that I might lose the ability to walk.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:37 PM

In other words, we seem to have a co-pathogenesis for both diseases. They do seem to cross their paths, indeed!

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:35 PM

What is the pathogenesis of autoimmunity? Well, 1 theory is that it's a gut inflmmation (gut permeability) disease, induced by Neolithic agents (wheat, grains, dairy, legumes, etc.)

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:34 PM

This also explains why so many T2 diabetics have autoimmune diseases. 70% of T2s have hypothyroidism, many of them Hashimoto's, which is autoimmune. Dr. B thinks nearly 100% of all his patients have at least 1 autoimmune disease: the most common being psoriasis.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:32 PM

It is true though that T2 diabetes is usually diagnosed after the patient is thought to have fatty liver. The sequence is like this: Gut Inflammation ==> Possible Fatty Liver and Fatty Pancreas ==> elevated liver enzymes and inflammation markers (CRP, IL-6, etc.) ==> Then Obesity (but may not happen in most Asian/Indian patients).

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:29 PM

Well, the new heuristic is that T2 diabetes could be an autoimmune disease just like 1 and 1.5 that originates from the gut. This is largely based on the reversal of insulin resistance after gastric bypass surgery. If true, this could mean that the fructose-induced liver malfunction may play a role but could be a smokescreen. Insulin resistance originates from the inflammation in the small instestine. The gut is where it's at! Note that inflammation PRECEDES obesity and in many Asian/Indian diabetics, obesity among T2 diabetics isn't very common. All you need is inflammation.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 23, 2011
at 05:12 AM

Travis, that's my boy talkin now. Absolutely we agree. We diabetics can recover optimal health. If we keep BS/insulin/leptin low, we get healthy, wealthy and wise. No meds or at best minimal. I will always have to take smal doses of insulin. So what. I take less than the normal person produces. Diet, some exercise, herbs (to keep me calm). "Getting fat is the price you pay to stay non diabetic". Dr. Ron Rosedale. I got fat, stayed fat, ate lots of carbs and sugar, believed fat was bad for me and wound up type 2 then type 1. Worked out 2 hourds per day/6 days per week all the while. Me tired.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 23, 2011
at 05:04 AM

The controversy is only among diabetics who don't want to get well or don't know how. Who are scared and misinformed by the ADA and their docs. Truth is truth. With diabetes, your meter is truth. Eat low carb and acheive normal BS and normal insulin levels. This is impossible on the ADA diet or any high carb diet. Don't believe me, don't believe your doc, don't believe any expert. Believe your meter and your labs that insulin and leptin are also normal.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 23, 2011
at 04:59 AM

I understand your point thhq, the advice was not meant "at" you. However, I am telling the truth about diabetes. If someone wants to come and get me for telling the truth, come on. Prove you are right, prove I am wrong. Dr. Bernstein put himself thru med school so he would get papers puplished and takin seriously. He still insn't. All the credintials or insurance in the world won't call of these dogs. I ain't yelling "fire" in a crowded theater. I am yelling "fire" your doc if he doesn't understand how to help you achieve "normal" BS/insulin/leptin.

Medium avatar

(39821)

on September 23, 2011
at 04:49 AM

OK, sure, it's not hyperuricemia and a sedentary lifestyle. What is it? Original sin and magic? CW states that diabetics had bad luck and are doomed and must take dangerous pharmaceuticals forever. Sounds profitable, but I don't think they're doomed, I think they can recover completely. Perhaps there's more to optimal health than eating bacon. Just perhaps.

Medium avatar

(39821)

on September 23, 2011
at 04:45 AM

OK, sure, it's not hyperuricemia and a sedentary lifestyle. What is it? Original sin and magic?

078b14042d995aa2ad3cf31a4dcde988

(613)

on September 23, 2011
at 03:45 AM

Ps (I'm lame at editing with iPad)- the more people there are like you who recognize the ADA's conventional advice is basically crazy, the sooner things will change for the better, so make this a conversation among your classmates! Good for you for questioning.

