- Diabetes is the inability of the body to safely metabolise the glucose and carbohydrate load it is presented with.
- Type 2 Diabetes is increasing in all society
- Obesity is the single greatest risk factor, even though ‘skinny’ people can develop Diabetes.
- Sugar Diabetes should be called CARBOHYDRATE Diabetes
- Insulin resistance at tissue level and particularly muscle
- Circulating fatty acids in the body have a negative feedback effect through IRS-1 on the muscle. This inhibits the effect of insulin upon muscle and its absorption of glucose.
- Childhood Type 1 Diabetes is increasing about 3% per annum.
- Seriously consider a Low Carbohydrate and Healthy Fat (LCHF) diet in Diabetes management
The long term complications of diabetes are related to poor blood glucose control.
Hyperglycaemia affects all tissue by way of the Maillard reaction and results in chronically damaged tissue.
Low carb living results in better blood glucose control, lower medication, less hypoglycaemic events, better weight control and getting ‘life’ back in control.
People with diabetes have a carbohydrate intolerance – it all comes down to glucose. Most carbohydrate breaks down ultimately to glucose. It’s just a matter of time. If you are intolerant of something, avoid it.
There is no absolute requirement for INGESTED carbohydrate, apart from the micronutrients. The small amount of glucose that the red blood cells and the thin cells in the loop of Henle in the kidney require can be manufactured by gluconeogenesis in the liver from protein.
Need personalised LCHF nutrition in Diabetes T1 and T2 management
Based in Launceston and Hobart, Tasmania help is available. They Skype aound Australia as an outreach service.
The consumption of Sugar and Polyunsaturated Seed Oils combine in our diet to create inflammation in every blood vessel wall and in every tissue in every organ of the body. The inflammatory process makes everything susceptible to damage and disease.
We have previously studied the economic cost of managing the well diabetic patient in 2011. We will effectively be spending the entire Australian health budget within 20 years just managing the well diabetic without complicating features. This is clearly unsustainable and a significant shift in society’s approach to health is going to be required.
A complete change of our dietary intake away from refined carbohydrate, fructose and polyunsaturated loads seems to be a reasonable option to consider. However, are we ready to make the big shift as a society?
Sugar Diabetes should be renamed ‘Carbohydrate’ Diabetes
Facebook Blog 14 August 2013
Please let all Diabetics know this basic fact. It will make a BIG difference.
It may be worth considering a Low and Complex Carbohydrate diet in the control of Type 1 and 2 Diabetes and in the avoidance of Type 2 Diabetes.
Most people think that Diabetes is a condition where the body has trouble controlling sugar and how it affects the blood sugar level. It is really about controlling carbohydrate!
Most people do not realise that sugar is just one form of carbohydrate and that all of the carbohydrate will affect blood glucose levels fairly rapidly. That is why the refined flours, breads, pasta, white rice, potatoes and other starches can cause a rapid rise in blood glucose and a spike in Insulin response.
These rapid responses and insulin spikes are probably accounting for the insulin resistance that is on the increase across the community. Our sugar intake is a huge part of this and the Fructose compounds the problem along a different pathway to the carbohydrate.
Most dietary advice for Diabetic patients is to maintain a regular amount of food coming in during the day and they encourage carbs in the form of breads, grains and fruit – all off that damn ‘food pyramid’. You are then encouraged to take medication and in particular Insulin to match your carbohydrate and sugar load. If you have more rapidly absorbed carbohydrate in your diet then you need more medication.
The problem of medical control in Diabetes is setting the level of medication to control the carbohydrate load. All Diabetic patients know to avoid high amounts of sugar unless they are having a hypoglycaemic event.
Most Diabetic patients are not taught to avoid a high carbohydrate load. This is an education issue.
It makes sense to cut the carbohydrate load way down and then you require less medication.
I have been encouraging patients down this path and seen some remarkable turn arounds in their overall Diabetic control.
I had one patient in hospital recently with poorly controlled Diabetes and we halved her Insulin requirement just by me taking her fruit bowl away.
