Hey, I have a current Australian diabetic magazine and apart from the
recipes and meal plans there are some interesting articles.

Hi bj

Possibly you weren't here when I first wrote what follows.
It clarifies my own position on this. Eventually I repeated
this as a blog entry.

I'll repeat two sections in advance to highlight them:

"To be clear, I think that both DA and the American Diabetes
Association are marvellous, worthy organisations doing
sterling work for diabetics in both countries. My only
disagreement is specifically to do with their dietary and
testing guidelines."
and:
"I am eternally grateful for the work the pioneers at
Diabetes Australia did in helping us get the NDSS and the
support system that we now have. The organisation continues
to do a great job."

Just for accuracy, note that I now take 1500mg metformin.

http://loraldiabetes.blogspot.com/2006/11/diabetes-authorities.html
What follows is a copy of a letter I wrote a couple of years
ago to the Editor of Conquest, the Diabetes Australia (DA)
quarterly magazine. Since then, nothing has changed - so
I'll repeat it as sent. Because my opinion hasn't changed
either. For accuracy, I will note that I have added 1000mg
metformin daily since writing the letter, so I can no longer
claim to "take no diabetes medications". But that doesn't
change the thrust of my argument.

To be clear, I think that both DA and the American Diabetes
Association are marvellous, worthy organisations doing
sterling work for diabetics in both countries. My only
disagreement is specifically to do with their dietary and
testing guidelines. The dietary advice and guidelines
promoted by DA is effectively a rubber-stamp of that issued
by the ADA; so the same comments apply to both.

I never received a reply.

Here is the letter:

'I am eternally grateful for the work the pioneers at
Diabetes Australia did in helping us get the NDSS and the
support system that we now have. The organisation continues
to do a great job. But I have a basic difficulty with the
logic of the dietary advice recommended by your dieticians.

I see their advice like this:
1. Dieticians advise high complex carbohydrate consumption,
apparently for heart, kidney and vascular health;
2. High complex carbohydrate consumption causes high blood
glucose levels;
3. High blood glucose levels cause diabetic complications
such as retinopathy, neuropathy, nephropathy and heart
disease;
4. DA dieticians therefore recommend balancing the high
complex carbohydrate consumption with medication or insulin
to control blood glucose levels. This advice appears to be
in line with the recommendations of overseas organisations
such as the American Diabetes Association (ADA).

Specific examples can be found on the DA web-site at
http://www.diabetesaustralia.com.au/multilingualdiabetes/healthpros/FoodNut/heal
thy.htm
or the ADA web-site at
http://www.diabetes.org/nutrition-and-recipes/nutrition/starches.jsp

My difficulty in understanding this is because no-one seems
to be investigating the alternative approaches. I don't mean
herbs and supplements, just a better diet for diabetics,
together with exercise, to enable minimal medication.

To me, the most obvious alternative is to search for a diet
for the diabetic which provides adequate nutrition for good
health but does not cause high blood glucose levels. If such
a diet is possible it would minimise the need for
medication, particularly for type 2, with side
benefits for overall health and health costs. I can attest
that it is possible; I've done it, as have many others.
However, when diabetics write to give examples, such as K
...... in the Autumn issue, they are dismissed and told that
their improvement must be because of exercise, or weight
loss, or some other factor.

The method I followed, as a type 2, was simple. I started
with a standard, sensible diet to lose weight. Then, as I
followed that diet, I tested everything I ate one hour and
two hours after I ate it. If I consistently found that
something led to high blood glucose, I changed it. Sometimes
I changed the food, sometimes the quantity, sometimes the
timing, but always the aim was to minimise "spikes".
Gradually I found I was eating significantly less
carbohydrates, a little more protein and a little more
"good" oils. And I did a little "lazy man's" exercise along
the way. I also gradually reduced the high level of initial
testing as results became predictable.

After attaining a degree of control over my blood glucose, I
now progressively review my diet to ensure there are no
missing nutritional requirements and to further improve
lipids etc. At diagnosis in 2002 my HbA1c was 8.2, now it's
5.9 and I take no diabetes medications. It's a long time
since I've seen a "spike" over 8, rarely over 7.5. The
improvements continued long after I reached my target
weight. And my heart, blood pressure, lipids, kidneys and so
on are also in good shape.

Why do your dieticians continue to promote high carbohydrate
consumption? What is it I'm missing, apart from
complications?'

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
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