91fe5b7e10068df9f147ee84320e38f7

(614)

on September 23, 2011
at 01:45 AM

Travis Culp, what do you ASSUME when fructose was never a factor, and the patients' aren't capable (due to the disease and related complications) of "walking in a fasted state?" With all due respect, don't let school get in the way of your education. You're coming off as mainstream, CW, *bluntness* stupidity. (Signed, respectful long-time lurker)

3aea514b680d01bfd7573d74517946a7

(11996)

on September 23, 2011
at 12:58 AM

Word. My 81-year-old mom was able to go off her diabetes meds due to cutting carbs. Her doctor was shocked, and had "no explanation." The last couple days my mom has been eating English muffins and crackers again, since her blood sugar's "been so good lately." Now her sugar's up at 200 again. My mom's pretty smart, so she'll stop with the bread, but dang -- people just can't give this sh*t up. People just don't seem to want to believe that their beloved starches really, truly drive bg up. It kills me. Or more to the point, it kills them.

40449b985898b088a64660b40f329f0f

(951)

on September 23, 2011
at 12:51 AM

I will agree with the not very helpful sentiment, as the pop-up box suggested I do.

77877f762c40637911396daa19b53094

(78467)

on September 22, 2011
at 09:59 PM

It is a great book for sure- when my husband eats like Dr. B says it controls his long term blood sugar. Unforunately he doesn't do it all the time.

Medium avatar

(10611)

on September 22, 2011
at 09:23 PM

andre and happy, I'm only reporting on what worked for me as a former D2 and that's what the OP asked for. My doctor and the NN book were helpful, but losing weight was the ultimate cure. As far as liability goes, if you're giving free advice with a good samaritan disclaimer fine, but if you're paid for your advice watch out.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 08:17 PM

Sorry , glucose is always a poison in a more than minimal dose. Glucose spikes insulin and leptin. Damage done. If what you say were true Travis, then there would be no Type 2 before the introduction of HFCS. It has grown since then but it was a problem before. Travis you can speak techno talk all you want but fructose and sugar is not needed by the body and they both cause damage. Glucose spikes insulin which makes for insulin resistance. Glucose spikes leptin which makes for leptin resistance. These set the stage for metabolic derangement.

Medium avatar

(10611)

on September 22, 2011
at 07:54 PM

Travis, glucose is never a poison, only a problem which is difficult for a diabetic to control. The most effective control is with glucose, which is why I specifically avoided high glycemic starches like sushi rice(even small portions could send my blood sugar over 200, with slow recovery), and why I carried glucose tabs for hypoglycemia. While my dietary modifications reduced fructose the intent was not immediate control of blood sugar so much as weight loss. The ultimate solution to my D2 was getting to normal waistline/weight, not tinkering with blood glucose to control symptoms.

Medium avatar

(39821)

on September 22, 2011
at 07:28 PM

thhq: NIDDM arises though as a result of fructose ingestion specifically. Once you have it, glucose becomes a poison, but glucose can't bring it about without fructose. OP just isn't realistically going to get these people on a HF/LC diet in a hospital. It's not going to happen. In lieu of that, exercising in the fasted state will readapt these people to lipid oxidation in their muscle mitochondria and massively increase insulin sensitivity.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 22, 2011
at 07:20 PM

I don't think anyone is getting sued over dietary advice. If so, I think we would have seen a few class action lawsuits against promoters of the food pyramid and pretty much every lifestyle magazine out there. A number of docs still believe that whole grains/low fat are the best way to eat yourself out of T2 diabetes because their education doesn't focus on nutrition and they don't have time for continuing ed on the matter, they will be referring patients out to you "the expert". As "the expert" I think it will be up to you to share the most truthful and up-to-date info you have.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 07:13 PM

Thank you for the links. Congrats on you reduction and attention to your new found power to heal yourself.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 07:05 PM

