Hi
I've been on Atkins for 26 weeks and I've lost 26 pounds and I feel great on it.
The snag is I had a GTT last week and I've just come back from seeing my doctor to get the results, which are that I have T2 diabetes (my glucose level two hours after the standard GTT test was 15 mmol).
He wants me to abandon Atkins and go on the diet recommended by Diabetes UK, which is just the sort of diet that didn't work for me for so many years. You know the sort of stuff: stacks of pasta, potatoes and fibre, low fat and 5 veg a day. The doctor says the high carbs are good for me because the body is slow to absorb glucose from them, but my feeling is wouldn't it be better to avoid the glucose causing carbs altogether?
This is really worrying just when I thought I had a diet for life: one that I like and one that makes me feel well, now I am having second thoughts about it. I'm even thinking, maybe the diet caused the high GTT readings.
I'd really like to hear the experiences of any T2 diabetics on Atkins. Were they on Atkins when they were diagnosed? Did they try other diets and compare the impact? How important is it to start measuring my BG levels every day?
Thanks
Paul

Hi Paul and Congrats on your success so far!

Now keep in mind I'm not a doctor and can't disperse medical advice! This has been my own experience. I was diagnosed 7 years ago with Type 2 diabetes. At the time I was a little floored by the diagnoses and everything was happening so fast. They put me on some kind of medication, I'm not even sure what kind at the moment and sent me immediately to the diabetic clinic, where of course the diet of choice was the Canadian Diabetic Association one, which like you say is chocked full of the so called "healthy" carbs, was low fat and low calorie, because of course I needed to lose weight. Well, over the years, I struggled. The medication was making me sick, the "diet" was making me gain weight and I just felt horrible all around. This so-called "healthy" eating plan was also causing my blood sugar levels to rise! That's when I decided to take things into my own hands. I started researching diabetes and found out that carbs are what makes blood sugar go up! I'm not sure what your doctor is talking about when he/she says...high carbs are good because the body is slow to absorb glucose from them. Then it made sense to me to start limiting carbs. I really didn't know anything about low carb plans at this time. I just cut out sugar, white bread, pasta, etc. The next thing I did was ask the doctor if I could go off the medication because it was making me ill all the time. Then I started researching the impact of exercise on diabetes and found I could lower my levels even more by exercising. So basically, what I have found ( for myself) is that a low carb diet will control my blood sugar. I have recently gone on Metformin as I have been doing some research into its effects on insulin resistance and have decided that it might be worth it for me to try to see if I can get some of this weight off. After all, decreases in body weight make controlling diabetes easier.

So, now, my "advice" to you would be this. Do as much research as you can! Read about diabetes in medical books. Read about the effects of diet and exercise! Read Dr. Bernstein's book! Then sit down and make a rational decision about what you'd like to do. I sometimes struggle with my decision because after all its going "against" the standard treatment. But I know it works for me and keeps my bloodsugar at much better levels. As far as measuring BS levels....it is VITAL that you do this. How will you know otherwise what effect certain foods have on your body? I'm gathering that you are from the UK and I'm not sure if the readings there are the same as in Canada, but isn't a reading of 15 quite high? Has your doctor discussed the possibility of going on some kind of medication to bring it down abit?

Ultimately Paul, we all have to do what we feel comfortable with. I know many people who are diabetic and follow the "standard" diet and just take medication to combat it. But they are doing what they feel is right for them at this point in their life. I'm lucky that I have finally found a supportive doctor who lets test results speak for themselves and doesn't spew standard drivel about diabetes!

Good luck to you and remember...BE INFORMED! It's your best weapon in the fight against this disease!

