Type 2 Diabetes
Learn how our type 2 diabetes resources can help you.
Carbohydrate Restriction for Type 2 Diabetes
Individuals with type 2 diabetes (T2D) are not able to efficiently metabolize dietary carbohydrates (starches and sugars) due to an insufficient production of the hormone insulin by the beta cells of the pancreas. It is for this reason that individuals with advanced T2D may be prescribed exogenous insulin (which is often administered by injection). Other pharmacologic approaches to treating T2D rely on reducing the liver’s production of glucose (sugar), increasing secretion of insulin from the beta cells, stimulating excretion of glucose by the kidney, or sensitizing the body’s tissues to insulin. None of these pharmacologic approaches addresses the root cause of T2D; although they may be effective in managing glucose (keeping blood sugar low), they do not prevent disease progression.
Fuel Metabolism
The only way to prevent disease progression, and to possibly promote disease remission, is to address the underlying cause of T2D, which lies in fuel metabolism. Individuals with T2D invariably have high amounts of fatty acids stored in organs and muscle. This “ectopic” fat storage is pathological, meaning that it leads to disease. Humans were designed to store excess fuel in adipose tissue deposits found primarily around the hips and thigh; they were not designed to store fat in or around the liver, the pancreas, the kidneys, the heart, or skeletal muscle. Fat that is stored ectopically is a signal that a problem exists with fuel metabolism, and is strongly associated with the development of chronic disease.
Metabolism & Carbohydrates
Defects in fuel metabolism are often caused by excessive consumption of carbohydrate-containing foods, such as starches & sugars (bread, pasta, cookies, snack cakes, etc.). Humans have only a very small capacity to store carbohydrates, which are converted to glycogen & stored in the muscle and liver to be used as a quick-release fuel. Rather, humans were designed to store excess fuel as fat in adipose tissue. Historically, humans ate more fat than carbohydrates, which were present only seasonally as fruit and honey. Most of the year we consumed fat and protein, and stored any excess fuel as fat. The modern diet contrasts sharply with our ancestral diet, being heavy in processed starches. We are not adapted to this diet, which is why the rates of obesity, T2D, and other chronic diseases are so high today. The excess carbohydrates that we consume are converted to long-chain fatty acids, which in susceptible individuals, are stored as ectopic fat. Thus, paradoxically, it is excess carbohydrate consumption that leads to ectopic fat storage, which leads to disease.
Development of T2D
Given the strong association between consumption of excess carbohydrates and the development of T2D, it makes sense that the most logical and effective treatment for T2D is to limit carbohydrate consumption. Numerous articles in the literature have documented the effectiveness of low carbohydrate diets in individuals with T2D (see citations below). Low carbohydrate diets are safe and sustainable, and are much closer to our ancestral diet than is a diet rich in heavily processed starches.
Manage T2D without Drugs
Our low-carbohydrate diet for T2D is rich in fat- and protein-containing foods, and very low in carbohydrates. It is very effective at lowering blood glucose and in many cases, allowing for management of T2D without drugs. It contains no fruit and no “starchy” vegetables such as corn and lima beans. We are sometimes asked whether this diet contains sufficient fiber, vitamins, and minerals to be healthy. Because the low carbohydrate diet contains ample non-starchy vegetables, it is sufficiently nutritious to maintain good health. High-sugar, high-starch diets cause a lot of oxidative stress, which depletes anti-oxidants such as vitamins. Thus, if you do not consume a lot of sugar and starch, your requirement for vitamins declines, and your need to supplement vitamins by eating fruit is not necessary. Your body makes its own anti-oxidants, which are sufficient to maintain good health in the context of a low-carbohydrate diet.
Low-Carbohydrate Diet for T2D
Details of the diet that we use for treating T2D can be found here. Many patients with T2D who use this diet no longer require medication, or find that their need for medication is reduced. Continuing to use medication for T2D when using a low-carbohydrate diet can lead to dangerously low blood sugar. Please talk with your doctor about reducing your medication before starting this diet. Guidelines for reducing diabetes medication when starting a low-carbohydrate diet can be found here.
Further Reading
Different types of type 2 diabetes based on genotype and phenotype:
Drugs mask progression of T2D:
Increased consumption of carbohydrates correlates with increased prevalence of obesity in the US:
“Statistical review of U.S. macronutrient consumption data, 1965–2011.”
Low carb diets beneficial in T2D:
Guidelines for reducing diabetes medication when starting a low-carbohydrate diet:
“Adapting Medication for Type 2 Diabetes to a Low Carbohydrate Diet.”
