New Study: A Low-Carb Diet and Intermittent Fasting Beneficial for Diabetics!

A Mediterranean breakfast without carbohydrates

A Mediterranean breakfast without carbohydrates

A new exciting Swedish study provides us with strong clues on how a person with diabetes should eat (and how to eat to maximize fat burning). It’s the first study to examine in detail how various blood markers change throughout the day depending on what a diabetic person eats.

The study examined the effects of three different diets in 19 subjects with diabetes type 2. They consumed breakfast and lunch under supervision in a diabetes ward. The caloric intake in the three diets examined was the same, but the diets differed in the following manner:

  1. A conventional low-fat diet (45-56% carbs)
  2. A Mediterranean diet with coffee only for breakfast (= similar to 16:8 intermittent fasting) and a big lunch (32-35% carbs)
  3. A moderate low-carbohydrate diet (16-24% carbs)

All participants tested all three diets, one diet each day in randomized order.

Results

The effects on blood sugar levels throughout the day are shown in this chart:

Nyström-Sugar-650x582

To convert glucose values to mg/dl multiply by 18 (e.g. 8 mmol/L = 144 mg/dl).

The red line represents the low-fat diet that most diabetics are still advised to follow. This diet produced the WORST blood sugar levels throughout the day, which was fully expected (the low-fat diet contains more carbohydrates that raise blood sugar). Because too high a blood sugar level is the main problem in diabetes you could stop right there and award the low-fat diet the label “worst in test”.

The green line shows a Mediterranean diet higher in fat. The participants skipped breakfast and had a big lunch instead (an equal number of calories in breakfast+lunch as other participants). As we can see this led to excellent blood sugar levels in the morning. After the big lunch, blood sugar levels were similar to those of the small low-fat lunch!

Please note that in several Mediterranean countries, such as Italy, Greece and Portugal, it’s quite common to skip breakfast.

The blue line represents a moderate low-carbohydrate diet. It only produced minor peaks after breakfast and lunch. In total it produced the lowest average blood sugar levels throughout the day.

Insulin

Insulin levels were also measured throughout the day. Here’s the result:

Nyström-Insulin-650x577

The color codings are the same as above: Red = low-fat, green = fasting breakfast and blue = low-carb.

Skipping breakfast will, as expected, not elevate insulin levels, while a big lunch will produce a substantial peak.

The low-fat diet contained mostly carbohydrates and, as expected, caused the highest average elevations of insulin levels throughout the day. Bad news here too for diabetics with a decreased insulin sensitivity and with difficulty producing enough insulin. The low-fat diet that most diabetics are recommended to follow is worst in test here too.

Lowest Insulin Levels, Best Fat-Burning Rates

The low-carbohydrate diet clearly produces the lowest average insulin levels throughout the day, despite what certain insulin-deniers usually claim.

This is just a repeat of many previous studies. A low-carbohydrate diet produces much lower levels of the fat-storing hormone insulin. Period. This represents an advantage to all that want to burn more fat and store less body fat.

Previously on insulin

Conclusion

This is an exciting study, I think. As expected, a moderate low-carb diet (including more fat) produces great results. But also skipping breakfast and eating a bigger lunch, as is common in several Mediterranean countries, seems to be beneficial.

What happens if you combine these two advantages? If you eat a more high-fat low-carb diet AND skip breakfast? This could create more positive effects. Perhaps 1+1=3? Furthermore, the positive effect would likely be greater on a stricter low-carb diet than the one used in the study. For example a strict LCHF diet.

Finally: Is one of the reasons that the Mediterranean diet has been associated with good health just that people quite often just skip breakfast? Should intermittent fasting, like 16:8, be viewed as part of a healthful Mediterranean diet?

The Study

Read the study online for free: PLOS ONE: A Randomized Cross-Over Trial of the Postprandial Effects of Three Different Diets in Patients with Type 2 Diabetes

I had en e-mail exchange with one of the authors, Professor Nyström, about the study. He contributed with an interesting observation:

Despite almost twice as much insulin being produced, the increase in glucose levels was twice as big on the low-fat diet as compared to the high-fat diet.

The low-fat diet forced the body to produce twice as much insulin as compared to the low-carb diet. And the increase in blood sugar levels was still dramatically bigger. This shows how disastrously bad a carbohydrate rich low-fat diet is for diabetics.