This week’s Health Report on the ABC highlights one doctor’s personal journey and revelation of adopting a Low and Complex Carbohydrate diet in his Type 1 Diabetic management. It is just as relevant for all Diabetic and pre diabetic patients. I believe it is relevant for all of us.
It is not a matter of just switching over to this, particularly if you have fragile control. Discuss it with your own doctor and do it over some weeks. Go to the Diabetes part of my website for relevant articles and more information
A bit more info.
At a tissue level our cells require glucose for their energy metabolism – not sugar or sucrose or carbohydrate or fat or protein. All of these substances can be turned into glucose by a variety of pathways. The carbohydrates do it faster in general.
The carbohydrates include glucose, sucrose and the starches. The simpler the carbohydrate the more rapid is the absorption across the gut wall and into the bloodstream. Grains and brown rice have more fibre within them and have a slower absorption profile across the gut. This means slower blood glucose level rises and less insulin spikes.
So if you want some carbohydrate go with the grains, brown rice, vegetables and particularly the green leafy ones.
CSIRO backs Low Carbohydrate management of Diabetes
That’s it for the naysayers.
50 grams per day. That’s very low carb and with great results.
Pennie Taylor is a senior research dietitian at the CSIRO and we had the pleasure of hosting her on Saturday for the “Choose Health” forum attended by 250 plus participants. (5/9/2015)
Pennie presented the latest results of the CSIRO’s 2 year study of very low carb versus ‘traditional guideline’ high carb dietary management. Low carb gave significantly better results in blood glucose control and cardiovascular risk factors. The low carb participants had a significant reduction in their medication requirements.
The study results build upon exactly what I have been advocating for the last few years, based on international literature. We now have local confirmation from Australia’s peak research body.
The CSIRO work is solid and is now being expanded out into the next phase as a community trial. Our Dietitians and Diabetes Nurse Educator at the Nutrition for Life Centre had the opportunity to liaise on the mutual ground and we hope to do some collaborative work with her.
We had many health practitioners and influencers of our community there this time. These people will help inform more and more people that there is an option in diet and lifestyle. Lowering Carbohydrates is integral to that.
Low Carbohydrate management in Diabetes and other health conditions is a real option. Our hospital services have to reflect the current research and cannot continue to ignore it, let alone call it a fad diet.
The emotion behind the diagnosis of diabetes.
Ketogenic Diets for Diabetes Control
Dr Troy Stapleton talks about a very low carbohydrate’ Ketogenic’ diet in controlling his Diabetes
David Dikeman living with his Type 1
Lisa Schreger telling her LCHF story for her teenager and getting control
Low Carb and Gestational Diabetes
Type 1 Childhood Diabetes
Is the increase in Type 1 Childhood Diabetes related to a maternal or infant exposure to high levels of Fructose and Polyunsaturated Oils?
It has generally been thought to be associated with Autoimmune Disease processes
Type 2 Diabetes
Theoretically if the chronic inflammatory state can be reduced before complete insulin resistance and the requirement for an injectable insulin, there may be a potential to reduce the incidence of diabetes with a combination of removal of fructose and polyunsaturated oils out of the diet and with a reduction of weight.
Low Carb Eating and Diabetes Facebook 11 4 2014
I keep coming back to this topic as I think it is the future of Diabetes management – both type 1 and type 2.
I think it also a major player in the prevention of Type 2 Diabetes.
If you have trouble processing something – avoid it. If you have a gluten sensitivity then you avoid gluten. Same goes with all food intolerances.
Diabetes is no different. I know that within seconds critics of this concept will tell me we need to have sugar and carbohydrate in our diet.
Our bodies will metabolise a baseline amount of glucose from all foods including protein and fat and from our fat stores.
When we take in sugar (glucose and fructose) and carbohydrate (essentially glucose), then that pushes up the blood glucose level and it is then that we produce insulin to start storing the excess. Pretty basic.
Now Type 1 Diabetics do not produce enough or any insulin so they need to inject some to bring that blood glucose level down to ‘normal’ and to help push the glucose into cells.
The Type 2 Diabetics are resistant to the effects of insulin so need bigger doses of insulin or other drugs to move it out of the bloodstream.
