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Hey,

I wasn't sure what to title this post as. Basically I'm wondering what the best diet is for someone with diabetes type 2, they used to take injections but now have drugs instead. This person is overweight with various other ailments.

I'm asking because I thought that paleo was a great way to control blood sugar spikes. I quizzed my dad and his wife on it today (as my dads been eating croissants w/ jam for breakfast every day!) and went ape before breakfast apparently due to low blood sugar. His wife told me that my dad needs to consume a lot of sugar throughout the day. I don't understand this, surely that will make the diabetes worse as it will increase insulin resistance?

If someone could explain or shed light that would be really helpful :) - concerned daughter.

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Check out this website for paleo/diabetic/low carb diet advice: diabetes-warrior.net – Dave S. Oct 4 at 12:42

10 Answers

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Dieticians and doctors routinely tell diabetics that they "need" the carbs so that they won't become hypoglycemic. This is because they have them on so much medication that hypoglycemia becomes an issue. Eliminate the carbs and blood sugars stabilize, and there is less need for the medications. But our health professionals have been trained that their patients need to "carb up and shoot up" instead.

Low carb and paelo is ideal, but you will be facing an uphill battle to suggest that for your dad because it goes against everything he is being told by his doctor and dietician or diabetes educator. People of our parents' generation tend to trust their health care practitioners and doubt their childrens' "woo woo" ideas.

You might try giving your parents a copy of Dr. Bernstein's Diabetic Solution. It is written by a physician of their generation and explains things very well.

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Thankyou, I will look into this book. I tried approaching the subject but his wife got quite aggressive/ defensive. – skye Oct 5 at 5:54
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For T2 diabetics then low-carb is the best diet. If you're properly low-carbing, the jump to Paleo is a small one anyway. I'd put the focus on low-carb rather than Paleo to start with, because Paleo is a pretty broad church these days, with many people enjoying "safe starches". Unfortunately, there is no such thing as a "safe starch" if you are a T2 diabetic (unless you eat it in very small quantities).

All carbohydrates are bad for him - not just sugar, as they all ultimately get converted to glucose in his blood.

If I was him I'd try and limit my (net) carbohydrate intake to less than 100g a day, and test my glood glucose before and two hours after every meal. The initial aim would be to keep his BG below 140 mg/dl (or 7.8 mmol/l) at the two hour mark.

I'd cut out bread, pasta, rice, potatoes, anything made from grains and anything with sugar or flour in it. He can eat lots of meat, lots of green veg, lots of eggs, and some cheese and cream.

What drugs is he on? He might need to be careful cutting back on his carbs if he is on an pancreas stimulating drug. If he's just on metformin he'll be fine, although getting used to "normal" blood glucose levels involves headaches for the first few months.

I've being doing low-carb Paleo for the last 18 months, and my HbA1c is 4.9% (which is better than most non-diabetics). I've never felt fitter, healthier or happier. If the cured my diabetes tomorrow, I'd still never go back to the carbs (apart from some "safe starches").

http://rdfeinman.wordpress.com/2012/03/26/dietary-carbohydrate-restriction-in-the-management-of-diabetes-the-15-theses/

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Thanks, this confirms what I thought. I believe that he is on pancreas stimulating drugs, does this change the situation? – skye Oct 4 at 10:23
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Not really - he'll just have to reduce his carbs a bit more slowly, and test his blood more often to make sure that he doesn't have a "hypo". Once he gets his BG down, you should talk to his Doctor about reducing his medication. – borofergie Oct 4 at 12:03
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Current American Association of Clinical Endocrinologists recommendations are below 140 at the one hour mark and below 120 at the two hour mark. More strict than the American Diabetic Association, but they aren't in bed with the grain industry, so I trust their recommendations more! – MathGirl72 Oct 4 at 12:40
I agree with MathGirl (as usual). I try to keep mine <120 mg/dl at any time (even straight after eating), but getting your father below 140 mg/dl 2 hours after meals is a great first step. – borofergie Oct 4 at 15:24
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A former T2 Diabetic here - I went LC-VLC and my blood glucose levels slowly went back to normal. As to whether I am 'cured' or not who knows. If I eat a large amount of carbs my body seems to handle it normally now. On the plus side I have just lost any & all desire for sugar, sweets and other craps food, I shake my head in wonder when I remember how I used to eat lol. 95% dark chocolate tastes sweet to me now, a small bowl of berries with cream is what I have if I ever want dessert, even fresh from the garden carrots taste sweet to me now.

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It is important to reduce carbohydrates but if your father is on medication it is important that he do this with medical cooperation. The glucose-lowering drugs will have the same effect as the diet (although less controllably) so you need to be sure that you avoid hypoglycemia. Typically drugs are stopped before the diet.

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Good point. If you're manipulating your blood glucose with drugs, abruptly changing to a low carb diet would exacerbate the swings between hypoglycemic and hyperglycemic. – thhq Mar 14 at 15:06
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For this Type 2 diabetic, the answer is yes. Doctors give diabetics a lot of bad advice, and it sounds like your dad has been on the receiving end of some of it. Good luck!

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My doc wanted me to eat low fat, limit red meat, and eat "healthy whole grains," lentils, and beans. He was speechless when I told him I have less of a glucose spike when I eat a cup of frosting (went up to 180) than I do a half-cup of lentils (went up to 289) and that the diet he wants me to follow is killing diabetics daily. – MathGirl72 Oct 4 at 15:53
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Get Dr Bernsteins 'The Diabetes Soltuion'. I'm a type 1 diabetic for a long time and ive recently read it and wished i had years ago. Ive been primal for a year and yes it was good for bringing control but Bernstein will provide a lot of knowledge and maybe help reverse type 2. Ive seen improvements in my diabets within a week of reading it. Dr Bernstein is about 80 years old and became a Dr because of his diabetes. It's stricter than paleo/primal but even if it's not followed they'll at least know why they feel like crap and that they can change they way they feel.

