An appeal for moderation

[Guest guest]

I am a long time lurker (and occasional contributor) to this list. I do read

every post and file those that have potential use for me. The recent reactions

to the article in Diabetes Self Management (and the reactions to the reactions)

concern me. A rather strong strain of distrust seems to be surfacing with

anything or anyone who suggests that Low carbing may not be the Holy Grail or

that Bernstein is not the messiah come to lead us to the promised land.

One thing that has been glaringly lacking in the discussions is any

consideration of the roles of calories and weight loss in attaining/maintaining

glucose control. Obviously, many of us are, or should be, concerned with

weight loss. Low carbing has been helpful to some in achieving this result

(although, I suspect the weight is not " lost " --I think I have found some of

it). Others have attained weight loss results by following more " traditional "

regimens. The common factor underlying most treatment is the need to get weight

off and keep it off. The only way you can lose weight is to burn more energy

that you consume. There are 3600 calories in a pound (sorry that my US

education prevents me from readily converting this to kilocalories and

kilograms). The thing that characterizes both the successful low-carb and

traditional exchange based diets is a restriction of calories. My humble

hypothesis is that the reason people have been successful in shedding weight is

that their caloric intake has been reduced. In turn, those good folk who have

succeeded in maintaining desired weights, are also keeping the caloric intake

and " burn rates " in balance. Reduction in weight to reduce the load on the

overall circulatory system seems to be one of the surest ways of reducing

insulin resistance. I suspect that the end result of weight loss, coupled with

medication and exercise, or maintaining a " healthy " weight, with or without

medication is far more important in the control of our 800 pound gorilla than

the precise type of diet that is used to get there. (I realize this is a

hopelessly old-fashioned view- but I suspect the weight of scientific evidence

is still in this direction).

Having said this, let me hasten to add that I have learned a great deal from the

discussions on this list. I have modified my carbohydrate intake by reducing

the amounts of bread, pasta, potatoes and pizza in my diet to almost nothing. I

try to stay under 125 grams of carbs per day. I also realize that the reason I

am not losing as much weight as I should is that I have not reduced my total

caloric intake as much as I have my carb intake and that I have not gotten the

exercise that I should. I am " morbidly obese " in the delightful terminology of

the insurance companies. My last A1bc was 6.6, my blood pressure is

disgustingly normal and my other blood factors are normal to borderline

" high/normal). Reducing my carb intake has helped control my sugar. However,

I noticed an even more dramatic improvement in control when I succeeded in

taking off several pounds. Since finding that which was lost, I have also

noticed an uptick in my daily glucose readings.

This has simply been a long winded plea for being less judgmental about the

motivations or the knowledge of those people or organizations that do not agree

that low carbing is the only way to find salvation and nirvanna. We can all

learn a great deal from one another by picking up on those things which seem to

work for us and keeping an open mind about ideas or approaches that do not seem

to be in total agreement with our own individual beliefs. The sad fact is that

the human body is such a wonderfully complex organism that we will probably

never be able do the fully controlled experiments that will let us identify one

absolutely guaranteed way of curing our common affliction. However, it is

likely that several different paths to control may exist and that our stumbling

efforts with various approaches to diet and medication will take us in that

direction.

Pax domine sit semper vobiscum

Grabner