Blog

On a high-​carb diet, people with diabetes need less insulin

Behind Barbed Wire_PrintAs I explain in my book Thin Diabetes, Fat Diabetes: Prevent Type 1, Cure Type 2, There are two main type of sugar diabetes (diabetes mellitus). If you have thin diabetes (type 1 diabetes mellitus), your pancreas cannot make enough insulin to keep you alive. If you have fat diabetes (type 2 diabetes mellitus), your body is resisting the effects of insulin, to keep you from storing more fat in your fat cells. You can have both problems at once. In other words, even people with insulin shortage can have some degree of insulin resistance.

The solution to insulin resistance has been known since the 1930s: eat a high-​carb, low-​fat diet. The more carbs you eat, the more sensitive your body becomes to insulin. The more fat you eat, the more resistant your body becomes to insulin. When people with type 1 diabetes start a high-​carb diet (>75% of calories in the form of carbohydrate), they often have to decrease their insulin dosage by about 30%.

 

Sugar diabetes and water diabetes

The word diabetes comes from the ancient Greek word for siphon. A siphon is a tube that is used to transfer water from one vessel to another. Ancient Greek physicians used the word diabetes to refer to any disease that makes you pee too much.

What is sugar diabetes?

Eventually, physicians realized that there was more than one kind of diabetes. You could tell them apart by tasting the urine. (Of course, nowadays we use laboratory tests instead of tasting the urine!) One kind of diabetes made the urine taste sweet, like honey. That kind of diabetes was called diabetes mellitus, which means honey diabetes.

What causes diabetes mellitus (sugar diabetes)?

Doctors use the term diabetes mellitus to refer to a group of unrelated diseases that result from different causes. However, they all have one important thing in common. If left untreated, they cause a sugar called glucose to build up to high levels in the bloodstream. When the blood glucose level is very high, some of the glucose starts to pass out of the body through the kidneys. This glucose draws water along with it. As a result, the person passes a lot of sugary urine. Because they lose so much water, they get very thirsty. Since the sugar that they are losing represents calories, they tend to lose weight. That is why sugar diabetes produces four classic signs:

  • Polyuria (lots of urine)
  • Polydipsia (severe thirst)
  • Glycosuria (sugar in the urine)
  • Weight loss

What causes diabetes mellitus?

There are two main types of diabetes mellitus. Type 1 diabetes (the French call it diabète maigre, which means thin diabetes) results from the loss of the insulin-​producing cells of the pancreas. If you have thin diabetes, it means that your pancreas can no longer make enough insulin to keep you alive. Type 2 diabetes (the French call it diabète gras, which means fat diabetes) means that your body is resisting the effects of the hormone insulin. If you have fat diabetes, it means that you are a naturally thin person. Your body is trying to prevent you from storing the fat that you have been eating. The solution to fat diabetes is to cut out the fat. You can reverse type 2 diabetes by eating less and exercising more. You can reverse it even more quickly by switching to a low-​fat diet.

A person can have some degree of insulin shortage (thin diabetes) and insulin resistance (fat diabetes) at the same time. A slight degree of insulin resistance is normal during pregnancy. However, if added to the insulin resistance that represents a resistance to gaining too much weight, the normal insulin resistance of pregnancy can lead to gestational diabetes, which is a temporary case of fat diabetes during pregnancy. Diabetes mellitus is particularly dangerous during pregnancy. Any pregnancy in a woman with diabetes mellitus is a high-​risk pregnancy.

Regardless of which type of diabetes mellitus you have, a high-​carbohydrate diet is important to maintaining blood sugar control. The more carbohydrate you eat, the more sensitive your body becomes to insulin.

What is diabetes insipidus (water diabetes)?

The other kind of diabetes makes people pass urine that was so dilute that it has no flavor. It was called diabetes insipidus, which means flavorless diabetes. Water diabetes can result from several different causes.

What causes water diabetes?