And so starts up this cycle of ongoing and increasing doses of insulin. When it becomes ineffective then the long term complicaions of raised blood glucose catch up.
I have just been introduced to the UK forum group – Diabetes.co.uk
This is the first Diabetes Group that I have found that openly discuss the LOW CARB option and recommend it.
It has more than a 100000 members and guess what – it is not run by government agencies or the food industry.
Take a look at this group at www.diabetes.co.uk and the pages around this topic of LOW CARB eating.
It may very well save someone you know from the long term complications of Diabetes. So important!
The diet recommended by the American Diabetes Association (and our Australian Dietitians Association) of a medium carbohydrate, low fat, calorie-restricted, carbohydrate counting diet failed in comparison to a diet of nutritional ketosis with educational support.
Type 2 Diabetes is a management problem of handling too much glucose.
The simplest way to manage that is to restrict the glucose load and that simply comes down to restricting sugar and carbohydrates (which are predominantly just glucose). Restricting fat and calories just does not work nearly as well.
Here is another study pointing us in the direction of common sense.
The very low carbohydrate, high fat and NON CALORIE RESTRICTED group lost more weight with better blood glucose control and a reduced need for medication – all in 3 months.
About a third of the population are Diabetic or pre Diabetic!
This is a definitive paper just released.
Avoid and treat Type 2 Diabetes and control Type 1 Diabetes. Same goes with your health.
EVERY diabetic patient I know that reduces their carbohydrate content in a controlled manner has an improvement.
Diabetes should be called Carbohydrate Diabetes and not Sugar Diabetes. It is a problem of handling glucose load and that is all carbohydrate is. In fact sugar or sucrose is just a form of carbohydrate.
Here are the major points for people with Diabetes but the same goes for everyone.
• We present major evidence for low-carbohydrate diets as first approach for diabetes.
• Such diets reliably reduce high blood glucose, the most salient feature of diabetes.
• Benefits do not require weight loss although nothing is better for weight reduction. • Carbohydrate-restricted diets reduce or eliminate medication.
• There are no side effects comparable to those seen in intensive treatment with drugs.
The 12 Points of Evidence
1. Hyperglycemia is the most salient feature of diabetes. Dietary carbohydrate restriction has the greatest effect on decreasing blood glucose levels.
2. During the epidemics of obesity and type 2 diabetes, caloric increases have been due almost entirely to increased carbohydrate.
3. Benefits of dietary carbohydrate restriction do not require weight loss.
4. Although weight loss is not required for benefit, no dietary intervention is better than carbohydrate restriction for weight loss.
5. Adherence to low-carbohydrate diets in people with type 2 diabetes is at least as good as adherence to any other dietary interventions and is frequently significantly better.
6. Replacement of carbohydrate with protein is generally beneficial.
7. Dietary total and saturated fat do not correlate with risk of CVD.
8. Plasma saturated fatty acids are controlled by dietary carbohydrate more than by dietary lipids.
9. The best predictor of microvascular and, to a lesser extent, macro-vascular complications in patients with type 2 diabetes, is glycemic control (HbA1c).
10. Dietary carbohydrate restriction is the most effective method (other than starvation) of reducing serum triglycerides and increasing high-density lipoprotein (HDL).
11. Patients with type 2 diabetes on carbohydrate-restricted diets reduce and frequently eliminate medication. People with type 1 usually require lower insulin.
12. Intensive glucose lowering by dietary carbohydrate restriction has no side effects comparable to the effects of intensive pharmacologic.
Great article that spells out the current science – reduce your sugar and carbs for your health – please. I would replace the carbs with more fat.
The medical profession and Diabetes Australia will come out of their ‘coma’ one day and wake up to the science.
Are most of us Type 2 Diabetic or Pre Diabetic?
I think we are as long as we consume the amounts of carbohydrate and processed food in the ‘average’ diet.
The massive glucose load of sugar and carbohydrate combined with low grade inflammation over a long term puts the pancreas in a state of exhaustion.
May 8 2015
Type II Diabetes Mellitus is an insulin resistance at a tissue level. There are a variety of tissue effects as a result of chronic Fructose load.
