Reversing Diabetes 101 With Dr Sarah Hallberg: The Truth About Carbs Blood Sugar And Reversing Type 2 Diabetes
You may have heard a lot about type 2 diabetes, but do you know what it actually does to your body?
What To Consider Before Following A Low
If you treat your diabetes with insulin or any other diabetes medication that puts you at risk of hypos, following a low-carb diet may increase this risk. Speak to your healthcare team about this so they can help you adjust your medications to reduce your risk of hypos. Your team may also support you to check your blood sugar levels more often.
I make sure I balance out my diet with what suits my insulin, but with a bit of tweaking, most things can be persuaded to suit my insulin!
I won’t eat a load of pasta with a side of garlic bread and not much else, because the carb load would be difficult to bolus for. But neither would I eat a completely carb free meal. It’s all a question of balance, and a healthy diet is good for all of us, diabetic or not.
– Online forum user living with type 1.
Depending on the approach, following a low-carb diet may also lead to other side effects, such as constipation or bad breath.
Although these can be unpleasant, they are usually temporary and shouldnt be harmful in the long term. Speak to your healthcare professional if youre concerned about any of these.
Its really important to first reduce your carb intake from unhealthy sources such as sugary drinks, pizzas, cakes, biscuits, chips, white bread, fruit juices and smoothies.
What Is A Carbohydrate
Itâs one of the main energy sources in many foods, including bread, pasta, fruit, and starches. When carbohydrates are digested, they are broken down into glucose in the blood. You may know this as blood sugar.
The body allows for only 1 teaspoon of sugar per 5 liters of blood, but there are 9 teaspoons in a cup of cooked rice.
The excess glucose in your blood is pulled out by the hormone insulin. In a person with a high carbohydrate tolerance, this process works well and excess blood sugar is promptly removed.
In a person with carbohydrate intolerance, type 2 diabetes, or prediabetes, this system breaks down. The body loses its insulin sensitivity and more and more insulin is required to remove the excess blood sugar. As a result, blood sugar levels remain high and insulin levels are high as well, and these high insulin levels can make your body even less sensitive to insulin.
âThe result? The cycle will happen over and over again and the problem will get worse.
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Systematic Reviews And Meta
There are a number of published systematic reviews considering the effect of LCDs on weight loss and other markers of health in people with Type 2 diabetes. All identified reviews which included meta-analyses of randomised controlled trials are outlined in Supplementary Table 1 . The general conclusion of many of these is that LCDs perform better for weight loss and improving diabetes control in the short-term, but over the longer-term there is often little difference between LCDs and control arms .
The apparently diminishing differences may be as a result of reduced adherence to LCDs over time , may be an artefact of limitations of the reviews , or indeed they may be a true reflection of the effectiveness of such diets. It is however difficult to fully elucidate the cause based on the available information. One of the included meta-analyses did attempt to assess this, finding, for example, that adherence did seem to explain the apparent reduction in efficacy of VLCDs for weight loss at 6 months . The authors of this review also ultimately concluded that it is difficult to determine with any certainty why the effect of LCDs appear to reduce over time though.
How Keto Can Help With Diabetes
The Ketogenic diet is a high-fat, low-carb eating plan in which you eat 60-70% of your calories from fat, 20-30% from protein, and 5-10% from carbohydrates. Keeping your macros in these ratios trains your metabolism to enter a fat-burning state called ketosis.
Think of ketosis as the opposite of diabetes. Instead of fostering high blood sugar, ketosis is generally a state of lower blood sugar, maintained within a healthy range. Ditto for insulin and its resultant fat-storage mode.
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Not Regularly Communicating With Your Healthcare Team
Your diabetes care team can help you determine the right low-carb approach for you, but it can also help to avoid any bad, potentially dangerous, or life-threatening side effects of going low-carb to help manage type 2 diabetes.
You and your doctor may need to lower or change your meds to avoid low blood sugar, or hypoglycemia cardiovascular complications and diabetic ketoacidosis , which is a health emergency. This is especially true for people taking insulin, insulin-promoting drugs, or blood pressure medications, Urbanski says. Additionally, SGLT2 inhibitors, oral medications that assist the kidneys in lowering blood glucose levels, push some people into potentially fatal DKA, with low-carb intake further exacerbating that risk, she says. Its recommended that someone on SGLT2 inhibitors should not go on a low-carb diet or should first discontinue and change medications under their doctors supervision, she says. According to the Food and Drug Administration, examples of SGLT2 inhibitors include canagliflozin, dapagliflozin, and empagliflozin.