F the doctors. If you listen to them, you will be doomed. Unless your doc believes you deserve normal (83-90) blood sugRS NEVER GOING OVER 130, don't listen to him. Read Dr. Bernstein's Diabetes Solution and maintain normal BS/insulin/leptin. I have yet to meet a doc that knows any of this in the field of diabetes. If you get one who can help you keep "normal" without meds or minimal meds, you got a winner.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 07:01 PM

Normal blood sugars/normal insulin/normal leptin is the way to prevent and treat diabetes. Exercise is in the 10%. Proper sleep, stress relief, maintain muscle mass, reduce excess inflammation and drink coffee. The 10% does not outweigh the 90%.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 06:58 PM

Wrong Travis. I am a Type 1 having been Type 2 and Pere. All the exercise in the world merely postponed my slide into diabetes. Diet is 90%...you can never get off the couch and still maintain normal blood sugars if you eat high fat/moderate protein/low carb. I used to believe as you. Then I experienced the result of this belief and started working with Dr. Rosedale and educated myself as to the leptin and insulin epegenetics. I believe exercise will help with diabetes but it is not the answer. Read Dr. Bernstein and Sr. Rosedale and you will get both sides of the equation.

Medium avatar

(10611)

on September 22, 2011
at 06:53 PM

Travis, removing fructose from your diet may help with appetite control, but the most immediate response on blood sugar comes from reducing glucose. The glycemic response to starches - from sushi rice for instance - is much higher than the effect of honey, HFCS or bananas. I targeted the truly bad calories - high glycemics - to control my blood sugar as a D2.

306aa57660d911781231f8090c2a5619

(3808)

on September 22, 2011
at 05:31 PM

While I fully believe in developing the ability to do independent research, I'm really not sure the community as a whole is helped by alienating future paleo-friendly healthcare professionals.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on September 22, 2011
at 04:17 PM

that's a killer chunk of weight to lose. awesome. and your eating sounds righteous. great answer.

1d0497f8781845ab371b479455bfee8e

(11157)

on September 22, 2011
at 01:48 PM

Uh, maybe he was hoping other members would have helpful links? Often times, there are international members here who might have access to different research articles than those in other countries.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on September 22, 2011
at 01:22 PM

I, too, have heard a lot of good things about Berstein's book, Diabetes Solution.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on September 22, 2011
at 01:22 PM

that's not a very helpful answer. why not just keep quiet if you have nothing constructive to add?

D3ff004d4a0c42b67cc2c49a5ee9c0f3

(5801)

on September 22, 2011
at 01:05 PM

Ok, you're not doing a paper. Does anyone see the problem with a person trying to enter the medical field and yet not be willing to do basic medical research?

332d9f75d1077abafff6887681f6b130

(1081)

on September 22, 2011
at 11:37 AM

Im not doing a paper, I'm looking for patient teaching that makes sense, doesn't contradict itself, and is in keeping with my nutritional beliefs. Were I to turn in a paper with paleo idiologies, I would fail the course. I want sources so I can show that I'm not just pulling ideas out of my rear.

1d0497f8781845ab371b479455bfee8e

(11157)

on September 22, 2011
at 11:37 AM

Books at the library aren't going to recommend a Paleo-friendly nutrition program, though, which is undoubtedly why Tom came to PH to ask this question. Simma down, now.

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9 Answers

8
464e1c66609d402615ae2b3cf72d53fb

(1472)

on September 22, 2011
at 01:01 PM

Dr. Bernstein's book, Diabetes Solution is the gold standard as far as I'm concerned. I started reading it 1/10 when I was at 300lbs. Today I'm at 218. I started following his advice and the side effect of eating right was weight loss...imagine that.

77877f762c40637911396daa19b53094

(78467)

on September 22, 2011
at 09:59 PM

It is a great book for sure- when my husband eats like Dr. B says it controls his long term blood sugar. Unforunately he doesn't do it all the time.

