9) CONTROLLING BLOOD SUGAR WITH DIET
h) Low Carbohydrate Diets
A1c is the blood test that is most important for any person with diabetes. It is desirable to keep this A1c number as low as possible. A1c is roughly proportional to the average amount of carbohydrates consumed in a period of two to three months. The lower the amount of carbohydrates consumed, the lower the A1c. Physicians commonly give individuals with type 2 diabetes so called "Alpha-Blood Sugar Inhibitors" which slow or block the breakdown of starches and certain sugars in the intestines. These drugs are Acarbose (Precose™) and Miglitol (Glyset™). So clearly reducing carbohydrates to at least a moderate level will benefit someone with type 2 diabetes, otherwise why would doctors prescribe these drugs?
There is a lot of research that says a low carbohydrate diet is beneficial to a person with diabetes and beneficial to the general population, especially if that low carbohydrate intake avoids low fiber, highly processed grains and sugars (nobody seems to want to call these foods "high glycemic index foods" but that is exactly what they are). The problem is with the term "reasonable". For a person with diabetes "reasonable" should mean an intake of about 10% to 40% of total calories from high fiber low glycemic index carbohydrates (vegetables, beans, oatmeal, bran, nuts, non-fat milk products, etc.) accompanied by a high protein intake (fish and white meat chicken and turkey), a low fat intake and a very low saturated fat intake. It doesn't mean going into ketosis! A short list of the good research that can be found on the internet which supports a low carbohydrate diet for individuals with type 2 diabetes would include the following:
Jeff S. Volek, PhD, RD, FACN, Matthew J. Sharman, MA, Ana L. Gómez, MS, Chris DiPasquale, MS, Melissa Roti, PhD, Amy Pumerantz, BS and William J. Kraemer, PhD, "Comparison of a Very Low-Carbohydrate and Low-Fat Diet on Fasting Lipids, LDL Subclasses, Insulin Resistance, and Postprandial Lipemic Responses in Overweight Women"
Nielsen JV, Jonsson E, Nilsson AK. "Lasting Improvement of Hyperglycaemia and Bodyweight: Low-carbohydrate diet in type 2 diabetes. A brief report".
Mary C Gannon, Frank Q Nuttall, Asad Saeed, Kelly Jordan, and Heidi Hoover, "An Increase in Dietary Protein Improves the Blood sugar Response in Persons with Type 2 Diabetes"
Gannon MC, Nuttall FQ, "Effect of a High-protein, Low-carbohydrate Diet on Blood Blood sugar Control in People with Type 2 Diabetes".
Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels and David A. D'Alessio, "Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women"
Guenther Boden, MD; Karin Sargrad, MS, RD, CDE; Carol Homko, PhD, RN, CDE; Maria Mozzoli, BS; and T. Peter Stein, PhD, "Effect of a Low-Carbohydrate Diet on Appetite, Blood Blood sugar Levels, and Insulin Resistance in Obese Patients with Type 2 Diabetes"Westman EC, Yancy WS, Mavroupolis JC, Marquart M, McDuffie JR, "The Effect of a Low-Carbohydrate, Ketogenic Diet versus a low Glycemic index diet on glycemic Control in Type 2 diabetes Mellitus"
Iris Shai, R.D., Ph.D., et al, "Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet"
Overall, the research above and mechanism of protein poisoning would seem to make a good case for the low carbohydrate diet of some plans ("The Carbohydrate Addict's Diet", "The Zone", "The South Beach Diet" and "Sugar Busters" are all similar diets, Doctor Bernstein's Diet is even lower on carbohydrates) or at least modification of their approaches. There does not appear to be any objective experimental based data that supports any negative impact from these type diets, unless a person with diabetes has kidney disease or a person with diabetes takes them to extremes such as going into ketosis. There appears only to be "expert" conjecture that these diets are bad for a person with diabetes. Another aspect that must be considered when looking at carbohydrate intake is that a large amount of carbohydrates ingested at a single sitting can take the blood sugar level over 180, at which point the body begins excreting the excess blood sugar in the urine. This excretion is very bad for the kidneys; they aren't built to do this. So excessive carbohydrates at one sitting need to be avoided by individuals with type 2 diabetes.
Current Chapter: 9) CONTROLLING BLOOD SUGAR WITH DIET
a) Blood Sugar Control
b) Individualized Reactions
c) What a Diary Tells a Person with Diabetes
d) Protein Poisoning by Fruit Sugar
e) What are "Acceptable Fruits
f) Other Sugars
g) Best Mix of Protein, Carbohydrates, and Fats
h) Low Carbohydrate Diets
i) Fitting the Diet to the Individual
© Copyright 2009 All Rights Reserved.