Ted Talks High Fat Diet for Diabetes
A reader left this comment on this page, but they want to remain anonymous, so I have edited their name out.
I was very recently diagnosed with Type 2 Diabetes / or at the very least pre-diabetes. The diagnosis is actually unclear since I also had a follow-up urine test which I understand is more accurate than a blood test and that result was in the "normal" range. Consequently I have to booked another appointment with the GP as a standard 5min consult isn't satisfactory at all.
My GP gave me a "tip" page from a 1996 book by John Murtagh – Patient Education. Despite it being a later edition of that book (2003) almost nothing on the page was that helpful apart from the "avoid sugar" information.
Next step look at Diabetes NZ information. They specifically preclude "low carb" https://www.diabetes.org.nz/living_well_with_diabetes/tips_guides_articles/tips/low_carbohydrate_diet
According to Diabetes NZ HBA1c (goal ≤ 55 mmol/mol) mine is lower than that but higher than the international standard which I see is ≥ 48 mmol/mol. At another page on the DNZ site they state "Less than or equal to 53 mmol/mol is a very healthy HbA1c level" which means I am in the "normal" range. https://www.diabetes.org.nz/living_well_with_diabetes/living_with_type_2_diabetes/lab_tests
The short version of this is that it is incredibly frustrating trying to sort through medical information from GP, Diabetes NZ and your book. All this conflicting information is not helping anyone.
On the plus side dropping sugar and starting on LCHF seems to be helping even though my GP & Diabetes NZ have been no real help. Are there any other doctors or nutritionists who support the thesis in the book or is this another "outlier" study that might work for some people?
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Patty says:
Check out Dr Jason FungS video lectures on T 2 diabetes at Intensive Dietary Management. He treats kidney patients. His testimony s to lchf are very encouraging
Ted Talks High Fat Diet for Diabetes
Source: https://whatthefatbook.com/a-good-tedx-talk-by-dr-sarah-hallberg/
That's a good strategy Anon.
Regarding Diabetes NZ, the only reason they give for not recommending low carb on their website – given the positive things they say about it – is that you might miss out on essential nutrients (vitamins and minerals) by cutting out foods. This is not a problem with a whole-food approach to low carb.
They summarize "A low carbohydrate diet may work for some people".
"However, such a diet needs to be carefully managed" – this is true of all diets with diabetes, and more true of high-carbohydrate diets, which require management with increasing medication – "and is not the answer for most people with diabetes" – there are no reasons given for this statement.
In fact the belief that a low-carb diet should be the first option for diabetes is not only held by a few rebels like ourselves, Tim Noakes, and others, but has a long history within the global community of diabetes experts. In fact, before the discovery of insulin in 1922, you could not feed high carbohydrate diets to diabetics; type 2 diabetics would deteriorate, and type 1 diabetics would die. Diets high in fat, limited in protein, and restricted in carbohydrate were the standard of care.
The mass production of insulin, and the later invention of other drugs, slowly undermined this practice. There were a number of reasons for this; many people wanted to enjoy carbohydrate-rich foods, and live a relatively normal life, and the drugs allowed them to do this. Also, the early low-carb diets weren't as nutritionally adequate as we can make them today, because we now understand that the fibre from vegetables, though it is technically a carbohydrate, doesn't turn to glucose in the body – so there is no reason to limit non-starchy veges, which are a great source of vitamins and minerals. But there was also a growing feeling that everyone, including diabetics "needs carbs for energy", as the low-fat fad got underway (and people, eating less fat, found they needed more energy). In fact one definition of diabetes is that your liver makes plenty of carbohydrate (as glucose) even when you don't want it to, and whether you eat carbs or not.
This attitude has reversed in recent years because of a combination of several factors – one is the increased availability of glucose monitoring devices, so that more people can track the effect of diet on their own blood sugars at home, another is the failure of low-fat, high-fibre diet advice to control the progression of type 2 diabetes in two very large trials in the UK and Northern Ireland. Yet another is that a continuing series of low-carb diet weightloss trials (about 25 to date), some in type 2 diabetics, has shown that low carb diets reduce the cardiovascular risk factors associated with diabetes better than diets similar to those recommended by the American Diabetes Association.
Recently 25 diabetes experts combined to write a paper (which has been downloaded more than any other paper in its journal Nutrition) recommending that carbohydrate restriction be the default treatment for diabetes. There is a Science Daily report on it here, http://www.sciencedaily.com/releases/2014/07/140724132354.htm
and the paper, which is mostly not too technical, can be accessed for free here (PDF)
http://tinyurl.com/p8qmeoa
So, I have confidence that the tide is turning, and that soon the NZ Diabetes association will claim to have been recommending carbohydrate restriction all along. We take any opportunity to present these ideas to professionals, some groups have been interested in debating them already. I see that the awareness that high insulin levels and high HbA1c, as seen in type 2 diabetes, are a risk factor for many diseases in the general population is already spreading.
I do have one gripe I need to get off my chest – you have been given your HbA1c results and goals in SI units (mmol/mol). This is a recent change in NZ (I presume LabTests is responsible). You will find that all diabetes research, since the discovery of HbA1c as a measurement, writes up HbA1c as a percentage. HbA1c of 48 SI units = 6.5%. (Under 5.7 is a good target).
This sort of arbitrary change devalues, at a single stroke, decades of diabetes research and research into cardiovascular risk factors, which has always used HbA1c as a % number. If the authorities, whoever they are, really want diabetics to understand their condition, they should continue to give out HbA1c results and advice in the old % form.
There is an online calculator that makes the conversion easier here:
http://www.nps.org.au/conditions/hormones-metabolism-and-nutritional-problems/diabetes-type-1/for-individuals/tests-and-monitoring/hba1c-unit-converter
That's my HbA1c rant over! Good luck with your low carb journey, Anon.