Thursday, March 11, 2010

Controlling Diabetes: What Happened to Common Sense?

But I got it back, I'm feelin' better every day. Tell all those pencil pushers, better get out of my way.

We all know that diabetics are supposed to avoid sugar, right? And since starches are sugars that are glued together, so to speak, diabetics shouldn't be eating very much of them, either. Right? Especially since complications from diabetes include blindness, amputation and organ damage. Aren't those good reasons for sticking to a diet low in sugar and starch--in other words, a low-carb diet? I'm not giving advice, I'm just stating what I believe used to be common knowledge and common sense.

So why don't more doctors and health organizations tell diabetics to avoid carbohydrates?

My mother has had diabetes for 20 years and says she never got any advice from her doctors on what to eat. Sadly, nobody in our family knew that starches were as bad as sugars, and she continued eating bread, potatoes, and cereal. What advice might she have gotten if they had counseled her? Consider some statements on the website of the American Diabetes Association:

Eat lots of vegetables and fruits. Try picking from the rainbow of colors available to maximize variety.

Choose whole grain foods over processed grain products. Try brown rice with your stir fry or whole wheat spaghetti with your favorite pasta sauce.

Include dried beans (like kidney or pinto beans) and lentils into your meals.

Choose non-fat dairy such as skim milk, non-fat yogurt and non-fat cheese.

The American Diatetic Association advises diabetics that "If you have diabetes, a healthy daily meal plan includes...starchy foods like breads, cereals, pasta, rice, other grains, and starchy vegetables such as beans, corn and peas...."

The web is likewise full of advice for feeding your diabetic dog:

"Diabetic dogs should be fed a diet high in complex carbohydrates and containing adequate fiber." The site's owner, Intervet/Schering Plough Animal Health, has some insulin to sell you if your diabetic dog puts on the pounds and deteriorates from that high-carb diet.

Other sites hedge their bets with language like, "No foods are off-limits, as long as you watch carbohydrates! Eat plenty of fruit, beans and whole grains!"

A Japanese doctor I had an online conversation with said she recommended that her American patients eat 130 grams of carbs per day because that's what the American Diabetes Association recommends. (This is an M.D. with a subspecialty in diabetes, not a doctor of funk.) She added that the surge in diabetes in her country was attributed to a western diet of high protein and fat. (A typical western diet might have included daily bacon, burgers and full-fat milkshakes a few generations ago, but we're in high-carb, low-fat mode now.)

What isn't as commonly known as the effect of sugar on a diabetic's blood sugar level is the effect of fat. I checked my own blood sugar last Sunday: fasting blood glucose (BG) was 85; one hour after I ate two strips of bacon and some cauliflower and cheese fried in bacon grease, it was 69--a drop of 14 points. I'm not metabolically unique, others report that fat blunts their sugar spikes. Yet the American Diabetes Association recommends skim milk, non-fat yogurt and non-fat cheese. The hoax that fat makes you fat was long ago debunked by Atkins, Michael Eades and others, but it still persists.

An oasis of common sense is http://bloodsugar101.com/. It's run by diabetics who vigilantly manage their illness, study medical literature, and chat online with other diabetics about foods, medications, side effects, supplies, and setting and achieving BG goals. In other words, it's run by bright people with skin in the game. Their position on carbohydrates is that diabetics should test, test, test to see what they can tolerate and stay within healthy BG limits. Scroll down on their page to find simple instructions for doing this.

With this information, I've spent the past few weeks pestering my mother to do what most doctors tell you not to do: eat a low-carb, moderate-fat diet. After learning what foods were high in carbs, measuring her BG after eating them, and finally understanding what was causing her BG to go up and down, my mother started eating low-carb in earnest about a week ago. She typically eats eggs, sausage, cheese, mushrooms, etc. for breakfast, and some meat and vegetables for dinner. Results:

BG after a carbohydrate bender a few weeks ago: 268--a potentially damaging level.

Fasting BG a week ago: in the 160s. Still not good.

Fasting BG today: 126. There's room for improvement, but that's below levels generally thought to be damaging to most tissues and organs. But the good news is that her fasting BG level is dropping like a rock. With the low-carb foods she's eating, she's unlikely to have blood sugar spikes. Her quality of life is improving, too: I've never seen her so energetic and upbeat. My mother has broken lifelong bad eating habits and is regaining her health. I'm proud of her.

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