low carb... what number - "low"

[CanadianJohn]

I've recently been diagnosed T2. I'm not much over-weight, and I am trying to change my diet to low-sugar and low-carb. The problem is, I cannot find out what # of carbs I should be aiming at. There seems to be no concensus at all. My poor wife, who has been cooking the same way for 60 years, is totally baffled.

This, from the Mayo clinic, is the best I can find "A daily limit of 0.7 to 2 ounces (20 to 57 grams) of carbohydrates is typical with a low-carb diet. These amounts of carbohydrates provide 80 to 240 calories."

Any ideas.

Welcome to the T2 club.

I'm about 1.5 to 2 years in. What I did was to get a libre 2 glucose monitor.

https://www.freestyle.abbott/uk-en/home.html You can get a free sample and then I paid for one, they are about £50 so not cheap.

Anyway it allowed me to monitor very closely my blood glucose response. I found that for me bananas cause a spike, so I don't eat them.

I cut out bread, potatoes, rice and pasta - I very occasionally have them.

I don't low carb everything eg I eat carrots and swede and sweet potatoes.

I try to stay close to 20g of carbs per meal.

I follow 2 rules, I eat low carb and I have protein for breakfast.

So breakfast might be bacon and egg, ham and cheese, yoghurt (full fat greek style) scrambled egg with cheese.

Lunch and dinner I try not to have more than 20g of carb per meal.

Snacks are fruit (but only one a day) nuts, baby bell cheese, pork scratchings.

I might eat something like steak with mushrooms and onions, chicken with salad and coleslaw.

If I do want to have potatoes with a main meal I get cheesy potato croquettes or potato gratin from cathedral city (I get them from Iceland).

So that's what I do, my A1C is now normal although I', still taking metformin.

20g total carbs is a good number to aim for. This is often called a ketogenic diet, or keto diet.

What that looks like in practice is one cup of vegetables, and two cups of leafy greens. Nothing made with flour, from flour, no rice, bread pasta or potatoes, and avoiding other starchy veg.

It is a huge change from the way we are all used to eating with meals based on carbs, but once you get your head round it is easy enough. It also means you need to get over this internalised avoidance of fat we have all gwon up with. Butter, cream, olive oil etc are good. Fatty cuts of meat are good.

If you want concrete information and advice I can recommend Dr Eric Westman on youtube.
s

Best of luck with it!

Hi OP, do you know what your Hba1c number is?

There is a lot of information around low carb and keto but it's about finding what works for you.

I too was diagnosed when not overweight. In fact I had a normal bmi. I initially did keto and this did bring my number down but I really struggled with it and was barely eating anything and was underweight and still losing.

Anyway nhs guidance for low carb is anything under 150g per day. I started eating carbs, I stick to between 70 and 100 a day, and my hba1c initially went back up a few points into type 2 levels but then came down into normal after a few months of continuing with the same level of carbs. No medication.

Obviously everyone is different in the way their body reacts and even trying the libre on the free trial might help establish triggers.

Diabetes UK Web site has some good advice and there are many experts that are good if you want to try full keto. Sten ekberg is good.

As I say that might not be for all though I'd say it's good to drop weight quickly which I think helps for blood glucose reasons.

When I have carbs now I try to have very small portions of better ones, brown rice, wholewheat pasta, lentils and pulses but I do sometimes have a bit of brown sourdough bread too.

There are lots of keto/low carb recipes on line. If you do keto I'd recommend getting some electrolytes and a good multivitamin.

What you are looking to do is stop carbs and sugar raising your blood sugar. What the keto diet is meant to do is change your body to burn fats instead of carbs, that's good for losing weight and also for type 2. My issue with it was that I ran out of body fat and wasn't consuming enough of anything to live on.

Your diet now should be normal level protein, low carb, high fat. It just depends on how low you want to/need to go.

Meant to add that exercise is good too, even if it's just getting out walking. Fidgeting and doing heel lifts, air punching etc also helps to burn glucose.

Thanks for your replies. Please note I am in Canada.

I was under the misconception that, because diabetes is so common, there would be an accepted way to treat it. Not so. Everybody and his grandmother has a different idea.

I go for blood tests regularly, and discovered to my horror that my A1C has been high for almost 4 years. My family doctor is of the opinion that A1C is less important than glucose tests... the thing is, I generally go for tests late morning, without having breakfast, so naturally my blood sugar is somewhat low at that time.

To give examples of the difficult I am having determining a course of action:

• The Diabetes Canada website talks about home glucose monitoring; the diabetes coordinator at the local health unit thinks home-monitoring is counter-productive, and A1C every few months is a better guide.
• My family doctor doesn't think I should be on medication, my internist says I definitely should be on medication.

So... I am trying to forge my own path.

I have a non-blood relative about 5 years older than me - I think he is 82 - who has been ignoring his T2 for years... he is slipping towards dementia, and has just had 4 toes amputated.

Hence my concern. I may end up writing my own book on how to manage T2 !!

I agree that blood glucose testing can be counter productive. I got a bit obsessed about it. The A1c shows how well your body had dealt with glucose over a 2 to 3 month period, so when you give the blood for that doesn't really matter.