More

Four Simple Steps to a Healthier and Leaner Life

Yes, a Low-Carb Diet Greatly Lowers Your Insulin

LCHF Wins Another Diabetes Study

Diabetes – How to Normalize Your Blood Sugar

More about the free updates that people get.

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45 Comments

Top Comment

  1. Djak
    I am a type 2 diabetic who has been eating low carb for the past 14 months. A few high carb meals on special occasions here and there, but primarily low carb all the way. I frequently skip breakfast simply because I'm not hungry in the morning. I wake up and drink coffee, somewhat slowly, and it doesn't even occur to me to find food until a few hours later. I usually end up making a spinach and cheese omelet for lunch. This was not done by design, but simply because I didn't feel hungry until lunch time. In the past 14 months, I've brought my HbA1c from an all time high of 14, down to a normal range 5.9, solely by eating a low carb - high fat diet. I've stopped taking all of my previous medications (metformin, lisinopril, and zocor) and now only take a vitamin supplement. My blood sugars and cholesterol are under control, my blood pressure is down, and even though my weight stays stubbornly high, I feel better than I have in years. I started eating this way after stumbling onto Dr. Eenfeldt's website here, and I can't tell you how grateful I am!
    Read more →

All Comments

  1. paulc
    Skipping breakfast? Depends what you have for breakfast. I have a two egg cheese omelette and a coffee made with double cream... minimal carbs there and has no effect on my blood sugars yet leaves me feeling full. I'd hate to have to try and make it through to lunch on just a coffee in the morning.
  2. FrankG
    I also have concerns about a diabetic skipping breakfast... carbohydrate intolerance for many seem worse at that time of the day, plus there is all too often the dreaded dawn phenomenon where we wake with higher BGs than before bed (without snacking through the night). I think some food (even just an handful of raw almonds and some heavy cream) on waking helps to stabilise the BG.

    I can go a good part of the day without food these days and still maintain stable BGs and energy levels but I'm loathe to skip breakfast.

  3. Zepp
    I can tell of my experience as not diabetic!

    In the beginning of my LCHF diet.. breakfast was crucial.. I didnt get any dips and did not need any inbetween meals.. just 3 ordanary planned meals.. it started my ability to rely on fat oxidation for longer satiety.

    But after a wail.. I didnt need any breakfast.. I was not hungry in the morning anymore.. then I shifted to 2 planned meals a day.. lunch and late supper!

    And I advice anybody to wait till this happens.. IE, you are not hungry in the morning!

    But.. we are different.. some.. probably those morning people?.. seems to benefits more frome breakfast and skipping lunch instead!

    Reply: #5
  4. Marcy
    I have good results but intermittent fast the opposite of this way. I wake early and eat breakfast, a LCHF breakfast, around 7 AM, then I eat a LCHF lunch and am not in the least hungry after those two meals so don't have anything until breakfast the next day. I guess it is all what works for you as an individual. One size doesn't fit all with the spacing of the LCHF meals.
  5. FrankG
    I would tend to agree Zepp... it did take a while to adjust to an LCHF way of eating but now I find that I am not regimented about meal times but rather I listen to my body and eat when I am hungry
    Reply: #7
  6. Ramsey
    I tend to eat 3-4 hours after I wake. Being a performer and working at night and sleeping through out the day, I still find myself loosing weight with LCHF despite my awkward hours. I was wondering however, coffee, what's your view Doctor Andreas? Stick to no more than 2-3 cups per day, preferably prior 7 hours prior to sleep? Appreciate all the work you've done/doing and this wonderful site/community.

