Counting Carbs

Dietician working on diet plan for weight loss and right nutrition concept. Source: BS

Canada urgently needs a diabetes strategy – just not necessarily the one that Diabetes Canada would have us believe is the right path

The following information is from Diabetes Canada – Basic carbohydrate counting for diabetes management. The charts and recommendations are EXACTLY as outlined in their PDF file available from the Diabetes Canada website

Following the information provided by Diabetes Canada, I will discuss briefly my own take on what this actually means, in the context of intermittent fasting and the low carb lifestyles recommended by Dr. Fung in his Diabetes Code.

STEP 1 Make healthy food choices

  • Enjoy a variety of vegetables, fruits, whole grains, low fat milk products, and meat and alternatives at your meals. A variety of foods will help to keep you healthy.
  • Use added fats in small amounts. This helps to control your weight and blood cholesterol.
  • Choose portion sizes to help you to reach or maintain a healthy weight.

STEP 2 Focus on carbohydrate

  • Your body breaks down carbohydrate into sugar (glucose). This raises your blood sugar levels.
  • Carbohydrate is found in many foods including grains and starches, fruits, some vegetables, legumes, milk and milk alternatives, sugary foods and many prepared foods.
  • Meat and alternatives, most vegetables and fats contain little carbohydrate. Moderate servings will not have a big effect on blood sugar levels.

STEP 3 Set carbohydrate goals

  • Your dietitian will help you set a goal for grams of carbohydrate at each meal and snack. This may be the same from day to day or may be flexible, depending on your needs.
  • Aim to meet your target within 5 grams per meal or snack.

STEP 4 Determine carbohydrate content

  • Write down what you eat and drink throughout the day.
  • Be sure to note the portion sizes. You may need to use measuring cups and food scales to be accurate.
  • Record the grams of carbohydrate in these foods and drinks.
  • For carbohydrate content of foods, check the Beyond the Basics resources, food packages, food composition books, restaurant fact sheets and websites.

STEP 5 Monitor effect on blood sugar level

  • Work with your health-care team to correct blood sugar levels that are too high or too low.

My take on the information provided above by Diabetes Canada is that it is great information, as far as it goes… Which means that I think that there’s a lot more to it than meets the eye.

Trust is a dangerous game.
—via Quotes ‘nd Notes

VARIATION 1 Make healthy food choices – just not the ones implied

Enjoy a variety of vegetables, fruits, whole grains, low fat milk products, and meat and alternatives at your meals. A variety of foods will help to keep you healthy.

Diabetes Canada

This is only one point of view, and one that isn’t necessarily all that helpful, especially since built into the advice are prejudices about the virtues of vegetables, fruits, whole grains and low fat. From my reading in the recent past I am now vitally convinced that the international obsession with starch and sugar based foods (ie: vegetables, fruit, and whole grains) is the fundamental CAUSE of the current epidemic of diabetes. Included in this obsession is the unproven argument against fat and meat.

Recent articles and books on the subject suggest strongly that the prejudice against fat has directly led the world’s health practitioners and public health authorities to make recommendations that have strongly affected whole populations into wrong minded and dangerous eating habits.

So the first point is almost right. Just totally wrong about low fat, oh, and about having a healthy mixture of vegetables, fruits and whole grains. Generally one considers that the first items listed in a list of recommended items should be the items encouraged and supported as the primary source of dietary energy. And this would be WRONG! Sugars and starches should never constitute more than about 10%, maybe 15% of your daily calories. The rest should be made up of proteins and fats, as your primary source of dietary energy for life.

And portion sizes are really important – mostly to keep the amount of starches and sugars to the lowest possible levels, to allow the body to use fat as a primary sources of energy, leaving dietary sugar and starches to supplementary roles.

VARIATION 2 – Don’t trust traditional dieticians or doctors to give you good dietary or lifestyle advice.

Don’t trust you dietician to set goals for you, especially regarding carbs, sugars, fats and protein. Most dieticians today have been trained in a world where fat and protein (especially from red meat) have demonized and starches and sugars elevated to saintly status. Most cook books, dietician training materials, and schools are teaching the same poisoned information that has led us into the diabetic disaster that is underscoring modern lifestyles.

If you want to continue to fight with obesity and diabetes, then follow the Canada or US National Health Strategies, because doing so with take you down the same path as millions of us who are now suffering from severe diabetes, and other side effects of this advice and governmentally supported policy.

