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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.

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

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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 by Introversion

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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 by Creekimp13

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

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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/

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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!

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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