carb contoversy

By KarieV Latest Reply 2011-07-28 17:50:40 -0500
Started 2011-07-18 20:51:22 -0500

I was away on vacation recently, and while I was gone there was quite a brouhaha in the low-carb community about an article on the Diabetes Health magazine Web site entitled "Type 2 Diabetes: From Old Dogmas to New Realities". In the second part of the article, diabetes educator and dietitian Hope Warshaw was quite negative about carbohydrate reduction, even implying that diabetics may not be eating enough foods which provide lots of glucose, fructose, and other sugars (she advocates 45%-65% of calories from carbohydrate. For a person eating 2000 calories per day, this totals between 1.2 and 1.7 cups of these sugars per day). She said that the concept of a low-carb diet for diabetes is an "old dogma" and that eating all this carbohydrate is the "new reality".

42 replies

pattroyka58 2011-07-28 14:14:37 -0500 Report

Depends on what KIND of carbs, I'll bet. Dr Fuhrman says you can eat up to a pound or so of non-starchy veggies and 6 diabetic servings of fruit/day. That can be quite a few "carbs" and yet this diet doesn't raise my BS; it's just really difficult to stick to. I lasted 2 weeks on the "whole" plan, and I'm still avoiding as many starch carbs as I can and losing weight.

Anonymous 2011-07-21 15:57:05 -0500 Report

and thats why lots of people are overweight i wouldn't doubt why even younger and younger kids are getting diabetes

JoleneAL 2011-07-21 04:53:33 -0500 Report

Well she needs to get a wake up call - but I can't wish diabetes on anyone. Sure you need "good" carbs, and you can get "bad" carbs in moderation - but from what I've read from other diabetics all across the internet - counting carbs has been the best way to keep your glucose under control.

SuziOJ 2011-07-21 16:39:11 -0500 Report

How many carbs should one have in a day? I have never counted them, just tried to eliminate them as much as possible.

Sidehack 2011-07-21 02:43:38 -0500 Report

the only reality is that you keep your blood sugars at a safe level. if you "count carbs" in a ratio to insulin, you may have a little more wiggle room. what i am trying to say is that with diabetis (t1 or t2); as the disease progresses; you WILL do whatever it takes to keep those sugars at a safe level. let your A1c be your guide!

MrsCDogg 2011-07-20 20:42:13 -0500 Report

Well, maybe in that world where the good doctor lives that is her "new reality". However, in my world if I eat lots of starchy sugary carbs my bs gets jacked up to the sky! That is "my reality". One size does not fit all when it comes to how we handle our diabetes.

nzingha 2011-07-21 00:27:43 -0500 Report

sooo true mrsdogg… i realise now my body does not like carbs…anymore…and i had better accept it…veg, veg, veg, and i better watch how much too …

Bunny Cakes
Bunny Cakes 2011-07-20 13:55:19 -0500 Report

I go by what has proven to work for me. When I eat low carb, I don't eat just four or five carbs a meal. Low carb for me is eating 45-50 carbs a meal, I call this low for me because I used to eat hundreds of carbs a meal. I do try to shoot for good carbs over bad carbs. But in my experience even too many good carbs is bad for my numbers. I've also found I can sneak in a few more carbs if they are paired with enough protein. I believe in low carb because my meter says it's good but again I'm not going super low carb, I think too few carbs could very much be a bad thing as well. Moderation in all things is the key. I trust in my meter more than dieticians promoting or denouncing new and old diets.

djan63 2011-07-20 10:12:17 -0500 Report

I am very confused because I recently had a diabetes coordinator tell us in a class that for women 30-45g carbs per meal and 15-30g per snack per day. I had told her that I could not lose weight and had been trying to eat right and she told me I was not getting enough carbs. So what is correct???

veggie1962 2011-07-23 12:30:00 -0500 Report

Not to confuse you more, but it's also the "type" of carbs you eat that makes a difference. If you stick with more low glycemic foods like non starchy veggies, berries, whole grains like brown rice, quinoa, beans/lentils, yogurt your blood sugar will not spike so much after meals and cause you to either release or need more insulin. Lowering your insulin levels, either by choosing low glycemic foods or eating a low carb diet will promote weight loss.