    All the best,
    Ramsey

  7. Zepp
    Then we can agree that on a LCHF diet.. one tend to eat when it suits your self.. and Im not a morning person.. more of a evening person and I like to eat late suppers!
  8. Paul the rat
    I have +- 50% of my daily energy for breakfast, usually eggs + beef fat, coconut oil, some butter, many a day I do not eat anymore till next morning. I am simply not hungry and full of energy.
  9. Raz
    Would be great to continue such experiments over a 3 month period and measure the Hemoglobin A1C as well. That would be solid
  10. Djak
    I am a type 2 diabetic who has been eating low carb for the past 14 months. A few high carb meals on special occasions here and there, but primarily low carb all the way. I frequently skip breakfast simply because I'm not hungry in the morning. I wake up and drink coffee, somewhat slowly, and it doesn't even occur to me to find food until a few hours later. I usually end up making a spinach and cheese omelet for lunch. This was not done by design, but simply because I didn't feel hungry until lunch time. In the past 14 months, I've brought my HbA1c from an all time high of 14, down to a normal range 5.9, solely by eating a low carb - high fat diet. I've stopped taking all of my previous medications (metformin, lisinopril, and zocor) and now only take a vitamin supplement. My blood sugars and cholesterol are under control, my blood pressure is down, and even though my weight stays stubbornly high, I feel better than I have in years. I started eating this way after stumbling onto Dr. Eenfeldt's website here, and I can't tell you how grateful I am!
  11. DonnaE
    I have a question for anyone who can answer [since Doc doesn't much answer questions in the comments anymore :( ]. Aside from blood sugar issues, to get the benefits of intermittent fasting, is it acceptable to drink coffee with cream and coconut oil in the morning, i.e., during one's intermittent fast?
    Reply: #12
  12. Zepp
    Thats dependant of your self, your goals and ofcourse your medical conditions!

    With this coconut oil coffe.. its more about a fat fast, making your fat burning period prolonged, befor you eat anything els.

    Fasting otherwise is whitout any calories of any kind.. if that suits you more!

    Fat fast and/or MBC is for low stabile blood sugar.. and high fat burning capability.
    Whitout starving!

  13. Joe B
    This sounds like a very restrictive and difficult diet to follow there are carbs in everything even blueberries and carrots have carbs!
    Replies: #14, #15, #16
  14. FrankG
    It is not a NO carb diet :-)
  15. Lynn
    It's not difficult, and in fact it's easier as meals are much more satisfying, food cravings reduce significantly and food tastes infinitely better! Also, it's not a zero-carb diet.
  16. Maki
    It is low carb not no carb, they eat 16-24% of kcal from carbs. If you eat carbs mostly from non starchy vegetables you actually eat more vegetables in volume then of anything else (since they are so low in caloric density) traditional salads with olive oil, or cheese are almost all fat in calories.
  17. Solomon
    Hi Doc, great work you are doing here. I have been learning as much as I can on LCHF diet. I haven't however gotten a lot of info on the long term effect of the diet, if any. Do you have some insights to share? This Australian site (http://www.news.com.au/lifestyle/health/carb-cutting-a-recipe-for-disaster/story-fneuzkvr-1226600134949) suggest it may be harmful in the long run, any thoughts? I will be very grateful.
    Replies: #20, #23, #24
  18. Ben
    I wish we could place bets on studies like this. We would be millionaires!

    BTW, there is a typo in the conversion from mg/dl to mmol/L . You have multiply by 14, should be 18.

  19. Arild
    I am 55.
    About 9 years ago my doctor started to talk about diabetes 2, high blood preassure and medication to lower the cholesterol.
    Have been living lchf for almost 9 years.
    My doctor keeps telling me now: "Whatever you're doing, just keep on doing it".
  20. FrankG
    Let's see what your common sense tells you.. comparing a diet of processed and packaged foods with plenty of sugars refined starches and cheap (non-nutritious) filler, to a diet of real whole food, prepared at home.

    Long term risks? This is a move back to the way humans have eaten for a great deal longer than the modern industrial "fad" diet.

    Harmful? Maybe to those with a vested interest in maintaining the status quo and propping up the profits of the food manufacturers sure.

    You need to read more from other sources and come to your decision, rather than waiting for someone to tell you what is best for you :-)

  21. Peggy Holloway
    I am now using bullet-proof coffee in the morning (blend coconut oil and butter or ghee with the coffee) and often don't eat until evening. If I do eat a mid-day meal, it is egg yolks and bacon late morning or early afternoon. Though I'm not Type II Diabetic, I have no doubt I would be if I had not started a low-carb diet 14 years ago when I was having all the symptoms of metabolic derangement and because I have a major family history of Type II. I've tweaked my diet over the years, mostly cutting carbs and upping fat. I started IF this past year primarily because I'm a cyclist and I prefer not to eat before biking. In the summer, I often bike 4 to 6 hours in the morning so I was fasting until after my bike-ride. When I started working mornings again this fall, it just felt good to go to work after a bullet-proof coffee and not eat until evening.
    I am almost 61, but my 25-year-old son is the one who encouraged me to try the bullet-proof "breakfast." He uses Yerba Matte and also delays eating until early afternoon. We both feel really good doing this.
    I would think it would work for a Type II but I'm not positive. My sister has issues with dawn syndrome. I have talked to her about trying IF and using bullet-proof coffee for breakfast, but I don't know if she's tried it. I think it's worth a try. BTW - I have not been concerned about my weight since going low-carb but I did lose weight and my body fat has gone way down since I went ketogenic and introduced IF and bullet-proof coffee.
  22. Alan
    I have been drinking fat (butter/coconut oil) and coffee for about 7 months and it is very effective. I have more energy and when lunch time rolls around I am not hungry, but I usually eat lunch and dinner. My wife, two kids, dad, and brother all drink a fat-drink in the morning. Kids (and Dad and brother) are drinking cocoa and fat. Everyone seems more energized and less hungry. I also add salt in my drink as the Tibetans do. LCHF is salt wasting. I suppose that one could have fat-coffee instead of breakfast or dinner.

