Low Sugar, Low Carbohydrate Diet as the First Step in Type 2 Diabetes Management

In my post before the last one, I reviewed the hard science of type 2 diabetes that showed diabetes is late disease when it is first diagnosed. Patients who are newly diabetic are maximally insulin resistant and have lost 80% of their ability to produce insulin. In my last post, I told you how advocates of lifestyle medicine promote diet as a primary intervention for type 2 diabetes to achieve remission by emphasizing whole, plant-based foods with minimal consumption of meat and other animal products.

Let’s explore that diet in a little more detail. “As far back as the 1950s, studies have been published on treating hyperglycemia with a high-carbohydrate, low-fat diet….There is a general consensus that the elements of a whole-foods plant-based diet—legumes (beans and peas), whole grains, fruits, vegetables, and nuts, with limited or no intake of refined foods and animal products—are highly beneficial for preventing and treating type 2 diabetes.” This diet is confusing and it is very different from the food culture in most American families. It discusses a high fiber, low fat diet and later on in the article relates the benefits of certain fats from plant sources.

If you are on a plant-based diet, many more of your calories are coming from carbohydrate and the carbohydrate or starch calories you absorb all become glucose— the sugar that goes up in your blood in diabetes. The concept of whole grains is especially confusing. The glycemic index compares the impact of any given food on glucose level compared with taking in glucose itself. Glucose has a glycemic index level of 100. A baked russet potato has a glycemic index of 111. Your blood glucose goes up more rapidly when you eat a russet potato than when you consume pure glucose. A white flour baguette is almost as bad at 95. When you eat that baguette, your sugar goes up almost as fast as eating pure sugar.

The plant-based diet recommends eating whole grains and that can be confusing and problematic. White wheat flour bread has a glycemic index of 75. Wonder bread is 73. Whole wheat bread on average has a glycemic index of 69— very little difference. White spaghetti is 46 and whole grain spaghetti is 42. Once again there is very little difference. As a general rule, the higher the fiber content, the lower the impact of a carb on your sugar level. Fiber counts as carbs but is passes right though you. It is not absorbed. Dave’s Killer 21 seed bread has five grams of fiber. Barilla’s whole grain pasta has seven grams of fiber per serving. Those are the highest fiber contents that I have seen. Barilla’s whole grain pasta has a glycemic index of 37 which makes it a low glycemic index food. If you are going to eat grain products, eating Barilla’s whole grain pasta is the best you can do and that is all that I buy.

That said, humans have only been farming and growing grains for about 10,000 years. Prior to that, we were hunter gatherers. Ten thousand years is the blink of an eye in terms of evolution and our bodies evolved to eat things that we hunted and gathered. As recently as the mid-1800s, Native Americans on the plains ate very little grain. If you are a type 2 diabetic and your blood sugar is running high, one of the best things you can do is cut your carbohydrate content, especially those concentrated carbs coming from grains.

One of the best supports for this idea comes from the experience of the marathon runner Tim Noakes. He was a serious runner who trained for marathons. He wrote books that including information on carb loading. He practiced carb loading and he gained 40 pounds and became diabetic. He cut way back on his carbs, lost weight, and achieved excellent control of his diabetes. Tim’s experience is proof positive that carbs can overcome exercise and make you diabetic no matter how intense your exercise program is. You can’t outrun a spoon.

There are many serious scientists who believe that carb restriction is a huge factor in preventing and controlling diabetes. “The benefits of carbohydrate restriction in diabetes are immediate and well documented.” The key feature of type 2 diabetes is sugar elevation and the idea that reducing carbohydrate and sugar in the diet would lower sugar is borne out by experience and experiment with no significant exceptions. If you have type 2 diabetes and your sugar is poorly controlled, limiting the carbs and sugar in your food and drink should be a major concern and goal. The most sensible and sustainable diet for diabetes and weight loss is lean meat, eggs, seafood, fruits, vegetables, beans, peas, and nuts. Products made from grains, even whole grains, may keep your sugar high and you should cut back on grain products until you can control your sugar level. That can help you avoid much more expensive medicines and insulin injections. It can slow or halt the progression of your diabetes.