Hi Paul:
IMHO, in order to get really accurate GTT results usually it's recommended to eat greater amout of carbs few days prior to the test (200-300g), otherwise, the results may not be accurate. I'm not sure if your doctor told you this. Since you've been on Atkins for 6 months, your body switched from glucose burning mode to fat burning, and 75 g of glucose given would spike your BG really high. After being on low carb diet for a few month, our body become even more "glucose intolerant" than before this diet. any significant amount of carbs, even slow acting affects BGs dramatically, it takes sort of a buffer zone for your body to swtich back to glucose burning. IMHO, it may be because basal insulin level is much lower after low carbing for a while. So, just hang in there and may be get meter and test few times during the day, before and after meals to see if you really spike high. as for switching from Atkins to high carb, I'd think twice. firstly, you'll regain all weight you've lost on Atkins, and second, it won't help your diabetes (if you have one) either. I'd try to get a bit more carbs from low GI vegetables, some low GI fruit (like berries) and go easy on saturated fat and protein. and watch your protein portions and calories as well. exercise is a life saver for diabetics, so it's a MUST, at least, 1 hour a day. go easy on fat, keep your carbs from low GI/high fiber source to below 100g a day or at the level which you feel comformable to maintain your weight, and watch your protein portions. I wonder, if they tested your Hb1C for this matter.
As for my own experinece, being at too low carbs level for a long time, makes my BGs spike higher after a carby meal, so I keep my active carbs at 70 g daily, and this keeps BGs lower and steady, without spikes. Cuttning protein and fat portions combined with lots of exercise helps me with a weight loss too.
Hope this helps.
regards,
Dina

Dr. Atkins agreed with you, Dina. In his book, he recommended eating about the level of carbs you stated above for at least a few days prior to having a glucose tolerance test or the results would be skewed (inaccurate) precisely for the reasons you gave.
As for the "standard" diabetic diet, IMHO it's a good recipe to make lifelong customers for the drug companies because the longer you stay on it, the more medications you are likely going to need.
Paul...it's up to you, but you can do an experiment and compare the results. Follow the diet that your doctor is prescribing for 2 weeks. Follow it exactly; weigh and record everything you eat. Record your blood sugar results, fasting, pre and post meal (preferably right next to your recorded food intake) and bedtime, for those two weeks. Then go back to low carb and do the same thing. If those numbers don't convince your doc which works better, I don't know what else possibly could. At the very minimum, it should convince you which is going to work better to control your diabetes and you can make an informed decision from there.

Thank you, thank you, thank you Charran, Dina1957 and Lisa N!

What a fund of practical information. Obviously I need to get myself a testing kit and start keeping a record of levels/spikes at different times of day and both before and after meals. I admire your strength of mind Charran in finding your own diet and having the guts to go against the accepted dietary 'wisdom'.

Dina's advice about eating high carbs for a few days before a GTT makes sense too. My doctor never told me this so I'll ask him for another test. I don't know what Hb1C is Dina. It wasn't mentioned, but to be honest my doctor just acted vague about the whole thing. He gave me a stack of literature to take away and told me to go back in week armed with questions, at which time we could start planning treatment. I'll ask him to explain Hb1C for certain. I really don't want to take any more medication. I'm already on statins, antihypertensives, thyroxine replacement and allopurinol (the last named for gout) and I have so many side effects I don't want to add to them, so it's good news that diet and exercise might be all I need to control the condition.

Lisa's advice to make my own decision based on my own findings and measurements is probably the way I'll go in the end, but first I ought to jump through the NHS (UK National Health Service) hoops and see what is on offer in terms of advice, care and monitoring.

By the way. Is 15mmol BG, two hours after the GTT high? (I think this equates to 270 in US/Canadian terms). My doctor said 10-11 (180-198) proved I was diabetic but didn't tell me the significance of the extra units. What sort of readings do you people have?

One thing's for sure. I'm not going to abandon low-carb eating unless somebody proves to me they've got something better!

Thanks again
Paul

Paul --

Congratulations on your weight loss!

I have a reference to a journal article for you to show your doctor regarding the question of low-carb dieting giving false results on GTT's (glucose tolerance tests).

Here is a link to the extract:

http://journal.med.tohoku.ac.jp/1891/189107.html

"Impairment of Glucose Tolerance in Normal Adults Following a Lowered Carbohydrate Intake."

authors: PEY-YU WANG, TAKASHI KANEKO, YUAN WANG, MASATO TAWATA1 and AKIO SATO

Tohoku J. Exp. Med., 1999, 189 (1)

"Some normal people are falsely classified as having impaired glucose tolerance (IGT) if they are given an oral glucose tolerance test (OGTT) when their last meal contained very few carbohydrates. In this study, the duration of carbohydrate restriction was extended to one and three days and the relationship between the carbohydrate restriction and the glucose tolerance after an OGTT was examined. Two different groups of normal subjects were placed on high-carbohydrate (80% carbohydrates) and low-carbohydrate (10%) diets before an OGTT; one group for one day and the other for 3 days ....

The longer the period of carbohydrate restriction, the severer was the glucose tolerance impairment....

