Low Carb Diet Study

diabetes diet
You don’t want to know what’s going in here…

So, you get to take all sorts of measurements and I need to answer lots of questions about what I eat? Sign me up!

Reader, I adore a study and even more so when it relates to lifestyle. I started work at Glasgow University in April and spotted a poster looking for participants in a low-carb study.

“Aha!” I said to myself. “I’m your woman! A low-carber for years, diabetic to boot and a person well-versed in the filling in of a form.”

While certain aspects of the low-carbohydrate diet have been well researched, such as weight loss, there has been little focus on testing how this way of eating affects micronutrient levels in the body. The Glasgow Uni study, Nutritional and Cardiovascular Risk Factors associated with Long-Term Adherence to Low-Carbohydrate/Gluten-Avoidance Diets, funded by the Faculty of Medicine, Prince of Songkla University, Thailand, concentrates on this.

What is the purpose of the study? Low carbohydrate diets (LCD) such as the Atkins Diet have become common dietary approaches for weight management, and aiming to avoid starchy foods such as bread, cereals, pasta, rice and potatoes which are major dietary sources of B-vitamins, magnesium, and fibre.

The researcher is investigating the contribution of starchy / sweet foods in body composition, micronutrient status and cardiovascular risk factors. To do this, they seek people who either exclude or include these foods in their diet.

I’m not one hundred percent low-carb compliant. Who is? But when I filled in the forms for the study, I realised that I follow a low-carb diet much more closely than I thought. How often do I eat potatoes, rice and pasta, the survey wanted to know—the answer, never or less than once a month for rice and pasta and about twice a month for potatoes.

I eat bread more often (LOVE bread), and ditto chocolate, but I don’t bother with most of the other high-carb foods listed in the questionnaire.

The outline of the survey had said they’d do urine testing. I assumed that meant a sample in one of those little tubes. Not so! The doctor sent me off with two large flasks (pictured) and asked me to collect all my pee over a 24-hour period.

TBH, I wasn’t sure the two flasks would be enough. We diabetics tend to wee more than ordinary folks, anyway. When you add in my daily diet coke, water and peppermint tea intake, a lot of fluid swishes around inside me.

And what goes in must come out!

The survey will be followed up in six months’ time, then another six months after that and so on until two years are up.

At the time of writing, the researchers hadn’t found that many people to take part—nine out of a necessary eighty. If you live in the Glasgow area and follow a low-carb diet (you don’t need to be diabetic and you don’t have to follow it all the time), then they’d love to hear from you—lowcarbstudy@gmail.com

The Fitbit!

I’ve joined the Fitbit world. Having dipped my toe in the water via the Jawbone Up Activity tracker, I’m now the proud owner of a Fitbit.

My Up activity tracker vanished in January when the device fell out of the wristband. It must be somewhere in the house. Maybe the system thinks I’m dead thanks to my lack of movement. Hey ho! Anyway, by that point I reckoned I knew what you needed to do to cover 10,000 steps a day, and I was quite happy to live tracker-free.

I didn’t stare at my phone so much. My health didn’t take a nosedive, and the world didn’t end.

On Valentine’s Day, however, my husband gave me a Fitbit Charge 2, the reward for staying alcohol-free so far this year. To be honest, when he hinted the other week that he’d got me a pressie for my teetotal efforts, I thought he was talking about champagne. It always makes sense to reward your giving up something with the very substance you’ve been avoiding, hmm?!

And I was grateful and touched that he’d bothered. He’d done the research, he told me happily. This tracker is the all-singing, all-dancing one! It counts your steps, how often you climb up stairs (you should climb ten flights a day for good health, apparently), checks your heart beat, auto-recognises different exercises and monitors your sleep. You can add in a food tracker and monitor your calorie intake if you want to lose weight.

For someone who tends to obsessiveness, this is good and bad news. To prevent myself repeatedly checking my phone, I downloaded the app for Fitbit onto my tablet instead.

