Flat line, but that's not the point


Apparently there’s an old wives’ tale (or I guess a lingering old, discredited idea) that if you eat more acidic foods somehow you wind up leaching calcium from your bones – which could be the case on a low carb diet. But I think studies have disproved this link.

However, I do think there are a lot of complicating factors, especially when it comes to women, and also with people who have diabetes. For instance, a lot of women who have stealth eating disorders may start by having specific, rigid and restrictive dietary plans. And then they wind up malnourished and will develop osteoporosis. So I would imagine a dietitian who hears an unusual or restrictive eating plan might have their ears perked up about this potential. On the other hand, dietitians learn stuff that is about 30 years out of date in a lot of ways, at least from what I can tell. Every time I write an article on a new fad diet, there’s some nutritionist telling me various things that I know have been debunked. Not really sure how the curriculum is developed.

That said, I am not a low-carber and don’t think it’s necessarily healthier for everyone. I think a lot may have to do with your genetic region of origin – if you’re an Inuit or from Mongolia a low-carb diet is for sure the healthiest. If you’re originally from the Indian subcontinent, I doubt it’s the case.


Tia, what do you define as low carb?

And thank you for explaining the stealth eating disorder idea, that makes sense.


well, I would see 50 to 80 carbs a day in a person eating more than 2000 calories a day as “low carb.” My son is basically a carb-aholic but he only eats, at most, 1,400 calories a day and probably eats about 80 grams of carbs (Excluding an additional 20 to 30g of fiber if we’re lucky) a day. Practically speaking this means his meals look pretty typical… he eats things like sandwiches for lunch, pancakes for breakfast and pasta for dinner fairly regularly – he just doesn’t eat as much of all these things as other people.

So I would see eating 80 g of carbs a day as low carb especially if you’re eating many more calories than my son, and especially if that includes fiber.


This is very true—lots of people with EDs will try to justify it by claiming very restrictive diets, so people don’t question their not eating and to reinforce restriction.

Still, I’ve gotten looks of confusion and horror from the dietician my endo works with when I asked about having breakfasts with no carbs, and I clearly don’t have an eating disorder. All around her office were food boxes and such, almost all super high carb. I never went back to her (and discovered that no carb breakfasts are indeed one of the single best dietary things I can do for blood sugar control), and my endo didn’t question me on it, ha. I lump dietitians in my “usually not worth it if you already know what you’re doing pretty well/are willing to self-educate” category of midlevel providers. A key difference between midlevel (bachelors/masters degrees) vs doctoral providers across clinical domains is that midlevel ones generally have much less scientific training—they get trained to practice, but once their knowledge is outdated, they aren’t trained to think as critically and scientifically about how to update it. Some exceptional ones do anyway, but they are far from the rule.

Edited to add: I should specify that I mean for diabetes care/education. Nurses/dietitians are essential and great in other contexts, but just not great for directing outpatient care for people who are at the level of savvy and engaged that everyone here seems to be.


I guess that according to your definition we are lowish carbs. My son who is definitely eating around 2000 calories or more a day, stays around 100 carbs. We don’t do the net carb thing, so those are actual carbs, not reduced by other factors.

I find it hard to understand how that could be unhealthy. In practice it means that his meat portions are 6-8 ounces instead of the 3-4 that the rest of the family eats. It means that when he has a sandwich it has more meat and only one slice of bread. The majority of what he eats in a day is vegetables and a little fruit. Does he eat pasta, sure, small portion though. Does he eat pizza, pancakes, etc. etc. Sure, just in moderation. He has certainly limited the number of milkshakes since diagnosis. None of these things seem out of whack. Could he add more carbs, yes, although at times he seems to be very sensitive to carbs i.e. 15-20 carbs without a proper prebolus can zoom him from 90-250 most days.

