Improvements In Glucose Metabolism And Insulin Sensitivity With A Low-carbohydrate Diet In Obese Patients With Type 2 Diabetes.
Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes. Endocrine, Diabetes and Research Centre, Wellington Hospital, Wellington, New Zealand. [email protected] The optimal diet for weight loss in type 2 diabetes remains controversial. This study examined a low-carbohydrate, high-fat diet with detailed physiological assessments of insulin sensitivity, glycemic control, and risk factors for cardiovascular disease. Fourteen obese patients (body mass index [BMI] 40.6 4.9 kg/m(2)) with type 2 diabetes were recruited for an "Atkins"-type low-carbohydrate diet. Measurements were made at 0, 12, and 24 weeks of weight, insulin sensitivity, HbA1c, lipids, and blood pressure. Twelve completers lost a mean of 9.7 1.8 kg over 24 weeks attributable to a major reduction in carbohydrates and resultant reduction in total energy intake. Glycemic control significantly improved (HbA1c -1.1 0.25%) with reductions in hypoglycemic medication. Fasting glucose, homeostasis model assessment (HOMA), and area under the curve (AUC) glucose (intravenous glucose tolerance test [IVGTT]) were significantly reduced by week 12 ( p < 0.05). There were nonsignificant improvements in insulin sensitivity (SI) at week 12 ( p = 0.19) and week 24 ( p = 0.31). Systolic blood pressure was reduced (mean -10.0 mmHg between weeks 0 and 24, p = 0.13). Mean high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol all increased. The ratio of total: HDL cholesterol and triglycerides was reduced. A low-carbohydrate diet was well tolerated and achieved weight loss over 24 weeks in subjects with diabetes. Glycemic control improved with a reduction in requirements for hypoglycemic agents. Continue reading >>
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- Insulin, glucagon and somatostatin stores in the pancreas of subjects with type-2 diabetes and their lean and obese non-diabetic controls
Low-carb Diet Vs. Low-fat Diet
How Jessica Increased Her Insulin Sensitivity by 25x in 6 Months by Transitioning to a Low-Fat Diet Since the time she was diagnosed with type 1 diabetes in 1996, she has worked hard to follow a strict low-carb diet, in order to control her blood glucose to the best of her ability. Over the course of time however, she found that no matter how few carbohydrate-rich foods she ate, her blood glucose was quite challenging to control. Searching for an easier approach to managing diabetes, Jessica adopted a low-carb diet in 2015. On her low-carb diet, she reduced her total carbohydrate intake to approximately 20 grams per day, hoping that it would give her tight blood glucose control. Following this low-carb diet, Jessica's blood glucose was chronically elevated. Routinely, when she checked her blood glucose - either before or after a meal - she often saw values in the high 200s or low 300s. To cope with increasing insulin requirements , Jessicas doctor recommended starting 1000 mg of Metformin on a daily basis in addition to basal and bolus insulin. She found her doctors advice quite strange, given that Metformin is often prescribed for people with type 2 diabetes suffering from insulin resistance. Despite this, she followed her doctor's advice and began taking 1000 mg of Metformin per day, desperate for any solution that would help improve her diabetes health. Jessica found herself losing energy rapidly. From the time she woke up in the morning to the time she went to sleep, staying awake seemed increasingly difficult, and exercise was almost entirely out of the question. Jessica knew something was terribly wrong, she just didn't know what to do to improve her health. Enter Low-Fat, Plant-Based, Whole-Food Nutrition While perusing on the Internet, Jessica stumbled across o Continue reading >>
Dear Mark: Does Eating A Low Carb Diet Cause Insulin Resistance?
