Hi everyone,

I've been moderately low carbing for sometime... I have insulin resistance so I link and balance my meals. I've hit a weight loss plateau from that eating method so I wanted to try the two week induction phase. I am going to talk to my endocronologist about it today. I know when I go too low on my carbohydrates, I get terrible low sugar headaches (reactive hypglycemia) -- a huge reason is the glucophage I take. It is to regulate my blood sugar and going too low on the carbohydrates makes me feel terrible. Anyway, I want to talk to my doctor and ask if I can reduce my dosage during induction.

Anyway, sorry for the long introduction... so do you count total or net carbs during induction? Also, milk doesn't affect insulin levels, why is it a nono? I love milk!

I am going to grab the paperback book today so my husband and I can follow induction properly, but I was curious about these.

Thanks

Cristina-

Welcome, Cristina! Great to have you join us here.

I had a friend that use to drink a gallon of milk a day, he was diabetic, when his doctor found out he went balistic. I'd also been taught while working as a CNA that drinking milk was as bad as juice. So I guess we've gotten conflicting stories regarding this.

Glad you are getting the book. (Would that be Atkins or another?) It will answer many of your questions. Like a maximum 20 net carbs for induction if Atkins. It's great that your husband is doing this as well. Good luck.

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Noël


Worry doesn't empty tomorrow of its sorrows, it empties today of its strengths.

The ONLY carbs I would subtract during induction are FIBER.
Skip the sugar alcohols and other "iffy" stuff.

Glad you're going to speak to your MD first, though. If you are on any kind of BG regulating meds, a CRUCIAL STEP.

Welcome, and hope you find info and support here to help you along your journey.

That is interesting Cushie. The "Insulin Resistance Diet" book doesn't shun milk. I'll have to ask my doctor about it. I'm getting the Atkins Revolution so I can have a list of approved foods for the induction period.

Thanks for the welcomes, LCAndrea

Ever since my brother and I were young children our doctors stressed that we were non-insulin dependent diabetics. After I saw how healthy my younger brother had become and how much weight he lost, I had to try the low carb approach. The New Diet Revolution book is worth every penny! I have read it and followed it very carefully. My husband and I started about 2 months ago and are doing very well. We believe that this way of life may have SAVED our lives. **Induction is pretty tough, don't give up....the results will be worth it!***

Welcome Boink. The reason that milk is avoided in a low carb lifestyle, especially during induction, is that milk contains lactose and lactose is a form of sugar. That may also explain the reaction Cushie referenced.

Whoever gave you this information is mistaken. Milk raises blood glucose levels and insulin is preciptated by blood glucose levels. I know this as a nurse and from my own personal blood glucose testing.

As for the glucophage, certainly work with your doctor on that. Following an induction diet will certainly lower your blood glucose levels and you will almost surely need to calibrate your medication to deal with a way of eating that does not cause much of an increase in BGL.

Let us know how things go.

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Well, my doctor vetoed the whole atkins thing. I'm a bit torn because I'd really like to try it. She said that the diet along with the glucophage would make my blood sugar levels too low. I've been doing a tremendous amount of reading pertaining to insulin resistance and PCOS -- everyone who's low carbed has greatly benefited. One of the users here (Lawbooks?) is one of the people whom I reference as well.

I really want to follow my doctors advice, but I'm a bit desperate for a solution to my belly. She did give me a diabetic diet and it looks somewhat reasonable, but I have to do alot of weighing and measuring. With full time school and work, I'm not sure how realistic that may be.

Regarding lactose, I actually got the information from The Insulin Resistance Diet book. As well as various articles and other website sources. It was basically explained that lactose did not affect insulin levels the way glucose did.

Thanks everyone. I'm going to read the Atkins book and weigh my options.

How to Talk to Your Doctor About Low Carb
(originally published on the LowCarb Living Magazine Web Site)

If you've decided that 2005 is your year to get healthy and fit - and you've decided that controlling your carbohydrates is the best way to do it - one of your first steps will be to discuss these planned changes with your personal physician. If your health care team isn't among the growing number of medical practices that are supportive of a controlled-carb approach to eating, you might be tempted to skip this all-important first stop in your fitness journey, or perhaps you're one of the many patients who feel intimidated or just plain rushed at the doctor's office and always end up leaving without discussing what's truly on your mind.

I had the opportunity to speak with Keith Berkowitz, M.D., a leading expert in controlled-carb nutrition at his Center For Balanced Health in Manhattan, where he combines his expertise in both traditional and complementary medicine. We asked Berkowitz for a crash course in "how to talk to your doctor about low carb."

Start With a Partnership Mentality

"It's all about partnership," says Berkowitz of the best mind-set to have when approaching your health care team. "And if you don't feel like your doctor is initiating the partnership, you take the initiative. It's your health, and you need to take ownership of it." Bringing together the medical knowledge and experience of your doctor and your own self-knowledge in a spirit of collaboration will produce a productive partnership and grow the long-term relationship. Never discount your own ideas or feelings about your health. "We doctors need to stop thinking we know more about the patient's body than they do!" admonishes Berkowitz.

On the other hand, this doesn't mean being confrontational, or discounting your physician's concerns. If your doctor is initially resistant to your plans to go "low-carb", don't have an all-or-nothing mentality. "Be willing to find a happy medium that doesn't damage your relationship OR your health," suggests Berkowitz. Open communication is the only way for both parties to understand each other's position, and all-or-nothing thinking closes the door.

