Type 2 diabetes

type-2

Type 2 diabetes is by far the most common form of diabetes (around 90% of all cases).1

The disease is getting more and more common, and there’re already an estimated 330-500 million people with type 2 diabetes worldwide.2

Most, but not all, people who are affected are overweight (especially those carrying excess abdominal fat), are middle aged or older, and may have high blood pressure, low HDL and high triglycerides.3 Although there is a growing trend of younger people, even teenagers, developing type 2 diabetes.4

For more on the background to the epidemic, how you can test if you have diabetes and how to naturally regulate your blood sugar, please read our evidence-based guide:

Diabetes – normalize your blood sugar

Here you’ll find more specific information on the cause of and treatment for type 2 diabetes.

Table of contents

  1. The cause of type 2 diabetes
  2. Treatment
  3. Other lifestyle modifications
  4. Dietary supplements
  5. Medications
  6. More education

The cause of type 2 diabetes

Type 2 diabetes results when the body can no longer handle large amounts of circulating blood sugar.5 As the blood sugar increases, the body needs to produce larger amounts of the blood sugar-lowering hormone insulin. However, over time sensitivity to insulin can decrease and the blood sugar rises out of control. At the time of diagnosis, people with type 2 diabetes often have ten times more insulin in their bodies than what’s normal.6 As a side effect all this insulin can lead to fat storage and weight gain, something that often has been going on for many years before the disease is diagnosed.7

So what’s the cause of this? This is still controversial and much debated. But there appears to be a clear correlation with the amount of sugar in the food. The more sugar people consume the more they get diabetes in the long run. According to a recent investigation this correlation is found in all countries around the world.8

Simple carbohydrates

Simple carbohydrates

Probably also contributing is ingestion of other rapidly-digested carbohydrates, such as white bread and pasta, because these too cause a rapid rise in blood sugar.9 Here too there are clear linkages: people who eat more simple carbohydrates are more likely to get type 2 diabetes.10

The associations between sugar, rapidly-digested carbohydrates and type 2 diabetes hold even in more rigorous studies. To give advice in favor of carbohydrate-rich food increases the risk of getting type 2 diabetes and worsens blood sugar levels in people who already have type 2 diabetes.11

Type 2 diabetes could thus very well be called sugar disease. And since starch in bread turns into glucose in the body – white flour is in fact also a form of sugar.12

Treatment of type 2 diabetes

type-2-b

How do we treat type 2 diabetes? Old wisdom and new science produce the same logical answer. The most important thing is to avoid eating too much blood sugar-raising food.13

Avoid eating large amounts of sugar and starch and your blood sugar will be better from the first meal on. Your high insulin levels will likely drop towards normal levels.14 Because insulin is a fat storing hormone when insulin levels drop most people gradually lose weight as well.15

If you’re lucky, especially if you haven’t had type 2 diabetes very long, this action may be all that’s needed to reverse your diabetes and become healthy.16

Try it yourself: LCHF for beginners

NOTE: If you’re being treated with insulin, insulin releasing tablets (Sulfonylureas) or other blood sugar medications, you may need to taper off your medications if you are eating fewer carbohydrates. Please do not attempt to do this on your won. Discuss this with your doctor before changing your diet as you may be at risk for dangerously low blood sugar levels. If you do experience low sugar levels, make sure to eat something sugary right away and contact your doctor immediately.

 

Other lifestyle modifications

Although other lifestyle habits can help treat type 2 diabetes, eating significantly fewer carbohydrates is definitely the most important thing.17 We recommend that initially you put all of your self discipline into changing your eating habits. It’s hardest in the beginning (first weeks and months), and likely gets easier over time.

Gradually, as your new eating habits start to flow easier you can start trying other beneficial lifestyle changes such as:

Dietary supplements

According to recent studies there is one supplement that can help many with type 2 diabetes a little: Vitamin D. Many people are deficient in Vitamin D, especially during the winter months. 18 Studies show that supplementation can improve blood sugar and insulin sensitivity somewhat in type 2 diabetes. In addition this may help with weight loss.19

Around 4 000 IU daily (100 µg) may be appropriate for most people with type 2 diabetes. However, this may depend on your baseline level, so ask you doctor for a simple blood test to see where you are and if vitamin D supplementation is right for you.

Medication

If diet changes and other lifestyle changes don’t improve blood sugar sufficiently, then you doctor may suggest stating medications. Although medications have a role, it is interesting to note that studies have shown worse outcomes with more aggressive medical therapy.20 So far, this has not been shown with lifestyle therapy. In fact, the opposite is likely true!21

1. Metformin

Metformin is the first-line treatment of choice. It’s an old and proven treatment that not only improves blood sugar, but it also aids in weight loss and potentially improves survival for those with type 2 diabetes.22

The most common side effects are stomach pain, nausea or diarrhea. These usually subside with time, but your doctor may want to start at a low dose and titrate it up over time if needed.

