Low-carb and Diabetes

I'm not officially "diabetic" but my doctor says I am "prediabetic". So some time back I got a blood glucose meter and tested myself for a while. Since then I have also started a very low-carb diet (call it Primal/Paleo or LCHF) and have lost a lot of weight. My HbA1C tests have showed I am still on the borderline, but my doctor says it shows "excellent control" (mine is 5.1%, non-diabetic will be 4.9% or less).

So I probably still have some level of insulin resistance, and will keep checking things. But, I am happy with the weight loss (70 pounds so far in the last 18 months) and I'm feeling great.

I found some links to suggest that the ADA still doesn't "recommend" low-carb diets, but has admitted that they are useful for some people. Looks like the biggest concerns they have are "other side effects" (i.e. not having to do with diabetes) and "compliance" (meaning that users will not stick to the diet).

Progression of info from ADA:
2006: ADA: Low Carb Diet Helps Diabetics, but Still Not Recommended — Patients Left On Their Own to Find Best Diet for Them
2007: Diabetes and Low-Carb Diets — Guidelines May Be Changing Soon
2008: ADA approved low-carb diets for weight loss, but not blood glucose control.
2009: A Low-Carb Diet Shown to Reverse Type 2 Diabetes — Study Proves Very Low Carb Diet is Effective (Not from ADA)
2011: Are carbs the enemy? (Diabetes Forecast Magazine)

The last one is a typical "mashup" magazine article that does a lot of quoting various experts, all of whom disagree, and doesn't really show any facts. The ADA party line is still that "You can do it for weight loss if you wanbt but it's not what we recommend for maintenance" – still quoting the conventional wisdom that "fat is bad, fat leads to heart disease" and "low-carb diets are a fad — people don't stick to them."

But, the official establishment (at least in US and UK) is that diabetics should continue to eat carbs, and should continue to chase them with added insulin and other medications.

Something has always struck me as fishy about this line of reasoning:
When you eat sugar or starch, your blood sugar level goes up
This triggers the production of insulin which in turn triggers your body's cells to store the blood sugar (somewhere?)
When this happens too often, your cells get resistant to the insulin and don't store the sugar
If you are insulin-resistant, or if you aren't producing enough, the excess sugar makes you feel crappy
The body will take the sugar out through your urine, but it has to be dangerously high to trigger this
Therefore we want you to keep eating sugar and starch.  (I'm sorry, what?)
Just keep track of how much you're eating and spread it out over time, plus inject some insulin (Wait, didn't you just say that starch and sugar started all this?)
By the way, we noticed you are fat, so eat less fat, because the word "fat" rhymes with "fat" so it must relate somehow  (OK now you're just making sh!t up, aren't you)

The official stance of ADA and Diabetes UK is still that diabetic patients "should have the right to enjoy the same diet as everyone else" — they just need to closely monitor its effects on them and take the right meds.

The other thing that doesn't quite ring true for me is the line about "you should have a balanced diet and have everything in moderation".  Sure, this sounds like good advice, but people fail to consider that today's "low-fat" diet craze it itself quite new.  These days the mainstream of doctors, nutritionists and media all say "Everything in moderation" but still they say *fat* is what needs to be moderated.  I mean, it still sounds like "Everyone knows Fat is bad for you, well except 'good fats'".   Sure, low-carb diets are one extreme, but the standard US diet is also an extreme.  Bacon and eggs are not new, bread is not new, but we are eating way more bread, and way less bacon/eggs/butter/oils than 50 or 100 years ago. 

Seriously, low-fat diets and emphasis on low-fat foods was not heard of before 50 years ago, and has really taken off in the last 30 years.  Has it helped the levels of obesity and diabetes in the US? 

In general I don't think doctors are recommending low-carb diets for people, mostly because "the evidence isn't there yet"… But, in my case my doctor has been quite supportive of what I say I want to try.  So, if you think it might work well for you also, check with your own doctor.  I wouldn't necessarily start with "Do you recommend low-carb diets" but instead start with "I'd like to try reducing my sugar and starch — what should I be aware of? And what should I watch out for?"

