I was diagnosed with T2 diabetes a few years ago. I went to dietitian who prescribed a diet with 60% carbs (I believe its roughly the same as the ADA dietary guidelines). The standard treatment is medication, followed by more medication, then insulin shots.
Frustrated, I read everything I could get my hands on, and found two books that I'd highly recommend: 1) Dr. Bernstein's Diabetes Solution, and 2) Think Like a Pancreas by Gary Scheiner. Dr. Bernstein is notable because he was diagnosed with T1 when it was a fatal condition. He survived, became an electrical engineer and ultimately went on to become an MD. He lobbied the AMA to allow patients to have blood glucose meters, when the AMA wanted them to be restricted to doctors offices.
I stopped listening to medical practitioners and starting experimenting with the foods I ate, using pairs testing with a glucose monitor. There is no question that a low carb diet is the way to go.
I sometimes wonder if the state of medical ethics is killing us. We've made it so expensive to do a medical study that nobody is going to do it unless the end result is something they can sell, so the only "solutions" we get are drugs because there is no money to be made in prescribing diabetics a diet of fish and vegetables.
It's a sad state if an individual can learn more by experimenting on themselves than their doctor knows because the doctor isn't allowed to participate in or publish the result of the same experiment without a multi-million dollar budget.
I think the problem might be more that there aren't very many universal results, and the fish and vegetables diet that works for one person won't work for others.
Not really. There's tons of studies on whether some particular food is connected to some very narrow positive or negative outcome for the heart, brain, etc., on which popular ideas about the food being generally good for the heart, brain, etc. are built. (And, from those, even flimsier popular ideas about the food being generally healthy or not.)
ie, you gather medical data from thousands of people and find someone similar on a micro level to the current patient and see what has helped them.
Exactly. The research is starting to show that individual reactions vary dramatically.
That's the ethics of business. We have no healthcare; there's a healthcare industry and we are how it extracts its profits.
This inevitably corrupts the goals of an "ideal world" healthcare system which would exist to provide efficient and affordable healthcare.
We produce shit studies with small sample sizes and dodgy methodologies all the time. They just don't add to the pool of human knowledge.
They actually do. A crappy study with p=.70 isn't enough to justify changing the standard treatment for a disease but it is enough to justify doing the more comprehensive study to see if the result still holds.
We have a choice between doing ten comprehensive studies only to prove that nine of the things didn't work, or using the same resources to do a hundred crappy studies and then repeat the five with the most promising results using the more robust methodology and discover that three of them still hold.
The problem is when the methodology itself is broken. For instance, using case-control methodologies on things with small-to-moderate effect sizes. Past studies comparing such studies with eventual RCTs showed that the case control studies gave absolutely no indication of what the RCTs would show as a consensus: it was entirely random.
There is no amount of money, small or large, worth throwing at studies that shift our prior probability to posterior by 0 units.
If you pick a very strict diet then people drop the diet completely or cheat all the time, resulting in uneven insulin levels.
It is like inflammatory bowel disease. Many doctors rarely prescribe rectal medication for long term use even if it might be more effective than alternatives just because it is difficult enough to get people to take their pills.
But I do think diet suggestions will change more in the future when it comes to diabetes.
I think Doctors need to be better trained, Americans need to completely rethink nutrition and health (I can't speak for other countries), government needs to help inform people, and laws about marketing food may need to be changed.
In addition further research could help, but in my opinion nutrition is a solved problem, eat real food and avoid meat and processed junk.
My opinion is based on how little my friends in the medical profession and/or training know about nutrition and the book How Not to Die which focuses on how diet affects deadly diseases.
I've been 'gotten' by carrots in a crock-pot beef. I miscounted and got waylaid by them.
http://www.sciencedirect.com/science/article/pii/S0899900714...
I've been customizing my meals based on what my glucose meter tells me raises my blood glucose the least and I am losing weight. The weight loss is gradual, but the most important thing is I am doing it eating foods I will eat, setting up a diet I can stick to long term, and I know that this will be good for me because the numbers back it up. Like you, I've always liked meats and testing myself with the glucose meter shows that eating more meats and less carbs is good for me personally. I should note I am not diagnosed with diabetes, I just bought the glucose meter to guide me in what I eat.
Link: http://www.cell.com/cell/fulltext/S0092-8674%2815%2901481-6
Dexcom has a CGM system that hooks up to your phone/watch, but is only available with prescription (and is extremely expensive without coverage), so this is effectively only available if you already have severe health problems.
Some former Dexcom employees founded a startup some time ago to do CGM for preventative healthcare, but I haven't heard anything of where it went. http://mobihealthnews.com/32601/dexcom-alums-develop-blood-s...
There are probably others.
To me these sorts of subcutaneous CGM systems seem more convenient for users than other initiatives (e.g, the contact lens projects). The sensor stays embedded for a week at a time, you can sleep with it in, and you get measurements every 5 minutes or so.
Can you elaborate ? What do you mean by extremely expensive ?
My "extremely expensive" was unfair. Some quick searching suggests ~$650 for the transmitter ~$100/week for sensors. "Not cheap" would be more accurate.
Don't let the fact that lifesaving treatments are often even more unaffordable shift your frame of reference.
It is, presuming that your macros and micros are still in line. It's easy to eat the same meal for lunch and dinner every day and lose weight but be very unhealthy while doing so.