A dose of two grams daily is often sufficient for a positive effect, and the maximum dose is three grams daily.

2. GLP-1 analogues or SGLT-2 Inhibitors?

When Metformin isn’t sufficient, or if you don’t tolerate it, then what to do? This is controversial today.

Often insulin injections are used. However, since overweight patients with type 2 diabetes already have pathologically high insulin levels, adding MORE insulin in this situation doesn’t make much sense. It will often cause a gradually worsening insulin resistance and obesity. Although not conclusive, it may even increase the risk of heart disease or death.23

Newer and potentially better alternatives are GLP-1 Agonists and SGLT-2 inhibitors.

GLP-1 agonists are injections that increase satiety, lower blood sugar and often lead to substantial weight loss (over 20 lbs is common). Together with Metformin, the effect on the majority of patients is very positive for both blood sugar and weight.

SGLT-2 inhibitors stimulate the kidneys to excrete excess glucose, thus lowering the blood glucose level without increasing circulating insulin. In fact, insulin levels tend to go down. Trials have shown reduced cardiovascular events in people with diabetes taking SGLT-2 inhibitors.24. However, they unfortunately can increase the risk of a life threatening condition called euglycemic ketoacidosis, especially in those eating ketogenic diets.25 Although this is very rare, we do not recommend SGLT-2 inhibitors for those who are eating low-carb.

Our hope, of course, is for you to take control of diabetes with low-carb nutrition so that you do not need any of these medications. Make sure you discuss your progress with your physician to see if you require medication or not.

Insulinbloodsugarmeasuring

Sometimes pills are not enough to control dangerous blood sugar levels and your doctor may recommend insulin injections. These are not without their concerns as they are expensive, may lead to weight gain, and they can also exacerbate the underlying disease by worsening hyperinsulinemia and insulin resistance.26

Fortunately, studies show that patients can quickly and dramatically reduce their need for insulin with low-carb diets.27 Therefore, if you are on insulin, please talk to your doctor before going on a low-carb diet as you will likely need to reduce your dose to prevent dangerously low blood sugar levels (hypoglycemia). Learn more in our guide Starting low carb or keto with diabetes medications.28

More education

Can you reverse type 2 diabetes?29

Can you reverse diabetes in only six months? Without medications or surgery? Now science says you can. Two different nonrandomized trials demonstrated that low carbs diets are effective at normalizing blood sugar while also reducing the need for medications.30

No expensive injections. No surgery. Just low-carb nutrition. That’s powerful.

Read more in our guide on reversing diabetes.

You can also read more blog posts about people with type 2 diabetes that have tried a low-carbohydrate diet [1 2] and inspirational stories from people who have taken control of their diabetes with low-carb nutrition.31

For example, pictured below is a large number of blood glucose readings in a person with type 2 diabetes in the first six months on an LCHF diet. The blue area corresponds to optimal blood glucose levels. Note that not one single elevated number was recorded after a few months! And then after just three days she was even able to stop daily 70E insulin injections. She also lost 68 lbs in the first year.32

 

kitabugraf

Studies on an LCHF diet for type 2 diabetes

Self monitoring

Monitoring your blood sugar yourself seems to have a small positive effect, even for people with diabetes not taking insulin.33

Of course, how great the effect will be depends entirely on whether the monitoring leads to an improved lifestyle. Just checking your blood sugar and writing down the number in a book will of course not make you any healthier at all. Instead, monitoring of blood sugar can be used to help improve diet and exercise and adjust medications as needed.

We can do better

High blood sugar produces a risk for severe complications in the long run. It degrades the body’s small blood vessels, increasing the risk for heart attack, blindness, amputations and more.34

Millions of patients have suffered these complications while the medical establishment tries to “manage” the disease. Even popular press such as the New York Times promotes the concept that type 2 diabetes is a chronic progressive disease that we are failing to treat. We disagree and so should you.

It may be true that a conventional low-fat diet (today’s dietary guidelines) and medications don’t cure diabetes. But fortunately a better treatment exists, and it’s obvious and logical when you understand.

We promote the science and practical aspects of using low carb to treat type 2 diabetes so the millions of people at risk can take charge of their own health and avoid suffering preventable complications.

Please keep reading and learn more in our guide How to reverse your diabetes

Presentation

marycvernon

A presentation on diabetes and a low-carbohydrate diet by Mary C. Vernon, an American physician, since long specializing on the subject.