On the other hand, if you want to get off the Merry Go Round, and start to live a healthy, happy life, start to adopt what is considered to be a radically reduced diet of sugars and starches. Take your primary sustenance from meat, butter, eggs and fat, or even from vegetables rich in fat. Sugars and starches should be considered as purely luxury items, to be consumed sparsely, and in consideration of their potential for causing harm

Fast Changes

At the end of another week of three 36 hour fasts, I’m contemplating how much my life has already changed, and how much it may still change, as I continue my fasting and attack on diabetes.

Changing your lifestyle is the first key to beating diabetes

First of all, I currently weigh about 30 pounds less than when I started on the low carb high fat program. Fasting started about two weeks later, after I took the time to consult with my endocrinologist about how to manage my blood sugars during my fasting. We had already switched to two different types of insulin, long acting and fast acting, and I’m using the new meter that tests all day long, so he felt that the risk of a dangerous low could be managed.

Secondly, I now know that fasting isn’t really all that hard, for me. I suspect that motivation is a huge part of this, but fasting seems pretty straightforward to me now. Take care of my insulin and blood glucose levels, otherwise just don’t eat. Anything. Instead of it being hard, it’s been pretty easy, and the results so far are gratifying.

Weighing myself every day has become a lifetime habit. Getting my weight to a better levels is one of the keys to improving my diabetes, blood pressure, arthritis, and many other inflammatory problems and diseases.

I made the change to my lifestyle on July 10, and began fasting near the end of the month. It’s now the end of the first week of September so I’m approach two months into the program. My insulin levels are lower than ever as are my glucose readings. I take half of the prescribed dose of long acting insulin these days, and no fast acting insulin at all on my fasting days, and about three quarters of the previous prescibed dose on my non fasting days.

The biggest concern is keeping my blood sugars high enough not to end up in a coma from hypoglycemia from having too much insulin in my system and lowering my blood sugar too much. In more than 20 years of trying to manage my diabetes low blood sugar was never ever a remote possibility, even after being on insulin, as my blood sugars were always higher than desireable.

I recently made two new holes in my belt to keep my pants from falling down, after moving from the last belt hole at the other extreme. I didn’t measure my waist when I started because I was too embarrassed to admit how big I had become. Now I wish that I had because I’m shrinking fast.

When I started this fast, I told myself that I would stay the course for three months, and then re-evaluate where I’m at then, from a health perspective as well as general feeling perspective. I also said that I would be happy if I were to get my weight under 200 lbs or 90 KG by the end of the 90 days of fasting. Today I weigh 217 lbs, down from 244 lbs on July 10th. I believe that I will achieve both goals, at which time I will commit to the next phase of this program.

I wish I could say that there have been no negative effects of fasting. It’s a little early to make that statement. What I can say is that there haven’t been any, so far.

Ending Diabetes

A couple of months ago I started to seriously revisit all the prescriptions and medications I am taking, by examining all the fact sheets on each prescription drug, particularly as to their side effects. Oh MY! did I open a can of worms when I did that! I would never have guessed that my doctors are quite supportive of my challenge to my existing regimen of treatment.

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My family doctor suggested I get my pharmacist to do a careful analysis of all of them, and make some recommendations as to how I might reduce the sheer number of drugs I’ve been taking, as well as to eliminate those which might be exacerbating some of my side effects. My pharmacist suggested that I could end up getting rid of virtually all my diabetes and related medications by the time we complete this review.

So, far from being discouraged after my initial review, I felt quite enthusiastic about challenging the status quo, and moving towards more control of my health, most particularly my diabetes.

A few weeks ago I wrote about changing how my insulin is administered as well as how it is monitored every day. My endocrinologist prescribed me new forms of insulin, one long acting and one fast acting. I also finally got the new patch, which allows me to monitor my glucose levels on an ongoing basis. Despite a bit of struggling with learning how to use the insulin, without plunging myself into a diabetic coma, it soon became clear to me that I was gaining a huge amount of control of my sugar levels, merely by having an effective biofeedback loop, combined with insulin which could be provided only when needed, and only the amounts needed at the time to control the blood sugar.

Wow! Was I surprised.

Suddenly, in a matter of only two or three weeks I discovered that I could bring my blood sugars down a lot, and not just my fasting sugars, but all of my blood sugars. I discovered that what I put in my body, other than the drugs, has a huge impact of my blood sugars.

Coincidentally, at about the same time, my son Donald, gave me a book, The Diabetes Code, by Jason Fung, MD. This book, which I have reviewed earlier in my blogs, was also a revelation. For the very first time I read about a treatment program which proposes that diabetes is NOT a lifetime sentence to a progressive and destructive disease. Instead, it is a preventable and treatable consequence of lifestyle choices within an individual’s personal control.

