...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 .

Diabetes.Uk does not recommend low carb over other diets, it is just an option.

This is their position statement
"Together with the Scientific Advisory Committee on Nutrition (SACN) we have released a report which recommends lower carb diets as a short-term effective option for adults with type 2 diabetes who have obesity or overweight. This includes low carb diets providing 50 – 130g of carbs a day. These diets can help with weight loss, glucose management and reduce the risk factors associated with cardiovascular disease. So, we can recommend them for some adults with type 2 diabetes. But, there is no consistent evidence that a low carb diet is any more effective than other approaches in the long term. So it shouldn’t be seen as the diet for everyone".

The recommended diet is wholegrains carbs rather than white carbs .

It’s incredibly frustrating isn’t it.
OP I’d advise him- also intermittent fasting/ eating in a 6hr window will give his sugars a chance to stabilise.

Yes good point

Do not get involved OP

You are not a health professional

Your advice could lead to this persons death

I don’t think anyone who isn’t a medical professional should be giving someone with diabetes advice. My adult son has T1 diabetes and the amount of ‘helpful’ advice he receives from randoms about low carbing is unreal, and potentially dangerous.

The irony of course is that lots of medical advice can be harmful and not up to date

Changes in diet would potentially affect the medication so can only be done under medical supervision. Diabetic patients are supposed to at least watch carb intake, his isn't the same as no carbs, consistency seems to be the key with diabetes management.

I have several type one diabetic friends who have to have a certain amount of carbs before taking insulin

8 years is amazing 🤩
I'm 1 year and love love love it!

As per an earlier comment I made - I work with diabetics and am also married to a T1 diabetic so have professional and personal experience. Sadly advice from Drs cannot be universally accepted as correct - I wish it could be. I’ve seen brilliant care and advice and absolutely shocking care and advice. So the comments to ‘trust the medical professionals’ in an ideal world are spot on, but in reality care isn’t as reliable as we would wish.

OP - I think your stance is very caring, measured and well thought out. There is no harm in mentioning it to your friend for him to mention to the people looking after him. Low carb looks different to different people and doesn’t have to mean no carb. Could mean gentle reductions in carb or switching to whole carbs. It may be he’s already following a low-ish carb diet anyway and no scope for improvement.
Some great references have been linked on this thread that you could share with your friend/he could ask diabetic team about

It's really not that. It's because diabetes is life long and every somoften someone will want to make the least bad bad choice. If you're managing type 2 for 40 years you may indeed want the odd apple strudel

It's important to remember that ops pal is telling them this is the dietary advice he was given. To avoid judgemental conversations. Because noones advising a diabetic to have a bowl of rice crispies and a banana. They just aren't. People sometimes either misunderstqnd or outright lie so people don't decide they'll solve their problems with their dietary knowledge of their extreme eating plan which must be superior to those who have studied the subject in detail and practiced with patients for mayb a decade or 2

'No carbs' is not being discussed here. Why on earth do people keep implying this???

Fruit, veg, dairy, beans, peas, legumes all contain carbohydrates.

A lot of people don't realise they have carbs. On a diabetic FB group I'm on it's surprising how many newly diagnosed people don't know that vegetables have carbs!

As per an earlier comment I made - I work with diabetics and am also married to a T1 diabetic so have professional and personal experience. Sadly advice from Drs cannot be universally accepted as correct - I wish it could be. I’ve seen brilliant care and advice and absolutely shocking care and advice. So the comments to ‘trust the medical professionals’ in an ideal world are spot on, but in reality care isn’t as reliable as we would wish.

This is spot on, sadly. There's about 100 years of direct experience of T1 in my immediate family (parents, us, kids) and a further 15 of T2. We've yet to meet a GP who knows as much about diabetes as we do - at least in terms of how it affects us - and even some DSNs and junior (specialist) doctors aren't great. I'm afraid in our experience it's entirely possible that diabetics could be advised that cereal and a banana constitute a healthy breakfast option.

We all now go to a fantastic clinic where they are totally up on the latest research and completely understand that everyone experiences diabetes differently and reacts differently to carbs, proteins, stress, exercise, alcohol and every other factor which can affect blood sugars.

@ItWasnaMeGuv I would say there's nothing wrong with mentioning low carbing to your friend. Just do it in a casual way and don't push anything too extreme on them. I probably wouldn't even mention your own experience, go with something neutral like: 'Have you and your team talked about reducing your intake of carbs at all? Some diabetics find that approach beneficial, so it might be worth having a chat with them about it'.

To eat no carbs at all, is pretty impossible

Unless you're Inuit I believe.

I would not necessarily assume that your relative was actually eating according to official dietary advice.

