Why Is Dietary Advice For Those With Diabetes So Bad?

Three different conversations between a healthcare provider, and patient:

HCP: “Mr. Jones, you have celiac disease.  Your body cannot tolerate gluten.  You need to remove gluten containing foods from your diet.”

Patient: “That makes sense.  Thank you.  I will do that.”

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HCP: “Mr. Smith, you have lactose intolerance. Your body cannot tolerate lactose.  You need to remove lactose containing foods from your diet.”

Patient: “That makes sense. Thank you. I will do that.”

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HCP: “Mr. Williams, you are overweight. You also have high blood sugar.  You need to lose weight and control your blood sugar.  My suggestion is to eat a diet high in carbohydrates.  At least 55% of your diet should come from carbohydrates.  Avoid fat as much as you can.”

Patient: “Don’t carbohydrates turn into sugar?  Won’t that make me gain more weight and raise my blood sugar even more?  Can’t I just cut down on carbohydrates?”

HCP: “No.  Low carb diets are a dangerous fad.  No healthy diet restricts any foods.  Eat anything you want in moderation.”

Patient: “But what about my weight and high blood sugar?”

HCP: “We have pills and shots for that.”

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For any health condition where dietary choices cause instant unpleasant side effects or health consequences, the advice is ALWAYS to remove that food from our diet, or at the very least, restrict it. Why is the same advice NOT given to those with diabetes? Because diabetes is called the “silent killer.” In other words, it is killing us slowly, usually, without us even knowing it. Why? Because the symptoms are not always as obvious. Often, the symptoms are not unpleasant enough for many to have the desire to make the needed dietary restrictions.

Make no doubt about it, diabetes is doing WAY MORE damage than just about any other health condition, as it effects every part of your body and is at the root of almost all major chronic disease. Don’t be lulled into a false sense of security by the lack of unpleasant symptoms. By the time symptoms start appearing, significant and sometimes irreversible damage has been done.

And can we just address the “everything in moderation” mantra once and for all? What is moderation? There is absolutely no definition when it comes to people’s eating habits. Moderation SHOULD mean…”once in a while,” or “for a special occasion.” However, moderation to a sugar addict might mean cutting back from 10 sodas per day, to 5.  There is no standard of “moderation.”  That phrase is COMPLETELY unuseful.  Sugar has been found to be highly more addictive than illegal drugs (wheat products are just about as addictive.) Do we tell drug addicts “just have your crack in moderation?” Ridiculous! So, why do we tell people with unhealthy eating habits to eat those addictive foods in moderation?  The “everything in moderation” is the famous tagline of major food corporations.  “You can have our sugar-laden death drink, or it’s sugar-free zero calorie chemical-nightmare alternative “in moderation” as long as you don’t overdo your daily calories and you exercise enough.”  Please, can we just stop the insanity?

Rather than having something “in moderation” every day, make healthy living your daily habit, saving anything typically off your menu for rare special occasions. And if certain foods are addictive to you, if they increase cravings or cause unpleasant side effects or aggravate your health condition, there is nothing wrong or “unbalanced” with avoiding them completely.

Different Types of Hypoglycemia – Different Treatment

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Many people don’t realize that there are different types of hypoglycemia, and therefore, very different treatment options. Let’s talk about the more common one first, medication induced hypoglycemia.

Medication Induced Hypoglycemia

For insulin dependent diabetes (Type 1 and Type 2), there is a greater chance of hypoglycemia due to the imperfect science of matching insulin to carbs. The more carbs we eat, the greater doses of insulin are needed. This INCREASES the chances of hypoglycemia. The BEST way to reduce this type of hypoglycemia is to reduce carbs, which will reduce insulin usage, which will lessen the chance of hypoglycemia. (See Dr. Bernstein’s “Law of Small Numbers” HERE). Despite a controlled low carb diet however, people with Type 1 will still experience occasional hypoglycemia. Glucose tablets are the optimal treatment for this type of hypoglycemia, as noted in this link I posted earlier this week. (HERE)

(For those with Type 2 that are insulin dependent, adopting a low carb approach and getting vigorously active is the best way to reduce or eliminate insulin usage. I highly recommend those with insulin dependent Type 2 to pursue this remedy.  Type 2 is reversible for most people.  Reversing diabetes should be the primary goal for those with Type 2.)