If everyone had an apple watch, fitbit, etc that told you your blood sugar levels, with an immediate effect you could usher in a hugely effective treatment and prevention of diabetes and obesity. Assuming you can get people to wear it and you don't have to prick their fingers.
Either way, the meter is about $10 and 25 strips is around $7, 50 is $12, 100, is $20. Very afforadable.
Lots of fats, proteins, and veggies, staying away from carbs and sugar, and I feel better than any other time in my entire life (at 34). I'm no longer eating simply to eat, and at this point I'm not craving the crap I used to. The sickness that now ensues after ingesting processed sugars or carbs, does make it easy to skip. While this story is anecdotal, it seemed worth a try because I kept stumbling on research supporting it.
just shave 400-500 calories per day and sure enough, each week on average you'll lose a pound
hmm spaghetti squash, I'll have to try that
"His routine went like this: Wake up at 5 a.m. and run on a treadmill for 45 minutes. Have breakfast — typically one egg and two egg whites, half a grapefruit and a piece of sprouted grain toast. Run on the treadmill for another 45 minutes. Rest for 40 minutes; bike ride nine miles to a gym. Work out for two and a half hours. Shower, ride home, eat lunch — typically a grilled skinless chicken breast, a cup of broccoli and 10 spears of asparagus. Rest for an hour. Drive to the gym for another round of exercise."
This is crazy. Huge caloric burn, but no calories to coming in, so your body burns fat and muscle, but there's still a deficit, so the metabolic rate starts lowering.
I really hate TBL for so a many reasons. As this research is showing, it's a total sham that hurts the participants for life. And for the millions of people watching, it creates completely unrealistic expectations, eg "Kenny lost 180 pounds, I can't lose 50 in the same amount of time."
Of course the body cannot maintain that metabolism.
I am talking a pound per WEEK.
Sugars really only have several places to go once they are ingested: Held in the fiber of undigested food, blood stream, liver and muscles.
We do really well with vegetables even though they are carbs since veggies are mostly fiber and very low carb. The high glycemic foods are okay provided that muscle glycogen is going-to-be/has-been depleted in the form of physical exertion.
Building muscle would also increases ones capacity for storing said glucose, but it's not easy or popular since the rate of muscle growth at best is about 1-2lbs/month under ideal conditions of physical exertion, nutrition and rest.
However, exercise and low-glycemic diets do explain the efficacy of reveesing t2 diabetes.
So for healthy, non-diabetic people it really doesn't matter.
(With the obligatory addendum that going all "low-carbs" or "keto" is a very, very bad idea if you expect to do any exercise at all)
Now, in reality, energy during exercise is always derived from a mix of both fatty acids and glycogen. In general, as exercise intensity increases (you are getting closer to VO2max), a larger ratio of energy will be derived from glycogen. So for your friend, running 54k of mountains is only going to be done at rather low intensity (50-60% of VO2max), where ~60% of energy will be from fatty acids, saving glycogen and preventing hypoglycemia.
Hypoglycemia, incidentally, is also known as "bonking". It's rather unpleasant. On long, high intensity exercise sessions you can't usually replace all the glycogen you deplete through food intake. So if you start with lower glycogen stores through a low carb diet, what you are doing is priming your body for hypoglycemia.
http://eatingacademy.com/how-a-low-carb-diet-affected-my-ath...
Is that related to glycemic index?
"The GI represents the total rise in a person's blood sugar level following consumption of the food; it may or may not represent the rapidity of the rise in blood sugar. The steepness of the rise can be influenced by a number of other factors, such as the quantity of fat eaten with the food."
But only "related to". GI is complicated. The whole blood sugar thing is complicated. I don't just mean in principle, I mean in practice, too. Measuring your own body's own reactions to foods may be the most practical route to go; reading that page leads one to the conclusion that any concrete numbers for GI you ever see are at best weak approximations even under the best of circumstances.
Which is a pity, seeing as how it seems like it would be very useful.
At first I was heavy on meat when I removed the carbs but it didn't help at all.
Last December, I was diagnosed with T2 diabetes. After talking with a researcher about this (have worked with diabetes research school locally due to job), I came across a few things:
1. Damage is done to the pancreas at 140mg/dL 2. Too long at 140mg/dL or above can cause permanent damage to the pancreas. 3. Early estimates indicate that 110mg/dL is a lower limit of beginning damage to the pancreas
Ok. There's a lot of moving parts in food. Nutritionists will tell you all sorts of bunkum, other than mineral assays and tests have discovered. But there's a simple way here: keep blood sugar under 140mg/dL, no matter what.
Is that possible? To keep your blood sugar under 140mg/dL? Yes. The answer is "Don't eat foods that raise your blood sugar above 140mg/dL". That's interestingly easy. What it amounts to, is cutting out sugars and carbohydrates out of your diet, and extensively testing when you come across foods you're unsure of.
My research shows that all the standard sugars are bad for me (Sucrose, glucose, fructose, lactose). I spike, and then fall. It also depends on what I'm eating with them. In those cases the rise and fall are longer.
Some complex carbohydrates I can handle. Potatoes are a nope, as are bread products. But spaghetti squash works with me well. I can handle it nicely, with a very low rise and fall.
I also end up eating a lot of fats, protein, and veggies. But I don't crave sugar at all. I've always liked meats, and this gives me the ability to continue that.