Starchy Carbohydrates with every meal is NOT good advice

Advice on carbohydrate intake 11g CHO 11 – 42g CHO Eating well with Type 2 diabetes

Figure 1. Rollo and Cruickshank’s report on curing diabetes Reproduced with permission from Wellcome Library, London, UK. Day C, Bailey C J British Journal of Diabetes & Vascular Disease 2012;12:48-51 Copyright © by SAGE Publications Diabetic diets through history

Not because carbs are good – but because protein and fat are bad

Pause for reflection…. We treat gluten intolerance with gluten-free diet We treat lactose intolerance with lactose-free diet Diabetes is glucose intolerance - why do we treat this with high levels of glucose? “I think trying to treat diabetes with starchy carbohydrate at every meal is like trying to treat alcoholism with alcohol!”

I'm type 2, diagnosed aged 62 in Nov I had eaten a "good wholefood diet" for the previous years and was about 4 stone overweight. I had had problems healing after foot surgery and after a leg injury. Saw an NHS dietitian who said carry on as I was but think about eating more red meat. I did a XXXXXXX course in March '10. People were told at great length about the fat and sugar content of various foods and told to eat low fat, starchy substitutes (7 to 14 units every day), and "plenty of fruit and veg". Fruit specifically included bananas, grapes, and orange juice. After I found this extremely helpful forum …. I try to keep my daily carbs below 100g. I maintain an A1c around 5.4 by diet and keeping active in various ways, and so far need no medication. I have lost 3 stone in weight and hope to lose another lb.

Low Carb diet in diabetes Boden et al. Ann Intern Med 2005

Weight Insulin TrigsHDL-C DBP Low Carb diet in obesity Foster et al. N Eng J Med 2003

Twin cycle hypothesis

Which is the healthier breakfast for a person with diabetes? poached egg bran flakes and milk grilled bacon toast

Which is the healthier breakfast for a person with diabetes? poached egg bran flakes and milk grilled bacon toast 186 calories 223 calories 10g Carb 40g Carb 11g fat4g fat

Evidence-based nutrition guidelines for the prevention and management of diabetes Diabetes UK Nutrition Working Group May 2011 Type 1 diabetes There is no evidence for a recommended ideal amount of carbohydrate for maintaining long term glycaemic control in people with Type 1 diabetes. Type 2 diabetes The total amount of carbohydrate consumed is a strong predictor of glycaemic response.

Starchy Carbohydrates with every meal is NOT good advice All carbohydrates increase blood glucose levels In Type 1 diabetes  Reduce flexibility  Increase insulin requirement  Increase risk of hyper and hypoglycarmia  Increase weight In Type 2 diabetes  Increase insulin resistance  Increase weight gain  Worsen diabetes control