Pills or Paleo?: Preventing and Reversing Type 2 Diabetes
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Pills or Paleo? Preventing and Reversing Type 2 Diabetes


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The incidence of type 2 diabetes continues to skyrocket, but current drug treatments are inadequate and potentially dangerous. The Paleo diet offers a safe and effective alternative.

paleo for diabetes
Nutrient dense fresh foods that frame the Paleo diet are great for treating type 2 diabetes. dml5050/iStock/Thinkstock

This article is the first in an ongoing series that compares a Paleo-based diet and lifestyle with medication for the prevention and treatment of chronic disease. Stay tuned for future articles on high blood pressure, heartburn/GERD, autoimmune disease, skin disorders, and more.

Insulin resistance, metabolic syndrome, and type 2 diabetes have reached epidemic proportions. In the U.S. today, someone dies from diabetes-related causes every ten seconds, and recent reports suggest that one-third of people born in 2010 will develop diabetes at some point in their lives.

Find out how the Paleo diet can prevent and even reverse diabetes naturally.

What is particularly horrifying about this statistic is that many of those who develop diabetes will be kids. Type 2 diabetes used to be a disease of the middle-aged and elderly. No longer. A recent Yale study indicated that nearly one in four kids between the ages of four and eighteen have pre-diabetes. And some regional studies show that the prevalence of type 2 diabetes in children and young adults has jumped from less than 5 percent before 1994 to 50 percent in 2004.

It’s clear that type 2 diabetes is one of the most significant and dangerous health problems of our times, and we desperately need safe and effective treatments that won’t bankrupt our health care system. With this in mind, let’s compare two possible ways of addressing type 2 diabetes: conventional medication, and a Paleo diet.

Conventional Medication for Type 2 Diabetes

Type 2 diabetes is typically treated with the following (impossible to pronounce!) classes of drugs:

  • Sulfonylureas
  • Biguanides
  • Alpha-glucosidase inhibitors
  • Thiazolidinediones
  • Meglitinides
  • Dipeptidyl-peptidase 4 (DPP-4) inhibitors
  • Sodium-glucose transporter 2 (SGLT2) inhibitors

These medications vary in their mechanism of action. Some increase the secretion of insulin, others inhibit the release of glucose from the liver, and still others suppress appetite.

But none of them address the real, underlying causes of type 2 diabetes: the environmental factors that lead to blood sugar problems in the first place. These include poor diet, lack of exercise and too much sitting, and poor sleep, among others.

What’s more, these drugs also have side effects which range from relatively minor discomfort to serious complications. They include:

  • Sulfonylureas: low blood sugar, upset stomach, skin rash or itching, weight gain
  • Biguanides: upset stomach, tiredness or dizziness, nausea, kidney complications
  • Alpha-glucosidase inhibitors: stomach pain, gas, diarrhea
  • Thiazolidinediones: heart failure, heart attack, fractures, increased risk of bladder cancer
  • Meglitinides: low blood sugar, weight gain, nausea and vomiting, headache
  • Dipeptidyl-peptidase 4 (DPP-4) inhibitors: upper respiratory tract infection, sore throat, headache, pancreatitis and increased risk of pancreatic cancer
  • Sodium-glucose transporter 2 (SGLT2) inhibitors: urinary tract infections, yeast infections, renal and gall bladder issues, bladder cancer

While there’s no doubt that some people with type 2 diabetes do need medication (those that have completely lost the ability to produce insulin, for example), the list of side effects above suggests that these drugs should only be used when other safer—and often more effective—treatments fail.

A Paleo Diet for Type 2 Diabetes

One such treatment is a Paleo-type diet, which emphasizes the real, nutrient-dense foods our ancestors ate. It features meat and fish, vegetables and fruits, nuts and seeds, and some starchy plants like sweet potatoes.

Studies have shown that the Paleo diet is an effective treatment for type 2 diabetes and metabolic problems in general. For example:

  • A study which compared the Paleo diet with a standard, low-fat “diabetes” diet in people with type 2 diabetes found that the Paleo diet lead to greater improvements in weight, blood sugar, triglycerides, blood pressure, body mass index, and waist circumference than the diabetes diet. (1)
  • Another similar study compared the Paleo diet with a low-fat diet in obese, postmenopausal women and found that the Paleo diet led to greater fat loss and metabolic improvements than the low-fat diet. (2)
  • A third study (also of obese postmenopausal women) found that a modified Paleo diet improved several metabolic markers, including weight, waist circumference, blood pressure, blood sugar, cholesterol, and kidney function. The Paleo diet also decreased the amount of fat stored in the liver by 50%. (3)

These studies clearly indicate that a Paleo diet is not only an effective treatment for type 2 diabetes and metabolic syndrome, it is often more effective than the standard “low-fat” diabetes diet that is recommended by groups like the American Diabetes Association.