The impairment of glucose tolerance after carbohydrate restriction may be associated with the Randle effect, which is the activation of the glucose-free fatty acid cycle."

© 1999 Tohoku University Medical Press


I don't have other links, but I am sure I have read elsewhere that it is important to eat a "normal" (i.e. high carb) diet for 2-3 days before a GTT.

It may be that you DO have impaired GT or even diabetes, but your results really may have been skewed by the low-carb diet.

I agree with the other advice you have been given:

1) get a monitor and start testing yourself throughout the day
2) ask your doctor to order a Hemoglobin A1c test
3) get a copy of Dr. Bernstein's book and read it cover-to-cover

Regards,
Marjorie

Paul --

Here's one more link about GTT:

http://unix.csuchico.edu/~ms34/Introduction.htm

Note that they say you should have at least 250g carbohydrate per day for at least 3 days before the test.

They say that you have diabetes if 2 hours after receiving 75 grams of glucose you have a reading greater than 11.1 mmol/L (equivalent to 200 mg/dL).


Marjorie

You have already received such great advice here.

My experience .. for what it is worth... is that Atkins has helped me significantly reduce my blood sugar levels, my mood is stable, and my tiredness alleviated. I am also on metform which i find helps a lot with weight loss on low carb (but not weight loss on the diabetic diet). The diabetic diet did help my blood sugar levels, but not enough, and i found it hard to stick with, and would end up losing it and going on binges of sweets.

First of all, let me say welcome.

The usual diagnoses of Type 2 diabetes is a fasting blood sugar of above 110 or 120 mg/dl (not sure on the European measurement). I am surprised that anyone would still think it's a good idea to feed someone a big pile of sugar (like that's good for anyone) and see if their body would handle it. I doubt I would get down as low as your's did. I guess that's why I don't drink 4 sugar colas at a time huh?

So, if you have a broken carb furnance, why feed it carbs. It will burn protein, fat, and a few carbs just fine, but it won't burn carbs very well at all. It makes no sense to me to sit and assault an already broken carb furnance with 80% carbs.

To me your doctor is saying "You have a carbohydrate processing disability (T2) so we want you to eat mostly carbohydrates, but don't worry, we will hopefully shove enough medicine down your throat and insulin into your veins that this many carbohydrates won't kill you. On our method, daily insulin shots will become part of life in less than 5 years, kidney damage, eye damage and nerve damage within 20 years."

I just can't justify their methodology, no matter how many times I read it.

Good luck in whatever you choose,
wsgts

Eve...I think the point that wsgts was trying to make is that too many doctors, at least with type 2 diabetics, don't address the root cause of the problem which is impaired carbohydrate metabolism and instead advise their patients to consume a level of carbohydrate that practically guarantees that they will wind up dependent on a prescription drug to control their blood sugars for the rest of their lives as well as injected insulin at some point down the road not to mention a whole host of complications from poorly controlled blood sugars.
Many type 2 diabetics still produce sufficient insulin of their own such that if they lower their carb intake to take the stress of their already overworked pancreas, blood sugars will come down into a normal range without the aid of oral antihyperglycemic drugs or injected insulin. For those that can't control with diet alone, they will at least achieve better control and require less medication by lowering their carb intake.
While I understand that a T1 must inject insulin several times a day in order to live (and thank God we have the knowledge and technology to make that possible!), speaking for myself as a T2, I would rather avoid having to go that route if it's at all possible instead of eating in a manner that almost guarantees that will be an eventual necessity.



In the case of type 2, I agree. It makes less and less sense to me every time I read it.

Sorry Paul, I was trying to help you without pointing out the very obvious.

You must have insulin to live, as you must have blood glucose to live. Something else that is obvious is that "too much of anything is no good". This is the same reason the Type 1 (those who make no or very little insulin) must inject their insulin daily. However, I wasn't trying to cover all bases or trying to write a book on diabetes.

You know what too much blood glucose is called which is diabetes either Type I or Type II. Type I, which is what Eve has, requires you to inject insulin. Type II's usually have way too much insulin already, and can't use very well what they have, thus, adding more insulin they can't use very well is not the be course of treatment in the opinion of my doctor as well as countless others. This is why that insulin sensitizers (Glucaphage, Actos, Avandia, and others) were invented and work the best to control T2 with low probability of lows blood glucose.