Steps for Clear Patient/Doctor Communication

Berkowitz suggests following these steps for having that initial "talk" with your doctor:

1. Be sure you've taken the time to get informed before bringing up the subject. You don't have to know everything about low-carb diets, metabolism and nutrition, but you do have to have some understanding of why and how they work. Pick up a copy of LowCarb Living Magazine, or read one of the popular low-carb diet books. Know about the research supporting controlled-carb nutrition and be willing to share it. "This is the stuff your doctor understands," says Berkowitz.
2. Be sure to tell your doctor WHY you want to follow a controlled-carb approach. For instance, remind him or her that you've tried other diets and haven't been successful. Like all good practitioners, your doctor really does want you to succeed, and being reminded that you have tried the "standard recommendations" for losing weight (maybe many times) will make him or her more likely to say yes to a new approach.
3. If your doctor is still against following a low-carb regimen, you need to confront the underlying reason - not dance around it. "If he or she says 'NO!', you need to come right back and ask 'What are your concerns?' and then LISTEN." Until you know what specific concerns exist, you're not having an open dialog.
4. The problem may simply be that your doctor thinks there's only one set way to "do" low-carb. "That's just not true," says Berkowitz. "No one diet or carb level works for everyone." Be sure your doctor knows this, too.
5. Suggest a short, supervised trial period. "Almost every doctor will say yes to that, especially if you agree to come in for periodic testing," is Berkowitz's final suggestion. At the end of the trial period, you and your doctor will hopefully be happy with the results, and you'll have strengthened the relationship as well.

But My Doctor's Not the Problem...

There is one other reason you might be hesitant to talk to your doctor about your diet, and it has nothing to do with his or her acceptance of a controlled-carb approach. It's shame and guilt.

If you've really had a bad year weight-wise and you're dreading the look of shock on the nurse's face when you get on that scale, if you've been putting off a check-up with your doctor for far too long because you're embarrassed about your weight, remember that everyone has to start somewhere, and your doctor knows that.

To patients who are having those kinds of feelings Berkowitz would say this: "There are realistic solutions to this problem, but we'll have to work together to come up with a plan. I'm not going to lecture you, because I'm your partner, not your parent. And it's better to get started now than to wait and put even more pressure on yourself. Whatever plan we come up with first, you should realize that it might not be the "be-all and end-all", but we'll work together to find what is realistic for you. Because a diet you can live with is ultimately the diet that will be successful for you."

There's no better time to get started on the journey to a healthier new you than now, so don't put off discussing your diet and health with your doctor. Follow the simple steps above, and most importantly, have a partnership mentality. Working together with your doctor as a partner in your own health is a great goal for 2005 and beyond.




Keith Berkowitz, M.D. is the founder and medical director of the Center for Balanced Health. He combines expertise in both traditional and complementary medicine. Prior to starting the Center for Balanced Health, he was the Medical Director and Business Director of The Atkins Center for Complementary Medicine, and was an associate of Dr. Robert C. Atkins since 1999.

Thanks for the article, LCAndrea. I actually did ask her if we could try a two week trial period. I told her that if I felt like my blood sugar was dropping too low, I would contact her and let her know. She said she would like me to get ~30 to 45 carbohydrates per meals. She gave me some guidelines, like, 45 at lunch, 30 for dinner, etc. I actually went to see her because she is a metabolic endocronologist and I was frustrated with my weight.

We'll see. I may be able to modify my diet to go lower calories and lower carbohydrates than I was... I'm just contemplating...

Thanks again!

Thinking of you, Cristina ...and wishing you luck!

When making an appt with a new doctor a couple years ago, I asked what how he felt about Atkins and was glad to hear he was in favor of it only as a lifestyle change and not for quick weight loss. There are many supportive doctors out there, including those treating diabetics. There are also, of course, unsupportive doctors... some who have open minds, some who don't.

Another book you might find useful is Dr. Bernstein's Diabetes Solution. www.diabetes-book.com It goes very well along with DANDR.

I'm not knocking your doctor at all, but do what you truely feel is in your own best interest. The more I deal with doctors, the more I realize that the best ones are open to the fact that they don't 'know it all'.

If you decide to go on a low carb program, you'll either need to have her support, even if it's given reluctantly, or the support of another doctor - which I have no doubt you'll be able to find if you need to.

~ Linda

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180 / 145 / 135

"Impatience comes from focusing on negative thoughts. Results come from focusing on being happy today and constantly renewing your commitment to change and to improve the things that you can, one small step at a time." - Bob Greene

Thank you for the kind response, Linda. I really appreciate it. I'm actually happy to report that I've been able to survive on ~40 grams of carbs a day using the same menu plan she gave me along with taking my glucophage. I've tweaked it just a bit, but my aim is to meet the calorie requirments she wants me to meet, 1500. I don't see any adverse affects yet, or at least not the low blood sugar she was worried about. My aim is to reduce my intake from 40 to between 30 and 25 next week to see how I feel. If I feel amazing, I must be doing something right. I've had about 15 carbohydrates today and I am full of energy. Another woman on a PCOS forum stated that during her initial weight loss, she had to stay at about 60 carbohydrates a day... after she dropped her weight she gradually increased that. She still needs her glucophage, but she's been able to maintain her 60 pound weight loss for 2 years. Talk about inspiring!