A friend of mine with type 2 diabetes has told me that his dietician told him that 50-60 gms of carbs per day is OK for someone who is pre-diabetic, but once you're diagnosed as type 2 diabetic, you need to eat 40 gms of carbs at each meal. Does anyone have any idea what this dietician is talking about? I have told him that I am skeptical about this information, but I'd like to show him some evidence that this advice is off the mark.

They are probably confused about benign dietary ketosis and the diabetec ketoacidosis. I wouldn't waste time with a dietician. Just get Protein Power Lifeplan and/or Dr. Bernstein's Diabetes Solution. Both are loaded with science and facts and not just beliefs that everyone needs whole grains. I'd like to ask people exactly what whole grain foods they actually eat. If they say bread and pasta, I bet there is more refined grains than whole in whatever they are eating. In the diabetic exchange booklet I was given, it allowed graham crackers and angel food cake!

According to Dr. Bernstein, eating that much carbohydrate at once makes your blood sugar go up. He recommends eating a consistent 6/12/12 at breakfast, lunch and dinner for a total of 30g of carbs every day. Keeping blood sugar in the normal range is the only way to avoid complications and enjoy better overall health.

Maybe someday, the low carb/high fat method will be understood and taught by dieticians because I think many people need a person to give them advice and hold their hand.

I certainly hope you are right, AuntJoyce. The dietician would probably disapprove of my current diet, but I tried the diabetic exchanges for years and only got fatter and had ever worsening test results.

Alls I know is...

A few weeks ago on vacation with my family, I ate the highest carb meal I've had in almost 2 years: Pepperoni pizza made with regular (fresh) crust. Probably 40 carbs, according to FitDay. The entire next day I thought I was gonna DIE I was so sick! Reflux, pressure, headache, total unpleasantness for 24 full hours following! Needless to say, that was not a pleasant travel day to be in the van with the kids for 6 hours, as one might imagine.

I don't know what others' experiences are, but I know that a high-carb meal is NOT for me. Nope. No way. Not worth it.

As a blanket statment, I'd say it's off the mark. If a person was taking Insulin and the dosage was tailored to 40 grams of carb per meal, cutting carbs drastically could put the patient at risk for a dangerous hypoglycemic reaction if the Insulin dosage wasn't also lowered. The same might be true of some oral medications that work by stimulating the pancreas to produce more insulin.
OTOH, if a T2 isn't taking any medications, there is no real reason that they must consume that level of carbs per meal.

Holy Moly!!! It was the title that caught my eye. 40G per meal--for me, try 40 grams for the whole day!! I would have your friend read The Diabetes Solution by Dr. Bernstein and Dr. Atkins Diabetes book. Bernstein advocates 30G per day, divided into 6G=breakfast, 12G=lunch, and 12G=dinner. Atkins has a few different levels of the plan but I don't think it goes past 60G per day for the highest level. (Oh AuntJoyce--I just read your detailed post abot Bernstein)

I work with pregnant diabetic women both diet controlled and medication dependent. It drives me crazy the diet that the nutritionists has them on. I just had one of my patients who is diet controlled call me because she couldn't figure out how come her 2 PP was 219--after her telling me she had corn flakes, skim milk, and 2 pieces of wheat toast with butter--talk about a quadruple whammy---of course I suggested eggs, a protein meat source, and some tea.

It just amazes me that people with diabetes are being taught that it's ok to eat things like toast, corn flakes, bananas, potatos, crackers and stuff of that nature.

My dream would to become a nutritonist and teach low carb, but then I would never get thru nutrition school because I would never be able to tote the carby party line.

Until the medical community (and I am part of it) recognizes the myths surrounding saturated fat/cholesterol and heart disease, and begins to understand that carbohydrate is not an essential nutrient to life, and that an adequate protein diet does not blow ones kidneys out etc, etc, etc. Then we will see a shift in diabetes education. I'm not holding my breath. I do what I can with each patient and that's all I can do.

Good luck to your friend, he's going to need it if he's following the ADA diet.

Lisa

Go for it Lisa. The more good nutritionists the better. It can be done. In the UK Barry Groves (who wrote Eat Fat get Thin) has been an advocate of low carb for over 40 years. He recently obtained his doctorate in nutrition and lectures to nurses about nutrition and diet with regard to diabetic patients - low carb, high fat.

I just saw a nutritionist also. She told me I could have 45 to 60 carbs per meal and 15 carbs per snack. I told her if I ate that way I would be 1000 pounds by now. She must of had some experience talking to low carbers because she didn't really have much to say after that. She couldn't explain how that many carbs was going to help lower my blood sugar. She didn't put up a fight at all. I just told her that I had been doing low carb for about 2 years.

I too get frustrated by the ADA recommendations - it is almost criminal to think all newly diagnosed will be told to eat 40-50 grams of carbs per meal and that doesn't include snacks! I remember when I was dx with type 2, I went to the diabetes class provided by the insurance company - while there, I thought, well.....this won't be so bad, I can have bread, cereal and even cake & cookies - it didn't take long to realize my b.g. was going up and had I continued on that path, I imagine I would be having many diabetic complications from high blood sugar. I follow Dr. B's plan and am working on the goal of non-diabetic fasting numbers in the 85-95 range.

Lilian15, the date on your post is a couple months back so I don't know if you'll be revisiting this thread (in which case, anyone can answer), but your comment brings to mind a question I was wondering about just today.

Are things the same in the UK? Without the ADA, is such scandoulously wrong information being given out to diabetics by a national organization?

Unfortunately I do not have much time but manage to pop in now and again.

Yes we have the same problem here in UK with advice to diabetics, very much the same as in the US.

Lilian

I imagine the problem is the same in the UK, where The Lancet is a big time supporter of the lipid hypothesis. Recently, The Lancet published a perfectly dishonest study that was done at Oxford and sponsored by the AHA. Fourteen people were switched to a low carbohydrate diet for two weeks, after which the study concluded that low carb diets are bad because they decrease energy to the heart. Numerous commentators pointed out that all that they showed were the consequences of an incomplete shift in the hormonal substrate from glycolytic to lipolytic metabolism. Had they measured the same people at six weeks, or if they had measured heart energy in people who had been eating low carb long term, they would have gotten very different results. It was shameful, though not unusual for the Lancet to publish such a badly done, dishonest study.

People are different.Some can probably tolerate up to 100 grams of carbs a day if they are good carbs i.e. minimal sugar and lots of whole grain with fiber in it.
Small amount of wheat pasta might be okay.2-3 pieces of Natures Own white wheat bread per day seems to be okay for me.I don't see how anyone who follows the Atkins/Bernstein diet can get enough fiber.Maybe I'll find out when my Bernstein book arrives. Each person needs to experiment a bit and find out what works for them.Let's not blindly follow the ADA,Atkins or Bernstein.

Take a look at Mike Eades' blog about fiber.
http://www.proteinpower.com/drmike/archives/2006/08/

Thanks for the link, Ceberezin.
Lots of good information there.
Didn't notice anything about fiber there but I read
the stuff pretty fast and skipped some of it.
I'll reread it later today when I have more time.
In order for my body waste to leave my body on
a regular basis,I have found that I need a minimum
of 20G a day of fiber.LC yogurt by BlueBunny helps
that problem a lot, probably because of all those
millions of friendly little active organisms.
Living and learning...