    Fortunately I am not diabetic, but I would be if I did not eat LCHF. I was damaged from ciprofloxacin and levofloxacin---antibiotics. I am hoping to keep my HbA1c below 5. I have not checked for months.

  23. Zepp
    Im not perticaly concerned about there message.. its the same bullshit we been feed up whit for a long time now.. whit disastrous result, like a epedemia in obesety and diabetes!

    But more scientist are getting to that the real problem is carbs.. to much, to fast acting, to processed and whitout the nutrinets that we need!

    Nothing wrong with old time carbs like starchy tubers and home made bread.. if one is working in the fields and/or in the woods all day long.. but for moste of us.. that time is long time gone.. we dont need that much rocket fuels!

    We eat less becuse of easyer work and shorter labour days.. and need nutrient dens foods.. the old dogma carb relyance are killing us slowly!

  24. Paul the rat
    Solomon,
    unfortunately I can not post full paper, so go to your closest University library and read it please.
    (by the way aren't you suppose to know everything?)

    Adv Nutr. 2013 May 1;4(3):294-302. doi: 10.3945/an.113.003657.
    Dietary fats and health: dietary recommendations in the context of scientific evidence.
    Lawrence GD.
    Source
    Department of Chemistry and Biochemistry, Long Island University, Brooklyn, NY, USA. lawrence@liu.edu
    Abstract
    Although early studies showed that saturated fat diets with very low levels of PUFAs increase serum cholesterol, whereas other studies showed high serum cholesterol increased the risk of coronary artery disease (CAD), the evidence of dietary saturated fats increasing CAD or causing premature death was weak. Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. The evidence of ω6 polyunsaturated fatty acids (PUFAs) promoting inflammation and augmenting many diseases continues to grow, whereas ω3 PUFAs seem to counter these adverse effects. The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, which are discussed here. This review calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking.

  25. Paul the rat
    Relaxation break
    Please go to 0:26:50 and watch our vegetarian great (x 100) grandfathers in action

    http://www.youtube.com/watch?v=GXh4BNYYObU

  26. Andrea
    These findings are consistent with the suggestions of the Bulletproof Diet. Check it out.
  27. Alan
    I read the paper and I was surprised to see that the triglycerides were higher with LC than with LF---this does not seem consistent with the literature that I have read. Maybe it takes time for LC to reduce triglycerides?
    Reply: #29
  28. Alan
    Or perhaps the moderately LC diet was not low enough in carbs to reduce triglycerides for the sample of diabetics?
  29. Rustybeth
    Yes, it takes time for triglycerides to fall on LCHF. If you read Phinney and Volek, they state it takes up to four weeks for full keto adaptation to occur, and then discuss in patients with large amounts of weight to lose, how circulating triglycerides from the fat breakdown process will artificially inflate the blood counts. That means the triglycerides are not from your dietary intake in source, but released from metabolized fat.
  30. Barb
    The only issue that I would have with skipping breakfast would be with medication. I take metformin 2X per day... morning and evening. Metformin MUST be taken with food for most people, lest they want to experience some of the worst gastro effects ever.

    What then?