This article may give you more insight into this subject:

I ate low carb for many years and after going on insulin and eating more carbs I finally felt better. I could think a lot better and had more energy. I think low carb is just not for everyone. it seems to work fine for some. Right now, I eat between 33 and 65g of carb per meal. I started out weighing about 150 when diagnosed in 2004 and am down to a stable 134 now (I'm only 5'5"). To answer your question directly, I don't think there is a "correct" answer. The coordinator gave you the medical community "correct" answer. But I don't think one way of eating is correct for everyone. BTW, I'm a dietitian.

djan63 2011-07-23 15:36:56 -0500 Report

Thank you so much! That makes alot more sense. I will look at the website.

veggie1962 2011-07-23 16:00:20 -0500 Report

Glad I could help clear up your confusion. It can be overwhelming at times-trying to determine what is "right" (esp when there really is no "right" answer!).

Type1Lou 2011-07-20 12:42:02 -0500 Report

In my experience, if you cut your carbs, the weight will drop off. When I started reducing the carbs in my diet, I lost 10 pounds. After all, it is the basis behind the Atkin's diet. The hard part is staying away from the carbs. I limit my carbs to a max of 45 per meal and try not to snack. I think your diabetes coordinator gave you incorrect info.

Type1Lou 2011-07-20 08:17:00 -0500 Report

"New dogma" ain't necessarily better and Warshaw's "new reality" would spell my doom! I'm not afraid to be labeled a "little old carb counter"!

nursepat1 2011-07-20 07:47:52 -0500 Report

The amount of carbs is important, but the quality is paramount. I have the most problems when I eat a lot of processed carbs. I am trying to cut out or severely limit white flours and sugars, crackers,and chips. Even chocolate can be a routine part of your diet if you look for a high percentage of cacao. Dark or bittersweet usually has the least amount of sugar. If I need something sweet I look for fruit; berries are the lowest in impact carbs. The more colorful veg you have in your diet also help because they are low in impact carbs. If you have a choice between white rice or potatoes and beans or greens, try to stay away from the white stuff, it has more impact carbs. Whole grains are also a dietary star. The upshot of all this is fiber-containing foods are great at slowing absorption of simple carbs. That said, I know all too well how difficult it is to change the bad habits of a lifetime; the thing that helps me more than anything is prayer-mine and my friends. Prayer opens the door to heaven so you can receive strength for your day. I covet the prayers of all who care to lift me up, and I will also lift up those I know.

MoeGig 2011-07-19 21:29:31 -0500 Report

I am sorry, she is just plain wrong…and I am living proof. Of course you end up eating some carbs, but the ultimate arbiter is your A1C. If it's 7 or higher, you are hurting yourself big time…(clogging small arteries that are mostly in your eyes, kidneys and feet). If your A1C is less than 6, you are probably experiencing acute lows (my biggest enemy) because you are having to correct with humalog/novalog which is like carefully handling dynamite to me… I don't believe you can stay in that range without the lows with many carbs and have sustainable weight loss. I've proven this to myself after 46 years of dealing with Type 1. lmb2749's nurse is correct—not the diabetes educator…sounds like she's a vegan which is a totally impossible/impractical/pointless diet for any diabetic to follow (IMHO)…:>) Anyway a more complete explanation of my thoughts is on this link:
(I know, tell them what you really think!)

pattroyka58 2011-07-28 14:21:17 -0500 Report

What makes you say Veganism is impossible/impractical/pointless for diabetics? The less meat I eat, the better I feel.

Anonymous 2011-07-28 17:50:40 -0500 Report

Isn't a mostly protein diet bad for the kidneys too? It makes the kidneys work harder. To those here eating a high-protein, no/low carb diet, I would be careful eating all that protein, especially animal-sourced, especially if you are a PWD with kidney problems.

MoeGig 2011-07-28 16:19:02 -0500 Report

Hello Pat: Look I believe that a vegan diet is probably a very healthy diet "other things being equal". Trouble is, other things aren't equal for a diabetic. I would think that if you eliminate eating most sources of protein and fat, then you are left eating carbs…mostly; and for me, if I'm not on a low carb diet, I have to take more insulin that just makes the whole disease harder to control…high's and low's. I'm not against a vegan diet, but it's benefit pales in comparison to the benefit of maintaining an A1c in the 6's. If you can do that, great; but, I know I couldn't; and, if you're not in the 6's, your circulatory system is enduring rapid progressive deterioration that cannot be reversed.