Exercise is very good for we folks with diabetes if you are able to be active. If you have type 2, you might be able to control the condition through diet and exercise alone. If you have type 1, exercise will mean you can reduce how much insulin you need to take overall, and it can be used with diet and insulin to keep your blood sugar levels in range.

At some point, perhaps activity trackers will be prescribed for people with diabetes? In the future, the Fitbit could include blood glucose monitoring, as a story earlier this year reported that Fitbit has just invested in a company that’s developing a minimally invasive glucose tracker. Imagine having all that information available in one place.

I, for one, would love that capability, so fingers crossed.

Having Hypos in Public

There was a story in the news this week* about a BBC presenter who had to apologise to listeners after having a hypo while on air.

World Service presenter Alex Ritson has type 1 diabetes, and apparently, his introduction to an early morning news programme left him stumbling over words. He later explained what had happened, and said it was appropriate, as the programme would also be running a story on new research into diabetes published in The Lancet.

I’ve often wondered how public figures who have type 1 diabetes cope with hypos. Those of us who aren’t famous only need to worry about treating them—and sometimes that isn’t always easy—but what about if you’re in the middle of presenting a news programme, or fighting with other politicians a la Theresa May?

[Perhaps she can blame low blood sugars for the immense confusion that currently surrounds Brexit. Some people get violent when they are hypo too so she could use that as an excuse to punch Boris.]

When you have experienced hypos over the years, your body adjusts to them, and the symptoms you get are nowhere near as severe as they were the first few times. Nevertheless, confusion and brain fog still occur.

I remember sitting at meetings or trying to explain myself at work and scrabbling around for words that suddenly seemed to vanish. You get a split second where you panic—where are the words, where are the words—before realising what is going on. I reckon that’s what happened to Alex Ritson, and the panic was probably vile because he was on-air and knew millions of people were listening to him.

Alex later said on Twitter that having a hypo on air had been a recurring nightmare for years, but the Twitter community responded really well with people sympathising, and the JDRF tweeted a handy infographic that showed the signs of hypos, a useful guide for family, friends and colleagues of we type 1s.

*While researching this article, I found out that actor James Norton is a type 1, which made me happy. Nothing at all to do with the fact that he’s exceptionally good looking, #T1DLooksLikeMe…

 

 

Diabetes Diet Book – Updated & Given a Make-over

We’ve been doing a little work in the background here at the Diabetes Diet. We decided to go for a print version via CreateSpace, and we’ve updated our book and uploaded it onto Kindle.

This is the new cover. What do you think?

diabetes diet
The Diabetes Diet is now on Amazon.

The Diabetes Diet explores what people affected with type one diabetes and type two diabetes, pre-diabetes and obesity need to do to get mastery over their blood sugars, metabolism and weight.

The scientific reasoning behind the low carbohydrate dietary approach is fully referenced and made easy by menu plans and low-carb recipes. You will be introduced to information and case studies that help you decide what level of blood sugar control, carbohydrate restriction and monitoring is most appropriate for your individual needs.

This book can help those with type 1 diabetes AND type 2 diabetes. It won’t cure diabetes, but it will make living with the condition so much easier.

The print version is going though some final checks, but should be ready in a few weeks’ time and we’ll update you.

You can buy the Diabetes Diet on Amazon.com here, and Amazon.co.uk here.

World Diabetes Day

Today is World Diabetes Day – happy diabetes day to my fellow (and female) diabetics the world over. May your blood sugars be stable for today at least. No hypos or hypers are allowed…

Who knows what the next year will bring? There have been lots of exciting developments in the diabetes world over the last 12 months – from the first hybrid insulin delivery system to the NHS’s decision to offer flash glucose monitoring, to the identification of a new biochemical ‘signature’ as a potential early indicator of type 1 diabetes onset, we edge closer than ever before to understanding and properly managing this condition.

One piece of news I spotted recently that has implications for all of us (and is relatively easy to do) was research that has shown that people with type 1 diabetes who are more active have a lower risk of premature death than those who don’t exercise.

