Reversing Type 2 Diabetes with low carb

By The Low Carb Clinic, 16 July 2019 - 719 words (4 munites)

Traditional low-fat diets are not working when it comes to managing the epidemic of type 2 diabetes[1].

Nor is conventional advice to ‘eat less’ and ‘move more.’ But time after time, low-carbohydrate diets are proving they are effective at treating type 2 diabetes – reducing or even eliminating the need for medication, and reversing risk factors for the disease[2]. And unlike medication, low-carbohydrate eating isn’t just a ‘band-aid’ over the symptoms of diabetes. High blood sugar is the ‘hallmark’ symptom of diabetes, but high blood sugar is not the cause of diabetes.

Type 2 diabetes is caused by insulin resistance – which is when the cells of the body no longer respond properly to insulin. Insulin resistance doesn’t just cause diabetes - it also underlies many other modern health ailments. It is associated with heart disease, cancer[3], Alzheimer’s disease[4], polycystic ovarian syndrome[5], and fatty liver disease. Insulin resistance causes fatigue, weight gain, and inflammation. But low carbohydrate eating reverses insulin resistance (and so in turn, also lowers blood sugar). So, whether you’ve got diabetes, insulin resistance, pre-diabetes, or, you want to prevent them all from happening, the answer is the same: a low-carbohydrate diet. By eating low-carb, the body learns to respond to insulin again – improving health all over the body.

Insulin resistance

We know that the ‘hallmark’ of type 2 diabetes is high blood sugar. We need to have a little sugar in the blood – the average person has about a teaspoon’s worth. But every time we eat carbohydrates, we add lots of extra sugar to the blood, and so the body releases more and more insulin, to move the sugar into the cells. Type 2 diabetes occurs when over time, constant exposure to insulin causes insulin resistance. This is when the cells no longer respond to insulin. It is just like how the body responds to addictive drugs. At first, a small dose of the drug is enough. But over time, that small dose doesn’t have the same effect. The dose needs to be higher and higher for the body to respond. The person needs more and more drugs to get the same effect. But we know that giving more and more drugs isn’t going to solve the problem. It’s only going to make the problem worse.

It’s the same with insulin. More and more insulin is not going to solve the problem in type 2 diabetes. Giving injections of insulin to people with type 2 diabetes just makes the problem worse, over time.

We need to remove the trigger – and in insulin’s case, the trigger is carbohydrates.

Type 2 diabetes can be thought of as a state of ‘carbohydrate intolerance.’ Thinking of it this way makes the solution far more obvious: a low-carbohydrate diet.

Reversing insulin resistance is possible in two steps.

Stop adding extra sugar to the body, that insulin has to clean up
Use up the body’s glucose stores (by practising intermittent fasting)

Carbohydrates are found in foods like bread, pasta, rice, biscuits, crackers, and cereal.

Sugar is a type of simple carbohydrate – found in sweets and treats, fruit, and flavoured drinks.
Starch is a type of complex carbohydrate – found in potatoes, flour, oats and corn.

Ultimately, they are all broken down into the same thing: glucose, which triggers insulin.

So what can you eat, on a low carbohydrate diet?

Fill your plate with low-carb vegetables, meat, fish, eggs, dairy, and healthy fats. Avoid processed and packaged foods, and stick with water, black coffee, and tea as drinks. There is no reason to fear healthy, natural fats (like olive, coconut and avocado oil, or butter, lard and tallow). These fats will not give you diabetes or make your diabetes worse if you are following a low carbohydrate diet. Eat enough natural fats to keep you satiated – cook with them to and add them to vegetables or salads. There’s no need to count calories. Low-carbohydrate eating promotes positive hormonal changes that help to bring back the body’s natural appetite regulation – reducing levels of hormones like ghrelin (a hunger hormone)6 and increasing levels of hormones like CCK (a satiety hormone)[7].

By reducing the amount of carbohydrates coming in, we prevent the blood sugar ‘highs’, ‘lows’ and ‘swings’ that occur with a higher carbohydrate diet - providing more stable energy through the day.

Important: If you take medication, make sure you consult a doctor.

Because low-carbohydrate eating is so effective at reversing insulin resistance in T2DM, doses of any medications you are taking for diabetes must be monitored, and doses decreased. With improved insulin sensitivity, injections of insulin (including long and short-acting insulin) will be much more effective – there is a significant risk of ‘hypoglycaemia’ or low blood sugar. The same is true for medications like gliclazide, glimepiride or dapagliflozin. Do not begin a low-carbohydrate diet without medical monitoring.

References

Feinman, R., Pogozelski, W., Astrup, A., Bernstein, R., Fine, E., Westman, E., . . . Worm, N. (2015). Dietary carbohydrate restriction as to the first approach in diabetes management: critical review and evidence base. Nutrition, 31, 1-13
Bhanpuri, N., Hallberg, S., Williams, P., McKenzie, A., Ballard, K., Campbell, W., . . . Volek, J. (2018). Cardiovascular disease risk factor responses to type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at 1 year: an open-label, non-randomized, controlled study. Cardiovascular Diabetology, 17(56). doi:https://doi.org/10.1186/s12933-018-0698-8
Fine, E., Champ, C., Feinman, R., Marquez, S., & Klement, R. (2016). An evolutionary and mechanistic perspective on dietary carbohydrate restriction in cancer prevention. Journal of evolution and health, 1(1). doi:https://doi.org/10.15310/2334-3591.1036
Ferreira, L., Fernandes, C., Vieira, M., & Felice, F. (2018). Insulin Resistance in Alzheimer's Disease. Frontiers in Neuroscience, 12(830). doi:https://doi.org/10.3389/fnins.2018.00830
Diamanti-Kandarakis, E., & Dunaif, A. (2012). Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine Reviews, 33(6), 981-1030. doi:10.1210/er.2011-1034
Sumithran, P., Prendergast, L., Delbridge, E., Purell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2013). Ketosis and appetite mediating nutrients and hormones after weight loss. European Journal of Clinical Nutrition, 67, 759-764.
Chearskul, S., Delbridge, E., Shulkes, A., Proietto, J., & Kriketos, A. (2008). Effect of weight loss and ketosis on postprandial cholecystokinin and free fatty acid concentrations. American Journal of Clinical Nutrition, 87(5), 1238-1246.