A fat chance

Is it ever safe for diabetics to try a 'faddy' diet? Linda Watson-Brown found one that helps her both to lose weight and control her condition
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Indy Lifestyle Online

When I was diagnosed with Type I diabetes 20 years ago, I had mixed feelings. Once treatment began, I felt better than I could remember, but I had an image of being diabetic that didn't appeal. Chocolate would be forbidden. I would survive on sugar-free squashes and a regime of carefully counted carbohydrate "exchanges". It was all going to be terribly restrictive.

When I was diagnosed with Type I diabetes 20 years ago, I had mixed feelings. Once treatment began, I felt better than I could remember, but I had an image of being diabetic that didn't appeal. Chocolate would be forbidden. I would survive on sugar-free squashes and a regime of carefully counted carbohydrate "exchanges". It was all going to be terribly restrictive.

As an adult, I feel there are even more exclusions. For some time, I have been wanting to lose weight. And everyone except me is on some kind of celebrity diet.

Until a week or so ago. Before then, there were two unanswered questions. Can diabetics diet like everyone else? And can their overall health and control actually benefit from apparently "faddy" regimes?

Yes, believes Jan de Vries. The healer, who has clinics in the UK, was diagnosed as diabetic a few years ago. "It came at a time when I was physically, emotionally and mentally drained," he recalls. "I've spent my working life emphasising how important it is to have all three aspects of the body working in harmony, but I didn't have that balance myself when I was diagnosed. My doctor revealed that my blood sugars had rocketed and I was faced with a lifetime of treatment. I begged him for six weeks to deal with it myself. He could not believe it when I returned. Through diet and supplements, I had got my bloods down to perfect levels - and I still manage that."

De Vries is sceptical about generalised dieting advice. "Although there are obviously broad guidelines everyone should adhere to, I believe that individually tailored diets are the key. You need to look at all aspects of your life, not just what you are eating. For diabetics this can be done, and I would always suggest particular natural remedies and supplements, such as Vitamin E, to be taken in conjunction with any diet to lower blood sugar and help weight loss."

De Vries's approach - individually tailored diets with specific supplements - may well work, but many people simply can't obtain or afford specialised advice. And the lure of a new bestselling diet book may be overpoweringly addictive, diabetic or not.

What many experts don't take into account is that "textbook" diabetes simply doesn't exist. From diagnosis, I had found out exactly how to manipulate my blood sugars. Insulin is not actually restrictive. Any reasonably switched-on diabetic knows that virtually nothing is off limits as long as a couple of extra units are bunged in the syringe. I had it down to a fine art. Come the glucose check, I could pretty much guarantee that I would return decent numbers.

But I was still wary of "diets". I had mine. It involved tricky balancing of rubbish food and pharmaceutical concoctions, but it felt safe. However, now, to my amazement, many dieting gurus are not excluding the insulin-challenged - we're being positively wooed. Anecdotally, it is claimed that diets such as Atkins et al can help diabetics to control the condition. Some say such diets have enabled them to stop taking insulin.

But is it true? Atkins advocates say that the fastest way to lose weight is to starve the body of carbohydrates to the point at which it burns fat instead. This is done in a two-week carbohydrate "crash". "Your body burns both carbohydrates and fat as fuel," says the bestselling Atkins Nutritional Principles. "Carbohydrate is the first fuel to be metabolised. However, when you cut down sufficiently on your intake of carbohydrates, your body converts from the metabolic pathway of burning carbohydrate to burning fat as the primary energy source. The result is weight loss."

Can it work for diabetics? Emma Bunn, a dietician and care adviser at Diabetes UK, thinks it's unlikely. "We don't recommend the Atkins diet at all for diabetics," she says. "The reality is that there is insufficient evidence for the safety or effectiveness of Atkins. There are also so many variations of it that it can be dangerous. You could easily end up with the exclusion of major food-groups for a long time and end up with a very high-fat diet that exacerbates many of the problems of diabetes."

But there are other diets. Anything with an understanding of the glycaemic index (GI) is, arguably, best for diabetics. Dr Anthony Leeds of King's College, London, a co-author of The New Glucose Revolution, believes this is critical. "Insulin sensitivity is desperately important for diabetics. By adopting a low glycaemic approach, diabetics are starting a healthy programme for life that can stand them in immeasurably good stead. We also have to consider that for every person diagnosed with diabetes, there is another undiagnosed. As the population becomes more obese, diabetes will increase. Pre-diabetics need to consider that a GI diet could stop them becoming insulin-dependent."

For 10 days a version of the Montignac method has been my "fad". Developed in the 1980s by a French nutrition researcher, it is based on the belief that hyperinsulinism is the cause of obesity - the reverse of what many believed. As a diabetic, I am drawn to many of Montignac's ideas. Since I was 14, I have balanced all carbohydrate intake with injected insulin. But then there was no notion that foods were absorbed into the bloodstream at different rates. This is what proponents of the GI approach advocate - and it works.

"I feel that the diet really is ideal for diabetics," says Stuart Rothey of the Montignac group. "It works in two phases, based on the GI of foods. This index uses sugar as a base and gives it an arbitrary value of 100. All carbohydrates are measured against this. We suggest that for phase one, people eat foods with an index of 35 or less - things like lentils, broccoli, tomatoes. Once they reach their ideal weight, they can move to phase two, to foods with a value of up to 50 for a maintenance approach. You also have to take into account that some foods are virtually banned - such as potatoes, cooked carrots, sweetcorn, turnip, couscous - even if they don't immediately seem 'bad'."

This involves much more understanding and application than most diets. I've become obsessed with values. I can spend hours in search of foods that conform, and I'm cooking rather than reheating meals. I haven't eaten anything from my freezer, or with a "pierce and cook on high" instruction. I make my own breakfast cereal, and potatoes are the devil. However, I've lost weight, I'm sleeping better, and my insulin requirements are down by two-thirds.

"It does work for diabetics, there's no doubt," Rothey says. "It's about balance and it puts the pleasure back into eating. Calorie-controlled diets simply don't work, and dietary change should be about life changes, not yo-yoing from fad to fad."

Anthony Leeds advises some caution. "I think some versions of the GI approach are keen to ensure that, for people who love food, allowances are made. You have to be very careful not to have high fat levels, for example. But, overall, there are simple ways of changing eating patterns that take GI into account. It's simply not true that it's all too complicated. If someone is having chocolate pops for breakfast, what's hard about trying porridge? How difficult is it to suggest that a white-bread sandwich isn't the best idea?" Not difficult at all - but I still yearn for my cheese-and-onion crisp sarnies with extra insulin for dessert.

'Eat Yourself Slim... and Stay Slim!' by Michel Montignac (Montignac, £12); 'The New Glucose Revolution' by Anthony Leeds et al (Hodder, £7.99); 'My Life With Diabetes' by Jan de Vries, (Mainstream, £5.99); www.diabetes.org.uk

Diabetics should not change their diet without first consulting their doctor