Type1Lou 2011-07-20 08:10:48 -0500 Report

I love your dynamite analogy re novolog/humalog. I've finally gotten my a1c's back in the 6's but have to deal with some scary lows. I find that eliminating as many carbs as possible gives me tighter control…but the tighter the control, the higher the likelihood of hypoglycemic episodes. Back in the 1970's or 80's (I think), Dr Richard Bernstein advocated eliminating carbs to better manage diabetes…his approach was pooh-pooh'd by the medical mainstream at the time but they couldn't argue with his results. Reading his book, "Diabetes Solution" radically changed my approach and brought me better control. There will always be some controversy about the RIGHT approach. It's a narrow road we travel and we each have to determine what works best for ourselves!

MoeGig 2011-07-20 15:52:15 -0500 Report

Thanks for the book recommendation…definitely will get it and read it. Basically what I try to do is to live off my Lantus dose as much as possible. It doesn't give you the acute lows/highs, so you see the low's coming better—it's not dynamite; it's more slow burning. The lows are a bigger problem for me and this approach minimizes them.

Type1Lou 2011-07-21 10:07:48 -0500 Report

The severe low BG's are relatively new for me…probably due, in part, to my aging body. Next week, I'm calling the Medtronics rep recommended by my endocrinologist to get myself on an insulin pump. Still struggling with the correct carb to insulin ratio…but that won't go away with the pump. Dr Bernstein's approach is still considered extreme as he advocates total elimination of carbs. I believe he was an engineer who returned to school to obtain a medical degree for credibility in his approach to dealing with his diabetes. A friend of mine "forced" his book on me and I'm glad she did. It changed my approach and opened my eyes.

lmb2749 2011-07-19 15:51:49 -0500 Report

I was just told by a nurse that carbs were my enemy, not sugar, so I was to avoid too many carbs. Being kind of new to this I will take the easy way out and listen to the nurse. I don't need anymore confusion.

Mistletoe 2011-07-19 22:28:29 -0500 Report

Carbs turn into sugar in the bloodstream, all foods do, some just go into the blood stream more slowly.

lmb2749 2011-07-20 00:06:42 -0500 Report

I actually did know that but before talking with the nurse I was more likely to try and avoid sugar than the carbs. I knew too many carbs were not good but I thought too much sugar was the worse. We learn as we go. Someone had to tell all of us at one time or another. I don't think any of us were born with all the answers. I'm grateful to all who help me along the way. And I have a long way to go :=)

Mistletoe 2011-07-20 11:33:15 -0500 Report

When I was first diagnosed, I read some really good books on Diabetes and that really helped me a lot. Yes, everyone has to start at the beginning and we learn as we go. Also everyone's body reacts differently to foods, so it is kind of a trial and error process in the beginning, but is great to have lots of people's input so we can learn from their experiences too.

nursepat1 2011-07-20 07:52:18 -0500 Report

We all need support, education, and encouragement. I am so glad there is this community available as a sounding board.

jayabee52 2011-07-19 20:58:30 -0500 Report

on the other hand your body and brain cannot function well on absolutely no carbs. so you would be wise to eas a few carbs every day. The problem for people with diabetes seems to be finding that delicate balance between zero and your optimum carb load. It's different for each PWD.

jayabee52 2011-07-18 23:05:24 -0500 Report

My experience with very low carb, high protein for the past 6 months keeping my BGs close to the normal range without insulin or other meds and losing about 40 lbs, and my May 2011 A1c at 5.5 would beg to differ with Hope Warshaw. Isn't her "New Reality" very close to the old ADA dogma?

I know what has worked for me. I shall continue with my current very low Carb, high protein eating plan, for the rest of my days.

pattroyka58 2011-07-28 14:25:58 -0500 Report

I wish I could! 'Way back when Dr. Atkins' diet was all the rage, I tried it for not quite 3 weeks. On day 17 I was in the ER with extremely high uric acid levels (gout) and they sent me home on a vegan diet for 2 weeks. Ever since, I can occasionally eat meat, but if I eat it daily the gout comes back in less than a week.

GabbyPA 2011-07-19 14:41:48 -0500 Report

Exactly. The proof is in the numbers. When I first was diagnosed, I almost eliminated carbs. Everyone kept telling me I had to eat more of them. So I did, and I have a harder time with my levels. The medicines are doing all the work. I really have been considering going back to very low carb meal plans again, and just ignoring the pro carb people. It really does boil down to each of us doing what works best for our numbers.

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