How Does a Low Carbohydrate Diet Help Diabetics?

Diabetes is a disease involving a dysfunction of sugar/carbohydrate metabolism, i.e. the body can’t process sugars/carbs in a “normal” way.  The cause of the dysfunction differs depending on what type of diabetes it is (Type 1, Type 2, etc.), but the resulting high blood sugar and inability for the cells to utilize glucose efficiently is essentially the same.  It is important to note that regardless of a patient’s diabetes diagnosis, the “whole person” must be treated. Naturopathic physicians see each person as a multifaceted individual and treats all of those facets as an integrated whole.

What is Normal Physiology?

diabetics and sugarThe body needs a constant supply of glucose in the bloodstream as an available energy source for all the cells of the body.  This comes either from the foods that we eat, i.e. the carbs that are absorbed from the intestines, or from the breakdown of glycogen which is the storage form of glucose in the liver.

Some of our cells are able to take glucose directly from the blood (e.g. brain, liver) whereas other cells require insulin as a transporter (e.g. fat, muscles).  If glycogen stores are full, any excess circulating sugar gets stored as fat for later energy utilization. To maintain homeostasis (balance) the blood sugar is kept within a fairly tight range between 70 and 130 g/dl.  If more glucose is needed than is available, the hormone glucagon will stimulate release of glycogen from the liver and fat will be burned for energy through a process call ketosis.

Diabetes is a System Dysregulated

What does that mean? Diabetics can have problems ranging from lack of insulin production to disruptions in cellular uptake of glucose, which both cause hyperglycemia (high blood sugar).

Upon diagnosis many diabetics receive the advice to “eat whatever you want as long as you cover it with insulin” using an individualized insulin to carb ratio.  Or some people may be told to eat a diet abundant in carbs and to take medication to control the absorption, excretion, utilization, or liver production of glucose.

This approach tends to lead to an all-too-familiar scenario which is blood sugar highs and lows – wide swings between the two.  The differential between the high and low may be as distressing and damaging to the body’s tissues as any of the high or low numbers on their own. Postprandial (after meal) blood sugar excursions above 130 are typical but definitely do not mimic normal!  It’s very common for a diabetic to have a blood sugar level of 180, 280, even 380 after meals.

Natural medicine takes a different approach by helping to find the cause of underlying illnesses. It doesn’t simply treat symptoms.

Excessive Sugar Consumption Can Impact Anyone in a Negative Way!

When a person who does not have diabetes eats sugar, insulin is secreted in a well-balanced way.  However, when sugar/simple carbohydrate consumption is excessive, even in a person with a normally functioning pancreas, there is a risk of too much insulin being secreted and a reactive low occurring resulting in hunger and irritability which often drives the person to correct it by eating more carbs.

Up and down goes the blood sugar, albeit to a lesser degree than in an insulin-dependent diabetic. However, the body does not experience homeostasis (stability), but has to adjust and compensate, using up valuable nutrients as cofactors in sugar and energy metabolism.

Ramifications after eating sugar can include:

  • Reactive hypoglycemia
  • Irritability
  • Getting a “sugar high” or sugar rush
  • Hyperactivity
  • Sleepiness
  • Sugar cravings
  • Weight gain
  • Overeating
  • Foggy thinking
  • Depression
  • Racing heart
  • Anxiety
  • Fatigue
  • And more

These health problems can occur in people who HAVE the pancreatic capacity to fine tune and finely regulate minor ups and downs with super responsive insulin and glucagon control.

What About Diabetic Medications?

low carb diet for diabeticsNow take a diabetic with suboptimal or failed pancreatic function and throw the same high sugar challenges at them and you get all the same side effects and less than optimal blood sugar control.  Oral diabetes medications and injected insulin take time to prepare and administer, to absorb, to peak, and to lower blood sugar.  Insulin’s blood sugar lowering action is completed 3 to 6 hours after injection which is a long time compared to 2-3 hours in a ‘normoglycemic’ person.

Some oral medications attempt to decrease glucose production in the body but have minimal effect on dietary carbs.  Other meds help the body get rid of excess glucose from the diet through the kidneys.  Still others decrease the liver’s release of glucose.  None of them address all aspects of optimal glucose regulation and all of them have side effects.

Naturopathic doctors help stimulate the body’s healing process and can work holistically with M.D.’s and other health practitioners.

It’s a Good Idea to Decrease Your Carbs & Ease Your Body’s Sugar Burden

Regulating glucose through any way other than a well-functioning pancreas and healthy body has its challenges. It seems like a no-brainer then that minimizing the amount of glucose that the body has to process, metabolize, and regulate would be easier on the body and result in a person feeling and functioning better with fewer short and long term consequences.  And this in fact has been found to be true.

So, what does “low carb” even mean?

These are rough guidelines, not hard and fast rules, just to give a general sense.

  • Ketogenic – 20g CHO (carbohydrates) daily

A ketogenic diet (keto) is a very low-carb diet. Ketosis is a normal metabolic process, something your body does to function properly. When the body doesn’t have enough carbohydrates from food in order for your cells to burn energy, your body will burn fat instead.

  • Low carb – 20-50g
  • Moderate carb – 50g -100g
  • High carb – 100g+

Know that spreading carb consumption evenly throughout the day can assist in better glycemic regulation.  This may result in less blood sugar fluctuations if diet, insulin, meds, and exercise are fairly stable and consistent.

Note: due to the wide variety of factors that affect blood sugar, absolute consistency and predictability is not possible. Talk to your naturopathic doctor before embarking on any new dietary plan.

How Can You Count Your Carbs? Educate Yourself!

Once you establish how many carbs to consume for good blood sugar control, you need to trust that carb counts of specific foods are accurate. There is a little know discrepancy between labeling and actual carb count in commercially packaged foods.  The FDA mandates that the label must be accurate plus or minus 20%.

This means that:

  • In food labeled as 50g of carbs, the actual number could be anywhere from 40-60g.
  • Whereas in food labeled 10g, the actual number will be somewhere between 8-12g.

If you are trying to keep to a specific number of carbs per day or dose insulin based on a carb to insulin ratio, the precision is going to be way better when eating lower carb foods because the discrepancy between actual and reported is so much less than in higher carb foods.

In Conclusion

In diabetes, which is characterized by problems with metabolizing carbohydrates, it would seem that a logical approach to disease management would be to minimize the amount of carbs that the body has to process.  Through carb restriction (aka “low-carb diet”) and modulation this is possible.  In both normal and diabetic people carbs are an integral part of energy production in the body.  However, it would seemingly be advantageous for both populations to consume fewer carbs in order to optimize overall health.

Disclaimer: As with all things in medicine and health, there are always individual variables that may influence a person’s need for more or less carbs.  This information in this article is my opinion and is not intended to be construed as medical advice for any particular person or health condition.

Julie VerfuthDr. Julie Verfurth is a naturopathic doctor in Portland, Oregon. The focus of her practice is mind-body medicine, holistic diabetes care, and natural menopausal support. She believes that people’s experiences, feelings, and beliefs play a key role in the state of their health. Schedule a complimentary consult to meet Dr. Julie: 503.956.9396.

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