Re: Confused about Carb Allowances

August 18, 2001

IMHO the " exchange system " (which is what you're talking about) isn't nearly

as effective as lowcarbing as a way to control BGs...however, it's what most

doctors will recommend (the exchange system, I mean). Again, IMHO. Vicki

In a message dated 01-08-18 18:05:48 EDT, you write:

<<

Isn't that bad advice when some of the very carbs someone is choosing is

going to make their blood sugar go high (even though they stayed within the

parameters)??

Janie

W >>

August 18, 2001

> I am confused about doctors allowing

> Diabetes to have certain carb

> " allowances " during a day, i.e. 45 gms

> of carb for breakfast, 30 gms for

> lunch, 25 for dinner, or anything like that.

I have never heard of any such " allowances " over here in Europe. That

must be a US idea. Diabetics here are usually recommended to eat

between 175g and 200g carbohydrates per day, divided approximately

evenly between all meals and snacks (usually a total of 6 per day).

That makes an average of around 30-33g/meal or snack but I never

heard of " allowing " an exact number of grams for a particular meal.

What could be the reasoning for that?

> If those " 45 " gms, for example,

> of carbs at breakfast are foods with

> white flour in them, then my husband's

> blood sugar would scoot sky high. Then if

> at lunch, that next carb amount consisted

> of what was found in a piece of pie (and

> the rest of the meal was protein), his

> blood sugar would again scoot high.

That is an easy one. Don't ever eat anything made of white flour,

ever. Eat only carbohydrates from fresh vegetables and fruit, or if

it must be grains or rice then use only flour made from the whole

grain. Hence don't eat pies unless you made them yourself with whole-

grain flour. That isn't only good for diabetics but for everybody

else as well. There doesn't seem to be any doubt about it any more -

low-extraction flour can, and probably will, damage your health! Stay

away from it and you (and your husband) have one problem less.

> Isn't that bad advice when some of the

> very carbs someone is choosing is

> going to make their blood sugar go high

> (even though they stayed within the

> parameters)?

It depends upon what you mean by " go high " . The opinion over here

seems to be that if you eat, say, 33g of carbohydrate as a part of a

low-glycemic mixed meal and your BG " peaks " (usually at somewhere

between 20 minutes to 60 minutes after you start to eat) at below

180mg% (you will need to take readings every 15-20 minutes if you

want to be able to estimate the " peak " accurately) and then returns

to below, say, 120mg% within 3 hours (some say 4 hours) then there is

no good, scientific, reason to believe that it will have done you any

harm. Even then it is a matter of averages, the occasional 200 or 220

probably won't hurt you either.

I know that many people on this list would not care to see 180mg% on

their BG meter too often but if they don't actually look for it (i.e.

if they only take spot readings at fixed times), then they might

never see it anyway. But there is a big difference between " not

liking to see " your BG " go high " and calling it " bad advice " ! It

would be bad advice if there was evidence that it could harm you, but

there isn't any so far as I know. If there is, then I am sure

somebody can quote a reference to a peer-reviewed study on the

subject (not passages in some " doctor " book, please!).

It is the glycosylation of protein that is said to harm you and

short " peaks " don't cause permanent glycosylation, i.e. the glucose

that attaches itself to the protein does not get converted to

advanced end products if the blood glucose concentration returns to a

normal level within 3-4 hours, i.e. it " falls back off again " .

Whether you believe that or not usually decides whether you are

willing to eat the way the school-medicine men recommend or prefer

some other way. There are good long-term nutritional and

physiological reasons for getting at least 50% of your energy intake

from low-glycemic carbohydrate, there are good short-term diabetes

reasons for avoiding most of it. The doctors over here are convinced

that long-term nutritional considerations are significantly more

important than short-term concern for post-prandial hyperglycemia.

It's your husband's body, let him make an informed choice, with

emphasis on " informed " ! That's my suggestion, for what it is worth.

(Who is also confused most of the time, by the way! But some things

are getting a little clearer).

August 19, 2001

In a message dated 01-08-18 20:02:52 EDT, you write:

<< That

must be a US idea. Diabetics here are usually recommended to eat

between 175g and 200g carbohydrates per day, divided approximately

evenly between all meals and snacks ( >>

There are a lot of people on this list who find excellent control by eating

considerably less carbs than that. I limit my carbs to between 60 and 75

grams per day and have excellent control. The best thing to do is eat and

test, everyone's body is different Some of us can eat more carbs and still

have good control, others can't. However, avoiding rice, pasta and grains

totally -- whole grain or otherwise -- seems to help. Vicki

August 19, 2001

I am pasting a (slight amended) excellent post from another list with

practical suggestions as to how to determine what foods work for you, in

terms of trying a lowcarb diet. You might what to give it a try. Vicki

<<

The fasting number is just one piece of information you need.

