Diabetic and struggling with diet shift

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Hi all,

I am struggling with transitioning to veg/vegan diet. Insulin dependent diabetic and the high carb loads have me quite concerned.

What substitutions for the OMG high carb foods like beans, grains and fruits that are not good for my diet?

The environmental justification for switching is a no-brainer but very concerned about overall potential health decline with the high-carb foods.

Cheers,

Bat Dude
 
Have you discussed this with a dietician who is familiar with veganism and diabetes? I don't know what insurance you have, but quite a few year ago, I was able to consult a local hospital's dietician for no charge (it was for about 20 minutes or less, and I had carefully recorded what I had eaten for the previous few days).

I'm not diabetic, but diabetes runs in my father's family so it's something I'm conscious of. I try to avoid eating large meals of rapidly-absorbed carbs if I'm not going to be physically active soon after.
 
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Tnx Tom,

I have learned most dieticians provide erroneous or incorrect information for tightly controlled diabetics. If they are trained to follow the ADA guidelines one will develop complications from high carb loads vs. low carb diet I was following for 15 years.

Hoping to see how others are substituting grains- beans, etc. that are very quick-acting high-carb loads that even fast-acting insulin can not deal with.
 
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I've only had good experiences with RDs.
It does depend on where you live tho. Here in California Registered Dietitians are well regulated and highly educated. But I know in some other states and countries that is not the case. Also be careful of "Nutritionists". Many people use the word interchangeably but again here in California a RD is liscenced but anybody can call themselves a Nutritionists.

That being said, it I my understanding of carbs is that what is very important is the amount of fiber associated with the food. Forgive me if you already know this but Carbs are not Evil. Not even sugar is evil. As long as there is fiber associated with the carbs, the digestion of those carbs are slowed down.

What I was taught is that you want at least a 10:1 ratio of carb to fiber.
An apple has 25 g of carbs but it also has 4 g of fiber. Even tho most of those g of carbs are just plain old sugar, the associated fiber still slows down the digestion of the sugar. As a comparison a slice of white bread has just 15 g of carbs. but less than a gram of fiber.

In many ways a plant based diet is a good diet for a diabetic. Sure it has a lot of carbs. But it also has a lot of fiber. Again, forgive me if you already know this but milk, eggs, and meat contain No fiber.

Another good tip for diabetics is to combine a high fiber food with a low fiber food. For instance if you miss white rice try eating it with black beans. Although black beans have a lot of carbs - they also have a lot of fiber. People who ate black beans over rice actually have their blood sugar levels go down

When buying processed food look for Whole Grains. but be careful. Many products that claim to be whole grains are not. Even the ingredients list can be misleading. A product can list whole grains as the first ingredient and only be 51% whole grains. The rest can be something worse.

Looking at the nutrition label and checking out the carb:fiber ratio is a good bet.
Also here in the US we have the Whole Grain Stamp. It takes a lot of the math out of figuring out if a food is healthy.

Diabetics also need to be concerned with timing. Even if the food is exceeding healthy you should not eat too much all at once. I think there is a 15/15 rule for diabetics. No more than 15 g of carbs every 15 minutes. So if you are going to have that apple - split it in half or even quarters and consume it over a half hour or hour.

The last thing I think is important to mention is that there is a lot evidence that diabetics should be concerned with the amount of fat they consume. I think its very important to keep the percentage of fat in your diet down.

FYI






 
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Tnx all,

I am aware of the varied claims of fiber "off-setting" glucose. That to me is kinda like a person ordering a diet beverage with a huge order of fries thinking the diet soda will make a difference ;-)

I will clarify a bit more where I am coming from; a very tightly controlled diet without any complications, eyes, kidneys etc.

I was on a low-carb diet and the "Fat" hypothesis does not hold up. Fats were free [i.e. No hypothetical insulin resistance as touted by some] on the previous diet and NO increase in blood glucose levels after meals with very little insulin needed. Morning carbs were limited to 6 g and the other 2 meals 12 g of carb each. Worked super. HBA1c was down in the non-diabetic normal range 4.6%-4.7% and daily target glucose has been 84-88 mg/dL. Insulin needed was only 2-3 u of fast-acting for meal coverage and the 7 u on arising of long-acting. Now with my transition to veg and morphing to vegan (at least 2 meals per day), my insulin needs are now nearly 5+ u of fast-acting needed to prevent these spikes of 120 mg/dL.