Diabetes.co.uk reported that the Helsinki study. It followed 2,639 people with type 1 diabetes, 310 of them had diabetic kidney disease. They were followed up eleven years later. During the course of the research, some 270 people diets. In the least active group, the death rate was 14.4 percent. Only 4.8 percent died in the group who performed more exercise. Activity seemed to benefit patients who had kidney disease and those who didn’t.

The lead study author, Der Heidi Tikkanen-Dolenc from the University of Helsinki and Helsinki University Hospital, said: “Doctors have always prescribed physical activity for their patients with type 1 diabetes without strong evidence. Now we can say that in patients with type 1 diabetes, physical activity not only reduces the risk of diabetic nephropathy and cardiovascular disease events but also premature mortality.”

Keeping active is a challenge in this day and age. Our governments and big business have unwittingly conspired to create a world where the default way to live is a sedentary one where cheap, nasty junk food is all-too-readily available. Being active and exercising often takes a lot of effort, unlike populations who lived years ago who were active because they had to be.

But the message that exercise can help prevent premature death IS a powerful one. Let’s celebrate World Diabetes Day with a walk!

Pic thanks to maxipixelfreepictures.com

 

Hypo or Not?

diabetes diet
A “serious and important” hypo.

When do you feel the symptoms of a hypo?

The November/December issue of Balance, Diabetes UK’s magazine, reported that researchers have proposed that we need to take a fresh look at defining low blood glucose levels.

At present, a ‘hypo’ (low blood glucose level) is 3.9mmol and below (70.2mg/dL in the US), which the researchers feel isn’t all that low.

A severe hypo is one where someone needs help from another person to recover, something that rarely happens in clinical trials. Rightly so, as letting someone go so low without help wouldn’t be ethical.

Researchers suggest that there should be three levels of hypo – low, lower and oh f*****g shit. I’m kidding, obviously, but they are looking for the level that, below this point, a person’s health is seriously affected, i.e. where their brain, blood and cardiovascular systems are compromised, the risk of death begins to rise, and the level that has an impact on mental health.

Current research suggests these begin to take effect at about 3.0mmol (54mg/dL in the US). The team’s three definitions are:

  • Level 1: 3.9mmol or less –a hypo alert
  • Level 2: less than 3.0mmol – serious and important hypo
  • Level 3: serious hypo, requiring external assistance, even if none is available.

Like all of us, hypos are individual. One person’s “I’m fine at 3.9” is another’s “oh shit”. I sometimes feel the symptoms of a hypo coming on at 4.6, say. Other times, I’ll prick my fingers, get a 3.9 and wonder where it’s come from.

As you can see from the picture, I had a “serious and important hypo” this morning, thanks to undereating and walking too enthusiastically yesterday. Oof. It happens.

Keeping your blood sugar levels stable without going too low is a huge challenge. One of the reasons we promote low-carb eating for type 1s in particular is that the risk of hypos can be reduced because you don’t need to take as much insulin.

If the researchers could include advice about how to avoid hypos, while also achieving good HbA1c results in the long-term, we will cheer them on…

 

*Some good news! The NHS has approved flash glucose monitoring technology – i.e. systems such as the FreeStyle Libre. I’m off to investigate the possibilities of getting one. Also, big love to the NHS, a wondrous, wondrous institution.

 

 

Tired, Tired, Oh So Tired…

I don’t usually use the blog as a one-person pity party, but this week I want to whinge about tiredness…

If there were one thing I could miraculously make disappear about life with diabetes, it would be the tiredness. Don’t get me wrong – with careful care of your medications, diet and exercise, you can minimise this aspect of the illness, but heck. Many’s the afternoon I spend fighting the urge that makes want to crawl under the covers.

And that makes me resentful from time to time.

Tricks for Small Children

I can live with the endless blood tests and injections. Hey, they’re not so bad. Last week, I managed to entertain my cousin’s young children with my lancet. They were wide-eyed when I let them push the button, and they saw they’d made me bleed. I’ve never yet met a small child who didn’t love this. Once they’ve figured it out, though, they’ll want to try it out on you endlessly. You have been warned.

The injections are rarely painful, and you get used to doing them discreetly in public, while no-one bats an eyelid.