Now let’s talk about a hypoglycemia that has NOTHING to do with medication. This type of hypoglycemia can be experienced by those Type 2 on NO insulin (and no meds that increase insulin.) More often, it is happening to those with pre-diabetes, people who don’t know they have pre-diabetes, and people who will soon have pre-diabetes or type 2…those on the road to Type 2. It is called “reactive hypoglycemia.”

Reactive Hypoglycemia

Why is it called “reactive.” Because our body is typically reacting to a stimulus…something we typically have done. Here’s how it goes. Most of you that follow this page already understand that Type 2 diabetes is a condition of too much insulin for many years, even decades leading up to a diagnosis. The most common factor that causes the high insulin levels is poor diet (too many processed and refined sugar and carbohydrates) and poor lifestyle habits (lack of sleep, sedentary, uncontrolled stress, medications, etc). We call high insulin levels hyperinsulinemia (literal translation:  hyper = too much / insulin / EEMIA=because we have to make it sound complicated…😜)

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When a person with hyperinsulinemia eats a meal loaded with carbohydrates, the body will try to match this carbohydrate load with insulin. But remember, the body was never designed to make these huge doses of insulin, and often, the body overshoots the target, making too much insulin. This causes blood sugar to fall rapidly after a meal. A person can start to feel symptoms of hypoglycemia even when their blood sugar is still high due to the rapid rate that the blood sugar is dropping. Eventually, the blood sugar really will go low, lower than it was before the meal. Most people at this point are craving more carbs to bring the blood sugar back up again.

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This is a vicious cycle that can only be stopped with a healthy diet low in carbohydrates. The source of carbohydrates is also important. The carbs that one DOES consume on a low carb diet should NOT be sugar or refined carbs, but rather, carbs derived from real, whole, unprocessed foods (non-starchy vegetables, etc)

As an adult with first diagnosis of pre-diabetes at 40, I can say that I can remember bouts of (reactive) hypoglycemia in my late teens and 20s. I didn’t know what it meant but I knew that if I drank juice, it went away…for a while…I wish I would have known the path I was on and what to do about it.

So for ALL types of hypoglycemia, the best treatment is a low carb, whole food diet. Getting active is also a great tool, as it improves insulin sensitivity. For those that inject insulin, that means you will need less. For those that make all of their own insulin, it means the body will need to make less.

Finally, if you take insulin (or medications that increase insulin), and have frequent hypoglycemia even with your healthy lifestyle, it’s time for a chat with your healthcare provider to discuss reductions in medication.

Be safe and be well 😉

(This article does not discuss other disorders of hyperinsulinism.)

I’ve Started Insulin and I’m Gaining Weight! Help!

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Ok, so you’ve begun an insulin regimen and now you are gaining weight, what is happening?

So let start from the beginning. Likely, you were placed on insulin because your blood glucose was consistently high, maybe 200, 300 or greater. When your blood glucose is very high, that means glucose is remaining in your bloodstream where it cannot be properly used. Sometimes it’s even high enough that it will start spilling into your urine. So, in the bloodstream, that damaging sugar is being carried all over your body, causing inflammation and damaging everything in its path. Bad news. You should NOT be living with high blood sugars.

So, with insulin, your blood glucose is coming down because now the glucose is going from the bloodstream, into the cells to be properly utilized. So why does this make you gain weight? We always hear “insulin is a fat storing hormone.” It’s true, but just how is this happening?

So now that your body can utilize the glucose, it has two options.

  • Use glucose, or
  • Store glucose

Now, most people don’t get active right after a meal, so very little glucose will actually be used around the time we consume a meal. The majority will be stored. There are three main places your body will store glucose.

  • Muscles
  • Liver
  • Fat

Your body stores glucose (in its stored form) in the muscles. This is glucose that can be quickly used for exercise or activity. There is a limited space in the muscles to store glucose. Also, if you have less muscle, you store less glucose. And if you are not active, these stores can stay full, not allowing more glucose in.

Your body stores glucose (in its stored form) in the liver. This glucose is used in between meals and during sleep to keep blood glucose stable when you’re not eating. There is a very limited space in the liver to store glucose. If you stay in the fed state too long or too often, and don’t allow sufficient fasting periods, these stores can stay full, not allowing more glucose in. What is “fed state” and “fasting state?” We are in the fed state when we eat a meal and for about 4 hours thereafter. In a fed state, your body relies on glucose from the food you have recently consumed. Then you enter the fasting state, where your body relies on stored glucose from the liver. So if you eat often, such as if you eat 3 meals per day, plus snacks in between, you are in a constant fed state for the majority of your day. This keeps your liver stores full. And if you have a bedtime snack, you are even interrupting your night time fast. This is not good.

