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

The more carbohydrate you eat, the more responsive your body becomes to the hormone insulin. That is why high-carbohydrate diets cure type 2 diabetes. They also reduce insulin requirements in people with type 1 diabetes. If you are taking insulin, talk to your doctor before you switch to a high-carbohydrate diet. Otherwise, you could end up with a dangerous bout of low blood sugar.

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%.


2 thoughts on “On a high-carb diet, people with diabetes need less insulin”

  1. This is 100% false. The more carbs the more insulin you need. I’m type 1 and you should delete this misinformation if you have any self respect.

    1. Hi Jeff:
      I have spent 30 years editing medical textbooks, including nutrition textbooks, and medical journal articles. Before the discovery of insulin, the only way to manage type 1 diabetes was to feed a near-starvation diet that was extremely low in carbohydrate. After the discovery of insulin, doctors at first thought that people with diabetes needed to eat low-carb diets. Yet by 1927, it was becoming obvious that insulin-treated patients with type 1 diabetes were doing better on high-carbohydrate, low-fat diets. In the 1930s, Dr. H. P. Himsworth did some important studies that showed that the high blood sugar in people with type 2 diabetes was due to insulin resistance, and that this insulin resistance could be created in a healthy person by feeding him a high-fat (80% fat by calorie) diet for only a week. As Himsworth replaced the fat in the test diet with starch, his subjects’ glucose tolerance (as indicated by the results of a glucose tolerance test) improved dramatically. The test subjects (again, these were healthy volunteers) had the most stable blood sugar after having eaten a high-carb test diet (80% carbohydrate by calorie) for a week. During the 1930s and 1940s, Dr. Walter Kempner began experimenting with an extremely high-carbohydrate diet for patients who had severe high blood pressure. He told his patients to eat nothing but white rice (Uncle Ben’s Converted Rice), fruit, and fruit juice. To reduce the protein content even more for patients with really severe kidney disease, he recommended that some of the rice be replaced with pure white sugar. This diet had such remarkable effects on the health of the circulatory system that Kempner was accused of faking his results. When Kempner started recommending this diet to patients with diabetes, he found that it cured “mild” diabetes (what is now called type 2) and reduced the insulin requirements for patients with “severe” diabetes (type 1). Likewise, Dr. John McDougall has found that he often has to cut the insulin dosages for his patients with type 1 diabetes by about 30% after they start eating the extremely high-carbohydrate diet that he recommends.

      The relationship between diet, insulin dosages, and blood sugar is confusing until you understand what insulin really does. Insulin is not an antidote to sugar. It is actually the hormone that switches the cells throughout your body from the fasting state to the fed state. Insulin encourages the liver to store a lot of the incoming sugar from a meal as a starch called glycogen. As a result of this effect of insulin on the liver, a lot of the sugar that is being absorbed from the food does not reach the general circulation. That is why healthy people on high-carbohydrate diets have a very small blood glucose spike even after they have eaten a high-carbohydrate meal. Insulin also triggers the expression of GLUT4 glucose transporters on heart and muscle cells. As a result, insulin allows the heart and muscles to use more glucose for energy. (You can also increase the expression of those GLUT4 transporters by exercising. That’s why exercise has been called the invisible insulin.) However, insulin also tells cells what to do with amino acids (the building blocks of protein) and fats. Insulin tells the fat cells to store fat right away. So under the influence of insulin, you store fat and burn sugar. Insulin also encourages cells to take in amino acids and use them for building proteins. In other words, insulin is an anabolic (growth) hormone. By telling your liver to store sugar and your heart and muscles to burn sugar, insulin decreases blood sugar levels. However, insulin’s most powerful (and most dangerous) effect on blood sugar comes through its effect within the pancreas. Insulin suppresses the release of glucagon, which is the anti-insulin. I mentioned that insulin is the hormone that allows your body to cope with a meal. Glucagon is the hormone that allows your body to survive a fast. Glucagon is a catabolic hormone, which means that it promotes breakdown of tissue. Glucagon tells the liver to turn some of its stored glycogen back to glucose, to keep blood sugar levels from dropping to a dangerously low level. That explains why insulin overdose can cause death from hypoglycemia, as well as why glucagon is used as an antidote to insulin overdose.

      Insulin is a hormone, and its effect on the body can in turn be regulated by other things. One is body weight, and another is the diet that you have been eating for the past week or so. If the body judges that it has already stored enough fat, it may start to resist the effects of insulin, to prevent further weight gain. If the person keeps gaining weight anyway, the insulin resistance can get so severe that the body loses control over its blood sugar. This is the underlying problem in type 2 diabetes. That is why weight loss of any cause reverses type 2 diabetes. The body can also resist the effects of insulin if the diet is high in fat. That’s why Himsworth was able to cause abnormal glucose tolerance in healthy subjects by feeding them a high-fat diet for a week, and why his test subjects had remarkably stable blood glucose levels during the glucose tolerance test after they had eaten a high-carbohydrate diet for a week.

      The take-home message is this: An extremely high-carbohydrate, low-fat diet based on whole plant foods is the best diet for promoting the long-term healthy survival of people with type 1 diabetes. Not only does it promote more stable blood sugar, it helps to protect against the circulatory diseases that are such important causes of death and disability in people with type 1 diabetes. However, and this is important, a switch to a very high-carbohydrate diet (80% or more by calorie) will cause your body to become much more sensitive to insulin. As a result, you will probably need to reduce your insulin dosage. This change may take a week or more, so you would need to monitor your blood sugar carefully and be on the lookout for hypoglycemia.

      I explain all this in detail in my book Thin Diabetes, Fat Diabetes: Prevent Type 1, Cure Type 2 (http://www.thindiabetes.com)

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