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Low Carbohydrate, Low Insulin, Moderate Protein, Healthy Fats AS THE BASIS FOR Blood Glucose Normalisation in Diabetes. RON RAAB. In controlling blood glucose levels there is a lot of focus on insulin and tablets... but little on the effect of the food we eat.... R. Raab.
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Low Carbohydrate, Low Insulin, Moderate Protein, Healthy Fats AS THE BASIS FOR Blood Glucose Normalisation in Diabetes RON RAAB
In controlling blood glucose levels there is a lot of focus on insulin and tablets... but little on the effect of the food we eat.... R. Raab
“Nutritional management is commonly described as one of the cornerstones of diabetes care “… unfortunately, it is the cornerstone which may be least understood, most under-researched, and to which there is the poorest adherence.” -Peter Swift, Secretary-General, ISPAD, 2002
Current recommendations eg. “Carbohydrate foods … need to be the basis of the eating plan and contribute 50% of the total energy intake.” Diabetes Australia & Royal Aust College of GPs, Diabetes Management in General Practice 2009-10, p. 22 = 4 glucose tolerance tests daily = 56 spoons of sugar daily
Increased insulin needs “Both the quantity of carbohydrate and the quality of carbohydrate will affect blood glucose levels. The amount of carbohydrate has a larger effect on glycaemia than the quality.” Diabetes Australia & Royal Aust College of GPs, Diabetes Management in General Practice 2009-10, p. 22
Usual recommended regimeHigh Carb – High InsulinOne of many unpredictable results Food absorption – amount of glucose entering blood Blood glucose level 5 Time (hours) Insulin absorption – amount of glucose leaving blood R. Raab Result Large and unpredictable variation in blood glucose levels
Low Carbohydrate Diet is Better Because Smaller Quantity of CHO Less Insulin Required Much More Predictability and Much Less VariationIn Blood Glucose Levels
“LOW” CHO, LOW G.I DIET AMOUNT OF GLUCOSE ENTERING THE BLOOD TIME RESULTS: LESSACTUAL AND POTENTIAL VARIATION AND MORE PREDICTABILITY IN BLOOD GLUCOSE LEVELS BETTER OUTCOME R. Raab INSULIN ACTION (AMOUNT OF GLUCOSE LEAVING THE BLOOD)
The effect on blood glucose • of a • 20% error in estimating CHO • in a high CHO meal • compared to a • low CHO meal • is much greater.
The timing of CHO as it enters the blood as glucose is “ significantly” Variable and unpredictable R. Raab
The effect on blood glucose • of a • 20% variation in insulin action (absorption) • of a “large” insulin dose • compared to a • “low” insulin dose • is much greater.
Severity of hypos • Can be greatly reduced • Less insulin = less risk of dangerously over-estimating and hypos R. Raab
Gastroparesis • Delayed stomach emptying resulting from nerve damage • Mild discomfort to acute pain • Carbohydrate processing becomes highly unpredictable • High carb diets are very problematic
Why did the high CHO diet advice evolve as part of the treatment of diabetes? R. Raab
World Diabetes Day Diabetes Association Breakfast
Don’t Confuse the Low Carb / Low GI Diet with “Radical” or “Fad” Diets R. Raab
In developing countries insulin costs families as much as 50% of their annual income. As a result of parents being unable to afford to buy insulin, a lot of children like me die. Helping children with Type 1 diabetes can be easier than you think.
Insulin for Life saves lives with insulin that would otherwise be wasted
Further information about Low Carb and Diabetes Metabolism Society nmsociety.org Diabetes Low Carb Resources, by Ron Raab www.diabetes-low-carb.org R. Raab