Related links

  1. Type 1, usually diagnosed in kids, makes up the rest. However, there are two other forms of diabetes. Latent Autoimmune Diabetes of Adults LADA is a form that has been described as “halfway between type 1 and type 2.” As with type 1 you have antibodies that attack the insulin producing beta cells. LADA usually debuts later in life then type 1 and develops more slowly. Maturity onset diabetes of the young, MODY, is a rarer form that is caused by a genetic abnormality and also mimics type 1 but is diagnosed in adults.

    BMJ 2018: Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study [observational study, weak evidence]

  2. Diabetes 2018: Global prevalence of type 2 diabetes over the next ten years (2018-2028) [review of observational studies; weak evidence]

    Medicine 2014: Epidemiology of diabetes [review of observational studies; weak evidence]

  3. BMJ 2018: Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study [observational study; weak evidence]

  4. World Journal of Diabetes 2013 Type 2 diabetes mellitus in children and adolescents. [overview article; ungraded]

  5. Diabetes Care 1992: Pathogenesis of NIDDM. A balanced overview. [overview article; ungraded]

  6. American Journal of Clinical Nutrition 1992: Surgical treatment of obesity and its effect on diabetes: 10-y follow-up. [observational study, weak evidence]

    Diabetes Care 2012: Diabetes: Have we got it all wrong? [overview article; ungraded]

  7. Although this is still controversial for some, the following review article summarizes insulin’s role in obesity, and the subsequent reference shows how inhibiting insulin secretion aids in weight loss. Taken together, it seems very likely that insulin has a direct action of increasing obesity.
    Journal of Endocrinology 2017: A causal role for hyperinsulinemia in obesity. [overview article; ungraded]

    International Journal of Obesity Related Metabolic Disorders 2003: Suppression of insulin secretion is associated with weight loss and altered macronutrient intake and preference in a subset of obese adults [observational study, weak evidence]

  8. PLoS One 2013: The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data. [observational study, weak evidence]

    BMC Public Health 2014: Per capita sugar consumption and prevalence of diabetes mellitus–global and regional associations. [observational study, weak evidence]

  9. PLoS Biology 2018: Glucotypes reveal new patterns of glucose dysregulation. [nonrandomized study, weak evidence]

  10. American Journal of Clinical Nutrition 2008: Glycemic index, glycemic load, and chronic disease risk–a meta-analysis of observational studies. [observational study, weak evidence]

  11. Nutrients 2018: The effect of dietary glycaemic index on glycaemia in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. [strong evidence]

    PLoS One 2014: A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. [randomized trial; moderate evidence]

  12. European Journal of Clinical Nutrition 1992: Classification and measurement of nutritionally important starch fractions. [mechanistic study article; ungraded]

    The following RCT showed that all types of bread, including sprouted and multi-grain, caused an elevation in blood sugar and serum insulin levels.

    Journal of Nutrition and Metabolism 2012: The acute impact of ingestion of sourdough and whole-grain breads on blood glucose, insulin, and incretins in overweight and obese men. [randomized trial; moderate evidence]

  13. Diabetes Care 2019: Nutrition therapy for adults with diabetes or prediabetes: a consensus report [overview article; ungraded]

  14. Annals of Internal Medicine 2005: Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. [observational study, weak evidence]

  15. Nutrition and Diabetes 2017: Enhanced insulin sensitivity in successful, long-term weight loss maintainers compared with matched controls with no weight loss history. [nonrandomized study, weak evidence]

  16. Some disagree with the use of the word “reverse” when it comes to type 2 diabetes. The concern is that it may imply the disease is completely gone, never to return. At Diet Doctor, we use the term “reverse” to indicate that the diagnosis of diabetes is no longer present at that moment. However, we acknowledge that the diagnosis of diabetes will likely return if a patient goes back to their prior high-carb eating habits. Therefore, “reverse” does not imply a cure. Instead, it identifies a successful intervention that, if maintained, will likely keep the disease at bay.

    The following study showed a ketogenic diet was effective at reversing diabetes or reducing medications in the majority of subjects.

    Frontiers in Endocrinology 2019: Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: A 2-year non-randomized clinical trial [weak evidence]

  17. This is based on consistent clinical experience of low-carb practitioners. [weak evidence]

  18. Nutrition Research 2011: Prevalence and correlates of vitamin D deficiency in US adults. [observational study, weak evidence]

  19. Although there is conflicting data on the subject, these studies suggest a potential benefit from vitamin D supplementation

    Nutrition Journal 2012: A 12-week double-blind randomized clinical trial of vitamin D3 supplementation on body fat mass in healthy overweight and obese women [moderate evidence]

    Journal of the American College of Nutrition 2016: The effect of vitamin D supplementation on glycemic control and lipid profile in patients with type 2 diabetes mellitus. [noncontrolled study, weak evidence]

  20. NEJM 2008: Effects of intensive glucose lowering in type 2 diabetes. [randomized trial; moderate evidence]

    The Lancet 2010: Survival as a function of HbA1c in people with type 2 diabetes: a retrospective cohort study [observational study; weak evidence]

    However, more recent trials of the drug class SGLT2 inhibitors do show an improvement in cardiovascular outcomes and risk of death. Oe hypothesis is that these drugs lower insulin levels whereas older drugs increased insulin levels.