This can happen because of high levels of free fatty acid affecting circulating triglycerides.
A chronic ATP depletion as a result of phosphorylation of Fructose creates a uric acid load. This has a nitric oxide vasoconstriction on tissue as well as increasing oxidative stress within tissue. The overall effect over time is that of insulin resistance.
The hyperuricemia also results in an inhibition of endothelial nitric oxide which has a vasoconstrictive effect on tissue.
The increase in the amount of circulating fatty acids in the body and the negative feedback effect through IRS-1 on the muscle itself inhibits the effect of insulin upon muscle and its absorption of glucose.
Insulin receptor substrate 1 plays a key role in transmitting signals from the insulin and insulin-like growth factor-1 (IGF-1) receptors to intracellular pathways.
Inflammation and oxidative stress within the adipocyte
Uric acid has been implicated in having a direct effect on the adipocyte (fat cell). It creates a combination of oxidative stress and inflammation within the tissue itself.
There is an increased amount of polyunsaturated oils within subcutaneous fat over the last 50 years. This increases the potential for inflammation within fat tissue.
Sugar Sweetened Beverages linked to Diabetes and Metabolic Syndrome
and artificially sweetened beverages
Artificial sweeteners induce glucose intolerance by altering the gut microbiota.
Read about the Damage Process
Read about the Metabolism
Read about the Health Issues
The NoFructose Handout Starter Sheet is your take away summary of this web site. Read it at the NoFructose Starter Sheet area of this web site or download it.
Please add information by going to Contribute to NoFructose.com
Effect of low-calorie versus low–carbohydrate ketogenic diet in type 2 diabetes.
Al Shaab Family Medicine Medical Center, Ministry of Health, Kuwait.
Effective diabetic management requires reasonable weight control. Previous studies from our laboratory have shown the beneficial effects of a low–carbohydrate ketogenic diet (LCKD) in patients with type 2 diabetes after its long term administration. Furthermore, it favorably alters the cardiac risk factors even in hyperlipidemic obese subjects. These studies have indicated that, in addition to decreasing body weight and improving glycemia, LCKD can be effective in decreasing antidiabetic medication dosage. Similar to the LCKD, the conventional low-calorie, high nutritional value diet is also used for weight loss. The purpose of this study was to understand the beneficial effects of LCKD compared with the low-calorie diet (LCD) in improving glycemia.
Three hundred and sixty-three overweight and obese participants were recruited from the Al-Shaab Clinic for a 24-wk diet intervention trial; 102 of them had type 2 diabetes. The participants were advised to choose LCD or LDKD, depending on their preference. Body weight, body mass index, changes in waist circumference, blood glucose level, changes in hemoglobin and glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, uric acid, urea and creatinine were determined before and at 4, 8, 12, 16, 20, and 24 wk after the administration of the LCD or LCKD. The initial dose of some antidiabetic medications was decreased to half and some were discontinued at the beginning of the dietary program in the LCKD group. Dietary counseling and further medication adjustment were done on a biweekly basis.
The LCD and LCKD had beneficial effects on all the parameters examined. Interestingly, these changes were more significant in subjects who were on the LCKD as compared with those on the LCD. Changes in the level of creatinine were not statistically significant.
This study shows the beneficial effects of a ketogenic diet over the conventional LCD in obese diabetic subjects. The ketogenic diet appears to improve glycemic control. Therefore, diabetic patients on a ketogenic diet should be under strict medical supervision because the LCKD can significantly lower blood glucose levels
Beneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity.
Center of Diabetes, Endocrine and Metabolism, Sakura Hospital, School of Medicine, Toho University, 564-1 Shimoshizu, Sakura-City, Chiba 285-0841, Japan.
