...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 .

Maybe suggest the NHS site https://lowcarbfreshwell.com/ which is specifically for Type 2 to help reduce complications by going low carb

I have type 1. I don't think there's anything wrong in mentioning it, your relative can decide for themself whether it's of interest. Aside from the medication concerns that PPs have talked about, if by lowering carbs, protein intake is increased, that can be unsuitable for people with kidney damage, which is a frequent complication of diabetes. So definitely needs to be done under medical supervision.

Thanks everyone for replies. Its given me much food for thought. I'm extremely aware of the danger of unsolicited advice to a vulnerable person who is already being closely monitored by specialist health professionals.

If DH does phone and chat with friend a suggestion to ask his diabetic team about Dr Unwin's low carb protocol may be something I could be comfortable with. This would mean that they could discuss it together and whether it would help.

I think your instinct to stay quiet was correct. He has medical professionals helping and guiding him to get him to better health. There is a reason they have not mentioned this diet to him.

My DH is T2D and the advice he has received from his ‘diabetic team’ ( he has never once in 3 years seen a doctor) has been atrocious and if he’d listened to them he’d be well down the road of multiple medications, insulin and complications. We joined some online groups when he was diagnosed 3 years ago and there are a lot of people continuing to eat the way that got them into trouble in the first place and constantly ramping up the medication trying to control sky high blood sugar and developing more and more complications. My husband went ‘against medical advice’ (but following the DIRECT trial) strict low calorie low carb for 12 weeks and reversed his diabetes. He’s eaten moderate low carb for 3 years and maintained a non diabetic HBa1C but he still gets patronised and ‘told off’ every time he sees the diabetic nurse who is convinced his approach is damaging even though his blood sugar, cholesterol and triglycerides have all normalised He had retinal changes at diagnosis but it hasn’t progressed - the only reason to stay in the system is to get the annual eye screening. It takes a huge amount of time for evidence from research studies to trickle through to changed practices. So it’s entirely possible if your friend has just done as he’s told that he’s not aware of an alternative.
I second the suggestion of sending a Caldesi cookbook which have a foreword by Dr Unwin explaining how the body processes carbs and recipes from Giancarlo Caldesi who is a chef who reversed his own diabetes with diet as a way of introducing that idea without overstepping.

I have very recently been diagnosed with type 2 diabetes and this is why I have only told my Sister and Best friend as I want to avoid even more information and opinions! I only had my first appointment and confirmation of diagnosis on the 22nd of December. On week 1 of taking Metformin so won't even be up to my full dose until week 4.

When it was suspected but waiting for blood test results in November the immediate changes I made have had some impact but I have only lost 7lbs in weight so far. Which is a start but I am morbidly obese so have quite a way to go.

I am still making my way through all the information I was given at my appointment and looking at a diabetes website. I don't think I could honestly handle any more information to process or unsolicited dietary advice. It is too much right now.

This is so interesting. I started keto a few weeks ago and researched it a lot. Most of the official health websites (universities and government) said that low carb and keto were commonly recommended for pre diabetic people and type 2 diabetics but that non diabetic overweight people could benefit too. I thought it was a given that low carb was an extremely common and recommended way to manage type 2 diabetes. I’m not diabetic but I remember this clearly from every website I looked at.

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.

Surely the diabetic team would advocate for low carb if they thought it would help him. You said they don't advocate for limiting carbs and he has cereal and a banana for breakfast but surely that's patient specific.

It's insane to consider that his team wouldn't have considered it unless you're assuming that the whole team are ridiculously incompetent.

Personally a huge fan of keto as it fixed my inflammation in my body when nothing else could and reset me so I'm back to normal, but if his team have not recommended it for him then they must have a very good reason not to.

@Panaa Not necessarily. It depends how up to date they are. I help care for someone with T2 and doctors - even specialists - are very variable. You still get the diabetic nurses reccommending the Eat Well plate and 'balanced' carbs with every meal. I've done enough research now (not to mention enough blood glucose monitoring of the patient!) to be convinced this is incorrect. The meter doesn't lie!

ETA: that doesn't mean I think carbs are 'bad'. I think it depends on the person's situation. I eat a lot of (whole) carbs because I struggle to keep my weight up, and I've checked out of interest - they do not raise my blood sugar out of the normal range. I'd venture to say that unrefined carbs are probably healthy for most people, but not for diabetics (disclaimer am not a medical doctor etc etc).

Low carb as a potential diet for diabetes isn't a new discovery though, how out of date would they have to be to not consider that as option?

That's terrifying!