BTW if he's having a lot of sugar he may be on too high a dose of meds but there are various reasons, Diabetes is complicated. Buy the book read it. The only problem is that after reading it you'll probably know more than your healthcare people and they wont agree with half of it.

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Low carb or paleo is a good choice for diabetics. One of my sons is insulin dependent and I have read a great deal around this topic. Before we had insulin patients had to stay below about 70 grams of carbs per day or risk death. It is all outlined in a book called “Life without bread”.

However many doctors and many patients would far rather prescribe and take insulin that cut back on carbs. Plus it may well be that doctors have to medicate or risk being accused of not following the current standard of care.

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I'm glad my Dr. was not one of the medicators. He put it on me to self-diagnose and solve MY problem. I did, and a year later when I was free of T2 symptoms, he shook my hand. He gave me some medicine (not insulin) which made me feel sick, and I quit taking it after a week. The blood glucose meter he gave me was far more useful, because I could self-diagnose the effects of different foods, fasting, and exercise. – thhq Mar 14 at 15:02
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Ya, I'd say the best but not the only way. Some folks do well with high starch, there's a couple of people there if you scroll down who improved their blood glucose tolerance with Dr. Mcdougall's diet. I remain unconvinced that his diet is "optimal" no animal fat equals poor mental health at least for me anyways. So it could be an option for some to get back to normal and then go from there.

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My Dr. gave me a pamphlet from Novo Nordisk when I had T2 diabetes. The recommended diet was carb exchange counting. It wasn't paleo, but it forced you to consume less carbs, especially high glycemic sugars and starches. It was food-agnostic, in that you could eat anything you liked, so long as you didn't exceed your carb allowance. The most useful part was seeing sample meals laid out representing 1500 calories per day. Just looking at the portions gave me an idea how much I was overeating in relation to my size.

Carb exchange counting is complex and hard to stay on without a lot of determination. Paleo achieves the same purpose, in stringently restricting the same carb-laden foods, and is simpler to stay on. However, paleo doesn't have the governing mechanisms of counting, and if followed blindly can lead to various "faileos". For instance, if a person starts eating carbs again, there can be a disappointingly large weight gain associated with water retention. This, combined with a shunning attitude of the paleo community towards reprobates, can cause someone to give up, even though the water gains are temporary and easily lost when the diet is resumed.

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Just a rant here... But for people to say that type 2 diabetics must avoid fats and eat carbs IS ASININE. Of course one must reduce the carbohydrates they consume to fight diabetes. It's so simple it's disgusting!

For an example of backwardness and horrible "prevention" tips, check out the American Diabetes Association's "tips" for healthy eating. http://www.diabetes.org/diabetes-basics/prevention/checkup-america/healthy-eating.html

Here are the highlights...

  1. Buy leaner meats (such as chicken, turkey and lean cuts of pork or beef such as sirloin or chuck roast) and lower fat dairy products (like low-fat or skim milk and yogurt).
  2. Use a grocery list when shopping for food to help you choose more fresh vegetables, fruits, and whole grains.
  3. Buy whole grain breads and cereals.
  4. Stock your pantry with plenty of healthy basics, including brown rice, whole grain pasta, crackers and cereals.
  5. Try starting meals with a salad or a broth or tomato- based soup with lots of vegetables. This helps you eat more good-for-you veggies while filling you up before you get to the higher fat and calorie courses.

Basically, the ADA says "to prevent type 2 diabetes, eat more carbs and eat less fat". LOL

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The carb exchange diet I ate to get rid of T2 was originally known as the ADA, but maybe it's been changed over time. The problem with a lot of diabetics is that overeating is a large part of the problem, and cutting out fats helps reduce calorie density on almost any food. While you can quibble with the grains, you don't exactly find the ADA giving ringing endorsements to eating milkshakes, cakes, pizzas and chips. These are all notoriously high fat foods. – thhq Mar 14 at 17:04
What are your credentials to call the ADA asinine, backward and horrible? Have you ever had diabetes? Have you ever treated a patient with diabetes? – thhq Mar 14 at 17:11
I don't have credentials. I just have my knowledge and criticism. They're guidelines are still pretty ridiculous, as with numerous national health panels. And I don't understand your point. Yes, overeating is a big part of the problem, but that doesn't cause insulin-resistance/T2. It's the massive sugar-bombing and insulin spikes that subsequently cause resistance overtime. Theoretically, one can overeat, but get at least 80% of their calories from fat and protein, and have minimal risk for type-2 diabetes. This is because blood-sugar is stable, thus insulin is never repeatedly spiked. – MPie Mar 14 at 23:49
Also, I'd imagine if blood-sugar levels are stable and insulin isn't spiked heavily and repeatedly, one would eat less do to reduced hunger. So why the heck would you want to cut out fat? – MPie Mar 14 at 23:50
Theoretically...when I was obese and T2 and my fasting blood glucose was 200 I needed to cut high glycemic carbs for sure. But it's not just about regulating blood sugar through dietary wonks and medication. Those treat the symptoms. The cause is obesity, and to treat that effectively BOTH fat and HG carbs have to be severely restricted. ADA dieting taught me a lot about portion size, and with that I fixed MY problem. I'd never consider them horrible. – thhq Mar 15 at 13:04
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