The brain and kidney normally work together to control the water balance in the body. Thus, water diabetes generally results either from a problem in the brain or a problem in the kidney. When you become dehydrated, your brain is supposed to make a hormone called antidiuretic hormone, which helps you retain water. While you are dehydrated, your brain is supposed to make you feel thirsty, so that you will drink water. Several things can go wrong with this system of control:

  • After a brain injury, the brain may not produce enough antidiuretic hormone. The solution to this problem is to take supplemental antidiuretic hormone.
  • The brain’s thirst mechanism might be on even when you are not dehydrated. The solution to this problem is to restrict the person’s access to water.
  • The kidney might not be responding normally to antidiuretic hormone. The solution to that problem is to treat the underlying cause.
  • During pregnancy, the placenta makes an enzyme that breaks down antidiuretic hormone. As a result, women can get a temporary case of water diabetes during pregnancy. Water diabetes during pregnancy can be serious and can lead to the death of the mother or the baby.

In people with water diabetes, the main challenge is to control the balance of water and electrolytes (such as sodium and potassium) in the body.

High-​Carb Diets Improve Blood Sugar Control

Back in 1927, an American physician named Shirley Sweeney recruited some healthy male medical students for a study of how diet affects blood sugar control. That study showed that you could make healthy young men seem diabetic by feeding them too much fat or too much protein or nothing at all for only two days.

Sweeney divided his volunteers into four groups. He asked the members of each group to eat a particular test diet for two days. One group ate mainly carbohydrates (starch and sugar). Another ate mainly protein. A third group ate mainly fats. The fourth group fasted for two days. On the morning of the third day, before the subjects had eaten or drunk anything else, they had a glucose tolerance test. They drank a beverage with a known amount of the sugar called glucose. Then, their blood sugar (blood glucose) levels were measured over the following few hours.

During the glucose tolerance test, the men who had been eating nothing but carbohydrates for two days had remarkably stable blood sugar levels. But the other men’s blood sugar levels spiked to abnormally high levels. The men who had been eating nothing but fat got results that suggested severe diabetes. Remember, these were healthy young men who had been eating an abnormal diet for only two days.

From these results, Sweeney concluded that a high-​carbohydrate diet helps to improve the body’s ability to tolerate carbohydrates. In contrast, high-​protein diets, high-​fat diets, and fasting undermine the body’s ability to control blood sugar. In a follow-​up article, Sweeney suggested that some patients might have abnormal glucose tolerance test results because of the diet that their doctors had been urging them to follow, rather than because of some underlying medical problem.

Sweeney was not the only researcher to show that high-​fat diets cause problems with blood sugar control. In the 1930s, a British physician named Sir Harold Percival Himsworth did similar studies and got similar results.

Starting in the late 1930s, a German émigré physician named Walter Kempner started applying these lessons to the treatment of patients at Duke University. Kempner started off by trying to find a dietary solution to severely high blood pressure. Back then, no effective drugs were available to reduce blood pressure. Kempner reasoned that since heart and kidney disease were rare in societies that ate a rice-​based diet, his patients should eat a rice-​based diet.

Because his patients had kidney problems and atherosclerosis, Kempner designed a diet to be as low as possible in protein and fat. So he told his patients to eat nothing but rice, fruit, and fruit juice. If they lost too much weight on that low-​fat diet, they were told to add some pure sugar. This diet produced dramatic improvements in patients with heart and kidney disease. It also did wonders for patients with diabetes.

Patients with what is now called type 2 diabetes, which is a complication of being overweight, lost weight and became undiabetic. Patients with type 1 diabetes, which results when the immune system destroys the pancreas’s ability to make insulin, had much better control of blood sugar levels and could get by on much smaller insulin doses. Even their eyes were healthier. (Diabetes is a major cause of blindness.)

The fact that high-​carb diets are good for diabetics has been known since the 1920s. Nevertheless, many doctors in the United States are still urging their overweight and diabetic patients to avoid eating carbs. Unfortunately, a low-​carb diet can make even a healthy young person look diabetic within a matter of days. Fortunately, a high-​carb diet can cure the most common form of diabetes and can improve the health of people with the incurable form of diabetes.

Note: This article was originally posted on my Where Do Gorillas Get Their Protein? blog (www​.gorillaprotein​.com).