...not to mention trying low carb to someone with T2 diabetic complications?

[ItWasnaMeGuv]

Over Christmas met lots of relatives and friends, and friends of DH etc. that we see annually.

One friend of DH has had a horrendous couple of years healthwise and is being cared and closely monitored by diabetic team through local hospital. They have T2 diabetes and risk losing feet and eyesight if they don't get control of it. Feet are currently 'stable', eyesight is more complicated and a real cause for concern. Friend can't read, struggles to see tv (jumping about, wavy lines, blank spots).

I'm a low carb fan and have removed starches and sugars for eight years now, I'm used to not having them and have adapted pretty well. No-one else in my family does this, just me. However I don't talk about it publicly as I know it is a 'hot potato' to some and considered a fad and I do not want to come across as a diet zealot.

After chatting with DHs friend I got to learn that the diabetic team do not advocate for limiting carbs (i.e. cereal and banana for breakfast etc) and felt somewhat dismayed as I'd thought that, over the past 8 years, limiting carbs had become more mainstream in NHS dietary advice. I know of a Dr David Unwin, a GP in a practice in North Liverpool. who has practiced limiting carbs with his T2 partients for several years now quite successfully. It was his infographics that got me interested.

I can't stop thinking about DHs friend and wonder whether I should have mentioned low carb to help minimise diabetic complications, bearing in mind they have experienced health professionals in Type2 diabetes advising them. I am not a health professional at all. Low carb works for me, that's all I can say. My instinct was to keep my mouth shut on the matter unless he had asked me for advice. I'm just very, very sad about the whole thing .

Hi OP that's very interesting.
I would maybe get DH to mention it to his friend.

What kinds of things do you eat? It feels carbs are everywhere!

Tbh if the complications are that advanced dietary changes may not have much impact for him.

That's a good point. My thought would be that every little might help. They eyesight in particular is worrying friend very much, they don't want to lose any more of it.

Depending on how his T2 is being managed, low carb may not be go.
I'm T2 and have started background insulin now. Low carb could cause me to have a hypo as the insulin needs a slow release carb to work with

I'm in a similar boat with my mil. She's type 2 and her diet consists of so many carbs, porridge, bread, potatoes, regular meals plus regular snacks, all instructions from her doctor or nurse. My DH recently diagnosed type 2 has had completely different advice.

Personally I couldn't ignore given it's a case of potentially losing his sight. Dr Unwin is respected in his field, he works for the NHS so can't be accused of trying to get £££ off his advice. Why not just send a message and some appropriate links on Dr Unwin and the success he's had with his patients.

Dr Unwin also has an excellent infographic about sugar in foods. If your friend is on insulin he does need to take care cutting carbs because blood sugars can get too low. So he may need to talk to a doctor about it.

Some parts of the NHS absolutely support low carb diets for Type 2. As does Diabetes UK. Personally I would feel obliged to mention the possibility so I knew I'd done all I could.

https://northeastlondon.icb.nhs.uk/your-health/diabetes/low-carb-diet-for-type-2-diabetes/

https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/meal-plans/low-carb

I work with patients with retinopathy and where as it’s true that a lot of the eye damage can’t always be reversed the improved control should stop it worsening which is crucial!! My husband is also a T1 diabetic of 30yrs + and the effect of carbs on his blood glucose and insulin requirement are clear. I’m astounded it’s not routine recommendations to reduce carbs for T2 🤷🏼‍♀️ Id defo mention to your friend, it will at best help him and at worst not change anything

(though if friend is on insulin would need to be careful reducing carbs initially to avoid hypos)

If he's already requiring insulting them low carb could be dangerous, as it could with many diabetic medications for causing hypoglycemia which is more immediatelynlife threatening.

His eyesightbwill response to improved diabetic control but diet isn't always enough, even with type 2 eventually the body doesn't produce enough insulin and supplementatiom is required.

His dietician will have advised him on combining protein and fat with carbs and slower release carbs etc which I know partly because I work closely with diabetic patients and partly because I had gestational diabetes managed within the NHS.

Diabetes diet advice (both T1 and T2) is often woeful. Low carb or even still eating carbs but working to minimise carb spikes like Glucose Goddess method can make such a difference.

Not just insulin but various other families if drugs used to treat diabetes, this is why low carb is not the go to, the danger of outright killing people

Do you really think they won't have heard about low carb and diabetes before? Keep out of it op it's not your business and its territory where people are often given unsolicited advice.

