[terraaus]

http://www.diabeticpastrychef.com

[llg]

Thanks.

I have mixed feelings about these sorts of recipes (as someone on a low-moderate glycemic index diet for my mild Type II diabets). On the one hand, I really miss pastry as it is perhaps my favorite food category. Giving it up has helped me enormously to lose some weight and stay off medication.

On the other hand, using these and similar recipes to allow such food back in my diet on a semi-regular basis makes me only want more of them ... and they are still not "healthy" choices for me. They still contain a lot of "empty" or "near-empty" calories. They will not help me lose more weight.

In other words, as a carbohydrate addict, I am like an alcoholic. Like an alcoholic who can't engage in social drinking and maintain sobriety, I find it difficult to include these items in my diet and maintain my low-carb lifestyle. I seem to have more success when I give them up completely and simply abstain from such foods completely. Having a little stimulates my body (and mind) to crave more -- and that's not healthy.

I hear health care providers often complain about poor compliance among diabetic patients. I often wonder how much of that poor compliance is due to the teaching that the patients receive that says its OK to eat these kinds of foods in moderation. Is that not like telling alcoholics that it's OK to continue drinking as long as they only have a couple of drinks? Maybe the failure of some diabetic patients to stick with the "moderation" approach should be addressed by advising them to take the abstinence approach.

I hope no alcoholics are offended by my post. I realize that the physical addiction to alcohol is stronger than that to carbohydrates. However, there is a physical craving for carbs that many of us experience -- a physical craving that grows stronger as we eat more carbs. I just think we can learn some valuable lessons from the alcoholic population and the programs that have been successful in helping them to maintain sobriety. I get frustrated with all the diabetic teaching materials that encourage diabetics to eat foods that stimulate our carb cravings -- then hear denigrating comments about us as a group because we struggle to comply with our diabetic diets.

[terraaus]

I've never heard of anyone in the medical profession refer to diabetics as "addicts". Diabetes is not an addiction but an illness. No one is going to completely give up carbs, its impossible. The website shows how to lower the carbs so they do not have such an adverse effect on blood sugar.

[llg]

I wasn't saying that diabetes = an addiction to carbohydrates. As you say, diabetes is a disease involving deficient glucose metabolism.

However, there is another phenomonon that causes people to crave carbohydrates. That phenomenon may not meet the technical definition of a physiological addiction, it has many similarities. An understanding of that phenomenon is the foundation of the low-carb weight loss diets ... and the low-glycemic index approach to both weight loss and diabetic management.

As someone who has that "carb addiction," I find that I start to crave them as soon as I eat them. But I find those cravings much more managable when I eat a low carb diet -- with only a minimal amount of carbs or with just a few low glycemic index carbs. I've talked to a lot of people who find the same thing.

When I see diabetics struggling to maintain their "moderate" carb diets being told that it is OK to eat high glycemic index foods, I cringe. I know those foods may stimulate their carb cravings and make it harder for that patient to resist the carbs they are supposed to eat "only in moderation." I think a lot of health care providers don't understand that and are inadvertantly encouraging diabetics to eat foods that will, in the long run, make it harder for them to maintain a health diet.

Fortunately, my doctor is familiar with the glycemic index literature -- and was fine with my decision to focus on that rather than going to the standard diabetic classes.

As for health professionals denigrating their patients for being "addicts," it's true that they don't use the "addict" word. However, it is quite common to hear them speak insultingly of patients who can't resist the high carb foods and stick to their diabetic diets. Some health care providers have little understanding of carb cravings and the difficulties of sticking with the standard diabetic diets -- particularly for patients with strong carb cravings who are told it is OK to eat high glycemic index foods.

[RN1989]

The diabetic ed class that I teach really focuses on carb counting and portion control.

Portion control is really the hardest thing. You truly don't realize that the 1/2 cup allotment is a lot smaller than you think it is until you measure it out. I also find that a lot of my students do not realize that things like dairy products have carbs in them. They look at the calories on a nutrition label but never think to see how many carbs they are consuming. They think that they are ok as long as they don't eat a loaf of bread.

It is more about making better choices. You do not have to adhere to a rigid, hard to understand diet anymore. But you do have to be willing to to make those choices. None of us are perfect and even making one or two small choices that improve what you are eating can make a vast difference in a diabetics control of sugar and their lifestyle.

We also go over tips and tricks to help curb appetite and get your stomach "shrunk" so that you don't feel so hungry with less food in a stretched out stomach.

There is also discussion about eating out. I printed out the nutritional info from various restaurants so that they can see what the food they like has in it and plan their outings.

Our last class went to a restuarant for graduation to see how well they did at making better choices. Some of them stuffed their faces full of the complimentary rolls. Some ate a giant baked potato with all the trimmings. Some ate a giant portion of steak but then only had 1/2 a roll and the rest of the meal was broccoli and carrots. Several who wanted to have lots of food ordered big salads with grilled chicken and dressing on the side. No, some of the people didn't follow what they had been taught and others followed it partially, but they all felt better that they were now in control of their own choices.

Yes, noncompliant diabetics frustrate me. Mostly because they lie about what they are doing. I know that it isn't easy to have to give so much thought to meds and food. But don't lie to me. If a diabetic pt chooses not to follow their instructions, I am not their momma. Frankly I don't care if they follow their diet and instructions or not. It is their body that they have to care for, not mine. I just wish that they would tell me the truth - that they have not interest in doing what they should. It would make it easier to help them plan if they would just be honest about whether or not they are doing anything about their diabetes.

And llg, I believe that most of the diabetic teaching that people are getting sucks! It is either non-existent or just horrible. None of the students in my last class had been given any instructions on how many calories they should be on, what to do on sick days, nothing! They related that they were told to "stay away from sugar and sweets". Yeah, that is really helpful. Only a handful had been given RX for meters and then had been told that they only needed to check their sugar once month or so, if they felt like it. How can these docs expect patients to do what they need to do when the docs will not give them the education and supplies to be successful? I swear this "herd" medicine mentality, get 'em in/get 'em out as fast as you can is going to be the death of a lot of people.

[llg]

Originally Posted by RN1989

And llg, I believe that most of the diabetic teaching that people are getting sucks! .

I whole-heartedly agree. I have several friends who have developed Type II diabetes over the last few years, and when I hear what they have been told, I cringe -- and they have all gone on to need meds. When I was diagnosed 18 months ago, I didn't think I could go to the classes and not argue with the instructor, so I chose not to go at all. So far, so good. No meds for me yet -- though I realize that my disease was caught exceptionally early. My friends all did not get diagnosed until their disease had progressed further than mine had. There may have been no way for them to avoid meds -- and I might have needed them by now had my disease not been found so early.

... But I still don't think the fact that they eat white potatoes, bread, and rice etc. on a daily basis is a good idea. When we eat together and I choose not to eat those things, they tell me that I am sacrificing unnecessarily. Their teacher told them it was OK to eat those things as long as they didn't eat an excessive amount. I just don't believe I would be doing as well as I am if I were eating those foods -- and I think they would be doing better if they didn't eat them so much.

... and I know that as soon as I let myself have a little, my body starts to crave more. So, I find it better to minimize my consumption of them. Of course, I need some carbs in my diet. I just try to get them through foods that are not empty calories (e.g. a little fruit, a little whole grain bread or pasta, dairy products, etc.) rather than cakes and pies and cookies etc.