Your post meal numbers can tell you much more about your glucose control.

Since your husband also has diabetes, I'm sure you have a meter around the

house. Now's the time to use it.

Here's the advice I give all newbies:

There is so much to absorb... you don't have to rush into anything. Begin

by using your best weapon in this war, your meter. The most important

thing you can do to learn about yourself and diabetes is test test test.

What you are looking to discover is how different foods affect you. As I'm

sure you've read, carbohydrates (sugars, wheat, rice... the things our

Grandmas called " starches " ) raise blood sugars the most rapidly. Protein

and fat do raise them, but not as high and much more slowly... so if you're

a T2, generally the insulin your body still makes may take care of the rise.

You might want to try some experiments.

First: Day one: eat whatever you've been

currently eating... but write it down.

Test yourself at the following times:

Upon waking (fasting)

Before each meal

1 hour after each meal

2 hours after each meal

At bedtime

That means 11 x for that day. What you will discover by this is how long

after a meal your highest reading comes... and how fast you return to

" normal " . Also, you may see that a meal that included bread, fruit or

other carbs gives you a higher reading.

Next: Day two: try to curb your carbs. For a few days eliminate breads,

cereals, rices, beans, any wheat products, potato, corn, fruit... get all

your carbs from veggies. Test at the same schedule above.

If you try this for a few days, you may find some pretty damn good

readings. It's worth a few days to discover.

That's the thing about this disease... we share much in common... we need to

follow certain guidelines... but in the end, our bodies dictate our

treatment and our success.

The closer we get to non-diabetic numbers, the greater chance we have of

avoiding horrible complications. The key here is AIM... I know that

everyone is at a different point in their disease... and it is progressive.

But, if we aim for the best numbers and do our best, that's all we can do.

Here's my opinion on what numbers to aim for, they are non-diabetic numbers.

FBG 60 - 110

One hour after meals under 140

Two hours after meals under 120

Recent studies have indicated that the most important numbers are your

" after meal " numbers. They may be the most indicative of future

complications, especially heart problems.

Listen to your doctor, but you are the leader of your diabetic

care team. While his /her advice is learned, it is not absolute. You

will end up knowing much more about your body and how it's handling

diabetes than your doctor will. The meter is our best weapon.

Just remember, we're not in a race or a competition with anyone but

ourselves... Play around with your food plan... TEST TEST TEST. Learn what

foods cause spikes, what foods cause cravings... Use your body as a science

experiment.

August 19, 2001

My dietician always encourages the best choices in carb allowances. It whole

fruits and vegetables etc. She does not encourage " whites " or high glycemic

foods.

ressy

August 19, 2001

I tried 2 slices of " good " wheat bread today and went from 96 to 190 in less

then 2 hrs. Bad for me. It had 24 carbs after I subtracted the fiber. Too

much for my system obviously-

E

dx'd 2/16/01-T2

hbA1c 2/16/01= 11.7

hbA1c 4/20/01=6.7

hbA1c 6/26/01= 5.0

44 yrs old,diet & exercise

----------

To: <diabetes_int >

Subject: Confused about " Carb Allowances "

Date: Sat, Aug 18, 2001, 6:03 PM

I am confused about doctors allowing Diabetes to have certain carb

" allowances " during a day, i.e. 45 gms of carb for breakfast, 30 gms for

lunch, 25 for dinner, or anything like that.

If those " 45 " gms, for example, of carbs at breakfast are foods with white

flour in them, then my husband's blood sugar would scoot sky high. Then if

at lunch, that next carb amount consisted of what was found in a piece of

pie (and the rest of the meal was protein), his blood sugar would again

scoot high.

Isn't that bad advice when some of the very carbs someone is choosing is

going to make their blood sugar go high (even though they stayed within the

parameters)??

Janie

August 19, 2001

---Your're like me, . I can't handle it either.

But I can eat fruit. It barely changes the readings. I went up 7

with honeydew melon. Haven't had watermelon yet this season. I have

mostly blue berries, cantaloupe and honeydew and strawberries.

