Type 2 Diabetes

type-2

Type 2 diabetes is by far the commonest form of diabetes (around 90% of all cases). The disease is getting more and more common, and there’re already around 330 million type 2 diabetics worldwide.

Most people who are affected are overweight (especially those carrying excess abdominal fat) and middle aged or older. People with high blood pressure and unfavorable cholesterol numbers also run an increased risk of developing the disease.

For more on the background to the epidemic, how you can test if you have diabetes and how to naturally regulate your blood sugar:

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 – previously called “adult onset diabetes” – results when the body no longer can handle large amounts of blood sugar. Large amounts of the blood sugar-lowering hormone insulin need to be produced, but this will still not be enough, because the sensitivity to the hormone decreases. At the time of diagnosis type 2 diabetics often have ten times more insulin in their bodies than what’s normal. As a side effect all this insulin causes fat storage and weight gain, something that often has been going on for many years before the disease is diagnosed.

So what’s the cause of this? This is still controversial and much debated. But there’s 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.

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. Here too there are clear linkages: people who eat more simple carbohydrates are more likely to get type 2 diabetes.

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.

Type 2 diabetes could thus very well be called sugar disease. But then do remember that starch in the bread turns in to glucose in the stomach – white flour is in fact also a form of sugar.

Treatment of Type 2 Diabetes

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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.

Avoid eating large amounts of sugar and starch and your blood sugar will be better from the first meal on. Your probably unhealthily high insulin levels will drop to normal levels. Because insulin is a fat storing hormone it has likely contributed to your overweight. When insulin levels drop most people will feel more satiated, eat less and gradually lose weight.

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

Try it yourself: LCHF for Beginners

NOTE: If you’re being treated with insulin or insulin releasing tablets (Sulfonylureas) you may need to taper off this medication if you are eating fewer carbohydrates.

 

Other Lifestyle Modifications

To eat significantly fewer carbohydrates is definitely the most important thing. I heartily 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).

Gradually, as your new eating habits start to flow easier you can start trying other positive lifestyle changes that can further improve your health and weight. There are two additional things that may be helpful:

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. Studies show that supplementation can improve blood sugar and insulin sensitivity somewhat in type 2 diabetes. In addition this may cause weight loss.

Around 4 000 IU daily (100 µg) may be appropriate for most people with type 2 diabetes.

Medication

If diet changes and other lifestyle changes don’t improve blood sugar sufficiently, then medication is added.

1. Metformin

Metformin tablets are without doubt the first-line treatment of choice. It’s an old and proven treatment. It has been proven to improve not only blood sugar but also general health in type 2 diabetics.

Unfortunately, some patients are unfortunately plagued by digestive problems (stomach pain, diarrhea) from the tablets. This side effect usually subsides with time. For susceptible people it may be wise to start with a small dose (0.25 – 0.5 g daily) that can then gradually be increased.

The dose of Metformin may be increased up to the highest dose the stomach will tolerate. 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?

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

Often insulin injections are used. I’d strongly advice against this if you are overweight, because you then usually already have pathologically high insulin levels in your body. To add MORE insulin in this situation often causes a gradually worsening of disease and an increase in obesity. It will make you sicker and fatter. It will increase the risk for cancer and in addition the risk for heart disease probably goes up.

If you’re already on insulin treatment you may need to taper off and go off it when you eat fewer carbohydrates and/or take other medication.

A newer and better alternative is injections with the hormone GLP-1. It produces an increased satiety, a lower blood sugar and often a substantial weight loss (over 20 lbs is common). This, in addition to Metformin, is what I use with my patients as needed. The effect on the majority of patients is very positive for both blood sugar and weight.

More Education

Blog posts on diabetes (mostly on type 2). Blog posts about type 2 diabetics that have tried a low-carbohydrate diet [1 2].

Type 2 diabetes is closely tied to the “western disease”, i.e. the Metabolic Syndrome.

Can You Cure Type 2 Diabetes?

In only six months? Without medications or surgery? This study suggests this:

Haimoto-liten

 

Type 2 Diabetes

kitabugraf

Pictured above is a large number of blood glucose readings in a type 2 diabetic in the first six months on an LCHF diet. The blue area corresponds to optimal blood glucose levels. Please 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.

