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This Common Sense Approach To Type 2 Diabetes Supported By Science

Jenni Gallagher's picture
Carbs in Diabetes Management

As a family nurse practitioner, I work with patients who have Type 2 diabetes. Type 2 diabetes has been traditionally recognized as an excess of glucose in the bloodstream. However, over recent years, we have begun to realize that the elevated glucose levels are only part of the problem; insulin resistance is the other half of diabetes.


Let’s take a look at how Type 2 diabetes mellitus, T2DM, actually develops.

First, a person consumes a high carbohydrate diet; the average carbohydrate intake for Americans has been estimated at 250 -300 grams daily, or approximately 1,200 calories. These carbohydrates are converted into glucose and some are broken down in the mouth, during chewing. As the enzymes in the saliva begin to convert carbohydrate into glucose, absorption begins too. More carbs are eaten and swallowed. The absorption of glucose triggers the pancreas to release insulin into the bloodstream. Under normal circumstances, insulin comes along and picks up the glucose and carries it into body cells for use or storage, much like a truck carries supplies.

When someone eats a very high carb diet over many weeks, months, and years, this signaling system becomes impaired because the pancreas has to overwork to produce enough insulin to keep up with the carbohydrate intake. (A good analogy is when people try to “keep up with the Joneses”.) Eventually, there just isn’t enough efficient insulin to carry the glucose into cells, so glucose continues to float around in the bloodstream.

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When the cells cannot get the glucose they need for their usual functions, the brain senses the need for more energy and triggers hunger or cravings. So then, more food is consumed, and more faulty or ineffective insulin is released. This cycle continues constantly, resulting in blood sugar levels well above normal or healthy. Eventually, the elevated glucose levels contribute to thick, sticky blood – like syrup. I often have patients imagine pouring out a bottle of syrup and a bottle of water. Diabetic blood is more like syrup than water, and this thick blood stresses the body’s organs and contributes to a variety of complications affecting health.

Common sense dictates, then, that reducing the carbohydrate intake will in turn reduce the glucose load within the bloodstream. According to Dr. Eric Westman, “At the end of our clinic day, we go home thinking, ‘The clinical improvements are so large and obvious, why don't other doctors understand?’ Carbohydrate restriction is easily grasped by patients: because carbohydrates in the diet raise the blood glucose, and as diabetes is defined by high blood glucose, it makes sense to lower the carbohydrate in the diet.”

Although the standard American recommendations for carb intake remain high at 250-300 grams per day, many patients and health care providers are realizing the dangers. In a critical review of the research, Dr. Westman et al, discuss 12 vital points of evidence in support of low carb nutrition as the first-line treatment for Type 2 diabetes. With the popularity of social media, a grass roots effort is snowballing across the nation that supports a drastic reduction of carbohydrates to less than 30 grams on a daily basis. A variety of nurses, physicians, nutritionists, dietitians, and everyday people have taken to social media, authoring books, producing videos, and spreading the word that low carb nutrition plans are actually reducing glucose levels, dropping medication doses, and reversing all sorts of diabetes complications, like nerve pain, kidney disease, and even high cholesterol levels.

Reference: Dietary carbohydrate restriction as the first approach in diabetes management

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