5
525cac40f08043be58ce67c734459969

(200)

on September 22, 2011
at 11:43 AM

As you are a student, be very careful of giving advice outside of the protocols of the clinic where you are working. You could suggest to you patients that they take their post meal blood sugars to work out for themselves which foods have the least impact. This lady has done a lot of research and self experimentation http://www.phlaunt.com/diabetes/index.php and this man http://diabetes-solution.net/

3
6498694060d879a7960b35913539b75f

(1307)

on September 22, 2011
at 11:56 PM

I don't have any studies I can cite. I can just tell you my own experience. I am a Type 2 diabetic. When I was first diagnosed by Dr. Atkins, he put me on Metformin, blood pressure meds and a low carb diet. Eventually I was able to go off all my meds. I'm still low carb now, but I consider myself more primal/paleo than anything.

I recently moved to California, and my new doctor told me that carb counting is very important, then gave me a meal plan that included TONS of carbs (bagels, cereal, muffins for breakfast). If I ate the way he recommended, I would be in big trouble, and on insulin. It's sad when we have to ignore our doctors' advice in order to stay healthy, but that's exactly what I need to do.

Medium avatar

(10611)

on September 23, 2011
at 01:48 PM

Starches are the worst for diabetics because they're 100% glucose. And they're not distinguished by being sweet, which makes them seem innocuous.

3aea514b680d01bfd7573d74517946a7

(11996)

on September 23, 2011
at 12:58 AM

Word. My 81-year-old mom was able to go off her diabetes meds due to cutting carbs. Her doctor was shocked, and had "no explanation." The last couple days my mom has been eating English muffins and crackers again, since her blood sugar's "been so good lately." Now her sugar's up at 200 again. My mom's pretty smart, so she'll stop with the bread, but dang -- people just can't give this sh*t up. People just don't seem to want to believe that their beloved starches really, truly drive bg up. It kills me. Or more to the point, it kills them.

2
078b14042d995aa2ad3cf31a4dcde988

(613)

on September 23, 2011
at 03:42 AM

I was diagnosed as type 2, then got tests indicating I am 1.5/LADA. I take a small amount of basal insulin, and eat pretty low carb with paeleo leanings. Thats where im coming from. And while I think there are lots of well-intended folks on paleo, primal, and LC sites who have opinions on what might work for a diabetic, you don't know until you have it yourself. And even then, you still don't know, because everyone's experience with it is fairly unique.

Ok, so, in any case, my answer to the question: you are really not going to find any conventionally-accepted final info on low carb for diabetics. It's still a big controversy, even among diabetics. A huge range of experiences, opinions, tolerances, etc. I concur on the Bernstein book, though it can feel extreme and scary to the newly diagnosed.

Check out diabetesforums.com for tons of anecdotal evidence, and experiences. The best thing to tell diabetics is to encourage them to take responsibility for their blood glucose management, test often, keep records of food and corresponding bg levels, make their meter their best friend. It's better if they can make their own connections between what they eat and how their numbers are, how exercise helps, and how they feel. So much better than having a study to cite or handing over a piece of paper with a "diet" on it.

078b14042d995aa2ad3cf31a4dcde988

(613)

on September 23, 2011
at 03:17 PM

Andre: To be clear, I do not disagree with you. But there are diabetics, perhaps those at early stages post-DX, who seem to be able to manage their disease with at least some conventional wisdom. The truth of their meters says they can eat toast, or whatever. So they're not just scared or misinformed; they are experiencing different results that reinforce their beliefs. This is why I (and you) say: it's all about your meter, your labs, taking ownership, collecting your own evidence from the lab of your body.

Medium avatar

(10611)

on September 23, 2011
at 01:39 PM

Amen Sara. You don't know until you have it, and even then everybody's unique. I backed in to paleo after I had gotten mine under control, when I came to realize that paleo could accomplish the same thing as exchange counting and glycemic index had already done for me. And I can't overemphasize the help that my doctor was. He gave me the meter, the book and the blood test. But he also did one other thing. With a clinical demeanor he inspected my feet for holes. That got my attention. High blood sugar and A1C scared me, but not as much as the idea that I might lose the ability to walk.