The story behind the image: Type 2 diabetic becomes symptom-free on an LCHF diet (Google translated from Swedish)

Studies on an LCHF diet for type 2 diabetics

Weight

Overweight diabetics (both type 1 and type 2) will as a rule lose fat weight on a low-carbohydrate diet.

Studies

Cholesterol

But what happens to blood lipid levels when you eat less carbohydrate, and a higher proportion of fat? The fact is that recent studies (contrary to what was previously believed) show clearly improved cholesterol numbers.

Blood Pressure

Blood pressure also often improves on a low-carbohydrate diet. Which partly, but not completely, is explained by the weight loss.

I’ve heard of many people that have had to reduce or stop using blood pressure medications, when their blood pressure had dropped too low.

Studies

NOTE

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, if possible, be done with support of your physician or diabetes nurse, especially if you have limited experience of insulin adjustment yourself. 

Insulin for Type 2 Diabeticsbloodsugarmeasuring

A suggestion from Dr. Vesti Nielsen (specializing in internal medicine): reduce insulin doses by 25-30% from day one, when on an LCHF diet. Monitor your blood sugar closely and adjust doses accordingly. Most people can cut their insulin dose in half in 3-6 days. The low-carbohydrate diet Dr. Nielsen used in his study was moderately strict: 20% carbohydrate (around 100 g daily).

Dr. Mary Vernon suggests (with a strict low-carbohydrate diet, < 20g carbs/day) that insulin doses below 10E daily can be terminated immediately, while higher doses can be cut in half immediately. Blood sugar needs to be monitored closely before and after meals in the beginning, and doses have to be adjusted until your levels are good.

It’s not uncommon for type 2 diabetics to be able to manage without insulin after a while (days to months) on a low-carbohydrate diet.

Treatment With Tablets

Even doses of certain tablet treatments for diabetes may also need to be reduced after some time on an LCHF diet. The risk of the blood sugar dropping too low is however smaller than what it is from insulin injections. If treated with any other diabetes medication you should closely monitor blood sugar to be safe, when you change your diet. The exception is Metformin tablets, which don’t make the blood sugar drop too low.

If you’re not taking any medication for your diabetes (or Metformin only) you don’t need to worry about blood sugar dropping too low on an LCHF diet. 

If Blood Sugar Drops Too Low

Immediately eat something carbohydrate-rich, such as a fruit or a sandwich. A glass of juice or glucose tablets may also work well. They raise blood sugar. If your blood sugar drops too low you should strongly consider reducing your medication. If you need help doing this contact your doctor.

More

In addition to type 1 and 2 there are a couple of other forms of diabetes. LADA-diabetes is a not too uncommon form (perhaps as much as 10%), 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 first debuts later in life than type 1 and develops more slowly.

MODY diabetes is a rarer form that is caused by a genetic abnormality.

Studies

Dangerous drugs?

Self Monitoring

Monitoring your blood sugar yourself seems to have a small positive effect, even for diabetics that are not insulin-treated:

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. Monitoring of blood sugar for non-insulin-treated diabetics should be used for pedagogic reasons or for the purpose of improving diet and exercise treatment.

Main Page on Diabetes

Diabetes – Normalize Your Blood Sugar

One Reason to Care

High blood sugar produces a risk for severe complications in the long run. It “eats” away the body’s small blood vessels. The higher the blood sugar the higher the risk for heart attack, blindness, amputations and other misery.

Just ask Richard Roseman, one of millions of victims of common complications of diabetes:

Roseman1

Obviously one would want to avoid this. But a conventional low-fat diet (today’s dietary guidelines) and medications in principle never cures diabetes. In the best case scenario the disease is kept under control without causing major damage. At worst it will go like it did for Richard Roseman. Or worse.

A better treatment than this is needed. It exists, and it’s obvious and logical when you understand.

Insulin and the Fear of Natural Fat

This knowledge was partly forgotten when the insulin came. In a too great a reliance on the new, one seems to have believed that diabetics without problems could inject unlimited amounts of insulin, in order to normalize blood sugar, and thereby be able to eat more blood sugar-raising carbohydrates. But excessive doses of insulin have negative long-term effects, and this has become more and more obvious – in studies as well as in reality. Excess insulin makes you gain weight, and is likely dangerous in other ways.

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

19 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

  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. 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?

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