So, when muscle and liver stores are full, what happens to all of the glucose?  It stores as fat! What’s worse, it stores as visceral fat, or fat around our organs, in other words, belly fat. This is dangerous. And guess what? Fat storage is unlimited. There is no end to how fat we can get.

So, is this whole picture insulin’s fault? No. Insulin’s job is to bring down blood glucose SO HIGH BLOOD SUGAR WON’T KILL YOU. The problem likely is, you are giving your body TOO MUCH GLUCOSE TO STORE. That is why it is imperative that if you have to use insulin, to take in as little glucose as possible. Remember that injected insulin is not quite as effective as insulin made by the body. This means that when we inject insulin, we typically end up using more than our body would have made with its own insulin. So how much glucose do we NEED to take in? Very little. The blood needs to maintain a circulating level of glucose of about 1 teaspoon (4g). We DO NOT need a bunch of carbohydrates to supply that glucose, as a great deal of the protein we eat also is converted to glucose.

So, pairing insulin with a low carbohydrate diet that focuses on nutrient dense carbohydrates (vegetables) versus nutrient devoid carbohydrates (sugar, grains) will help to insure the least possible amount of insulin used, and the least amount of weight gain, possibly no gain, possibly even weight loss.

What else can we do to take even less insulin? Get active. Exercise improves insulin sensitivity. In other words, your insulin will work better and you’ll need less. And don’t just focus on cardio (walking, jogging, etc). Build some muscle. The more muscle we have, the more our body can both burn glucose and store it. We have to use and deplete stored glucose regularly. This will allow us to replenish those stores from our meals. Daily exercise is a key to using this stored glucose.

What else helps? Spend less time in the fed state and more time in the fasted state. Go more than 4 hours between meals, avoid snacking, have a long daily fast at night by not eating within 2 hours of bedtime, all the way until you wake up the next morning. Even better, try intermittent fasting. This allows us to access and burn stored glucose in the liver. Once again, we have to use and deplete stored glucose regularly. This will allow us to replenish those stores from our meals. Daily adequate fast periods are a key to using this stored glucose.

If you mix injected insulin with a high carb diet, frequent snacking and a sedentary lifestyle, you are playing with fire. Expect to gain a lot of weight. Expect increased insulin doses regularly, and a rapid decline in your health. Expect your heart, kidneys and brain to suffer significant damage. Expect fatigue, depression, sleep disturbances and memory problems. Expect chronic aches and pains. Expect vision problems. Expect pain in your legs and feet. Expect urinary tract infections and yeast infections. I could really just go on and on…

How do you know if you are taking in too much glucose? Well, how much weight are you gaining? If you are gaining weight, your stores of glucose are likely full. So you have to eat less glucose, by adopting a low carb way of eating, and burn more glucose, by exercise and allowing greater fasting periods in your daily routine.. By doing this, your chances of eliminating injected insulin is very likely. At the very least, you can expect a significant decrease in insulin usage.

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Wishing you all health and happiness.

Difference Between Type 1 and Type 2

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Type 1
  • Autoimmune destruction of the insulin producing cells (beta cells) of the pancreas.
  • Diagnosed more often in childhood or early adulthood, but can be diagnosed at any age.
  • Due to inability to produce insulin, injections of insulin must be administered daily.
  • Best treatment: a healthy, low carb whole food way of eating, plus exercise and insulin.
  • There is no cure, YET, for Type 1 diabetes, and no way to prevent it that we know of.
  • When we talk about needing to find a “cure” for diabetes, this is the Type of diabetes we are speaking of.
Type 2
  • A condition of insulin resistance. Is related to family history and, significantly, to lifestyle factors.
  • The body often makes adequate insulin but the insulin is not able to be used properly (due to insulin resistance), causing yet more insulin production and more insulin resistance.
  • Can lead to an insulin deficiency over time, especially if not treated early and appropriately.
  • Diagnosed most often in adulthood, but is increasing in the childhood population.
  • Best treatment: a healthy, low carb whole food way of eating, plus exercise. These should be pursued early and aggressively, preferably in the “pre-diabetes” stage. Medication may need to be added if these measures are not effective enough.
  • There is no cure for Type 2 diabetes.  In other words, you cannot completely regain lost beta cell function.  However, with aggressive lifestyle management, many can reverse the process of Type 2 so that they are able to live within their bodies ability to produce enough insulin for their healthy lifestyle. Many are able to eliminate some or all medications.  (Some consider this being “cured.” 👍 So if someone says their diabetes has been “cured,” this is the diabetes they are talking about.  I prefer the term “reverse.”)
  • The best “cure” for Type 2 diabetes is PREVENTION.  Type 2 is most often highly preventable, even if one has a strong family history.