078b14042d995aa2ad3cf31a4dcde988

(613)

on September 23, 2011
at 03:45 AM

Ps (I'm lame at editing with iPad)- the more people there are like you who recognize the ADA's conventional advice is basically crazy, the sooner things will change for the better, so make this a conversation among your classmates! Good for you for questioning.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 23, 2011
at 05:04 AM

The controversy is only among diabetics who don't want to get well or don't know how. Who are scared and misinformed by the ADA and their docs. Truth is truth. With diabetes, your meter is truth. Eat low carb and acheive normal BS and normal insulin levels. This is impossible on the ADA diet or any high carb diet. Don't believe me, don't believe your doc, don't believe any expert. Believe your meter and your labs that insulin and leptin are also normal.

1
332d9f75d1077abafff6887681f6b130

on September 26, 2011
at 12:37 AM

Just got a chance to log back in and check on this post... a lotta good info here! I like the "let the meter be the truth" advice, that's something that I can easily teach to patients and get them to understand the impact of their food choices. One question on that though, I'm not diabetic so I'm unsure about this part. How long does it take for food to impact your BG levels? If I tell them to check their levels after eating some pancakes with syrup, how long should they wait in order to get a good reading?

Medium avatar

(10611)

on September 26, 2011
at 03:00 AM

I usually waited 1-2 hours to see the full blood glucose effect on the meter. My T2 was diagnosed because my numbers did not go down with fasting, so for a while I ran pre and post meal tests. I went through a lot of strips. The meter is good for running N=1 experiments....your pancakes and syrup example ought to give them a shock...

1
Ca1150430b1904659742ce2cad621c7d

(12540)

on September 22, 2011
at 02:02 PM

Might want to consider reading and preparing your plan based on some of this research:

  1. Nutr Hosp. 2011 Jan-Feb;26(1):170-5. Effect of a low glycemic load on body composition and Homeostasis Model Assessment (HOMA) in overweight and obese subjects. Armend??riz-Anguiano AL, Jim??nez-Cruz A, Bacard??-Gasc??n M, Hurtado-Ayala L. Source Medicine and Psychology School, Universidad Aunt??noma de Baja California, Tijuana, Baja California, Mexico.

  2. Nutr Clin Pract. 2011 Jun;26(3):300-8. Low-carbohydrate diet review: shifting the paradigm. Hite AH, Berkowitz VG, Berkowitz K. Source Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, USA.

These articles are both pretty recent, and provide a little bit of groundwork for developing a plan. My recommendations for myself (now free of metabolic syndrome and down 150 lbs from my high weight over 3 years, though I am still quite obese--but a surprisingly 'healthy' obese...) is to eat a good bit of leafy foods; a small amount of "fruity" foods (any seed-bearing production from a plant -- not necessarily sweet... for example, zucchini and cucumbers are both "fruits" of the vines they grow on, and are as much 'fruits' for my purposes as blueberries or mangos); occasional roots, nuts, and seeds; and animal, avian, and piscean foods (eggs, meat, poultry, and fish, and even a little full-fat raw fermented/cultured dairy)--provided that they are grown on their naturally-selected food-source, in fresh air and sunshine, and killed humanely, with as little stress as possible. If i can't get good food, I choose not to substitute with unhealthy options (most of the time -- I'll occasionally waver on a good friend's birthday cheesecake)... instead, I just don't eat at that time. Oh... and move around... a lot... use your body and put it to work and it will usually thank you over time (even when the initial work causes it to complain like an ol' creaky door!)

667f6c030b0245d71d8ef50c72b097dc

(15976)

on September 22, 2011
at 04:17 PM

that's a killer chunk of weight to lose. awesome. and your eating sounds righteous. great answer.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 07:13 PM

Thank you for the links. Congrats on you reduction and attention to your new found power to heal yourself.

