Low Carbohydrate, Low Insulin, Moderate Protein, Healthy Fats

1
Low Carbohydrate, Low Insulin, Moderate Protein,
Healthy Fats AS THE BASIS FOR Blood Glucose
Normalisation in Diabetes
RON RAAB
2

• In controlling blood glucose levels
• there is a lot of focus on
• insulin and tablets...
• but
• little on the effect of
• the food we eat....
• R. Raab

3
Nutritional management is commonly described as
one of the cornerstones of diabetes care
unfortunately, it is the cornerstone which may be
least understood, most under-researched, and to
which there is the poorest adherence. -Peter
Swift, Secretary-General, ISPAD, 2002
4
Current recommendations

• eg. Carbohydrate foods need to be the basis of
  the eating plan and contribute 50 of the total
  energy intake.

Diabetes Australia Royal Aust College of GPs,
Diabetes Management in General Practice
2009-10, p. 22
4 glucose tolerance tests daily 56 spoons of
sugar daily
5
Increased insulin needs
Both the quantity of carbohydrate and the
quality of carbohydrate will affect blood glucose
levels. The amount of carbohydrate has a larger
effect on glycaemia than the quality.
Diabetes Australia Royal Aust College of GPs,
Diabetes Management in General Practice 2009-10,
p. 22
6
Usual recommended regimeHigh Carb High
InsulinOne of many unpredictable results
Food absorption amount of glucose entering blood
Blood glucose level
5
Time (hours)
Insulin absorption amount of glucose leaving
blood
R. Raab
Result ? Large and unpredictable variation in
blood glucose levels
7
(No Transcript)
8
Low Carbohydrate Diet is Better Because
Smaller Quantity of CHO Less Insulin
Required Much More Predictability and Much Less
VariationIn Blood Glucose Levels
9
LOW CHO, LOW G.I DIET
AMOUNT OF GLUCOSE ENTERING THE BLOOD
TIME
RESULTS LESS ACTUAL AND POTENTIAL VARIATION AND
MORE PREDICTABILITY IN BLOOD GLUCOSE
LEVELS BETTER OUTCOME

R. Raab
INSULIN ACTION (AMOUNT OF GLUCOSE LEAVING THE
BLOOD)
10
The effect on blood glucose

• of a
• 20 error in estimating CHO
• in a high CHO meal
• compared to a
• low CHO meal
• is much greater.

11

• The timing of CHO as it enters the blood as
  glucose is
• significantly
• Variable and unpredictable
• R. Raab

12
The effect on blood glucose

• of a
• 20 variation in insulin action (absorption)
• of a large insulin dose
• compared to a
• low insulin dose
• is much greater.

13
Severity of hypos

• Can be greatly reduced
• Less insulin less risk of dangerously
  over-estimating and hypos
• R. Raab

14
Gastroparesis

• Delayed stomach emptying resulting from nerve
  damage
• Mild discomfort to acute pain
• Carbohydrate processing becomes highly
  unpredictable
• High carb diets are very problematic

15

• Why did the high CHO diet advice
• evolve as part of the
• treatment of diabetes?
• R. Raab

16
World Diabetes Day Diabetes Association
Breakfast
17
Dont Confuse the Low Carb / Low GI
Diet with Radical or Fad Diets

R. Raab
18
In developing countries insulin costs families as
much as 50 of their annual income.
As a result of parents being unable to afford to
buy insulin, a lot of children like me die.
Helping children with Type 1 diabetes can be
easier than you think.
19
Insulin for Life saves lives with insulin that
would otherwise be wasted
20
Further information about Low Carb and
Diabetes Metabolism Society nmsociety.org Diabe
tes Low Carb Resources, by Ron Raab www.diabetes-l
ow-carb.org R. Raab