Apparently, I have offended others by not proposing that you immediately add extra insulin to your regime. After all, you will die without it. Sadly, that is one ideology of treatment that some doctors use, especially with the elderly. So take that for what it worth.

Good luck to you Paul, I wish we didn't have controversy on every thread.
wsgts

Paul,
There's been alot of info here for you... I'll throw in my two cents as well. I'm a T2, non insulin dependant. I have to agree with alot of what's been said here with regards to T2's and insulin... since the day I first met with my endo, he's been presenting insulin to me as a 'when' not an 'if'. The CDA diet did nothing for me, but send me spiralling out of control and make me feel weak and gluttonous (sp?). I would be so 'good' for six months, and then my cravings would get out of control, and I'd fall off the wagon. But, no matter what I did, my A1C results were basically the same, bad.
A1C is a test that they do that measures your average blood sugar for the past three months. If your doctor isn't doing this, that's pretty scary. I agree that a GTT should be an absolute last resort, my doctor told me that they gave me the equivalent of ten chocolate bars... I asked her why they didn't just let me eat the chocolate bars! The A1C should've been done first, before a GTT. You should have all of your tests redone as soon as possible, to try and reverse your diagnosis as diabetic... if the low carbing caused the GTT to show incorrectly high results, perhaps you aren't diabetic. Seems to me you were pretty close to the threshold and there are alot of things about being diabetic that aren't desirable... first and foremost is insurance. Hard to get and the rates are through the roof. If you can get this reversed, do so immediately.
For the record, I was diagnosed in 1996, and started low carbing this past November. My previous A1C was >10, and my most recent was exactly 7 (we use mmol in Canada too, I think just the US uses the other measurement) and my endo was so happy with me. I told him I was doing Atkins and he was perfectly fine with that... if you can't get your diagnosis reversed, at least find a doctor who will support you. If you can't change your doctor, then do the research and change his mind instead! Prove him wrong!

Take care,

Jenn

I hope wstgs that you are not implying here that the only reason a T1, or myself, injects insulin is because we "have too much"...but that is certainly the way it reads.....
...again an inference that I (presumably) cause controversy..I do seem to be one of the few who does not always praise, but why is that controversial..? Foolishly, I thougth this was a forum for discussion. Who is going to learn much from a chorus of "isn't this WOL wonderful". There are issues which need to be addressed, and I'm prepared to address them.

Lisa, nowhere will you find that I have said people shouldn't eat low carb..what you will find is that I say there is a danger in T1s going no-carb, and nowhere is this addressed. The distance between 6-12-12 and 0-0-0 is so minimal that is so easy to not even notice one has gone over the threshold. Then what does a T1 do when they need to recover from a low...have bGs in the 20s/360s just because they ate 6g carbohydrate. I know I am not the only T1 with this problem, and I shall continue to caution any time I think that the line between T1 & T2 has been blurred with regard to this...!!
Has anyone even thought about how many T2s have turned away from this forum because they cannot achieve optimal numbers without some sort of medical intervention..??...burning out beta cells to the point they will surely need insulin..??..all they read here is "do it on your own"....I don't call that support, I call it intimidation.

There is a lot of great knowledge of this dx and support here, but there is no way, unless you are T1 with, generally, multiple auto-immune problems, that the advice given here is necessarily correct. To imply that the only difference is that those of us with poor control "have too much" is just too much for me to ignore.

I think most people come to this forum because it is a low carb forum and the Bernstein/diabetes section. To me, that means they want to try the low carb diet and are not interested in or have already gone the ADA route.
We are all different with various different issues to deal with but, in general, low carb does work for 99% of us.
As far as eating too few carbs - I wish I had that problem. As my new doctor said, it is almost impossible to eat too few carbs since they are in almost everything and because most all of us crave some variety in our diets. Carb creep is more generally the problem here.
Many people on this forum are able to deal with their diabetes without meds. Some of us are not (yet!). People have to do what works for them. BUT, people have to know there are alternatives to the drugs, shots, diets recommended by some uneducated doctors. And, some people are looking for information because their doctors just do like mine (my former doc, that it) and say - you have diabetes, take 2 pills a day. He said nothing about diet, nothing about testing, nothing, nothing , nothing. Unfortunately, there are way too many doctors like that and this forum and the books we recommend to newbies can be a lifesaver.
I have never seen anyone recommend no carb.