0
Medium avatar

(10611)

on September 22, 2011
at 05:20 PM

As an ex Type 2 here's what helped me:

-My dr asking me what I had done to junk up my diet. It was overeating dry breakfast cereal. He suggested peanut buttered toast instead. Not paleo, but a step in the right direction.

-He also gave me a book on carb exchange counting published by Novo Nordisk. Following that, and changing my breakfast habits, got my blood glucose (which had been 200 fasting) down to normal in a week.

-After this, I found glycemicindex.com. It puts numbers to the problem paleo addresses: just how bad a carb is. It immediately steered me into eliminating or severely limiting sugars, starches (breakfast cereal and white rice especially), pastries and bread.

I hope that helps. But as mentioned earlier, let the dr's prescribe it. You don't carry the malpractice insurance.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 22, 2011
at 07:20 PM

I don't think anyone is getting sued over dietary advice. If so, I think we would have seen a few class action lawsuits against promoters of the food pyramid and pretty much every lifestyle magazine out there. A number of docs still believe that whole grains/low fat are the best way to eat yourself out of T2 diabetes because their education doesn't focus on nutrition and they don't have time for continuing ed on the matter, they will be referring patients out to you "the expert". As "the expert" I think it will be up to you to share the most truthful and up-to-date info you have.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 07:05 PM

F the doctors. If you listen to them, you will be doomed. Unless your doc believes you deserve normal (83-90) blood sugRS NEVER GOING OVER 130, don't listen to him. Read Dr. Bernstein's Diabetes Solution and maintain normal BS/insulin/leptin. I have yet to meet a doc that knows any of this in the field of diabetes. If you get one who can help you keep "normal" without meds or minimal meds, you got a winner.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 23, 2011
at 04:59 AM

I understand your point thhq, the advice was not meant "at" you. However, I am telling the truth about diabetes. If someone wants to come and get me for telling the truth, come on. Prove you are right, prove I am wrong. Dr. Bernstein put himself thru med school so he would get papers puplished and takin seriously. He still insn't. All the credintials or insurance in the world won't call of these dogs. I ain't yelling "fire" in a crowded theater. I am yelling "fire" your doc if he doesn't understand how to help you achieve "normal" BS/insulin/leptin.

Medium avatar

(10611)

on September 22, 2011
at 09:23 PM

andre and happy, I'm only reporting on what worked for me as a former D2 and that's what the OP asked for. My doctor and the NN book were helpful, but losing weight was the ultimate cure. As far as liability goes, if you're giving free advice with a good samaritan disclaimer fine, but if you're paid for your advice watch out.

-2
Medium avatar

on September 22, 2011
at 06:19 PM

Assuming that the person has removed the most obvious cause (fructose) from their diet, I think it's actually far more effective to focus on increasing activity. If these people did a large volume of walking in the fasted state they would likely cure their NIDDM in pretty short order. Boiling it down to "walk a couple miles before every meal" would take them much further toward managing their blood glucose (and be more accepted by conventional structures in place) than most dietary details beyond fructose avoidance.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 23, 2011
at 05:12 AM

Travis, that's my boy talkin now. Absolutely we agree. We diabetics can recover optimal health. If we keep BS/insulin/leptin low, we get healthy, wealthy and wise. No meds or at best minimal. I will always have to take smal doses of insulin. So what. I take less than the normal person produces. Diet, some exercise, herbs (to keep me calm). "Getting fat is the price you pay to stay non diabetic". Dr. Ron Rosedale. I got fat, stayed fat, ate lots of carbs and sugar, believed fat was bad for me and wound up type 2 then type 1. Worked out 2 hourds per day/6 days per week all the while. Me tired.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 07:01 PM

Normal blood sugars/normal insulin/normal leptin is the way to prevent and treat diabetes. Exercise is in the 10%. Proper sleep, stress relief, maintain muscle mass, reduce excess inflammation and drink coffee. The 10% does not outweigh the 90%.