There's lots of diabetic educators and doctors who follow the old guidelines and ignore the research. Those of you saying that surely the man has been given a personalised diet which involved cereal and banana are sadly very wrong.

Low carb is not risky for T2 if you are not on insulin. I'd had to adjust my meds over time but never felt at risk.

I was planning on recommending the same thing. Dr. Fung's work is really important, I have read the obesity code and the complete guide to fasting and he talks about the benefits on diabetes throughout the book (as his fasting protocol was developed to help his diabetic patients). I would recommend both of these books, in fact, I would probably send them to the friend.

OP I was diagnosed with type 2 about a year and a half ago.

I read a lot, watched some stuff and then got a freestyle Libra (free trial). I started low carbing and I have protein for breakfast.

The Libra allowed me to see what foods did what to my blood glucose. Interestingly a banana spiked my blood glucose more than anything else I ate.

My A1C dropped from 69 to 36.

So yes maybe do mention it. The nurses at my GP's surgery tried to give me advice, but the numbers don't lie so they are happy for me to carry on as I am.

@ItWasnaMeGuv
This sounds like a plug for dr unwin's snake oil. Have you looked at the research. Do you have links to the peer-reviwed journals the papers have been published in?

You have no business proffering unsolocited advice to someone with a medical condition. Carbs arexrequired, even in a diet of thosexwith diabetes
What a self-entitled, egoistical way of approaching life; that you are able to offer advice that is 'better' than medical

I have been Type 2 for 25 years and do well on low carb . However , I'm not a medical expert on diabetes and wouldn't dream of advocating low carbing for OP's friend . They know what they're doing for whatever reasons , and I don't think this thread is helping OP at all .

Sounds like his diabetes is not controlled well

It may be that he is in insulin - so limiting carbs may be much less important- what matters is getting sugar levels stable and carbs can be a part of that if you are on insulin - my type 1 dh needs sweets sometimes to stay alive as the balancing act with insulin is hard to achieve . So it may be that the medics are focussed on getting stable sugars with insulin not diet

I think a lot of people still associate low carb with the Atkins diet and assume it means having bacon and eggs for breakfast and steak for lunch every day. So they default to the current healthy eating guidelines of loads of carbohydrates with every meal. Whereas for someone with diabetes who is using insulin it might be better for their health to swap very high carb foods such as rice, pasta and bread for pulses and other vegetable without necessarily going very low carb or keto.

Then why do Diabetes UK have a low carb meal plan on their website? www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/meal-plans/low-carb

It really beggars belief at times what the NHS will advocate for

Of course there are exceptions, as others have said sometimes lower carb may interfere with other meds or the insulin (and so OPs friend should check with their team), but generally speaking the vast majority of evidence shows that t2 diabetes can be supported or even put into remission by a lower carb diet

However whenever you say that you get the nay sayers who scream about 'cutting out food groups' when there are plenty of carbs in fruit, veg, dairy and peas/beans/legumes so no one is eating no carbs at all

There have been countless studies, specialist diets developed etc to support this

I have just clicked on the link for the low carb eating plan from Diabetes UK just out of interest- and this plan does include eating cereal for breakfast (oats), slices of bread with some meals plus quite a lot of fruit . It's possible that your DH's friend is actually following these guidelines. I would say the eating plan is more about cutting sugar and cakes than being properly low carb .

Low carb takes lots of forms so the phrase 'properly low carb' is a misnomer, its dependent on each individual person as to how many grams they want per day and what they are made up of

The fact that this person's diabetes is not controlled says quite a lot about whether their intake is working for them. Perhaps its not

I just looked at the NHS first one and clicked into the plan, the fruit is low carb fruit, like melon and blueberries, the bread is rye bread.

However what 'apple strudel' is doing there as a pudding I do not know!!

Do people have puddings, I never have afters but then I dont have a sweet tooth (she says, still going through the christmas chocs)

Support for T2 is notoriously poor. I have been in remission for 2 years and eat far fewer carbs than I used to. I don't follow any particular diets, just no pasta or rice, potato only if a baked potato as the meal and only brown bread. Lots of veg. I got a dog to walk for gentle exercise. It is working so far but no one advised me. I considered myself 'lucky' in that I have a type 1 child so I did have an above average understanding of what carbs and sugars do to levels so was able to hit the ground running. Please mention it, it won't hurt and may help.

Yes I have puddings. I make low carb cakes with almond meal and monkfruit. A small amount of dark chocolate.

Apple strudel made with apples, sugar and pastry? Nope that would send me skyhigh.

I suspect part of the rationale is that a lot of people with t2 tend to like
Puddings and it's easier to make small adjustments to the diet