There is a lot of definitions of what low carb means or more particularly how low is low carb.
And that is the case when you are using it to manage type 2 diabetes (and type 1) too.
The objective as I see it is to reduce carbs so as to have blood sugar (glucose circulating in the blood) in the range that is normal for non-diabetics with the least amount of drug and/or insulin. This reduces the side effects of the drugs and gives your body chance to recover from the toxic effects of high blood sugars. (It may or may not require the use of drugs and/or insulin to do this – it is the blood sugar level that is the goal).
The recommended blood sugars are (and if you can be better than well done)
Fasting blood sugar under 5.5 mmol/L (100 mg/dl)
1 hour after meal under 7.7 mmol/L (140 mg/dl)
When blood sugar goes high than the normal range it can cause a number of issues – and over time it can result in lost limbs, dead nerves in the feet especially, blindness, heart attacks. None of which happen overnight but slowly get worse (silently it seems).
With the low carb diet I follow I don’t use drugs or insulin and there are many people who do manage their diabetes in the same way. They have effectively reversed the symptoms of the disease., although you do need to continue to eat this way on an ongoing basis – it doesn’t mean you can go back and eat the way you used to.
For me this is around 30 carbs or so each day (which is Dr Bernstein’s recommendation for managing Type 1 as well as Type2 in his book The Diabetes Solution).
It is a diet that is similar to the Atkins diet or ketogenic diet, but the objective is different. There for weight loss and going into ketosis. This low carb diet can result in that but it’s not the goal.
The calories that you cut out due to less carbohydrate are replaced by fat rather than protein. If you eat more protein than you need this can be converted into glucose by the liver (glucogenesis) which can then increase the blood sugar.
To be able to know you are operating in normal range requires you to measure your blood sugars using a monitor. When getting started on this the end of your fingers aren’t going to like you – not that it hurts too much. You need to prick your fingers with the stick pin and then test your blood using the meter.
When Should You Do It?
The times recommended are first thing in the morning, 1 hour and 2 hours after food and just before bed at night.
This helps you to see the effect that the food you ate has on your blood and that you are staying in the safe range of blood glucose and your fasting blood sugar..
(See blood sugar 101 for a printable PDF chart)
To be able to get carbs low enough it means removing all grains, cake, most beans, legumes, root vegetables, most fruits, (potatoes, carrots etc) low fat products, processed foods and sugars.
That does leave you with plenty of food options – Greek yogurt, leafy vegetables, cauliflower, broccoli, berries, avocadoes, cheeses, fatty meats, coconut oil, olive oil (not manmade vegetable oils). There is bacon, butter and eggs and loads more. You just don’t eat them with bread or potatoes or pudding anymore.
Going this low has helped me to lose weight I was 17 stone (238) I’m now 12 stone 11 lbs (179 lbs). I am 6 foot tall – just about. My blood sugar is in the normal range – morning blood sugar ranges from 4.5 to 5.2 usually). It reversed by non-alcoholic fatty liver disease and my cholesterol has stayed in the normal range for non-diabetics (as it was when diagnosed although the doctor did want to put me on statins of course).
This type of diet can help a lot of people control Type 2 Diabetes without drugs and insulin but won’t do it for everyone. What this can do is reduce the amount of drugs needed to achieve normal blood sugars. If you do use insulin or drugs and want to try a low carb approach it is important to be careful to prevent hypos (low blood sugars) and you probably need the assistance of a doctor to get this right.
This is not the medical profession or other professionals approach to low carb (although there are some that do recommend in addition to Dr Bernstein). There’s on the whole is to tell you to stop taking table sugar, process foods, white flour goods, stop drinking pop/sodas and fruit juices – but you should still eat the healthful diet recommended of non-diabetics. But they still want 45 – 60% of calories to come from carbs although high blood sugar and insulin can cause plenty of complications which they hope to control with drugs. This is despite you being glucose intolerant to start with.
Much of the research in this is funded or performed by food companies and pharmacies and this is relied on by the medical profession. The sources of the research really is to sell more food and drugs not necessarily to improve your diabetes (which is secondary to them at best).
The diabetes.org (UK diabetes association) do have a course you can take that recommends a minimum of 150 grams which for me is way too high for me.
The profession does expect Type 2 diabetes to be a progressive disease where you get steadily worse over 10 years and require more drugs and/or insulin as you become more resistant and your pancreas wears out over time.
There isn’t any research been done to determine what the outcome is of eating a low carb diet on type 2 diabetes (over a longer period of time) – it could be the same in terms of the progression of the pancreas etc but at least you’re blood sugar levels haven’t been slowly poisoning the rest of your body.
When you first go on a low carb diet you can have something called the low carb flu where you feel like you have a mild flu and may feel a little tired. It passes normally in a couple of weeks. I didn’t really notice this I did have a feeling that I needed sugar – and when I tested it was 7 which was down from 10 and you shouldn’t have a real problem with hypos if you aren’t on drugs or insulin.
Low carb for Type 2 diabetes management is that level where blood sugars can be normalized at non-diabetic levels with the minimum amount of drugs and insulin to prevent damage from high blood sugar, insulin and the effects of the drugs.
What that number (carbohydrate intake nuber) is will be different from individual to individual (but 30 grams is what I aim for as recommended ). It depends on that persons response to carbs which is down to their insulin resistance and pancreas function. The only way to determine this is though monitoring blood glucose in the beginning at least.