    NEJM 2015: Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. [randomized trial; moderate evidence]

    Cardiovascular Ultrasound 2019: Effect of sodium glucose cotransporter 2 inhibitors on cardiac function and cardiovascular outcome: a systematic review [overview article; ungraded]

  21. The studies that show no improvement with more intensive medications included insulin and medications that increased insulin. Newer drugs, like the SGLT2 inhibitors, can lower insulin and have been shown to improve risk of heart disease or overall mortality. Since lifestyle interventions, like low-carb diets and exercise, also lower both glucose and insulin, one could assume they would likewise show beneficial results although this has yet to be studied in adequately designed long term trials.

    The following trial, called the LOOK AHEAD trial, is frequently cited as evidence that lifestyle interventions do not improve clinical outcomes in patients with diabetes. However, the intervention was general calorie reduction and did not address carbohydrate intake.

    NEJM 2013: Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. [randomized trial; moderate evidence]

  22. JNCI Cancer Spectrum 2017: The effect of metformin on mortality among cancer patients with diabetes: A systematic review and meta-analysis [review of observational studies, weak evidence]

  23. Experimental and Therapeutic Medicine 2016: Association between insulin dosage and insulin usage time, and coronary artery lesions in patients with type 2 diabetes and coronary heart disease [observational study, weak evidence]

    European Heart Journal 2007: The impact of glucose lowering treatment on long-term prognosis in patients with type 2 diabetes and myocardial infarction: a report from the DIGAMI 2 trial [observational study, weak evidence]

    Diabetologia 2009: The influence of glucose-lowering therapies on cancer risk in type 2 diabetes. [observational study, weak evidence]

    NEJM 2008: Effects of intensive glucose lowering in type 2 diabetes. [randomized trial; moderate evidence]

  24. NEJM 2015: Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. [randomized trial; moderate evidence]

  25. Diabetes Care 2015: Euglycemic diabetic ketoacidosis: A predictable, detectable, and preventable safety concern with SGLT2 inhibitors[case reports; very weak evidence]

  26. Journal of Endocrinology and Metabolism 1997: Effect of obesity on the response to insulin therapy in noninsulin-dependent diabetes mellitus. [nonrandomized study, weak evidence]

    Nature Medicine 2017: Insulin action and resistance in obesity and type 2 diabetes. [overview article; ungraded]

  27. Nutrition & Diabetes 2017: Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes [moderate evidence]

    Diabetes Therapy 2018: Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study [weak evidence]

  28. With insulin-treated diabetes it’s important to monitor your blood sugar closely in the beginning when starting an LCHF diet! A diet including few carbohydrates usually causes a greatly reduced need for insulin. It’s then important to adjust (lower) the doses sufficiently to avoid that blood sugar drops too low. This should always be done with support of your physician or diabetes nurse.

  29. Some disagree with the use of the word “reverse” when it comes to type 2 diabetes. The concern is that it may imply the disease is completely gone, never to return. At Diet Doctor, we use the term “reverse” to indicate that the diagnosis of diabetes is no longer present at that moment. However, we acknowledge that the diagnosis of diabetes will likely return if a patient goes back to their prior high-carb eating habits. Therefore, “reverse” does not imply a cure. Instead, it identifies a successful intervention that, if maintained, will likely keep the disease at bay.

  30. Diabetes Therapy 2018: Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study [weak evidence]

    The longest published study yet on low carb for type 2 diabetes, is a non-randomized intervention trial of a 20% carbohydrate diet for people with obesity and type 2 diabetes. They published a 44-month followup showing continued good results on A1c, weight and reduction of diabetes medications:

    Nutrition & Metabolism 2008: Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up [weak evidence]

  31. [anecdotal report; very weak evidence]

  32. [anecdotal report; very weak evidence]

  33. BMJ 2012: Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes. [systematic review of randomized trials; strong evidence]

  34. Clinical Diabetes 2011: Microvascular and macrovascular complications of diabetes [overview article; ungraded]

37 comments

  1. Shubha ranjan
    I am on insulin and after reading this I would like to cut down on carbohydrate and try and control my type 2 diabetes.
    Reply: #3
  2. Chris
    Instead of taking metformin I did some research of the symptoms I was experiencing (neuropathy) and now take magnesium 450-600mg a day, vitamin D 2000IU, Benfotiamine (B1) 250mg twice a day, Methylcobalamin (B12) 2x 1000mg a day and now Alpha Lipoic Acid 600mg a day.
    My doc had prescribed me metformin, ramipril (for slightly elevated BP) and baby aspirin to thin the blood. Improving blood sugars, BP and blood flow can all be done with magnesium (citrate is one I use). All 3 meds he had prescribed me affect the ability of the body to absorb B12..and I was already deficent in this vitamin!