I suppose we should probably do a diary and track the macro-nutrients sometime. Prior to tackling this disease I subscribed to the idea that anything in moderation is fine, and this seems to fall in the same bucket. I think there are probably a healthy range of carb diets, and of course, anything taken to an extreme is probably not good. Wish the dieticians out there had as open an attitude.


I had my first appointment at a new endo group since my previous endo passed away. One of the new patient forms they asked I sign was my consent to be seen by a Nurse Practitioner. I did not sign the form. If I wanted to see a Nurse Practitioner, I would have made my appointment with the Nurse Practitioner.


@Chris, I have read that many low carbers end up with giant spikes for 2-3 days when they switch back to a regular carb mode, then settle down again. Possibly this is what is hitting you?


I found this to be very informative:http://www.diabetes-symposium.org/index.php?menu=view&source=authors&sourceid=49&id=322.

It’s a pretty good overall review of what’s considered normal BG in healthy subjects. What I found enlightening were:

  1. Glucose excursions during daytime range from 55-160 mg/dl while night time tissue glucose is very stable.
  2. Tmax after a meal is around 45 minutes.

There are other good information in the presentation.

If one can achieve a delta of somewhere around 50 between pre and post prandial, then we would be similar to healthy subjects. For this study, they defined healthy subjects to be those with a mean age of 27.1, BMI 22.6 kg/m2. I wonder if insulin, and blood sugar results change as healthy subjects age. Metabolically, we all change as time goes by.


@Michel. I have been eating a regular carb diet 140-160g/day) for the past three days. My C/I for this period is back to about 0.6, and I have been taking almost 100 units of novolog/day. And spiking enormously after each meal.

It was fun, but now I’m back to low carb.


90-100g of carbs per day (which works for my son, and non-diabetic me), doesn’t look like what everyone else eats, but doesn’t feel too restrictive to me. Getting below 50g of carbs would be difficult.


I tend to agree that staying below 50g carbs would be difficult and restrictive. My daily carb intake average around 60.

For all of you who take Afreeza, and are Afreeza experts, if you eat a “nasty” meal like Burger and Fries or Chinese/Japanese Food, lots of carbs and oil/fat/grease, the Afreeza works quickly and is out of the system in about one hour. How do you address the delayed increase? typically, I find that 3-4 hours later, there is a BG increase for me. So I’ve addressed these situations with small multiple doses spaced 1 hour apart after the start of the meal.

On a slightly different topic: Has anyone heard of intranasal insulin? I read about it in a paper that I posted on a different thread about alzeheimer and type 3 diabetes.


I tried snorting Afrezza powder, but it didn’t do much. It might work with more (I only tried a 4 unit dose). I plan to try it again with a bigger amount of powder. But I know that is not what the article was referring to. :smile:

I do something like this on days when I am doing intravenous.

Intravenous insulin runs through completely in well under an hour, so I need to use both normal subcu and IV at the same time. Roughly a 50-50% split works well for me.

This is similar to how it might be for Afrezza. Combining it with a normal injection at a certain time.


For higher carb meals, l take 4u of Afrezza a little bit after staring the meal and then follow up with Humalog an hour after the meal. Based on past experience, if I know I’ll spike after a meal, then I’ll also take a few units of Humalog halfway through the meal and monitor things to see if I need a few more units 1-2 hours afterwards.

I rarely use the 8u Afrezza cartridges so I have been splitting them into 2u’s each. Thanks @mentat for the suggestion and great video showing how to do it!!


Bummer :frowning:

But at least we know why. This was a very interesting episode for all of us. I am really sorry that it was not the start of a major remission!

split this topic #95

12 posts were split to a new topic: Speeding insulin activaction: IM

Speeding insulin activation: IM

I want to share this with the group:

It’s Entitled: Dr. Gary Fettke - ‘Nutrition and Cancer - Time to Rethink. He’s not an endo, nor is he an oncologist, but rather a surgeon and has had to ampute diabetics’ limbs.

split this topic #101

A post was split to a new topic: NYT: Hlow to push blood sugar