157 Comments Despite all the success you might have had with the Primal way of life, doubts can still nag at you. Maybe it’s something you read, or something someone said to you, or a disapproving glance or offhand comment from a person you otherwise respect, but it’s pretty common when you’re doing something, like giving up grains, avoiding processed food, or eating animal fat, that challenges deeply-and-widely held beliefs about health and wellness. It doesn’t really even matter that you’re losing weight or seem to be thriving; you may still have questions. That’s healthy and smart, and it’s totally natural. A question I’ve been getting of late is the effect of reducing carb intake on insulin sensitivity. It’s often bandied about that going low carb is good for folks with insulin resistance, but it’s also said that low carb can worsen insulin resistance. Are both true and, if so, how do they all jibe together? That’s what the reader was wondering with this week’s question: Hi Mark, I’ve been Primal for a few months now and love it. Lowering my carbs and upping my animal fat helped me lose weight and gain tons of energy (not too shabby for a middle-aged guy!). However, I’m a little worried. I’ve heard that low carb diets can increase insulin resistance. Even though I’ve done well and feel great, should I be worried about insulin resistance? Do I need to increase my carb intake? I always thought low carb Primal was supposed to improve insulin function. Vince Going Primal usually does improve insulin sensitivity, both directly and in a roundabout way. It improves directly because you lose weight, you reduce your intake of inflammatory foods, you lower systemic inflammation (by getting some sun, smart exercise, omega-3s, and reducing or dea Continue reading >>
A Practical Guide To Carb Tolerance And Insulin Sensitivity
One of the biggest reasons why people go Paleo is the metabolic benefits. Most people find Paleo to be very therapeutic for a whole cluster of carb-related problems: high blood sugar (or the rollercoaster of highs and lows), insulin resistance, and all the related issues. These issues can make weight loss difficult or impossible, but on the flip side, addressing them through diet can make it easier and more pleasant than you ever thought could happen! On the other hand, though, there are a lot of myths and half-truths floating around about diet, exercise, and carb metabolism. So here’s a quick review of what it all means, and the evidence supporting various different complementary strategies for improving your carb tolerance (preview: it’s so much more than dietary carbs). Note: This article is not written for diabetics. Diabetes is a very complicated disease and strategies that are right for other people might not be appropriate. If you have diabetes, see a doctor! What Is “Carb Tolerance”/Insulin Sensitivity? (If you already know how insulin and glucose work, this section has nothing new for you; just skip down to the next one) Very simply put, insulin sensitivity (or “carb tolerance” in everyday language) is a healthy hormonal state that allows your body to digest and store carbohydrates without a problem. In healthy people, here’s how it works: You eat something with carbs (let’s say a potato, but it could be anything). Your digestive system breaks down the starch in that potato into glucose. Glucose is a simple sugar – this is the form of carbohydrate that you’ll either use for energy or store as fat. Your blood sugar temporarily rises as the glucose enters the bloodstream. This is not a big problem, because… Insulin (produced in the pancreas) Continue reading >>
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- Alpha Lipoic Acid: Improve Insulin Sensitivity & Fight Diabetes!
Insulin Resistance, Low-fat Diets, And Low-carbohydrate Diets: Time To Test New Menus.
Abstract PURPOSE OF REVIEW: Insulin resistance increases the risk of cardiovascular disease and diabetes, and the risk of cardiovascular disease increases further once diabetes has developed. As insulin resistance is a precursor to diabetes, it is critically important to identify cost-effective means, such as dietary changes, by which to reduce insulin resistance. The purpose of this review is to evaluate recent findings concerning dietary composition and insulin resistance, with particular focus on low-fat diets compared with the currently popular low-carbohydrate diets. RECENT FINDINGS: Recent findings indicate little support for the value of low-carbohydrate diets as therapies for insulin resistance. In contrast, the limited data available suggest that the higher fat content of typical low-carbohydrate diets may exacerbate insulin resistance in the long term. Preliminary data indicate that proteins from different sources may have differing effects on insulin resistance. Preliminary data also suggest the potential value of whole grains, fruits and vegetables in therapeutic diets to reduce insulin resistance. SUMMARY: Current evidence supports the inclusion of whole grains, fruits and vegetables, and lean sources of animal proteins including low-fat dairy products in dietary therapies for insulin resistance. Those who wish to follow a low-carbohydrate diet should be encouraged to follow a new menu low in fat, and with most of the protein derived from plant sources. Continue reading >>
If Low Carb Eating Is So Effective, Why Are People Still Overweight?