    Magnesium is so vital for heart function that almost all post mortems/autopsies of heart attack fatalities found severe magnesium deficiency in the deceased!. Interestingly a principal agent in metformin is..you guessed it..magnesium!!

    http://dietheartnews.com/2012/04/ten-important-things-to-know-about-m...

    http://www.healthsavers.info/Aspirin.htm

  3. Zepp
    Measure your blood sugar very often.. becuse if you cut out to much carbs to fast you need to lower your insulin as well!

    Make sure to have som glucose tablets at hand in the first time so you dont get any hypoglycemia!

  4. Candy
    Check expiration date on your testing strips! I did not, and had very high results. Scared me!
  5. nikky
    I don't have most oif the symptoms for diabetes e.g, excessive thirst, hunger & frequent urination. All I experience is my blood sugar going high whenever I eat bread or pasta. Could it be from having my gallbladder removed?
  6. BooDreaux
    I'm on Invokana nothing else.......when put on Insulin I gained 35 pounds & freaked me & my cardiologist out

    Blood sugar when getting up was 147

    Had a protein shake with 34grams of Optima Whey protein with 5g carbs, tablespoon of Beneful, 2oz of heavy whipping cream & 1 tbsp of MCT oil
    Blood sugar 3 hours after 185

    Lunch was a 6 gram net carb whole grain wrap & 4 eggs scrambled with bacon fat, cheese and lean ham
    Blood sugar 3 hours after was 215.

    I just don't get the high readings......I'm doing LCHF and many times BS is good but seems there are too many times no matter how low carb i go it's high.....doesn't seem to be any rhyme or reason.......anyone have any insights.......I'm losing BF/weight so that part is working.

    Thanks

    Reply: #31
  7. Toddster63
    BooDreax--there is nothing LC about a whole grain wrap!! If you are serious about this LC diet, then wheat has to go! I have had amazing results with true low carb, with BC levels of 70-119, and I even eat a little fruit in my smoothies. I am almost off of all insulin too...

    Biggest key is to CUT THE WHEAT OUT entirely!

  8. barb hawkins
    Toddster63 May I ask you how long have you been diabetic?
  9. Lori Fuller
    BooDreaux, You have to exercise. I finally committed thanks to my daughter and started exercising at Guts Church with a trainer and a group of mixed age ladies for 45 minutes 3x per week and I'm past 50 years old. It has played a big part in my getting lower numbers. L, Tulsa, OK
  10. Leigh
    How long should it take to see reduced blood sugar numbers if you are eating a low carb diet?
    Reply: #11
  11. Peter Biörck Team Diet Doctor
    Hi Leigh!

    For most people it happens really fast, so if taking medication you have to monitor blood sugar and adjust medication accordingly.

    How long should it take to see reduced blood sugar numbers if you are eating a low carb diet?

  12. precious
    I was averaging over 350bg (uncontrolled/no meds) Recently I had pancreatitis and was in the hospital for a few days. I fasted for 2 days then a liquid diet. They started me on Lantus and Humalog. My bg was averaging 170. Now I am home and eating food again. I generally consume 20-35g carbs at each meal. Today alone, my fasting was at 235 (took insulin and had breakfast) then 225 at lunch (4 hrs later, insulin again). I've been told low carbs then more carbs...I'm so confused. I just want to get better. Very frustrating!
  13. Babs
    Precious 20 to 30 carbs A DAY is more like it,. I'm also on insullin and LCHF and haven't lost a pound and I keep carbs below 20gr a day. Talking to the DR, next month about getting off of the insulin. Insulin is the fat storing hormone,.
  14. Lynn
    I was told to have 45 carbs each meal in diabetes class at the hospital. Could they be wrong?
  15. T2D
    I got the T2D diagnosis in mid may last year, i had HBa1c at 11,3 mmol/L with absolutly no signs at all. I found out the T2D diagnosis when i get an medical check and get my health certificate. I ate my self down to HBa1c 10.2 mmol/L three months later. I almost did'nt eat sugar at all.