My MIL is at the pre-diabetic stage and has been given advice about diet etc, but she is absolutely shite at following it. Basically, she has interpreted advice to reduce carbs as 'Don't eat bread' and so has stopped eating sandwiches but still eats porridge, cereal, cakes, chocolate, biscuits, pastry, potatoes, rice, pasta, fruit juice etc. No amount of conversation about this has made the slightest difference. I love her, but it's SO infuriating when she's fretting about blood sugar and telling us she never eats toast any more when she's literally tucking into a pain au chocolat and a caramel latte.

Nobody is talking about ‘no carb’. My husband eats 50-80g of carb a day - much less than the typical British beige diet. Dr Unwin is a well respected GP and is not peddling anything except proper nutrition support for his diabetic patients, by virtue of which he slashed his GP practice drug budget by a huge amount. I will post a link to the DIRECT trial which was huge - and this advice is supposed to be rolled out across the NHS - so it’s massively frustrating that it’s not even mentioned to newly diagnosed patients.

HCPs tend to advocate complex carbs/low-med glycaemic index foods rather than low carb along with portion control/low fat if overweight or has high cholesterol.
Medication is key to diet recommendations--as PP have said persons need sufficient carbs (this will vary person to person) to maintain control (as we know) when taking insulin but also with some oral medications (such as gliclazide, which can cause hypos.)
Additionally, some other medications (Empagliflozin, for instance) requires a sufficient carb intake otherwise a diabetic can go into ketoacidosis (DKA), which is, like a severe hypo, life-threatening.

I'd avoid given dietary advice without knowing medications/history of the patient's condition.

Also, HCPs have to work with the lifestyle the patient chooses to follow.
For instance, rice crispies and banana was mentioned upthread. This may have been recommended to 1) keep sugar levels up if prone to dropping or 2) if the patient eats this anyway and not likely to try alternatives.

This is a link to a report about the Direct trial with clicky links if anyone wants to look at the whole thing https://www.diabetes.org.uk/about-us/news-and-views/weight-loss-can-put-type-2-diabetes-remission-least-five-years-reveal-latest-findings

We did the Fast800 a few years ago and lost a lot of weight and now generally practice a low carb/IF diet most of the time (holidays and Christmas being the only real exceptions) DH was able to decrease his high blood pressure medication. He had been warned that he might be pre-diabetic - I think thats what they said - but that seemed to disappear along with the high blood pressure.

I have enjoyed Christmas food - but I am feeling sluggish and experiencing indigestion again. I am back on the low carb/IF wagon again as from today (apart for the remaining Xmas cake) and definitely do notice that carbs have a negative effect.

Definitely. But like others have said nobody here is recommending trying to go no carb.

I did low carb diet a few years ago when first diagnosed as T2 - v successful
Despite excellent, results, GP v positive, but diabetic nurse completely negative.

I then came across a good article about good carbs and bad carbs - ie good carbs are lentils, pulses, wholegrain rice/pasta.
Bad carbs sugar/pastry/cake etc.
So now I have a not particularly low carb diet, but predominantly 'good' carbs.
Works for me.

People uninvited telling you what to eat can be really irritating/difficult, but if its as serious as losing limbs/sight, based on the ignorance I encountered with the diabetic 'specialist' - give it a go (tactfully)

My daughter is a medical doctor in the US and a Type 1 diabetic and she is convinced that the so called "diabetic diet" is a travesty. She eats Mediterranean low carb, which greatly helps in maintaining steady blood sugar levels. She also recommends it to her patients, even though it goes against the official medical advice. Diabetes is a disease of carbohydrate metabolism. It just makes sense to limit (not eliminate) carbs, since they are the culprit. No diabetic should eat a breakfast of banana and cereal--that's asking for major blood sugar swings which cause long-term damage to the body.

"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."

Nope. Not mainstream at all. T1 for 50 years.

@KnowledgeableMomma

yes, but often that reason is not a good one. There's still a LOT of resistance to anything that doesn't involve taking a shit load of medicine to what could be controlled by diet & exercise!

@ItWasnaMeGuv

I don't know. I'm low carb for diabetes. The NHS advice at my GP & hospital (when I was for an operation after a car accident, not related) is STILL 'moderate carbs' weetbix & banana for breakfast type crap.

you can't even get just a salad or fresh veg as a patient. 'Diabetic jelly etc' constant bread, crackers, cereal etc.

i think with DH's friend, it depends on his ability to access information (could he listen to Unwin on audio books?) & his ability to question the advice he's being given.

im a bit of a feisty little mare, & still struggled to be heard while in hospital.

How far away does he live? Is he ok on the phone etc.