If low carb eating is so effective, why are people still overweight? I find myself getting asked this question, or some variant of this question, with increasing frequency as I speak and write about the Alternative Hypothesis I find most compelling surrounding obesity and chronic disease. One implication of the Alternative Hypothesis, as you probably understand by now if youve been reading this blog, is that many carbohydrates, especially if consumed at the levels most Americans consume them, promote fat gain. In other words, overweight people are not the lazy, constantly grazing, weak-willed individuals many in the mainstream have led us to believe. They just eat the wrong foods (rather than simply too much food). Remember, I was one of those doctors in the mainstream once upon a time. While I always tried (and hopefully succeeded most of the time) to treat overweight patients with respect, I silently judged them. Why cant you just eat less and exercise more? Only when I realized, despite my diet which rigorously adhered to formal recommendations and my 3 to 4 hours of exercise per day, that even I was getting too fat for comfort, did I begin to question the Conventional Wisdom of why we get fat. Of course, not everyone (fortunately) was born with my level of genetic susceptibility to insulin resistance (stated another way, not everyone is born with my level of carbohydrate sensitivity). In my experience, about 10-20% of the population (my lucky wife included) seem resistant to carbohydrates and maintain exquisite insulin sensitivity, almost independent of diet. Roughly 30-40% of the population are, conversely, very sensitive to carbohydrates and appear to be quite insulin resistant until nearly the last gram of sugar and most carbohydrates are removed from their diet Continue reading >>
Insulin And Insulin Resistance - The Ultimate Guide
Insulin is an important hormone that controls many processes in the body. However, problems with this hormone are at the heart of many modern health conditions. Sometimes our cells stop responding to insulin like they are supposed to. This condition is termed insulin resistance, and is incredibly common. In fact, a 2002 study showed that 32.2% of the US population may be insulin resistant (1). This number may rise to 70% in obese adult women and over 80% in some patient groups (2, 3). About a third of obese children and teenagers may also have insulin resistance (4). These numbers are scary, but the good news is that insulin resistance can be dramatically improved with simple lifestyle measures. This article explains what insulin resistance is, why you should care and how you can overcome it. Insulin is a hormone secreted by an organ called the pancreas. Its main role is to regulate the amount of nutrients circulating in the bloodstream. Although insulin is mostly implicated in blood sugar management, it also affects fat and protein metabolism. When we eat a meal that contains carbohydrates, the amount of blood sugar in the bloodstream increases. This is sensed by the cells in the pancreas, which then release insulin into the blood. Then insulin travels around the bloodstream, telling the body's cells that they should pick up sugar from the blood. This leads to reduced amounts of sugar in the blood, and puts it where it is intended to go, into the cells for use or storage. This is important, because high amounts of sugar in the blood can have toxic effects, causing severe harm and potentially leading to death if untreated. However, due to various reasons (discussed below), sometimes the cells stop responding to the insulin like they are supposed to. In other words, they Continue reading >>
What Is The Perfect Diet For Weight Loss And Diabetics? What Is Insulin Resistance?