  31. lee
    Barb i take my metformin with my two meals -- doesn't have to be morning. I usually don't eat breakfast until 1:30-2 or so then dinner around 8. Works fine for me that way. Or you could take it with bulletproof coffee in the morning. Experiment and see what works for you.
  32. murray
    Common threads I am seeing on numerous research reports are the desirability of reducing blood sugar (both average and peak), reducing insulin and increasing ketones. For over a year I have been reading about the debate (especially in the Paleo community) as to whether a diet should include "safe starches." The more I read and ruminate, the more I am leaning to elimination of starches and staying in ketosis. Peter Attia has some interesting thoughts on how to get the carb-boost for extreme exercise without throwing oneself out of ketosis by keeping the starch low enough for the liver to absorb without raising blood sugar or insulin. Learning to restore a glycogen buffer in the liver is important for that, otherwise the "safe" starch is not safe in all respects. Dave Asprey eats lower carb but seems to allow some safe starches which would throw me out of ketosis, but he consumes copious amounts of caprylic acid (C8:0) or MCT oil to maintain a supply of ketones in the blood despite the starch. But if the starch boosts blood sugar and insulin, then two of the three metabolic benefits of avoiding safe starches are forgone. So for the time being, I use my morning ketone measurement as a guide as to whether I have been eating too much carbohydrate. This has not resulted in any detectable ill effects and I seem to be getting all the advantages of ketosis.

    I am a breakfast person. It is easier for me to skip dinner than skip breakfast. It is interesting how people tend to like the same breakfast most days but dislike having the same dinner. For my breakfast I have a bullet tea (with added 100% chocolate or cacao beans, for about 75 grams of fat) then walk and run our dog for about 30 minutes. This gets me in fat-burning, ketone-producing metabolism. An hour or so later I have two to five raw egg yolks (depending on hunger level) with a little of the white (the dog gets most of the whites), some bone marrow, 15 ml (a tablespoon) of extra virgin olive oil, some cheese and full-fat yoghurt, kefir or 35% m.f. creme fraiche (kefir and creme fraiche today), a couple of nuts (walnut and peeled Brazil nut), chia seeds and a few fresh cranberries and Saskatoon berries (which are less sweet than wild blueberries). I have a small bowl I use to guide my overall portion size. Often I will have some leftover vegetable from the previous dinner. Egg yolks and avocado are a nice variation for breakfast. My before food blood sugar today was 4.2 mmol/L (75 mg/dL) and with my breakfast it peaks under 5.0 mmol/L (<90 mg/dL). This breakfast keeps me going well into the afternoon and I sometimes just skip lunch, or have lunch and skip dinner. My HbA1c, measured a couple of months ago, was 4.7.

  33. Paul the rat
    J Neural Transm. 2012 June; 119(6): 679–684.
    Published online 2011 December 27. doi: 10.1007/s00702-011-0750-2
    PMCID: PMC3359463

    Ketogenic diet increases concentrations of kynurenic acid in discrete brain structures of young and adult rats

    Tomasz Żarnowski,1 Tomasz Chorągiewicz,1 Maria Tulidowicz-Bielak,1 Sebastian Thaler,2 Robert Rejdak,1 Iwona Żarnowska,3 Waldemar Andrzej Turski,4,5 and Maciej Gasiorcorresponding author6
    Author information ► Article notes ► Copyright and License information ►
    Go to:
    Abstract
    Targeting mechanisms that result in increased concentrations of kynurenic acid (KYNA) in the brain has been considered as a therapeutic approach for the treatment of epilepsy and certain neurodegenerative disorders. Recently, KYNA has been implicated in the effects produced by the high-fat and low-protein/carbohydrate ketogenic diet (KD) in a report demonstrating an increased production of KYNA in vitro by one of the ketone bodies, β-hydroxybutyrate, elevated by the KD. To further explore this association, brain concentrations of KYNA were compared in young (3 weeks old) and adult (8–10 weeks old) rats that were chronically exposed to the KD and regular diet. Exposure to the KD resulted in the anticipated elevations of β-hydroxybutyrate with accompanying decreases in glucose concentrations. In comparison to rats fed the regular diet, KYNA concentrations were significantly (p 0.05). Exposure to the KD had no effect on KYNA concentrations in the cortex of young and adult rats (p > 0.05). In summary, chronic exposure to the KD resulted in several-fold increases in KYNA concentrations in discrete brain structures in the rats.

    Thus, the relevant clinical question for further exploration is whether KD-induced increases in KYNA concentrations can translate into clinically significant improvements in neuropsychiatric diseases associated with KYNA hypofunction.