8 thoughts on “Low-carb and Diabetes

  1. arkady

    My partner () has been on a low-carb diet – a sort of modified version of Atkins – for over a year now and is having no problems keeping to it; he has one “binge day” a week in which he eats carbs, including lots of sugary, fattening stuff like cakes & sweets & fizzy drinks and sticks strictly to it the rest of the week. It’s got to the point where he actually finds binge days to be onerous and often skips it. He’s lost over 10kg on it and is finding it really easy to stick to.

    It’s not practical for the whole family to be on the same diet, because my 5-year-old daughter does need the carbs – and on my last lot of bloods I had a slightly elevated cholesterol reading so I’m not sure it would be a good idea for me. Instead I’m opting not to change what I’m eating – instead I’m being more cautious about portion sizes. I think part of the problem with obesity in the West is that portion sizes have more than doubled or even trebled in the past 60 years. Smaller portion sizes and more exercise is probably the key to weight-loss more than “extreme” diets.

    1. gconnor

      I totally agree, that portion sizes (especially in restaurants) have ballooned recently. I think it is important to be aware of them, but I’m increasingly skeptical that portion size is the most important thing.

      In the last18 months I have tried two different diets. One was a very typical “small portions, spaced out during the day” low-fat diet, typical of the mainstream dieting literature. It was effective–I lost 25 pounds (11kg) but I found that I really had to eat 6x per day and watch portion sizes very carefully. I eventually got distracted by something shiny (might have been Las Vegas) and set it aside.

      More recently (since Sep of last year, so 10 months) I have gone very-low-carb (moving from 50C/30F/20P to 60F/20C/20P) and this plan has been much more effortless. I do count calories, but if I am hungry, I eat, and sometimes that means I go over my calorie goal.

      I’ve found that I am able to go longer between meals, and if I skip a meal, I almost don’t notice it. I’d like to think I’ve trained my body to burn fat so it is just accessing the not-so-strategic energy reserve on days when I skip a meal. Mostly I have been eating 2-3 times a day and snacking 1-2 times a day (like “normal people” do :)

      I also do the “cheat day” method, but even on my cheat day I find that I don’t crave sugar/starch, and a much smaller amount satisfies me.

      Anyway on the low-carb plan I have lost another 50 pounds (22kg) and I’m enjoying it much more.

      I really think that everyone needs a slightly different balance of Protein/Fat/Carb, and one size can’t fit all, but I also think most people in the US are oblivious to their balance and just alternate between eating what they want and avoiding fatty foods, neither of which help them. Anyone who is aware of their carbs and tracking what she eats (which it sounds like you are) is way ahead of the game in my opinion.

      I was able to go really really low, but my sweetie tried it and could not go as low — it triggered her depression and she was suicidal for a time until we figured out what was wrong. I would advise people to tread very carefully on the very-low side (like

  2. firecat

    I have had diabetes for a while. I lasted about four months on a low carb diet. I know some people who were able to maintain it for longer, but overall I think it’s right that they are hard to stick to, just like the other kinds of restrictive diets. If it’s working for you, though, that’s cool.

    1. gconnor

      Thanks for taking the time to read and comment.

      I’m curious, did you go back to your previous diet after stopping the low-carb plan, or did you end up at a lower carb baseline?

      Take care.

      1. firecat

        I notice this: if my bgs are not well controlled, I am hungry for carbs all the time. If they are OK, I don’t want as many carbs. So when I’m doing well, I have a lower carb baseline than when I’m not — not “low carb” though.

  3. gconnor

    Something else I wrote on Facebook recently… a lot of friends are linked there but not everyone…

    I have come to believe that the mix of carb/protein/fat calories is the #1 *most* important measure of a diet.. there are plenty of other concerns but I believe they are all minor compared to C/P/F ratio. Right now mine is about 20% carb/20% protein/60% fat and I feel much better than when I was at 50% carbs.

    1. Eat nothing toxic
    2. Eat the right balance of protein, fat, carbs.
    3. Everything else ;)

  4. Anonymous


    Thanks for your comment on my lose it post. Since the bariatric surgery, the dr told me I have to eat 90 grams of protein a day. After net searches of people with the same surgery, i found that i ought to be eating low carb as well. The dr had said low carb and low fat but i couldn’t do that. I eat high protein/ high fat and am still ravenous. After your post, I had a heaping tbls of peanut butter and feel much better. I am going to up my fat for a while and see if that helps.

    Thanks for the post.

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