Okay, I'm confused. (Not uncommon, but I thought I had this one figured out)

I had my regularly scheduled meeting with my nurse at the bariatric clinic today. One of the things she commented on is that I'm not eating enough carbs... insert confused emoji here.

I'm a type 2 diabetic for five years and had gestational diabetes before then, and somewhere along the way I had been told/read/somehow absorbed the idea that I'm supposed to be eating than less than 100g of carbs (net) per day. My nurse was shocked that I was trying to keep my carbs 'that low'. She wants my carbs to be 50% of my macros. I currently am striving for less than 35%. 50%, which works out to 200g (total) carbs per day on a 1500-1600 calorie diet, just feels like way too much.

Am I completely off base? Have I been misinformed all this time? I'm not looking to go keto or Atkins right now, just keeping my carbs low enough to keep my blood sugars controlled and to lose the 10% that my surgeon requires. I don't get to see my nutritionist again until May. Any insight would be appreciated.

You’re nurse sounds off base, especially if this has allowed you to manage your diabetes.

It sounds as if the nurse at the bariatric clinic subscribes to the dogma from the American Diabetes Association...you know, the same guidelines that have partially contributed to increasing numbers of sicker diabetics over the past few decades in America.

http://www.diabetes.org/mfa-recipes/about-our-meal-plans.html

The ADA recommends a low-fat, moderate carbohydrate, low sodium diet. Per the ADA, carbs should be spread out throughout the day and be 45% of a diabetic's diet.

Of course, more progressive clinicians such as Dr. Jason Fung have put type 2 diabetes into remission by advising formerly diabetic patients to greatly curtail carb intake while increasing dietary fat.

https://idmprogram.com/treatments-that-cure-type-2-diabetes-t2d5/

You see, fat does not precipitate an insulin response within the body, while carbs do. Insulin drives fat storage. The less carbs you eat, the lower your insulin levels.

Edited March 23, 20188 yr by Introversion

Or...the nurse understand that high protein diets can further stress kidneys that may have already been damaged by diabetes. High protein diets can also be hard on the cardiovascular system long term.

There will be a lot of controversy about this topic because high protein low carb diets are very popular right now and some folks do very well on them.

But yes, my nutritionist would say the same thing to you.

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/high-protein-diets/faq-20058207

Edited March 23, 20188 yr by Creekimp13

It also depends on where those carbs are coming from too - vegetables, fruits, grains, sugars, etc.

We should also be cognizant that a low-carb diet doesn't necessarily mean the protein content is high. Many clinicians have been able to put type 2 diabetes into remission by prescribing low-carb high-fat (LCHF) diets.

For instance, the nephrologist I referenced in my previous post doesn't believe in high-protein diets because protein stimulates insulin production in addition to placing potential strain on the kidneys.

http://foodmed.net/2016/07/cure-diabetes-jason-fung-2-steps-lchf/

Whew... ok. So I think what I'm going to do is to keep on what I've been doing... for now. I had be trying (and not succeeding) to go lower than 100g net carbs, but I'll stick there and not sweat it if I go over a little now and then. I've been able to keep my blood sugars in check, and that's a priority for sure. This is going to be topic number 1 when I see my nutritionist in May. Thank you for all the input!