Medium avatar

(39821)

on September 22, 2011
at 07:28 PM

thhq: NIDDM arises though as a result of fructose ingestion specifically. Once you have it, glucose becomes a poison, but glucose can't bring it about without fructose. OP just isn't realistically going to get these people on a HF/LC diet in a hospital. It's not going to happen. In lieu of that, exercising in the fasted state will readapt these people to lipid oxidation in their muscle mitochondria and massively increase insulin sensitivity.

Medium avatar

(39821)

on September 23, 2011
at 04:45 AM

OK, sure, it's not hyperuricemia and a sedentary lifestyle. What is it? Original sin and magic?

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 06:58 PM

Wrong Travis. I am a Type 1 having been Type 2 and Pere. All the exercise in the world merely postponed my slide into diabetes. Diet is 90%...you can never get off the couch and still maintain normal blood sugars if you eat high fat/moderate protein/low carb. I used to believe as you. Then I experienced the result of this belief and started working with Dr. Rosedale and educated myself as to the leptin and insulin epegenetics. I believe exercise will help with diabetes but it is not the answer. Read Dr. Bernstein and Sr. Rosedale and you will get both sides of the equation.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:37 PM

In other words, we seem to have a co-pathogenesis for both diseases. They do seem to cross their paths, indeed!

Medium avatar

(10611)

on September 22, 2011
at 06:53 PM

Travis, removing fructose from your diet may help with appetite control, but the most immediate response on blood sugar comes from reducing glucose. The glycemic response to starches - from sushi rice for instance - is much higher than the effect of honey, HFCS or bananas. I targeted the truly bad calories - high glycemics - to control my blood sugar as a D2.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on September 22, 2011
at 08:17 PM

Sorry , glucose is always a poison in a more than minimal dose. Glucose spikes insulin and leptin. Damage done. If what you say were true Travis, then there would be no Type 2 before the introduction of HFCS. It has grown since then but it was a problem before. Travis you can speak techno talk all you want but fructose and sugar is not needed by the body and they both cause damage. Glucose spikes insulin which makes for insulin resistance. Glucose spikes leptin which makes for leptin resistance. These set the stage for metabolic derangement.

Medium avatar

(10611)

on September 23, 2011
at 01:55 PM

Namby do you have D2? In my case there was no such diagnostic trail. It showed up in my annual blood test. I had two dr visits afterwards and was left on my own with a meter, a book, an appointment with a dietician. I figured it out, but I daresay most type 2's never even see the dr to have it diagnosed. No insurance leads to no diagnosis.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:34 PM

This also explains why so many T2 diabetics have autoimmune diseases. 70% of T2s have hypothyroidism, many of them Hashimoto's, which is autoimmune. Dr. B thinks nearly 100% of all his patients have at least 1 autoimmune disease: the most common being psoriasis.

Medium avatar

(39821)

on September 23, 2011
at 04:49 AM

OK, sure, it's not hyperuricemia and a sedentary lifestyle. What is it? Original sin and magic? CW states that diabetics had bad luck and are doomed and must take dangerous pharmaceuticals forever. Sounds profitable, but I don't think they're doomed, I think they can recover completely. Perhaps there's more to optimal health than eating bacon. Just perhaps.

Medium avatar

(10611)

on September 22, 2011
at 07:54 PM

Travis, glucose is never a poison, only a problem which is difficult for a diabetic to control. The most effective control is with glucose, which is why I specifically avoided high glycemic starches like sushi rice(even small portions could send my blood sugar over 200, with slow recovery), and why I carried glucose tabs for hypoglycemia. While my dietary modifications reduced fructose the intent was not immediate control of blood sugar so much as weight loss. The ultimate solution to my D2 was getting to normal waistline/weight, not tinkering with blood glucose to control symptoms.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:32 PM

It is true though that T2 diabetes is usually diagnosed after the patient is thought to have fatty liver. The sequence is like this: Gut Inflammation ==> Possible Fatty Liver and Fatty Pancreas ==> elevated liver enzymes and inflammation markers (CRP, IL-6, etc.) ==> Then Obesity (but may not happen in most Asian/Indian patients).