When I went on the diabetic low-carb diet some 15 years back I lost some 40 lbs in 3 months and within 6 months all complications went away.
Lots of veggies were on the diet just not fruits grains, beans, etc which are very carb-rich.

Now, my A1c is in the OMG high territory of 5.7%!!! An average of 117 mg/dL for the previous 90 days. Yikes, and I have also gained about 10 lbs from the excess carbs. I really really want to work out how to modify a veg/vegan diet so I can survive.

ANY bg levels above 120 mg/dL contribute to microcapillary and nerve damage and 117 is getting too close for me. Even for a short time for an hour after eating, say an apple or other rapid-acting carb.

I have a continuous glucose monitor and one mouthful of rice or beans (or other fast-acting high carb-load foods) will very very rapidly raise my BG levels and "fiber" seems not to influence it at all. While it may slow down digestion and break down to glucose it still does happen and is not acceptable for my goal of tight control.

Unfortunately Gregor "cherry picks" bits and pieces (some out of context) from published papers, at least for those related to diabetes I have read. When you read the entire paper it often is not stating what he was claiming in his nifty bullet points. A few he cited show a reduction in A1c but a reduction from the mid-9s to low 8s is NOT significant if one is trying to avoid diabetic complications. Sorta like saying the fire department is happy as the fire on the garage side of the house has been extinguished. Success??? And ignoring and not worried about the rest of the house that is still smoldering.

Not trying to rock the boat just trying to see how to make this work for me and see if any other insulin-dependent diabetics have managed to adapt to a vegan-veg diet and maintain healthy non-diabetic glucose levels.

Tnx again all for your thoughtful replies.

Bat Dude
 
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welcome to the forum Bat Dude

It is not clear from your posts if you are a Type I or Type II diabetic.

If you are Type I my comments will not apply although some of them may be a bit relevant.

IMO and in the experience of doctors like Dr McDougall and Dr Neal Barnard / Physicians Committee - it is fat that is the most important component of your diet if you are Type II. Dr McDougall has endless stories on his website of people that have been able to transition away from having to take insulin and Dr Barnard has tons of information on their website on this topic. Diabetes

If you choose not to believe that fat influences the effectiveness of your insulin, so be it, I personally choose to believe the information that they present.

From the webpage I linked "Studies show that eating a diet high in fatty foods can cause fat particles to build up inside our cells. These fat particles interfere with insulin’s ability to move sugar out from our bloodstream and into our cells. Instead of powering our cells, the glucose remains in our bloodstream, eventually leading to diabetes. A plant-based diet is low in fat, which allows insulin to function properly."

Here is the link to Dr McDougall's webpage on diabetes and he does mention there that it can be helpful also for Type I.

I wish you all the best with your health.

Emma JC
Find your vegan soulmate or just a friend. www.spiritualmatchmaking.com
 
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1. A vegan diet doesn't have to be high-carb. Nuts and seeds can be the primary sources of protein and calories.

2. Because you are managing a potentially life-threatening illness, you absolutely do need to plan your diet with the help of a Registered Dietitian.
 
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Tnx Emma,

Sorry I was not more clear. Insulin-dependent = T1.

With fats included in my former low-carb diet. Empirical evidence showed there was NO increased insulin resistance as purported by Dr. Barnard.
I needed very little insulin to maintain my tight glucose levels for meal coverage as opposed to now with the higher carb loads of the veg/vegan approach. Insulin use has more than doubled in order to attempt to prevent spikes.

For those of us with NO Phase 1 insulin response (that non-diabetics have) our physiology can not deal with the rapid spikes from higher carb foods. Even the most rapid acting insulin can not compensate.

Low carb also does not imply "high protein" as is often suggested. Even proteins will break down to carbs via gluconeogenesis, it is simply not very rapid but still needs to be calculated into diet management.

Soy is out as the phytoestrogens as well as the impact on thyroid hormones are unacceptable.

I did sign up on Dr. Cyrus Khambatta and Robby Barbaro's site a few years back but even when I offered to pay for a live consultation neither chose to address how they were suggesting dealing with the glucose spikes from higher carb loads and achieving tight control

I did also have several meetings with an RD who was a T1 herself. Disappointedly her response was just "Accept" higher glucose levels, and going plant-based would in the end balance out for longevity. Seems not supported by studies.