Have you heard but don’t understand what is insulin resistance? Are you gaining weight no matter what you try? Are you pre diabetic or been diagnosed as a diabetic (T1 or T2)? Has your appetite always been out of control? Well watch this fabulous Tedx talk by Dr Sarah Hallberg and see how insulin resistance can be playing a part in all the above conditions. Everyone can benefit from cutting carbs. Not only will it reduce your risk of T2 diabetes, obesity, cardiovascular risk factors and more importantly, your inflammatory markers are reduced which has huge implications for cancer prevention. Why are the guidelines still recommending for diabetics to consumes carbohydrates when they are intolerant to them? The message for so long has been “eat whatever you want, then medicate for it”. This is such nonsense. None of us should be eating so many carbs, let alone diabetics. We can have the beginnings of insulin resistance for years, even decades, before we are classed as pre diabetic or T2 diabetic. Having such high circulating levels of insulin is the problem. High insulin levels leads to insulin resistance. Our cells start to require more and more insulin to function. Click To Tweet So now you have watched the talk, lets look again at what insulin resistance is. We are all advised to eat far too many carbs, whether it is ‘healthy wholegrain’, sweets, ice cream, ‘natural’ muesli bars, cereals, bread or potatoes. This constant high level of circulating glucose (which all carbs are converted to) requires more and more insulin to push that glucose into your cells as glycogen. We can only store so much glycogen in our body so the remainder is stored as fat. Insulin is our fat storing hormone. Remember that again, insulin is our fat storing hormone. So whilst our b Continue reading >>
Low Carbohydrate Diets: Understanding The Grim Long-term Effects
Diabetes is growing faster now than at any point in human history, yet despite this doctors continue to prescribe low carbohydrate diets, a strategy that is often viewed as the most effective nutrition approach for optimal diabetes health. On the surface, this appears to make sense because low carbohydrate diets often result in rapid weight loss, reduced A1c values, and decreased blood glucose. However, more than 85 years of research has clearly demonstrated that low carbohydrate diets cause insulin resistance, the behind-the-scenes condition that complicates and worsens all forms of diabetes (1–30). A growing body of evidence now shows that diets low in fat and high in unrefined carbohydrates from fruits, vegetables, beans, lentils, and whole grains are remarkably effective at reversing insulin resistance in patients with type 1 diabetes, prediabetes, and type 2 diabetes (20–25,31–42). Insulin resistance results from the accumulation of fat in tissues that are not designed to store fat, mainly in your liver and muscles (2,3,9–14,16–18,27,43,44). When you eat a low carbohydrate diet high in fat and protein, fatty acids are burned for energy, however they also accumulate in tissues like your muscle and liver. When your muscle and liver begin accumulating fat, both tissues begin rejecting insulin in an effort to block more energy from entering. Essentially, the more fat you eat, the weaker insulin becomes. Low carbohydrate diets are the easiest way to develop insulin resistance. In the research setting, scientists induce insulin resistance and diabetes by feeding laboratory animals a low carbohydrate diet high in fat and protein. These animals gain weight, develop severe insulin resistance, and show early signs of diabetes in as little as 8 weeks (1,45,46,46–5 Continue reading >>
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- How Low Can You Go? Expert Advice On Low Carb Diets and Diabetes
- The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials
Low-carb Diet For Insulin Resistance
Losing weight and making healthier food choices are two of the most important modes of treatment recommended for people with insulin resistance, also known as prediabetes. Following a low-carb diet can help you with both. But before you get started, consult with your doctor and a dietitian to go over the diet plan and discuss health and safety concerns. Video of the Day Insulin is a hormone responsible for carrying glucose from your bloodstream into your cells. The cells can then use the glucose for energy. Insulin resistance means your body makes insulin, but the hormone can't do its job effectively. To compensate, your body produces more insulin, and you end up with consistently elevated blood sugars and, eventually, diabetes. Excess weight and lack of activity are the two most common causes of insulin resistance, which is why diet and activity are recommend as the primary forms of treatment. Eating healthy foods and using portion control are typically recommended to promote weight loss. Low-carb diets may be especially effective, however, because they not only promote weight loss but improve insulin resistance as well, according to a 2007 article published in the American Journal of Clinical Nutrition. Cutting Carbs to Fight Insulin Resistance While there are no clear guidelines for what makes up a low-carb diet, most experts agree that limiting carbs to 50 to 150 grams a day is considered a low-carb diet, and limiting to 20 to 50 grams a day is a very-low-carb diet. Many low-carb diet plans begin with a very-low-carb restriction to induce ketosis -- the process by which the body uses fat for energy instead of glucose -- which is a telltale sign for fat burning. The very-low-carb plan seems to work best for people with insulin resistance, according to the 2007 Americ Continue reading >>