  34. FrankG
    Finally... a good use for cornstarch! Tetra KO. Made into a non-Newtonian fluid with water -- it's a gel in the tank, sprays as a liquid then back to a gel on contact with a surface. This stuff knocks down fires and keeps them down... amazing. In a fraction of the time and using a fraction of the water

    http://www.youtube.com/watch?v=Hv2Ciett774

    Reply: #35
  35. Paul the rat
    Mcdugalls will crucify you Frank.
  36. Jonathan Christie
    Look! Their fasting blood sugar is 8+ mmol/l !!! This may be a lower carb diet, but it's still a recipe for complications and early death.

    I'm Type 1 for 30 years, I eat 6% carbs a la Bernstein, my HbA1c is 4.9%

    What part of 'low carbohydrate' is so difficult to understand?

  37. Linda Mack
    I have been on the LCHF for a week and it has changed my life. I was wondering how it effects cholesterol and triglycerides. I do not take any cholesterol medications. My doctor took me off of Crestor.
    Reply: #38
  38. Zepp
    The most comon result on a low carb high fat diet is slightly elevated total cholesterols.. mostly becuse HDL rises.. and triglycerids often drops like a stone!

    LDL is often the same or slightly elevated.. but if one check APOb/APOa1 the quota often get better, and that supose to be becuse LDL often get bigger.. but fewer, thats good!

    "CONCLUSIONS
    Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. "

    http://www.nejm.org/doi/full/10.1056/NEJMoa0708681

  39. UK patient
    Excellent blog, thanks.

    Friends alerted me in 2005 to the likely benefits of LCHF diets, even for thin people.

    There is some diabetes in my family medical history. Best not to take risks in my view. In my last test in 2008, FBG = 5 mmol/l and TG = 0.8 mmol/l.

    However, the UK NHS shows no interest in the routine testing of healthy people to ensure that they stay healthy. So I cannot get repeat tests!

    In my situation, I cannot see the benefit in eliminating all significant carbohydrates. So I probably eat 100-150 g/day. The closest approximations would be perfecthealthdiet.com and diabeticmediterraneandiet.com, but the LC one, not the VLC one.

    Reply: #40
  40. Zepp
    Best test is to take a glucose provocation test or measure your glucose levels after your meals.

    A Swedish study says that with measuring fasting glucose levels they only find 10% of the prediabetics.. with postprandial values they fund the rest 90%!

    And as you probably allredy know.. there are a significant contribution to diabetes of heritage.

    "Slow Glucose Removal Rate and Hyperinsulinemia Precede the Development of Type II Diabetes in the Offspring of Diabetic Parents"

    http://annals.org/article.aspx?articleid=704330

  41. Duytran
    A Low-Carb Diet and Intermittent Fasting Beneficial for Diabetics
    I like this post, thanks for your sharing, I am difficult to plan meals for diabetic patients. Hope to read more helpful information from you. Have a nice day
    http://vkool.com/natural-remedies-for-diabetes-with-cure-diabetes-nat...
  42. Lucille
    Any studies on the effects of artificial sweeteners on insulin?
  43. Luis
    Hey,
    I am Portuguese and am afraid that your sentence about skipping breakfast ("Please note that in several Mediterranean countries, such as Italy, Greece and Portugal, it’s quite common to skip breakfast.") is not so accurate, as far as I know from Mediterranean countries (I've never been in Greece but won't thinkk it's too different).
    Traditional breakfast over here is light (a cup of milk with coffee or powder chocolate, and bread with butter or jam), which will give a lift to glucose levels.
  44. Slow Carb
    I have just started on a Slow Carb Diet and after only 4 days of a protein shake for breakfast and then a slow carb meal for lunch and dinner I am already feeling much better. I aim to continue the Slow Carb Diet for two months and then go onto the 5:2 intermittent fasting diet and see how I feel after 3 months!

    If you would like to follow my progress and have any questions then please check out my site here - http://www.2014thisismyyear.com

    The initial goal on the Slow Carb Diet is to lose weight and then after that the intermittent diet will hopefully keep the weight at bay and I can resume a healthy lifestyle!

    Good luck to everyone in their quest at getting fit, getting healthy and reducing or trying to cure diabetes!

  45. Frances
    After reading this research, I encouraged my 48y/o T2DM partner to experiment with his low carb menu to swap breakfast for black coffee. After introducing daily moderate exercise several months ago we noticed immediate improvements in his daily blood glucose range, which has now narrowed even further .... yet, for the first time, his stubborn weight has begun to shed now he's having coffee for his first meal of the day. In 3 weeks he has gone from 96 to 91kg, while maintaining muscle mass/fluid . I'm very proud of his improvements.
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