The organisation needed for diabetes (have I got all my equipment, do I need to order and pick up repeat, when are my hospital appointments, is my medication matching my insulin intake, etc.) can be seen as a transferable skill. I often feel I should add it to my CV: Emma Baird, Type 1 Diabetic, Organiser Extraordinaire.

The hospital appointments give you an afternoon or morning off and, with any luck, the waiting room will be full of trashy magazines to read.

And – it’s an ego thing – but I quite like being different from the general population. We all like to think of ourselves as unique little snowflakes after all…

The Pull of the Afternoon Nap

But the tiredness. Of late, I have been tired. Tired in the mornings, tired in the afternoons. Getting up in the morning and promising myself an early night, or an extended afternoon nap. Sometimes, it’s because my blood sugar levels aren’t right, at times it’s just because.

People with diabetes need enormous amounts of willpower, as the tiredness can be all-consuming. When you’re tired, everything is an effort – from getting up in the morning, to doing work* that brings the money in, forcing yourself to go for a walk because you’ll feel better afterwards, and making the right choices about what to eat. Luxuries like meeting up with friends sometimes fall by the wayside because the effort it entails feels as if it will be too much.

Tiredness makes you prone to negativity too. Don’t ever open your social media accounts when you’re exhausted. Envy, discontent, paranoia, dissatisfaction – all will surface too readily.

So, yes. I’ll keep diabetes. I made my peace with it a long time ago, but if you can find a permanent, works-all-day way of ridding me of the bone-crushing weariness, I’ll take that, thank you very much.

 

*I don’t agree with her politics, but I admire Theresa May hugely for managing to pull off diabetes, run the country AND manage the Brexit negotiations at the same time. (Though, many might argue that she doesn’t…)

Photo thanks to Jessica Cross on flickr. Entry for Canon Photo5 2009 Brief 4: Spectacles Portraiture. Picture recreated thanks to Creative Commons Attribution 2.0 Generic.

 

Diabetes in the News

What’s new in the world of diabetes? We’ve rounded up the news for you…

The BBC reported that a pioneering therapy is safe for type 1 diabetics. The therapy retrains the immune system, and it was tested on 27 people in the UK. It showed signs of slowing the disease. Like many of these kinds of treatments, though, it only works on people who have been diagnosed recently – it’s unlikely to help those who’ve had the condition for years.

Another BBC report focused on the rise of Type 2 diabetes in children. More than 600 children and teenagers in England and Wales are being treated for the condition. A report from child health experts found 110 more cases among the under-19s in 2015-16 than two years before. Local councils have warned this is a “hugely disturbing trend” – and that urgent action to tackle childhood obesity is needed.

Bedfordshire News reported on a new approach to type 2 diabetes treatment the University of Bedfordshire and the local branch of Diabetes UK is trying out. The university is hosting weekly exercise sessions so people can take advantage of regular exercise sessions and support to help them make changes to their lifestyle. One 70-year-old told the newspaper the clinic had made a huge difference to his strength and energy levels.

How do you feel about your diabetes? Amy Mercer thought she’d come to terms with her condition a long time ago, but a chakra reading revealed pent-up anger and frustration. Amy wrote an interesting post on what she learned from the reading on Diabetes Self-Management.

Finally, it’s not a week if there isn’t at least one article purporting a ‘cure’ for diabetes… Clinical trials have begun for ViaCyte’s PEC-Direct – an implant that grows insulin-producing cells from stem cells, according to futurism.com. ViaCyte’s president, Paul Laikind, said he thought the PEC-Direct product had the potential to transform the lives of people with type 1 diabetes.

 

 

Blogging About Diabetes

Medical News Today summed up ten of the best diabetes blogs. Sadly, we weren’t one of them (there’s no justice in this world), but they did make some great suggestions that I want to check out.

Why blog about diabetes? When I was first diagnosed, there were few opportunities to meet other people with diabetes. Weirdly enough, I grew up in a tiny town (population sub 2,500), and five of us were diagnosed with type 1 in a short space of time. I did have other diabetics around me, and my mum ended up developing a close friendship with the mother of one of them.

