Wednesday, 29 July 2015

Type 2 Diabetes - dietary advice from Diabetes UK

A couple of weeks ago I received an e-newsletter "Type 2 Together" about peer support for Type 2 diabetics arranged by the charity Diabetes UK. It featured a recipe :

One slice of this contains at least 4 times the amount of glucose in my bloodstream, so I am somewhat confused as to why this would be a good recipe for Type 2 diabetics. Perhaps it's because it is low in fat. That's right, patients with an excess of carbohydrate in their bloodstream and a problem managing it are apparently supposed to be primarily concerned about fat, so at least there's only 1g per slice.

The ingredients aren't exactly inspiring - mixed fruit, wholemeal flour and fructose - or sugar, sugar and sugar for simplicity.

Around the same time Diabetes UK were running a PR campaign about the number of foot amputations occurring in the UK diabetic population. As I understand it the foot amputations result from diabetic neuropathy, which is caused by elevated blood glucose, which in turn is caused by digesting carbohydrates.

If we're worried about foot amputations, why not suggest eating less carbohydrate !

The hand wringing about fat arises from increased heart disease in diabetics. I would imagine this is entirely due to the effects of elevated blood sugar on the cardiovascular system, so once again carbohydrate restriction would appear to have some merit.

I used the UKPDS risk calculator to estimate the effect of HbA1c on my personal heart disease risk over 10 years. With all other variables constant the risk rises with HbA1c :-

HbA1c %        10 year risk %
4                              4.7
5                              5.5
6                              6.5
7                              7.6
8                              9.0

So reducing HbA1c from 8 to 4 brings a corresponding halving of the heart disease risk. Once again, does this not suggest less blood glucose is good for the heart ? Especially when low carb diets also improve the CVD risk profile by increasing HDL cholesterol and reducing triglycerides.

Whichever way I look at it the Diabetes UK cake recipe and their dietary advice in general is a recipe for heart disease and amputations.

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