I'm not a medical person, but logic tells me......You wouldn't feed a kid with a nut allergy a peanut butter sandwich, and then tell him, it's ok, I'll give you an injection afterwards to stop you getting ill. By the same token, a diabetic shouldn't be eating sugars/carbs their body can't cope with, and then relying on insulin injections to sort it out.
My T2 husband was on insulin, which as far as he was concerned, was a one way street to putting even more weight on because it makes you hungry all the time. He bit the bullet and went low carb ( I joined him, although not quite so strictly, so we could both eat more or less the same food) we both lost loads of weight and he gained enough control over the diabetes to be able to come off of insulin injections altogether. He's not cured - T2 diabetes is a lifelong thing- but he can eat pretty normally now without his blood sugars going berserk. So it's definitely worth trying, although if you are on insulin injections you'd need to know what you're doing with the doses.

Of course, you should discuss a major diet change like low carb with medical professionals before you try it. If you can get an appointment to see them.......

He's like me, reticent about sticking his oar in about something that health professionals are already advising on, when he hasn't been asked for an opinion. All we did was listen and sympathise.

All low carb means for me is Keep It Simple Always - eating salads or veggies with protein i.e. steak/salmon/chicken plus a salad. Leave all desserts alone, they're not my friend. Using lettuce as a wrap for things, using sliced cucumber instead of crackers with pate or cheese. Fortunately I find rice, potatoes and pasta boring so don't miss them. Bread , I do miss that.

I cook from scratch (meat and two veg) and never use take aways. I love lentil soup and make it in winter as a treat. I like intermittent fasting so leave breakfast until lunchtime but sometimes do have breakfast if on holiday (bacon and poached eggs). At 60 I have to think of my health and am very lucky to not be on any medication nor need doctor visits. Long may it continue.

AS you can see, it is not for everyone but as Dr Unwin says, as long as you know the amount of sugar in foods, you can make a judgement about what you choose to eat for your health.

Here is a link to the infographics (Public Health Collaboration) https://phcuk.org/sugar/ just click on Breads to see how many teaspoons of sugar is in each 30g slice.

My mum has put her type 2 into remission by eating low carb

Low carb is the way to go. I've control t2 diabetes for 10 years just by going low carb. I'd recommend it to anyone with t2. Lots of people don't know how much it helps, especially if they only hear the NHS advice, which is pretty awful.

Mention it but also be aware he needs medical advice before changing his diet to reduce carbs. Quickly reducing blood sugars can damage your eyesight and make his current problems worse, or the medication he’s on could cause hypos if he reduces carbs without also adjusting the medication.

I don't advocate either for or against but I found the following book (with foreword by Dr Unwin) really interesting:
The diabetes weight-loss cookbook by Katie & Giancarlo Caldesi.

Although primarily about diet (with some great recipes), the science-bit, personal stories etc are really informative.

I agree, which I why I was surprised about the cereal and banana breakfast. I assume that was official dietary advice... My elderly mum, also T2, was given same advice and has porridge,banana and squeezed orange every morning . She takes advice from GP surgery not me.

@Cmonluv absolutely would need to be done under supervision if on meds or insulin but gradual carb reduction would result in medication and insulin requirements reducing which a professional could guide someone through (well, hopefully!) This would be a better solution all round. Obviously unadjusted meds plus low carb would result in lots of hypos which you wouldn’t want either, although not damaging in the long term like high blood sugar is. I see some terrible sights at work of people with irreversible sight loss because of poorly controlled diabetes and often lack of education/advice once I start talking with them 😔

Blood sugars going too low can be life threatening in a single instance, so perhaps if his blood sugar is badly controlled they might feel they can't risk the lows. Just a thought based on my diabetic cat mainly though! And what my mums said about her husband, who struggles with his levels even with a dexcom pump.

This would be my view too, diabetes is the sort of thing where people tend to think they know more than they do iykwim. If you don't have diabetes or any health qualifications I'd keep your mouth closed tbh.

I’m type 2 and have been doing really well with a low carb, intermittent fasting approach (with the blessing of my diabetes team). However, ex (adult son’s dad) is more dependent on carbs, so is now on background insulin. Going low carb made him rebound and end up eating more carbs.

For me, carbs aren’t a must have (having IBS and cereal making things worse makes the whole low carb diet far easier, I don’t enjoy playing fart roulette after a baguette if I’m honest).

I’ve been more relaxed than usual for the past week or so (and my blood glucose levels can attest to an influx of mince pies and Christmas cake); tomorrow I’m back to fasting & low carbs again. I’ll feel better, being high makes me feel bloody atrocious.

And having seen my uncontrolled type 2 Dad’s gangrenous feet before amputations (that’s a smell I can’t forget), going back to a strict regime is easy. I can’t guarantee I’ll never have complications (it looks like I was actually diabetic throughout 2020-22, when regular medication bloods were patchy at best for under stable reasons), but not wanting to put my kids through what my Dad put us through in the past 10 years before his death, exactly one month before my diagnosis and as a cause of his death, rather makes the mind focus on taking my diabetes seriously!