    Then i had to go to my doctor nearly 2 months later, then the HBa1c was 9,5 mmol/L still with no medications. I was put on Metformin and my last check about 1 month ago said HBa1c 8,3 mmol/L.

    So i started on my own with the 8 week blodsugar diet by Dr. Mosley. This was just before christmas. I was on it 8 days straight. Then off every other day during the christmas holydays. The tick in my finger said lower blodsugar.

    Then i went for the 5:2 diet, but no eating two days a week, and my BS was still low, altmost normal parts of the day. So now i'm trying lchf diet. I'm on my third day so far, did come strait out of my fast day (nearly 32 hours of no eating). So i should be low in carbs by now, right?

    But still i have higher BS in the morings than on the evenings??

    2 days ago, in the evening; 5.6 mmol/L, in the morning; 7,3 mmol/L.
    Last evening; 7.1 mmol/L, this morning; 8,3 mmol/L.

    Why?

    Nearly 4.5 days without carbs.. i should be empty by now or what? Why do i get higher BS in the morning with hardly no carbs at all?

  16. T2D
    @Lynn

    Take a look here: https://www.dietdoctor.com/how-low-carb-is-low-carb

    :)

    If you want to loose weight fast, then you have to go for max 20 g carbs a day, NOT 20 - 30 g carbs a meal!! :)

  17. Marinelle
    Hi there! Seems like the best guys to ask is my fellow diabetics. I really need help with this as I am doing this completely without my Doctor's support. He is incredibly stubborn and believes insulin increase is the only way to go. I have posted a question before but believe this one is more important. It might sound insane but I am not even sure if I am type 1 or 2. I was diagnosed 15 years ago, I am 35 now so I was 20, I am overweight. For the past 14 years I have taken Metformin and had incredibly erratic sugar counts. I went vegan for 4 years and had stable sugar but felt like death..haha...back to meat again. It has been 3 years since then and about a year ago my doctor put me on insulin. I fought against it but finally submitted, at that time my A1c was 11. I have been using insulin for the last year without much supervision and haven't really increased the dosage. I am using the 30/70 insulin. I inject 22 units in the morning and 20 units at night. The thing is my sugar was very high in the last month. Over 20 mmol... I found this site a week ago and have been on the diet for the last week. I am still injecting the same insulin dose and my sugar has gone down to about average of 13 mmol which is great but still not ideal. I am worried because everyone reports huge sugar lows in their first weeks, why is mine not dropping as fast? is this normal and should I be patient? I am barely consuming 20 grams of carbs daily. I desperately want to get off the insulin but have not been able to drop it yet. Secondly my weight is a bit stagnant even though it was my first week. I am worried that I might get DKA with my high sugar levels. Also lastly I took the bulletproof coffee for the first time today and bang...diarrhea, is this normal? I am sorry for all these questions, it is just in my area there aren't really doctors that support LCHF and I really want this to work for me. Regards, Marinelle
  18. r
    Look up on the internet Jason Fung if you haven't already.
  19. HabeebuRahman
    can someone help me?
    I am a diabetic for the last 10 years and on LCHF for the last 5 months. I was taking met 1000, glym 2 and glyclazide 30 and my FBS was 178. my weight was 72 kg, waist 36 inches, Triglyceride 131 and HDL 41.
    after one month of LCHF, everything improved. FBS 106, medicines, met 500 and glym 1. weight 64 and waist 33 inches. Triglyceride 109 and HDL 47.

    after that there is no further improvements for the last 4 months. when I try to reduce med, FBS shoot up. A stand still. My fasting insulin is very low like 3 mU/L even with glym 1mg. C Peptide is 2.1 ng/ml.
    What should I do further to reduce med at least to stop glymepiride?