People do not progress from Type 1 to Type 2 or vice versa.  These are two completely separate diseases with completely different etiologies.  (However, Type 1’s can develop insulin resistance IN ADDITION to their autoimmune diabetes.  LADA is a slower onset autoimmune diabetes and is sometimes called Type “1 1/2”.  Although slower in onset, once reaching the point where insulin is needed, those with LADA are treated as, and considered, a Type 1.)

My First 21 Days as a Diabetes “Warrior” and My Dexcom Experiment

About a month ago, I discovered this book. I’ve been LCHF for close to two years, had already lost 80 lbs, reversed my pre-diabetes without medication, eliminated my high blood pressure and cholesterol problems, fixed my reflux and other complaints, like insomnia. All gone.  I am medicine free. But I was 20 lbs from my goal and needed to refine my program just a bit more to reach my goal. I stumbled across this book. It was just what I needed.

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As someone with a history of blood sugar control issues, I will always and forever be cognizant of keeping my blood sugars controlled.  I also personally believe it is one of the most important factors to good health. When I found this book, I was just about to start a 21-day challenge with folks in my group, with the intention of building healthy habits. It was the perfect time to put the program in this book to work. So I stocked up on meats, lots and lots of non starchy veggies, eggs (I have my own chickens), and fats, mostly butter. I cooked large batches of them. Within just a couple days on the program, my weight was moving for the first time in a long time, and my fasting blood sugars were dropping.

Then something really exciting happened. I had the opportunity to wear a continuous blood glucose monitor (CGM) as a demo. I am a diabetes educator and I prefer to self test all of the equipment. I have worn several insulin pumps (with saline of course) so that I can better teach the use of the equipment to my patients. In my experiment with the CGM, following the program in this book, I spent 30% of my time with my blood sugars in the 70’s and the remaining 70% of the time with my blood sugars between 80-100.  I never went over 100 while wearing the monitor.  This was really fantastic, but I’ll tell you what is even better.

The CGM not only tells you your blood glucose every 5 minutes, it tells you how rapidly you are rising and falling. If you are rising 1-2 points per minute, you get an arrow angled upwards. If you are rising 2-3 points per minute, you get a straight up arrow. If you are rising more than 3 points per minute, you get a double up arrow. These parameters are the same for downward arrows, when your blood sugar is falling. When your blood sugar is steady, you get a straight, right-pointing arrow. Why is this important? Fast rises and sharp falls are not good for the body.  Besides, they can make you feel lousy. So here is the amazing thing. NOT ONCE in 6 days of wearing the CGM and following the program did I EVER see an up or down arrow, ever. I typically never had an increase of more than 7-10 points for a generous meal, and it was such a slow rise, that the arrows never moved!!

Here is my steady arrow.  Each one of those dots represents a blood sugar check.  My blood sugar was extremely stable.

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This graph shows my average glucose readings, averaged 79-89.

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This graphs shows my average blood sugar of 85 with 70% of my readings between 80-100 (as I never went over 100) and 30% of my readings between 70-80 (which is not low).

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Why would anyone that is looking to control their blood sugar NOT want exactly this? And bonus, I lost 8 lbs over the 21-day period. I feel like I could have lost 10, but a few extra nuts and dairy (cheese, creams, I do not drink milk) sometimes crept in when I didn’t have food prepared. Not that I’m against nuts and dairy, I love them. But I have found that they stall my weight loss a bit, and for me, should be considered treats.

I’m extremely grateful to have found this book. It is my goal to continue with this plan indefinitely. I’m loaded with energy, my blood sugars are perfect, I feel great and my scale is moving. I will probably stay on this plan 90% of the time, and 10% of the time will allow myself LCHF foods that I enjoy like nuts, dairy and berries.

I sincerely recommend this book for anyone needing to control their blood sugars and/or lose weight.  If you are interested in the book, click the book image above for more information.

Thanks for sharing in my experiment!  Good health to you!