It sounds to me that you are maybe not too far into type 2 levels given the conflicting advice?

Going low carb or even keto can only do good in your situation. It certainly can't do any harm if you aren't medicated.

Keto is generally under 20g carbs a day and requires quite a significant change in your diet but is definitely doable. I'd do that for a fixed period and then increase carbs and watch to see how your body copes.

I think a weight drop of about 10% can trigger an improvement in insulin response.

Your body stops craving sugar pretty quickly and you start to appreciate small amounts of very dark chocolate. Combine any carbs eaten with fat to slow the absorbtion and glucose spikes. Move more.

That's basically the principal, it's just down to how low carb you are prepared to go.

I've got my levels to non diabetic by diet management.

And re blood glucose in the morning with no breakfast, actually there is a thing called the dawn phenomenon where your reading is actually higher than you'd think. My fasted morning readings were always much higher than my 2 hour post meal readings.

Just reduce the quantity of carbs on your plate and increase the amount of veg by the same amount.

Also, bear in mind that by carbs they also mean sugar in all its forms. Carbohydrate breaks down in the body and converts to sugar.

Can you get an appointment with a diabetic dietitian? Take a true list of things you have eaten in as long a period as you can to the appointment.

They will be able to guide you. I was told I had to have about 140g of carb a day, roughly 40, 40 and 60g. Found my trigger was bread but not other carbs. Dietitian also told me not to go lower as I would start storing more fat .Everyone is different and what works for me may not work for others.

Thanks for your replies. Please note I am in Canada.

Please note then that net carbs and carbs differ between the UK and North América. I think 20g is net carbs. UK LC people may be eating 40-50 but they're counting before fibre is subtracted.

I thought it was the other way around? UK carbs quoted are net carbs whereas in US you can deduct the fibre. No idea what Canada does though.

Keto is below 20 net carbs. UK nhs quotes under 150g net carbs ar low carb but experts would base it on body size/a percentage of consumed calories. For me it's about 70-80g I think.

Unfortunately there's no single definition of 'low carb' - there is for a ketogenic diet, in that you should be at 20g or less of carbs per day (although I have seen some keto sites suggest up to 50g is OK)

The reason for this is that everyone tolerates carbohydrate differently. Some people can get away with a higher daily intake than others - which means, I'm afraid, that it's just down to trial and error for you.

I'd suggest that you start by cutting out the obvious 'culprits' - bread, rice, pasta, potatoes, flour and sugar. Make sure your diet is high in fat. It probably won't be currently, as we've been indoctrinated over the last 40 or so years to think that fat is the baddie.

Keep your protein levels up and make sure your plate is full of vegetables and salad. Keep fruit to a minimum, as this is also sugar. (Especially bananas)

Buy yourself a low carb or keto cook book (there are loads of them these days) and find meals that you enjoy cooking and eating.

The A1C is the important one. Eg if it is your birthday and you have some cake and take a glucose test it will be higher, but the A1C tests how much glucose is attached to your red blood cells so a slice of cake in the scheme of things that slice of cake won't matter.

You are right, everyone and his dog has an opinion. But we are all individual. As I said a banana caused a spike for me which was a surprise.

The one thing they all agree on though is that you need to keep your blood sugar level and between certain numbers (I know the US uses different numbers, not sure what Canada uses) in the UK it is 4-7 pre meals.

I have arthritis so I don't exercise, which means I always forget to mention it.

At the end of the day if you can get your blood glucose under control for you that is what matters.

Thanks for all your comments. I have managed to get printouts of 13 years (!) of blood tests, all the way back to 2011. I think the receptionist at the GP got tired of me whining.

A1C was 6.1 mostly, all the way to 2020, then it jumped to 6.8, and recently (Sept 2023) is 6.9. So, I was pre-diabetic for 10 years, and have been diabetic since 2020. It's nice to know. I guess.

I went for a A1C test yesterday, and I'm supposed to have another next week, so I hope to get recent numbers. I have an appointment with a diabetes specialist in... April, I think.

In the short run, I am trying to reduce carbs and sugar. I have lost 8 lbs since Dec 1st, when I went to a diabetes info session run by the local health authority. I will have a meeting with a diabetic dietician in February. I am not much overweight, but I would mind moving some inches from my waistline up to my chest.

In the response to the person who suggested I learn how to cook... this is a problem. I have been banned from the kitchen for over 40 years. My wife is totally baffled by the idea that a main meal does not have to include potatoes, rice, or pasta, and also professes not to understand why I am turning down desserts.

Love and marriage. In sickness and in health. All that good stuff.

Can your wife come to the diabetes dietician with you? If possible, try to find one who does low carb diets for diabetics. Not all do.

Saying you're banned from the kitchen is nonsense.

If you've been pre-diabetic for so long, such that you have records of your tests, then you need to make it clear to your wife what you can/can't eat - but you need to get yourself into the kitchen if she won't/can't understand.

To blame it on her is ridiculous.

Why are you having two HbA1c tests in two weeks ? These tests show your average blood sugar level over the last three months , so no point in having two so close together .