91fe5b7e10068df9f147ee84320e38f7

(614)

on September 23, 2011
at 01:45 AM

Travis Culp, what do you ASSUME when fructose was never a factor, and the patients' aren't capable (due to the disease and related complications) of "walking in a fasted state?" With all due respect, don't let school get in the way of your education. You're coming off as mainstream, CW, *bluntness* stupidity. (Signed, respectful long-time lurker)

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:35 PM

What is the pathogenesis of autoimmunity? Well, 1 theory is that it's a gut inflmmation (gut permeability) disease, induced by Neolithic agents (wheat, grains, dairy, legumes, etc.)

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 23, 2011
at 01:29 PM

Well, the new heuristic is that T2 diabetes could be an autoimmune disease just like 1 and 1.5 that originates from the gut. This is largely based on the reversal of insulin resistance after gastric bypass surgery. If true, this could mean that the fructose-induced liver malfunction may play a role but could be a smokescreen. Insulin resistance originates from the inflammation in the small instestine. The gut is where it's at! Note that inflammation PRECEDES obesity and in many Asian/Indian diabetics, obesity among T2 diabetics isn't very common. All you need is inflammation.

-7
D3ff004d4a0c42b67cc2c49a5ee9c0f3

(5801)

on September 22, 2011
at 11:23 AM

"To be clear, I know there are two types of diabetes, and I would like this thread to contain info on both types, but I work with a lot more type 2 diabetics, so I would prefer resources for type 2."

Wow, you're in a nursing program asking for research and citations. Why don't you just come out and ask for me to write your paper for you.

Most colleges have a place full of books called a library. There is also this electronic database like thing that is connected like a web all over the world. I can't remember it's name but it starts with WWW. Both are fantastic resources for college homework.

EDIT:

OK, since he says he isn't doing a paper but is still too lazy to do his own research in his chosen field, I'll do your research for you: At the library or any book store, they will probably have the book Good Calories, Bad Calories. Open the book and look at the bibliography.

332d9f75d1077abafff6887681f6b130

(1081)

on September 22, 2011
at 11:37 AM

Im not doing a paper, I'm looking for patient teaching that makes sense, doesn't contradict itself, and is in keeping with my nutritional beliefs. Were I to turn in a paper with paleo idiologies, I would fail the course. I want sources so I can show that I'm not just pulling ideas out of my rear.

40449b985898b088a64660b40f329f0f

(951)

on September 23, 2011
at 12:51 AM

I will agree with the not very helpful sentiment, as the pop-up box suggested I do.

1d0497f8781845ab371b479455bfee8e

(11157)

on September 22, 2011
at 11:37 AM

Books at the library aren't going to recommend a Paleo-friendly nutrition program, though, which is undoubtedly why Tom came to PH to ask this question. Simma down, now.

D3ff004d4a0c42b67cc2c49a5ee9c0f3

(5801)

on September 22, 2011
at 01:05 PM

Ok, you're not doing a paper. Does anyone see the problem with a person trying to enter the medical field and yet not be willing to do basic medical research?

1d0497f8781845ab371b479455bfee8e

(11157)

on September 22, 2011
at 01:48 PM

Uh, maybe he was hoping other members would have helpful links? Often times, there are international members here who might have access to different research articles than those in other countries.

306aa57660d911781231f8090c2a5619

(3808)

on September 22, 2011
at 05:31 PM

While I fully believe in developing the ability to do independent research, I'm really not sure the community as a whole is helped by alienating future paleo-friendly healthcare professionals.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on September 22, 2011
at 01:22 PM

that's not a very helpful answer. why not just keep quiet if you have nothing constructive to add?

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