And even for someone with long term diabetes, after years of treatment and drugs, with many negative physical problems directly caused by diabetes, diabetes can still be beaten.

Step One. Understand that almost everything we think we know about a healthy diet is simply wrong, and out of date. In a sense, the modern type 2 diabetes epidemic is a creation of modern science in a willing collusion with food manufactures and dieticians. Prior to the last forty years Type 2 diabetes was a relatively rare disorder. In the past forty years, however, it has exploded to becoming one of the number one causes of serious illness and death. Nobody is saying that it is being done on purpose by someone, however, even if someone deliberately set out to destroy public health, all around the world, they couldn’t have done a better job of ruining millions of lives and destroying the health and well being of almost the entire population.

Step Two. Reexamine what Type 2 Diabetes actually is, rather than what health professionals have been saying for the past forty years. Type 2 Diabetes is basically the body overdosing on carbohydrates and sugars, over producing insulin in a vain attempt to force the body to use the excessive amounts of sugars being forced into the system, and systematically creating Insulin Resistance, by trying to get insulin to do a job it is not designed to do – which is to take the constant overdosing on carbohydrates and sugars, and force the cells of the body to use ever more and more of the sugars. Doing this eventually destroys the liver, and packs the liver with excessive stored energy in the form of fat. The fatter the liver, the less effective it becomes at managing the body’s blood sugar levels. Stuff too much sugar and carbohydrates into a body and eventually the body becomes diabetic and obese. Dr. Fung calls the disease Diabesity, combining the words Diabetes and Obesity into one word that describes the condition responsible for the modern malaise that is destroying so many.

Step Three. It is curable, or at least treatable. Not with complicated and expensive prescriptions but with the simplest of instructions, albeit difficult to follow for many. At the simplest level, stop eating that which is killing you. At least stop eating a potentially fatal dose of it every day of your life. It will require a major change in dietary habits, starting with today, and continuing for the rest of your life.

Step Four. Reset the diabetic system of your body. Although simply reducing carbs and sugars radically will bring your sugars (and your weight) down if followed with a certain amount of discipline, what it won’t do, according to Dr. Fung, and his research, is undo the damage done to your body from overeating and overusing carbohydrates and sugar for many years prior to diabetes being diagnosed.

What’s happened, most importantly, is that the body has over-stuffed the critical inner organs, the liver most critically, with fat converted from all the excess sugar and carbs eaten for a lifetime. The fat in the liver is hard to get rid of, even by extremely consistent reduction of carbs and sugars. And it is this fat in the liver that makes you insulin resistant. So getting rid of it as possible is essential for a long term “cure” of diabetes. Dr. Fung believes that intermittent fasting may be the only way, or at least the most likely way, to force the body to eliminate the fat in the internal organs that is most directly responsible for insulin resistance.

Woman Power Walking — Image by � MM Productions/Corbis

So, to make a long blog just a little bit shorter, I’ll get to the point. Fasting is a way to radically improve my health, by busting the elevated fat out of my “fatty liver”. So starting today, with my first 30 hour fast, I am undertaking a systematic program of combining a low carbohydrate and sugar diet with 36 hours of fasting, three days a week.

I’m planning, initially, to pursue this program for three months, in consultation with my endocrinologist and careful planning of my insulin and drug therapies. I’m to monitor my blood sugars all day long with my new meter, and adjust my insulin, up and down as needed to maintain my blood sugar in the healthy target zone of 5.8 mMl t0 7.8 mMl over the twenty-four hour day.

One last point. Do radically reduce carbs in your diet, whether you’re a diabetic or not, because if you are eating too much sugar and carbohydrates, you are now or soon still be a diabetic.

DON’T do this fast without medical consultation and supervision if you are a diabetic on insulin. I have had six dangerously low blood sugar events in the past three weeks, after never having had one in more than twenty years of diabetes. Because I monitor my blood sugars with the Freestyle patch and meter, on a regular basis, I know quickly if my blood sugars are going too low, and have taken corrective steps immediately, which means eating or drinking a high sugar content food, so immediately raise the blood sugars out of the danger zone.

While I am fasting the doctor and I have developed a strategy for administration of my insulin, to ensure that I don’t have any of these extremely low blood sugar events. So please don’t try this without medical advice and support.

So if you’re following me, and want to know how it goes, add follow and I’ll let you know.

How to improve your health when your blood sugars are out of control.