Why Low-carb Diets Aren’t The Answer
What raises blood sugar? The simple answer is carbohydrates. So why not just yank them out of your diet like weeds in your garden? Why not quash blood sugar by swearing off bread, pasta, rice, and cereal? Been there, done that. The low-carb craze is on the downswing, and that’s a good thing because over the long haul, very low carb diets simply aren’t good for you, as you’ll discover in this chapter. That doesn’t mean it’s not smart to cut back on carbs—but don’t go crazy. When low-carb diets first became popular, they seemed to be a breath of fresh air after the low-fat (and high-carb) diets that preceded them. Remember low-fat cookies, lowfat snack cakes, and low-fat everything else? With low-carb diets, suddenly people could load up on bacon and still lose weight as long as they were willing to eat hamburgers without buns and pretty much give up sandwiches and spaghetti. People were amazed at how effective these diets could be. Weight loss could happen very quickly, sometimes within days. And amazingly, it often seemed to come with added health benefits, including lower cholesterol, blood pressure, and triglycerides (blood fats linked to heart attacks.) The most extreme kind of low-carb diet was pioneered by the late Robert Atkins, M.D., whose first book, Dr. Atkins’ Diet Revolution, came out in 1972. It promised quick and long-lasting weight loss and prevention of chronic disease, all while allowing high-fat steak and ice cream. Since then, other, more moderate low-carb diets have allowed small amounts of carbohydrate-rich foods, but they still cut out most grains as well as starchy vegetables and even fruit. The Downsides of These Diets The Atkins diet and the many other low-carb diets that followed in its footsteps have turned out to be less effect Continue reading >>
Is Your Low Carb Diet Making You Metabolically Inflexible?
The answer for a lot of people is “Yes.” Let me explain both kinds of insulin resistance and pay particular note to the italicized portion at the bottom. Once again “eat less do less” isn’t helping but leaving out carbs actually harms your cells and the result is a withering metabolism. I wrote this about a year and a half ago and I (actually my editor at the time and I) use the word toxin pretty freely. Since then I have come to think the word toxin is overused and is often the defense of someone that really doesn’t know what they are talking about. Insulin Resistance With the growing population of type 2 diabetes, most everyone has been informed of insulin resistance yet it is poorly understood. The result of excessive intakes of empty carbohydrate foods lacking vitamins and minerals leads to jacked up blood sugar levels. These constantly jacked up blood sugars lead to chronically elevated insulin levels because insulin and blood glucose should rise in a relatively similar fashion but not ALWAYS be high. The result of inadequate vitamins and minerals (namely magnesium) leaves an exhausted liver and pancreas; two crucial organs to insulin’s stability and reliance. Chronically elevated blood gucose is toxic and inflammatory. The inflammation centers itself in the abdominal cavity and arteries, focusing on the liver and pancreas and widening to other parts of the body as it progresses. The body handles toxins by storing them in the body. This leaves your fat stores full of toxins. Your organs become ‘fatty.’ You store excess body fat. This is metabolic syndrome. Many doctors are forced to inform their patients these days of their ‘fatty livers.’ Over time, an overworked body with excessive glucose becomes insulin resistant which is a precursor to ty Continue reading >>
The Ketogenic Diet And Insulin Resistance