The Potential* Benefits Of Living Low Carb For Diabetics
Numerous studies in a variety of settings show dramatic improvements in blood glucose control and blood lipids in type 2 diabetics consuming a low-carb diet . When these studies included a low-fat, high-carb comparison group, the low-carb diet consistently showed superior effects on blood glucose control, medication reduction, blood lipids and weight loss. Weight loss is particularly important because treatment goals for patients with type 2 diabetes always emphasize weight loss if the individual is overweight, yet the drugs used to treat diabetics can increase the risk of weight gain. Unlike medications, a low-carb dietary approach to type 2 diabetes can deliver improved blood sugar control and weight loss.
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The Side Effects Of Diabetes
1. Weight Gain
On its surface, the management of type 2 diabetes seems pretty easy: just get your blood glucose back down into the normal range. But insulin resistance characterizes type 2 diabetes put simply, the glucose level doesnt want to go down. This means that the body is less responsive to the most powerful drug used to treat it: insulin. So the dose of insulin that most type 2 diabetics are prescribed is sometimes very high. Moreover, because insulin not only drives glucose into muscle cells but also accelerates fat synthesis and storage, weight gain is usually one side effect of aggressive insulin therapy Other pills and injected medications have been developed to reduce this effect, but on average, the harder one tries to control blood glucose, the greater the tendency to weight gain .
The other major side effect of attempting to gain tight control of blood sugar with medication is driving it too low, resulting in hypoglycemia, which causes weakness, shakiness and confusion. If these symptoms appear, the advice is to immediately eat a lot of sugar, which jump-starts the blood sugar roller coaster all over again. Interestingly, once type 2 diabetics work with their doctors to adjust medications, follow the program correctly and complete the first few weeks of the Atkins program, they rarely experience hypoglycemia.
Very Low Carbohydrate Diets
The third treatment is a very-low carbohydrate diet. Carbohydrate restriction can quickly result in lower blood sugar, less reliance on diabetes medications, weight loss, and can reduce hungerâ·. Many of these improvements can be sustained, tooâ¸. Usually, very low carbohydrate diets are defined by an intake less than 50g of total carbohydrates per day.
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Important Points About This Meal Plan
Disclaimer: every effort has been taken to make these meal plans as accurate as possible, but there will be some variation in nutritional values. Speak to a dietitian or your diabetes healthcare team if you have questions about your individual dietary needs.
Can Type 2 Diabetes Be Reversed Naturally
Type 2 diabetes can be reversed naturallyâor without medications and surgeryâwith diet and lifestyle changes. One of the most-studied eating patterns for reducing A1c and medication dependence is carbohydrate restrictionÂ¹Â¹.Reversing diabetes may not be possible for everyoneâfor example, people who are more recently diagnosed may be more likely to achieve reversal naturallyâ¶. But even in the absence of reversal, adherence to some of the natural methods for achieving it may still lead to an overall reduction in A1c, less reliance on diabetes medications, and more benefits like:â¸
- Weight loss
Reverse your diabetes naturallyâsee if you’re eligible for Virta Health.
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How Do Carbs Affect Diabetes
A low-carb diet may be one of the most effective diabetes management strategies, especially for people who might be able to avoid medication.
Carbs elevate blood glucose more than any other food. For people with insulin resistance, blood glucose may remain elevated for hours after eating carbs.
For those with type 1 diabetes who do not produce enough insulin, carbs can also cause blood glucose spikes, so a low-carb diet may help people with both type 1 and type 2 diabetes.
Carbs can also affect a persons health in other ways. Carb-rich foods tend to be high in calories but low in some important nutrients, such as protein. Eating too many of these empty calories can lead to weight gain.
Research shows that people who eat carb-rich foods may also feel more hunger between meals, causing them to overeat.
A low-carb diet may also:
- give a person more energy
- lower average blood glucose, or HbA1c levels
- reduce food cravings, especially for sugar
- lower the risk of hypoglycemia
- aid weight loss efforts
- lower cholesterol
Not Exploring All Of Your Low
What low-carb actually constitutes varies from person to person and researcher to researcher. No universally agreed upon recommendation exists for how many carbs you should eat on a low-carb diet, explains Patti Urbanski, RD, CDCES, a clinical dietitian at St. Lukes Hospitals Diabetes Care Program in Duluth, Minnesota, who has helped create past American Diabetes Association nutritional recommendations
That said, in broad strokes, getting less than 26 percent of your daily calories from carbs can be considered low-carb, according to an article published in January 2020 in StatPearls. For someone eating a 2,000-calorie diet, that would mean eating fewer than 130 grams of carbs per day.
Very low-carb diets involve eating as little as 20 to 50 total grams of carbs per day. Ketogenic diets, which have some overlap with very low-carb diets, can often require eating even fewer grams of carbohydrates per day.
Which ones right for you? There are many factors that must be considered when deciding how many carbs an individual should consume daily, says Lori Zanini, RD, CDCES, whos based in Manhattan Beach, California. Some of these factors include how well controlled blood sugar levels are, current medications or insulin, additional health conditions, food preferences, budget, and health goals.