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  • Healthy people are proactive about our health
  • Healthy people seek out more information
  • Healthy people consult professionals before implementing significant changes in our medications or lifestyle choices
  • Healthy people are patient and persistent in overcoming health or lifestyle challenges.
  • Healthy people accept total accountability for our own health, without taking on blame for things beyond our control.

What can you do to improve your AIC when you’re feeling terrible from a variety of symptoms and conditions, many of which are either a direct result of your diabetes, or at least are indirectly impacted by persistent high blood sugars.

There are any number of things you need to deal with in order to make real change. The most important of these things is probably NOT your diabetes. At least not directly.

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I’ve been a type two diabetic for many years. Diabetes probably started with me in my twenties although my first symptoms didn’t start to show up until I was nearly forty. I’m now in my sixties and I’ve been on insulin for more than fifteen years. That means I’ve been pricking my finger at least once a day since I was fifty years old, and injecting myself with insulin ever since.

The one thing I can say about my diabetes is that it has progressed in a predictable way, gradually causing negative effects to my body. All the way along the road various doctors have given me a lot of prescription medications, as well as a lot of advice. I’ve been to diabetic clinics where nurses and dieticians have attempted to teach me how to control my blood sugars through diet and exercise.

Why Me?

When I was first diagnosed with diabetes I even received counselling, to try to make sense of Why Me? I think everyone feels victimized by negative health conditions, whether it’s COPD, Heart Disease or Cancer. The answers to Why Me? are both existential and practical.

There are two parts to the answer. First, there is the part of Why Me? over which you have no control, never did, never will have and makes no difference anyway. Whether it’s fate, God, a cruel universe, DNA or the conditions of your life (including a bad diet, smoking, poor or no exercise, etc.) leading up to becoming diabetic none of them actually matter in coming to terms with the emotional fallout of Why Me?

Truthfully, there are many things I could have done differently in the past that might have made a huge difference in my experience of diabetes now and in the future. But for whatever reasons I had, or gave myself, I did what I thought was within my capacity to change in my habits and behaviors.

You can check your blood sugars regularly with you meter tests, get your AIC blood work done in the lab and consult with your doctor as often as she thinks is useful or necessary. You may make changes in your diet and exercise program, and do your best to lose weight and keep it within certain boundaries. And if you do all these things from the beginning, your diabetes will be stable and you will reduce the consequences of this disease.

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For most of us, however, no matter how much we say we care about our health, we’re not really willing to do whatever is necessary to fundamentally change our outcomes. We do some of it, maybe ever some of it every day with serious intentions.

This is the Second Part to Why Me?

This is the part of Why Me? you can control if you choose to do so. So how do you change what you do and how you act, to have a real impact on your own health? This goes back to me saying that it’s not actually about diabetes, or even about your physical health.

It’s really about becoming conscious about who and what you want to be in your own life. We’ve all been beat-up by life along the way. Parents, friends, lovers, partners and even strangers have both positive and negative impacts on our self esteem. Why is that? Why do we let anyone else impact how we feel about ourselves, and how we make positive or negative choices about our lives, including those choices about dealing with negative health outcomes resulting from poor choices.

I hate to say this but “Who cares?” It doesn’t matter what happened in the past, or how you allowed yourself to be negatively influenced regarding healthy living. It really doesn’t matter, but only if there is some way you can turn your life around and ultimately take control of those things that you can control.

How to take control and like it.

The first thing is to understand what it is you need to do to make things better. If you don’t know what you need to do, it’s pretty hard to decide what to do. So find out. See you doctors. Read everything you can find out about current treatment alternatives, and inquire from other people their experiences. Read blogs. Get new referrals to diabetic clinics and resources. Talk over alternatives with your specialist. Make a plan of action with on a few, specific steps, done regularly and persistently.

Don’t try to do everything all at once. Set limited goals with realistic objectives. For example: Don’t try to lose a lot of weight in a week or even a month. Lose weight in amounts that can actually be achieved. If you find it too hard to do by yourself, join a club or a weight loss program which comes with monitoring and emotional support. But don’t blame the program if your weight loss isn’t happening. Be totally honest with yourself, and reset your goals. Weight loss is fundamental to improved diabetic outcomes and lowering blood sugar.

Don’t hang around waiting for someone else to improve your health.

If it isn’t happening, then look elsewhere for support, but don’t give up on necessary change. Remember that whatever happened yesterday is no longer relevant unless it results in change today. Guilt is useless unless it is accompanies by a renewed sense of personal accountability.

When I graduated many years ago from UBC my school motto was TU UM EST. What I didn’t realize was how powerful an idea that really is.

TU UM EST!