We recently touched on how you can use the ketogenic diet to control symptoms of diabetes such as elevated glucose and triglycerides. In this article, we examine research showing the impact that the ketogenic diet has on levels of the hormone insulin, a key regulator of blood sugar in the body. What is Insulin’s Role in the Body? Before we look at the research, we need to know our main players. Insulin is a protein-based hormone produced by beta-cells located in the pancreas. The pancreas, which is located under the stomach, also produces enzymes that aid with digestion. Insulin’s primary purpose is to regulate the metabolism of fats and carbohydrates. The digestive system breaks down carbohydrates, such as sugars and starches, into a molecule called glucose. This compound can be used by cells to produce energy through a process called cellular respiration. Insulin allows cells in the body absorb glucose, ultimately lowering levels of glucose in the blood stream. After a meal is consumed, blood glucose levels increase and the pancreas responds by releasing insulin into the blood. Insulin assists fat, liver, and muscle cells absorb glucose from the blood, resulting in lower levels of blood glucose. Insulin stimulates liver and muscle tissues to store excess glucose as a molecule called glycogen and also reduces glucose production by the liver. When blood sugar is low, the hormone glucagon (produced by alpha-cells in the pancreas) stimulate cells to break down glycogen into glucose that is subsequently released into the blood stream. In healthy people who do not have type II diabetes, these functions allow levels of blood glucose and insulin to stay in a normal range. What Is Insulin Resistance and Why Is It a Problem? Unfortunately, for many Americans and other peopl Continue reading >>
One Day Of A Low-carb Diet Decreases Insulin Resistance, Study Finds
Eating three low-carb meals within 24 hours reduces after-meal insulin resistance by over 30%, while eating three high-carb meals maintains insulin resistance, according to a new study from the University of Michigan. Insulin resistance can lead to prediabetes and Type 2 diabetes, which affect approximately 114 million Americans combined. Insulin resistance, a hallmark of Type 2 diabetes, is a condition in which the body requires extra insulin to keep blood sugar levels within normal range. To evaluate the effect of the carbohydrate content of meals on insulin resistance, researchers assigned 32 metabolically healthy, postmenopausal women to have three meals within 24 hours containing either 30% or 60% carbohydrate, with or without moderate-intensity exercise prior to eating. The meals in the 60%, or high-carb, group were in line with the 45% to 60% range of daily carbohydrate intake recommended by the U.S. Departments of Agriculture and Health and Human Services. The researchers found that insulin resistance after the third meal in the evening was decreased by 30% in those eating the low-carb meals, but that insulin resistance was maintained in those eating the high-carb meals. They also discovered that two hours of moderate-intensity exercise prior to eating did not lower insulin resistance, and actually was associated with increased blood sugar levels. Although the study was small, the researchers say the results are significant, as they support the findings of two earlier studies and a review on the effects of high-carb diets on insulin. “What is remarkable about our findings is that they show that a simple dietary modification of reducing the carbohydrate content of the meals can, within a day, protect against insulin resistance and block the path toward developm Continue reading >>
Yes, A Low-carb Diet Greatly Lowers Your Insulin
Is “eat less and run more” really the only thing you need to know in order to lose weight? Why is it then that most people lose weight on a LCHF diet, even when eating until satisfied? And this without even any increase in exercise? To think that this should be so controversial! The best explanation, in a simplified version, looks like this: Carbohydrates – > insulin – > obesity Thus more carbohydrates lead to more insulin which leads to more fat accumulation. With more details this can be written as follows: Too many (bad) carbohydrates – > pathologically high insulin levels – > obesity What constitutes “too many” varies from person to person depending on sensitivity and activity level (how much carbs you burn). Intensely exercising young men can often tolerate a fair amount of carbs, while heavily overweight older diabetics can only tolerate minimal amounts without problems. The opposite is the following: Less carbs – > lower insulin levels – > loss of excess fat Insulin is a fat storing hormone. And the easiest way to increase your insulin levels is to eat more carbohydrates. The easiest way to lower insulin levels is to eat fewer carbohydrates. This seems very straight forward. But some are still adamant opponents. Without being able to come up with any better explanation as to why a low-carbohydrate diet works (it does) they still don’t want to accept this explanation. They come up with all kinds of objections. Some don’t even want to recognize the most basic, that carbohydrates increase insulin levels or that a low-carb diet lowers insulin levels. Their complicated objections don’t matter much in reality. The truth is clear in study after study on humans. Insulin levels are much higher when you eat a lot of carbohydrates and lower on a lo Continue reading >>