Unfortunately continued excursions into higher blood glucose levels will increase risks of eye, kidney, and cardiovascular issues.
Oddly "Long Covid" is also the result of micro clotting and distrubance of capillary beds in the lungs, brain etc.

I am as a research science guy who reads the medical literature likely to be considerably more strict or has been tightly controlled to avoid complications than most. It is clear even transient spikes in glucose are cumulative to cellular damage.

This transition has been a tough struggle as I would really like to have this diet approach work for me.
Hoping the experience of others who are diabetic and have successfully transitioned may be able to offer some suggestions.
 
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I did also have several meetings with an RD who was a T1 herself. Disappointedly her response was just "Accept" higher glucose levels, and going plant-based would in the end balance out for longevity. Seems not supported by studies.
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If a previous Registered Dietitian didn't provide acceptable service, then the recommendation is to consult with another one.

In the United States, you can find local RD's through the website of the Academy of Nutrition and Dietetics: Find a Nutrition Expert . Their website allows you to select RD's according to their areas of expertise (such as vegetarian nutrition, kidney care, and diabetes).
 
Hi David3,

Tnx for the reply.

As noted above to Ms. Emma...re: RD ... Been there and done that and not much help. Most follow ADA guidelines which are not sound for tight glucose control. Also as an aside, I have been a diabetes educator and was a moderator at a diabetes forum for > 5 years, and lead a live diabetes support group in my community. But at the time was focused on a low-carb diet which included some meats and certainly dairy. Now Vegan breakfast (well actually been doing green smoothies for nearly 10 years) and our main meal at lunch. Generally in the evening (a light meal like "lunch") a tin of fish and a bit of cream cheese with fresh cut up veg and homemade hummus.

I do use mixed nuts as a snack. Try to avoid many peanuts which are legumes.

Cheers all,

Bat Dude
 
It depends on your particular interest. If you would like to follow a low-carb vegan diet, then try speaking with an RD who specializes in vegetarian nutrition and diabetes treatment. Make it clear that you wish to follow a low-carb diet. There should be no objection from them, as low-carb diets have been shown to improve diabetes markers, at least in the short term.

The peer-reviewed literature contains ample evidence that properly-planned vegetarian diets can be effective for preventing and managing type 2 diabetes (which is, by far, the most common type of diabetes in the United States).
 
Per the 2019 Consensus Report on the management of type 1 diabetes in adults, co-authored by the American Diabetes Association and the European Association for the Study of Diabetes, Section 9:

"There is no one eating pattern recommended for people with type 1 diabetes. The nutrition approach should be individualised based on personal preferences, socioeconomic status, cultural backgrounds and comorbidities. Carbohydrate counting is the most common meal planning approach in type 1 diabetes. In conjunction with promoting healthy eating patterns, carbohydrate counting and insulin:carbohydrate ratios can be a useful method for adjusting mealtime insulin dosing for optimal glycaemic outcomes [132, 133]. While low-carbohydrate and very-low-carbohydrate eating patterns have become increasingly popular and reduce HbA1c levels in the short term, it is important to incorporate these in conjunction with healthy eating guidelines. Additional components of the meal, including high fat and/or high protein, may contribute to delayed hyperglycaemia and the need for insulin dose adjustments. Since this is highly variable between individuals, postprandial glucose measurements for up to 3 h or more may be needed to determine initial dose adjustments [134]."

Link: The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) - Diabetologia
 
Hi David,

Not saying legumes are unhealthy for non-diabetics. I noted that I need to avoid peanuts over tree nuts as they generally increase BG levels. Although cashews are very high carb. A few are OK but try to eat just 5 or 6 LOL

For insulin-dependent people like me, too many carbs and does causes spikes. I have been very well managed and tightly controlled for nearly 20 years and understand details such as 1 g of carb will raise MY blood sugar by 5 mg/dL and 1 unit of my fast-acting insulin will drop me 40 mg/dL. So tightly titrated and controlled. Just trying to determine how others have tweaked their vegan diets.

Low carb diets were the ONLY way T1s survived at all prior to the development of insulin so it is not a new trend ;-)

Yes slowly the ADA is accepting low-carb diets like those prescribed by Dr. Berstein one of the pioneers in treating diabetes. The ADA target levels of A1C are still far too high

Perhaps not many diabetics on this site, was just hoping.

Tnx again for taking the time to reply. I will search for another veg/vegan forum to see what I can find.

Cheers all,

Bat Dude
 
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I can manage a high protein diet that's actually cheaper than the carnist diet.