Tomatoes are fine also for me. Thank goodness I can still have my

fruit.

madge

In diabetes_int@y..., " " <woodduckflds@e...> wrote:

> I tried 2 slices of " good " wheat bread today and went from 96 to

190 in less

> then 2 hrs. Bad for me. It had 24 carbs after I subtracted the

fiber. Too

> much for my system obviously-

>

> E

> dx'd 2/16/01-T2

> hbA1c 2/16/01= 11.7

> hbA1c 4/20/01=6.7

> hbA1c 6/26/01= 5.0

> 44 yrs old,diet & exercise

>

> ----------

> From: " Janie " <usns@r...>

> To: <diabetes_int@y...>

> Subject: Confused about " Carb Allowances "

> Date: Sat, Aug 18, 2001, 6:03 PM

>

> I am confused about doctors allowing Diabetes to have certain carb

> " allowances " during a day, i.e. 45 gms of carb for breakfast, 30

gms for

> lunch, 25 for dinner, or anything like that.

>

> If those " 45 " gms, for example, of carbs at breakfast are foods

with white

> flour in them, then my husband's blood sugar would scoot sky high.

Then if

> at lunch, that next carb amount consisted of what was found in a

piece of

> pie (and the rest of the meal was protein), his blood sugar would

again

> scoot high.

>

> Isn't that bad advice when some of the very carbs someone is

choosing is

> going to make their blood sugar go high (even though they stayed

within the

> parameters)??

>

> Janie

>

August 20, 2001

Well, first of all, I get plenty of fiber. I do eat lowcarb cereal (which has

plenty) and lowcarb bread (also high fiber) if those were the nutrients you

were thinking of...I don't eat high fat at all. I do totally avoid rice and

pasta and don't miss it, either. I do eat more protein but not what I'd

really call high protein. And my kidneys, along with the rest of me are in

very good shape, even considering the fact that I'm 63, .

I don't understand how your last paragraph relates to anything I said. I

agree with you totally -- sustained high BGs are sure to cause complications

down the line. But I don't have 'em - that's the whole point of eating a

lowcarb diet.

Incidentally, I just read in the paper that a local Kaiser hospital along

with OHSU (Oregon Health Sciences University, the medical university in our

state) has just received a major grant to design a study that will compare

the health effects of low carb programs such as the Atkins diet with

conventional (carbohydrate-heavy) diets. While this isn't specifically aimed

at diabetics, the study will be important and I'm looking forward to reading

the results. It's about time a scientific study of this is made! Vicki

In a message dated 01-08-20 07:01:48 EDT, you write:

<<

Missing out on one bowl of rice won't do you any harm at all, I feel

sure - but avoiding cereals on principle is said to increase your

statistical risk of a number of unpleasant conditions, not so much

because the grains will give you any particular short-term benefit

but because you have to take on correspondingly more fat and protein

to maintain your energy balance and there are limits to the amount of

those that you can eat and still remain healthy (or so they claim).

Experiencing brief BG excursions is said not to statistically

increase your risk of diabetes complications, but sustained high BG

surely does - isn't it a matter of faith whichever route you take?

>>

August 20, 2001

> I tried 2 slices of " good " wheat bread

> today and went from 96 to 190 in less

> then 2 hrs. Bad for me. It had 24 carbs

> after I subtracted the fiber. Too

> much for my system obviously

Why 2 slices, and what did you eat with them?

It doesn't matter how little carbohydrate you eat, it is unwise to

eat it in isolation.

If you always eat balanced mixed meals (e.g. 1 slice of " good " wheat

bread with a slice of boiled ham, a boiled egg, a raw tomato and a

cup of coffee with milk) you will reduce the overal glycemic index,

give your stomach something to digest and shouldn't see such a

big " peak " afterwards.

I never eat rice or bread or potato alone but always as a part of a

mixed meal with the appropriate amount of protein and fat (and

including as a major component some fruit and vegetable).

August 20, 2001

> I limit my carbs to between 60 and 75

> grams per day and have excellent control.

> The best thing to do is eat and test,

> everyone's body is different Some of

> us can eat more carbs and still

> have good control, others can't.

Vicki, the only problem is that although you can test to see what

happened to your blood glucose, you cannot test to see what happened

long-term to everything else!

> However, avoiding rice, pasta and grains

> totally -- whole grain or otherwise --

> seems to help.

It only seems to help you limit that post-prandial rise but it won't

help you with your overall nutrition. This is the point at which you

have to decide whether to believe the nutritionists or not, right?