That said, though – we didn’t have that much information at our fingertips and in those days, the GP, the consultant and the diabetic nurse were autocratic figures. No-one challenged them or the recommendations they made.

Fast forward thirty-odd years and millions of people share their experiences of living with diabetes, types 1 and 2. Obviously, we don’t all have medical qualifications, and can’t and shouldn’t offer medical advice but we can tell stories about what has worked for us.

We can share our experiences of how we exercise, what we eat, what we do to prepare for holidays – it’s all about how we live as well as we can with the ol’ sugar curse! Online friendships and communities can’t replace real-life meetings and connections, but they do go some way to making you feel less alone with your diabetes.

So, here are some of Medical News Today’s best blogs about diabetes that I’m going to be investigating…

Bitter-Sweet – Karen Graffeo was diagnosed at the age of eleven and remembers daily insulin injections, a strict exchange diet and sugar monitoring involving urine and glass test tubes. (Me too!)

She started Bitter Sweet in 2008, tagline “life with diabetes isn’t all that bad”.

The College Diabetes Network sounds useful for anyone (or the parents of anyone) about to go off to college/university. It can be scary for both prospects, and the site provides the tools and resources that can help people with diabetes live well as students. Categories include clinics, student rights, job opportunities, dining hall eating, relationships and more.

The FitBlog is run by husband and wife team, Tobias and Christel Oerum. Christel has type 1 diabetes, and the site is for people to find out more about exercising safely and efficiently when you have diabetes.

 

 

 

 

 

 

Study Finds Some Type 1s DO Produce Insulin

Free stock photo of health, medical, medicine, prickAn article in Medical New Today caught our eye this week – research recently found that people with type 1 diabetes produced some insulin.

Yeah, yeah, I thought, it’s the newbies again. But apparently not. The Uppsala University in Sweden’s researchers found that nearly half of patients who’d had the condition for more than ten years did produce insulin.

Type 1 diabetes is routinely described as a condition where the body doesn’t make insulin. The researchers found that the insulin-producing patients had higher levels of immune cells that produce a protein called interleukin-35 (IL-35). This is believed to suppress the immune system and reduce inflammation in the body.

The findings were reported by the study’s co-author, Dr Daniel Epses, in Diabetes Care.

Type 1 diabetes happens when the immune system mistakenly attacks insulin-producing cells or beta cells in the pancreas.

This was believed to lead to a complete loss of insulin production in type 1 diabetics, but studies in recent years have shown that some patients still have functioning beta cells.

Dr Epses and his colleagues wanted to work out if there are any immunological mechanisms that could explain why some type 1 diabetics still produce small amounts of insulin.

The study looked at 113 patients aged 18 and over. All of them had been living with diabetes for at least ten years.

Researchers measured the levels of C-peptide in the blood – an indicator of insulin production. They also measured circulating cytokine levels, including IL-35. Cytokines are proteins that are secreted by the immune cells and they play a major role in cell signalling.

The team found that almost half the patients were C-peptide positive – in other words, they had some level of insulin production. The results also showed that patients who were C-peptide positive had significantly higher levels of IL-35 in their blood, compared with the patients who were C-peptide negative (the ones who had lost all insulin production).

Previous research has indicated that IL-35 can suppress auto-immune disease. It is possible that in some type 1 diabetics, the protein prevents the immune system from attacking and destroying beta cells.

Dr Epses and his colleagues, who are based at the Department of Medical Cell Biology at Uppsala University, couldn’t determine if C-peptide positive patients had higher IL-35 levels at type 1 diabetes diagnosis, or whether levels of the protein increased over time because of a reduced immune system attack on insulin-producing beta cells.

More study is needed to gain an understanding of how IL-35 might relate to insulin production. The researchers believe, however, that their findings show the potential of IL-35 as a treatment for type 1 diabetes. As the findings also show that almost half of patients with type 1 diabetes produce some insulin, the team thinks it might be possible to encourage regeneration of their remaining beta cells and so boost insulin production.