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Carbohydrates And Blood Sugar
Carbohydrates, or carbs, usually come from starches or sugars and turn into glucose when they are digested. When glucose enters the bloodstream, its called blood glucose, or blood sugar.
The more carbohydrate eaten in a meal, the more sugar is absorbed into the bloodstream and usually the higher the blood sugar will be.
Although very few people would agree that sugary foods are good for you, some foods that we think of as healthy such as fruit can have a lot of sugar. And many people dont know that starchy foods such as bread, rice, pasta, and potatoes quickly turn to sugar when you digest them.10
For some people, eating a potato could raise blood sugar as much as eating 9 teaspoons of sugar! It can be hard to predict exactly how someones blood sugar will respond, as this will likely vary based on genetics and baseline insulin sensitivity.11 By testing your blood sugar before eating and every 30-minutes after eating for up to two hours, you can quickly learn how different foods affect your blood glucose level. The results may surprise you!
Chart: Dr. David Unwin
Keto For T2d: Clinical Evidence
Eating a low-carb diet for type 2 diabetes sounds good in theory. But does it work in practice?
A growing body of literature suggests the answer is yes. In a 2019 consensus report published in the journal Diabetes Care, the authors write that carbohydrate reduction has the most evidence for reducing glycemia in those with type 2 diabetes.
Some of the most compelling evidence comes from a company called Virta Health. Researchers from Virta Health rounded up 218 type 2 diabetics, placed them on a supervised keto diet for a full year, and published the results in the peer-reviewed journal Diabetes Therapy.
Here are some highlights from that 2018 study:
- Average weight loss was 30.4 pounds
- 60% of patients moved from diabetic to prediabetic or normal blood sugar
- 94% of patients reduced or eliminated insulin therapy
Thats nuts, Robb! But what happened to the 87 patients in standard care that served as a control group? Their biomarkers did not improve.
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Is It Possible To Reverse The Lifestyle Disease By Altering Eating Habits And Bringing Positive Changes In Your Regular Routine Read On To Find Out
Type 2 diabetes is a lifelong, metabolic disorder caused by the body’s ineffectiveness in utilising insulin. Insulin is a hormone that helps move glucose from blood to the cells. Ineffective utilisation of insulin leads to accumulation of glucose in the blood, affect overall physiological health and lead to several complications.
T2D is often attributed to lack of physical activity, excess body weight, consumption of high-calorie or high-carbohydrate diet, junk foods and stress.
Growing prevalence of T2D is a matter of concern for healthcare industry worldwide. According to World Health Organization, 422 million people are suffering from T2D across globe, majority of them are living in middle- and low-income countries. A large review in 2020 by Sachin Atre and colleagues screened 1,751 articles and reported the prevalence of T2D in India ranged between 1.9% and 25.2%. In 2019, around 1.5 million deaths were directly caused by T2D.
What is reversal of diabetes?
However, before stopping diabetes medication, discussing with the medical team is a must.
How can diabetes be reversed?
The key to reverse diabetes is to reduce weight. Losing weight can be achieved by several ways among which the safe, scientifically backed lifestyle-based methods can be eating a low-carbohydrate diet, physical activity and managing stress.
Diabetes diet is a myth
How The Keto Diet Helps Reverse Type 2 Diabetes
The keto diet is an extremely helpful method in reversing Type 2 Diabetes as it helps people maintain a low blood sugar content. It is able to do this due to its high-fat, low-carb diet structure and forcing the body into Ketosis – burning fat as opposed to carbs. When the body burns fat particles, ketones are produced. Ketones are small molecules that are comprised of fat and are made in the liver. From there, energy is created, which travels to the vital organs, including the heart, brain, and the muscles. New evidence is emerging that ketones are able to reduce oxidative stress, otherwise known as free radicals, as well as inflammation. Both these ailments are known to be underlying causes behind the emergence of Type 2 Diabetes.
Since ketones serve a double function in the body – they work as an energy provider as well as a metabolic regulator. Keto Diets are readily believed to be effective remedies in treating Type 2 Diabetes. Ketosis can reduce blood glucose and improve the bodys sensitivity to the hormone insulin, as well as reducing inflammation.
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The Misconception Around Glycemic Index
Another reason that people are afraid of a low-fat diet is a misconception around the Glycemic Index. The Glycemic Index is a measure of how fast your blood sugar will spike after ingesting certain types of foods.
This is a very helpful tool if you’re living with diabetes, because you’re able to understand which foods will cause blood sugar levels to rise, and by how much but the problem is that people assume you need to avoid foods with a high Glycemic Index.
However, just because something has a higher GI doesn’t mean it’s not healthy! Low-fat whole grains have been shown in multiple studies to benefit people living with diabetes by reducing insulin resistance and helping their cells process glucose normally. And yet, they’re higher on the glycemic index.
Fruits like watermelon and bananas are similar — great for reducing insulin resistance, but high on the Glycemic Index.