I've been type 2 for 25 odd years . Was on a low sugar diet for ten years and then it was discovered that carbs in pasta , potato, bread and rice also raise blood sugar so I cut them out too as much as I could .

However , recent tests have shown that a cooked but cooled potato/pasta etc . will have made some of the carbs change to resistant starch so the blood sugar isn't raised so much .

I was sceptical as carbs always made my blood sugar shoot up . However , I bought a cold pasta and pesto pack and my blood sugar wasn't raised by nearly as much as usual , likewise potatoes .

Remember though , that we are all individuals and what affects someone a lot will not necessarily affect others to the same degree . I take my blood sugar every morning, have done for 25 years !!

Yes you see for me, i would have to be very strict with making sure the carbs definantly get reduced, if i am eating high fat items. As I have a tendency when trying to diet/lose weight etc, to eat what i should be having, then go and binge on all of what I have been trying to reduce/cut out.
With the then added high calories of high fat foods, i would pile on even more.

That's interesting, re: the 150g NHS guidance. I have never heard that, nor have they ever mentioned it in all the different consultations I've had over the years.
Even after being diagnosed with PCOS. The dietitian gave me print outs lol, as they do, it did however tell me something when it said no more than two fruits a day.
It talked about looking at a low GI way of eating. Then I learnt on here the other day there are two different things. GI and GL, never knew that either!

The 150g or less a day of carbs makes sense, especially when under a typical 2000 cal diet, they say 250g, which always seemed a lot to me, but I know with my life long eating, and worse at some times than others, I have gone way over that.

I am not a big cook. I don't make dishes, but I just think for my DC I have to include carbs at dinner, so I can do a separate portion of something for DC.

Also agree with another post, about it's a big change when it's what you have grown up with.
I was eating coco pops for breakfast, or tons of biscuits with tea as a child. I get it now as a parent myself life gets stressful, some of us have additional circumstances to deal with, and busy morning rush, other kids to take care of/get to day care, school and parent off to work.
But it makes me so angry that I was allowed to eat like that.
My DM says she did say that it wouldn't be her choice, and not good, but that's what I wanted. But I was a child 🤷🏻‍♀️

I like to think that I am a bit better in that aspect, that my DC has 50/50 or Wholemeal toast with real butter for breakfast. Or porridge. Or sometimes some other cereals.
Summer we've done more things like plain butter croissant with cheese fruit etc.

When I had Gestational diabetes the most helpful thing for me was to keep a food diary and use that to identify what had resulted in higher blood glucose readings.

My triggers were:

• low fat yoghurts (they may be low fat but they're high sugar)
• white bread, pasta and potatoes

I could tolerate oats, rice but in smaller quantities and better if I made sure they were paired with a protein, so if I wanted porridge I would add peanut butter to it, seeded bread with egg or bacon.

It was quite simple to switch out sides once I decided to do it, I just started using veg grown above ground instead. So if the family had spaghetti bolognaise I switched the spaghetti for green beans, if I was making chicken and potatoes then I'd put some tenderstem broccoli or cauliflower in to roast with the chicken, really nice with some garlic, olive oil and salt. Cauliflower cheese as a side or try mushrooms/pepper with a meat based stuffing.

Sweet potatoes are generally better than white potatoes and are generally cooked the same so you could give those a try.

Sweet potatoes are still high in carbs though - they're around 5g less per 100g than ordinary potatoes, but still around 18g per 100g, which is quite a lot.

Also, sweet potatoes are horrible.

If you're having potatoes, new potatoes tend to be better than the floury types.

I found it easiest to cut out pasta, rice, most spuds and bread, also no cakes/biscuits/sweets, avoid snacks. I'm not puritanical about it - if I go to a friends and they have pasta, I'll have it, but then it's like once a month rather than 2 or 3 times a week.

But it helps to work out what you react most to yourself. We don't all spike at the same things.

Wow, such a lot of replies! I have numerous health problems, it's a competition to see which one finally knocks me off the twig. Not counting dentist, periodontist, optometrist, and an opthalmic surgeon, I also have a back specialist, TWO internists, a family doctor, and soon will be adding a diabetes specialist. It's getting so I need a secretary to manage my appointments.

The family doctor should be the one to manage all of this, but in fact he is the weakest of the bunch, perhaps because he has too many patients. I am lucky to have a family doctor at all: about 36,000 people in this city of 250,000 have no family doctor, and must rely on walk-in clinics for health care.

@BIWI no need to be so nasty. My wife is 82, almost 83, and VERY set in her ways. She has trouble figuring out the TV remote sometimes. She is one of these lucky (?) people who is chronically thin, and has no interest in new-fangled stuff like carbs and calories. She loves cooking, the kitchen is her domain, and she no more wants me there than I would want her rooting around in my workshop. I make the tea every day, and last week I boiled an egg, while she hovered anxiously.

I'm pretty pleased with the way my change-of-diet is going; it's only been 6 weeks since the diabetes info session. It will be interesting to see the new A1C numbers.

I wasn't being nasty. You've chosen to interpret it that way, however. You're hiding behind outdated and sexist clichés with the whole nonsense about not being allowed in the kitchen.