The adequate composition of carbohydrate and fat in low calorie diets for type 2 diabetes mellitus patients with obesity is not fully established. The aim of this study was to investigate the effects of low carbohydrate diet on glucose and lipid metabolism, especially on visceral fat accumulation, and comparing that of a high carbohydrate diet. Obese subjects with type 2 diabetes mellitus were randomly assigned to take a low calorie and low carbohydrate diet (n = 11, 1000 kcal per day, protein:carbohydrate:fat = 25:40:35) or a low calorie and high carbohydrate diet (n = 11, 1000 kcal per day, protein:carbohydrate:fat = 25:65:10) for 4 weeks. Similar decreases in body weight and serum glucose levels were observed in both groups. Fasting serum insulin levels were reduced in the low carbohydrate diet group compared to the high carbohydrate diet group (-30% versus -10%, P < 0.05). Total serum cholesterol and triglyceride levels decreased in both groups, but were not significantly different from each other. High-density lipoprotein-cholesterol (HDL-C) increased in the low carbohydrate diet group but not in the high carbohydrate diet group (+15% versus 0%, P < 0.01). There was a larger decrease in visceral fat area measured by computed tomography in the low carbohydrate diet group compared to the high carbohydrate diet group (-40 cm(2) versus -10 cm(2), P < 0.05). The ratio of visceral fat area to subcutaneous fat area did not change in the high carbohydrate diet group (from 0.70 to 0.68), but it decreased significantly in the low carbohydrate diet group (from 0.69 to 0.47, P < 0.005). These results suggest that, when restrict diet was made isocaloric, a low calorie/low carbohydrate diet might be more effective treatment for a reduction of visceral fat, improved insulin sensitivity and increased in HDL-C levels than low calorie/high carbohydrate diet in obese subjects with type 2 diabetes mellitus.
Treatment of diabetes and diabetic complications with a ketogenic diet.
1The Graduate School of the Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Accumulating evidence suggests that low–carbohydrate, high-fat diets are safe and effective to reduce glycemia in diabetic patients without producing significant cardiovascular risks. Most of these studies have been carried out specifically restricting carbohydrates, which tends to lead to increased protein intake, thus reducing the ketosis. However, diets that limit protein as well as carbohydrates, entailing a composition very high in fat, appear even more effective to reduce glucose and whole-body glucose metabolism in humans. In animal models, low–carbohydrate, high-protein diets do not produce ketosis or reduce glycemia but rather cause obesity. However, limiting both protein and carbohydrates as in a classic ketogenic diet remarkably reduces blood glucose in animal models of type 1 and type 2 diabetes and reverses diabetic nephropathy. Future studies should assess if ketogenic diets would be effective to reverse diabetic complications in humans.
Effects of Low–Carbohydrate/High-Monounsaturated Fatty Acid Liquid Diets on Diurnal Glucose Variability and Insulin Dose in Type 2 Diabetes Patients on Tube Feeding Who Require Insulin Therapy.
1 Division of Diabetes and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine , Tokyo, Japan .
Abstract Objective: A low–carbohydrate/high-monounsaturated fatty acid liquid diet (LC/HMD) was investigated for its role in long-term glycemic control in tube-fed type 2 diabetes patients who require insulin therapy. Patients and Methods: The study included 10 type 2 diabetes patients requiring insulin therapy who were being tube-fed with a high-carbohydrate liquid diet (HCD). With stable glucose control maintained, these patients were monitored for glucose levels for 4 consecutive days by using continuous glucose monitoring (CGM). The patients were continued on HCD during the first 2 days and were switched to an LC/HMD during the final 2 days. The patients were then continued on the LC/HMD, and seven of the 10 patients were monitored for glucose levels for 2 consecutive days by using CGM after 3 months of feeding with the LC/HMD. Insulin regimens used included basal-bolus insulin in five of these seven patients and intermediate-acting insulin in two patients. Results: Based on CGM data, the indices for glucose variability, such as SDs of 288 glucose levels for 24 h, total area for the range of glucose variability, mean amplitude of glycemic excursions, and 24-h mean glucose levels were significantly decreased 3 months after switching from the HCD to the LC/HMD. Additionally, despite the significant decrease in required insulin dose, the hemoglobin A1c (HbA1c) values were significantly decreased 3 months after switching. Conclusions: Study results demonstrated that the LC/HMD not only narrowed the range of glucose variability, but also decreased the required insulin dose and HbA1c values in diabetes patients on tube feeding who required insulin therapy, suggesting the LC/HMD may be useful in long-term glycemic control in these patients.