  20. 1 comment removed
  21. El
    8 months ago my A1c was 7.3%. Yesterday went to the doctor and my A1C is now 5.6% (I am no longer diabetic). Been doing the low carb for over three months and have lost 25 pounds as well. Why do doctors not push this LCHF diet is beyond me. Must be money motives. Sad.
  22. Alison
    Diagnosed T2D in May this year after 800ml hydrocortisone iv a day to control a nasty Crohns flare. I’m also a kidney transplant patient of 17 yrs and to my horror, they started me on insulin because they thought tablets would agrivate the IBD. I have knuckled down to under 20gm carbs a day and wow! Have I seen a major improvement in my BG readings.
    I am never over 7.1 after a meal and 4.1 is what I normally wake up on. That’s with me slowly reducing my insulin. I’m on 2 units at night (hardly seems worth it) and 22 units in the morning. I do a fast most days till 3-4pm. A have a coffee then eat a salad with 100-150gm protein. Drink lots of water and exercise 3 x a week for 45 mins. I want to show my Transplant physician these videos and get him on side. I’m in Australia.
  23. MJ
    MJ. 10/07/2017
    Was gestational with each of my pregnancies, both boys were over 8lbs, then I was hypo for a few years. Been overweight for over 30 years. I am trying to get healthy. Just started insulin and the diet they gave me is too hard to follow as I work 6p to 6a 3 days a week and the same time 4 days a week. On work days I don't eat right if we are really busy. then on my days off I binge. I want to try this LCHF to get my eating more controlled, BS normal for me, and lose weight. I take 12 u Tresiba at 6p every day and Novolog SS 3X a day. My friend shared this site with me at work last night she looks great and feels better since starting 2 weeks ago. She has lost weight and is sleeping better and eating good healthy meals until she feels full. I want that too.Just reading the posts tonight has given me courage to try . Thanks you all for your information. God bless you all
  24. Linda
    I have a solid family history of diabetes,and I watched my stepfather die a slow death from complications of diabetes in 2016. I also had genetic testing done when I was trying to get pregnant and found out that I have a genetic disorder where my body doesn't process sugars properly so it was like a double whammy. Metformin did nothing for me and my A1C numbers remained prediabetic, about 6.2 despite working out 5 days a week and reducing my carbs a bit. The doctor mentioned that if I don't lose weight, (I am slightly overweight) or make some change, in time, my organs will be taxed and could fail since the typical drugs weren't working for me.
    I came across Diet Doctor last July 2017 and decided to give the low carb high fat diet a try. I wanted to give myself 8 months to see if my A1C numbers improved. July 2017 my A1C was down to 5.9 so I was happier c/c I had cut out carbs at breakfast and lunch, but figured it couldn't hurt to try to lower them even further so I wouldn't be considered "prediabetic" anymore. I started by following the diet for 6-7 days of the week (all meals) and did go into ketosis for a bit, but then social events and summer BBQ's introduced more carbs into my life. So I wound up shooting for 5 days a week of LCHF and then relaxing over the weekends. I do have pasta and sometimes waffles on the weekends and don't stress about it since now my body naturally is satisfied with Low Carb now so long as I have the High Fat as well. I had concerns as well about raising my cholesterol levels since we eat eggs and bacon almost every day of the week! But figured, I'm doing a test, so let's see if anything changes. I told my doctor about it and he was skeptical about the high-fat part, but low and behold, I got my blood work back yesterday and my A1C went from 5.9 to 5.6!! I am NORMAL!! No longer pre-diabetic! AND... my cholesterol when DOWN! I was 230 and it's now 223! So how about that? I've been doing the happy dance since yesterday. For me, the lifestyle does work and I seem to be ok with 2-3 meals (not days) a week containing carbs. I have never felt better, I sleep great and no longer have blood sugar highs and lows. I had to share my story since I just got my numbers back. Diet Doctor is incredible!
  25. Flora
    Hi, I also have a history of diabet in my family and lost my mom at 68 years of age because of it. My A1c went up to 8.9 once, and it was scary. I came across diet doctor and Dr. Fung's videos and started following fasting and LCHF. My last A1c, last week was 5.7. But unfortunately my Triglyceride went up to 300, from 150, and my cholesterol to 265 from 199. I have lost about 15 lbs in last 8 months, and I am happy for my A1c. however my doctor emailed me couple times and she is worried about my Triglyceride, and cholesterol and wants me to to take Statin. I am not sure how to go about it.
    Thank you for this site and everyone who support it, so we can all benefit.
  26. John from Lancaster
    In June 2016 my doctor told me that my A1c was over 12 and that I had type 2 diabetes, he put me Metforin and another drug and encouraged me to lose some weight. In August my wife found the DietDoctor website and we decided to try out a low carb diet along with daily exercise. By September my A1c was down to 5.4 and my doctor cut back on my meds. . In January my A1c was down to 5.1 where it has remained. Last July my doctor had me stop taking any meds and my A1c has stayed at 5.1

    Over the course of the first six months of being on the diet I lost about 40 pounds of weight, and my weight is now stable with a good BMI

    I do not know if the low carb diet is good for everyone with type 2 diabetes, but it sure worked for me!

  27. Margaret Black
    Hi everyone. Have been very interested in everyone's comments. I have been pre-diabetic but since having pancreatitis last August all my blood work has been good. However now that am back eating "normally" for me am wondering about LCHF diet being any good for me as I was told when leaving hospital- Very low fat meals and no alcohol. Well I am not drinking any alcohol but will high fat be a disadvantage for me as I don't want to have pancreatitis again.
  28. 1 comment removed
  29. Vicki
    Get a hold of a copy of The Keto Zone by Dr Don Colbert and read the section on cholesterol. He goes into it and breaks it down, including how the LDL breaks down into two different parts and while we think of LDL as 'bad', one of the parts of LDL is good and can 'offset' the bad so in effect, the numbers are not as high or as bad as they may seem. He also gives you the name of the test to ask for that will break down those numbers for you.

    Actually, there's a fair amount of info in there that most doctors don't tell you, but the book is well researched and thoroughly referenced.

  30. Lori Ritchie
    Hello, I was all gungho to start the two week meal plan tomorrow but I am type 2 diabetic, on Lantus at bedtime, Metformin and Humalog with meals. I was worried about what to do with my insulin doses when I started. As it turned out I was able to get into see my local diabetes clinic this morning. The diabetic nurse would not support me going onto the LCHF diet. Because there is no way to test what kind of insulin my body produces on my own, she is extremely concerned about Ketoacidosis. If I get some symptoms of the flu, how do I know if it is the LCHF flu or ketoacidosis? She has scared me with all this ketoacidosis and recommends 30-45 grams carbs per meal. Help I don't know who to trust!
  31. kikiriki
    Cut wheat, grains and dairy... see if that helps.
  32. Susan
    I'm 71 and only this year was diagnosed with prediabetes. No strong genetic link although both grandmothers were diabetic and died young. My father never went to visit an MD and then was taken by cancer at 72. My mother had a high triglyceride problem at 60 and lived on a low-fat diet until she passed at 84 from a heart attack. One of my cousins is diabetic and I worry about her because she does not control it, but not my overweight sister, who nonetheless eats without sugar most of the time so seems OK. After diagnosis I cut out sugar immediately but did not catch on to the fact that carbs turn into sugar after eating. I bought a blood glucose meter and started using it and was really surprised to see that although my morning readings were normal anytime I so much as had a white-bread sandwich I was getting high readings after eating. So I'm attempting LCHF eating. It's harder than cutting sugar! I'm starting at the moderate-liberal level as there's so much to get used to. Cutting out sugar is easier - stop drinking sugar drinks and eating desserts, but LCHF requires a total revamp. But the more I make those low carb recipes and test my blood glucose after I can see it's worth it so will keep on with this new way of eating. My doctor scared me so much 6 months ago, saying I would go blind and lose limbs and would have to take medication "for life". I want to prove her wrong because I just could not take the Metformin. It gave me severe stomach pain, constant black diarrhea and acid reflux so I had to stop taking it. Before I could tell the doctor, I got pneumonia and the hospital started me back on Metformin. It was a double whammy of feeling sick. I was in the hospital because I have COPD and the pneumonia made breathing hard. But I'm home now and back to normal and have lost about 20 pounds which I attribute to my new way of eating.
  33. Anthony
    What if you're already thin and don't want to lose wait. Diet recommended for a pancreas problem.
    Reply: #34
  34. Kristin Parker Team Diet Doctor
    This article on our website should help with that.
    https://www.dietdoctor.com/low-carb/gain-weight

    --Kristin

  35. Ewa
    I've been diagnosed with prediabetes, on Metformin (3000) now, I've always been told I should eat more often in smaller portions - 4-5 times a day. How does this relate to 3 meals per day on keto?
    Reply: #36
  36. Kristin Parker Team Diet Doctor

    I've been diagnosed with prediabetes, on Metformin (3000) now, I've always been told I should eat more often in smaller portions - 4-5 times a day. How does this relate to 3 meals per day on keto?

    The dietary advice given to diabetics is given with the assumption that they will control their blood sugar with medication rather than through diet. By eating fewer times per day, this will help keep blood sugar stable for longer. Since you are on medication, make sure and keep in touch with your doctor as your medication dosage may need to be adjusted.

  37. Raj
    I was wondering how important glycemic load is. Is it a good guideline to avoid sweets/carbs?
    Reply: #38
  38. Kristin Parker Team Diet Doctor

    I was wondering how important glycemic load is. Is it a good guideline to avoid sweets/carbs?

    It's more important to measure actual blood sugar levels.
    https://www.dietdoctor.com/blood-sugar

  39. ziming chen
    I have been suffering from diabetes for more than 20 years and have injected insulin for thirteen years. I started low-carbon ketones on March 4, and a1c dropped from 11.4 to 6.5, and weighed 23 pounds. After the ketogenic diet, insulin was not used again, and only metformin, 1000 mg, was administered twice. Occasional blood sugar will be high at 140. But in the last two weeks, when I got up in the morning, my blood sugar was very high. Sometimes it was 180 to 200. It was also very high during the day. 140-160. I mainly eat vegetables, meat, fat, and bulletproof coffee. It is not very big. Change, why is this? Do I need to re-inject insulin now?

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