But Paleo isn’t just about what you eat, it’s also about how you live. Sitting less, getting enough exercise, sleeping 7–8 hours a night, healing your gut, and managing your stress are also important steps you can take to prevent and even reverse type 2 diabetes and metabolic problems. These changes can often have profound effects:

  • People who work at a standing desk burn up to 75 percent more calories per day than people who sit for most of the day. (4)
  • The more breaks you take from sitting, the lower your waist circumference, body mass index, and triglycerides, and the more stable your blood sugar. (5)
  • A single night of partial sleep deprivation causes insulin resistance even in healthy people with no preexisting metabolic disease. (6)

I’ve seen incredible results using the Paleo diet (and lifestyle) in my work with patients, and I’ve heard countless stories like this, from reader Dave Harvey:

In mid-December 2011, I was awakened in the middle of the night experiencing rapid, erratic heartbeats which continued for an hour before I decided to have it checked out. After undergoing many tests as well as a cardiac catheritization to check for heart damage, I was told I did not have a heart attack, but that I did have atrial fibrillation and that I was a type 2 diabetic. The doctors put me on Metformin, a beta blocker, an ACE inhibitor and a statin which I took for a short time. I discontinued it after I began experiencing severe muscle cramping which CoQ10 didn’t help, and weird losses of memory.

I became interested in paleo and low carbohydrate eating to control my Type 2 diabetes. I discovered Chris Kresser’s website and began reading his blog posts which prompted me to devote myself to completely transforming my lifestyle into one of monitoring my diet, recording everything I ate and improving my health.

Since settling into a gluten free, low carb, paleo way of living in April of 2012, my weight has dropped to 140 pounds on a 5’6″ frame. My body fat, which was at about 30%, is 16% and my health has improved tremendously.

My T2 diabetes is in total remission, without medication. I do not have food cravings like I did with low-fat dieting. I don’t feel hungry shortly after eating. I don’t make multiple trips to the kitchen and refrigerator for snacks in the evenings. I have more energy throughout the day. I don’t have feelings of anxiety.

Lastly, and most importantly, it has been four months since I have experienced any sign of the atrial fibrillation which sent me to the hospital in December of 2011.

Unlike the prescription medications used to treat type 2 diabetes, which often have significant side effects, the only “side effects” of a Paleo-type diet and lifestyle tend to be positive things like improved energy, clearer skin, and smoother digestion.

When you look at it this way, which would you choose: pills or Paleo?

If your answer is Paleo, make sure to check out my book (just published in paperback with a new name: The Paleo Cure) for a detailed explanation of how to use the Paleo diet and lifestyle to prevent and reverse disease and feel better than you have in years. And don’t miss the bonus chapter (available online after you buy the book) on addressing type 2 diabetes with diet, lifestyle, and supplements.

As always, check with your doctor before starting or stopping any new treatment plan—including what I’ve suggested in this article. This is not intended to be medical advice, and is not a substitute for being under the care of a physician.


Join the conversation

  1. Let me just start off by saying that the Paleo diet may have worked for our ancestors, but may not work for (all of) us today living in the modern world because…

    …they didn’t live with smart devices.

    They also didn’t live with air pollution, polluted waters, war, electricity, traffic, cosmetics, pharmaceuticals and their animals weren’t shot up with antibiotics and their produce wasn’t grown with GMOs! But, who ever thinks about these things when considering the next fad diet? Besides, who among us was even there and can vouch for our ancestors, anyway? How do we even know what they ate, how much and when? It’s all speculation. We’re just guessing.

    Truth is, if you think early humans didn’t have stress, you’re crazy! And they probably sat a helluva lot more than we sit today, because they didn’t have a gym membership and they didn’t build freeways. They also didn’t have electricity and couldn’t go out after dark. Plus, they couldn’t be active in their caves after dark, either, since they didn’t even have light aside from a firepit, and not much incentive to move indoors — there were no Wiis in those days, remember?

    Plus, they were living among ferocious wild animals and were in constant danger; they feared getting eaten by predators all the time, even in their caves, and hunting was no easy feat. But, they didn’t hunt 24/7 — only a few hours at time during daylight hours, and then came home and sat around the fire telling stories and eating what little food they had.

    I seriously doubt you’re about to give up your deodorant and nail polish, so if the Paleo diet isn’t working for you (and it doesn’t work for everyone), I suggest you look inside your medicine cabinet and see what the culprit really is; look around your home, how many things do you have plugged in right now? Look in your pocket — how many smart devices are you carrying on you at any given moment? Look in the mirror — what’s the goop you’re wearing? And look in your pantry — is there a box of seemingly healthy cereal or oatmeal in your cupboard? You’re lying if you say NO!!!!!

    I’m not saying you shouldn’t eat Paleo — it seems like the right thing to do. It’s a no-brainer, if you ask me. But, it won’t work if you buy cheap cuts of meat and cheap produce. Even the organic stuff ain’t all it’s cracked up to be. They sneak carcinogens into everything these days, whether we like it or not. And, l’eggo that damn eggo, already!

    • You couldn’t have said this any better! It’s important for people to understand the quality of their food and products just as much as the diet as a whole.

    • Very well said Lana, but I believe that an all knowing God created our bodies, we didn’t evolve and He gave us the foods to eat that grow on this earth and the meat that He says is clean for us to eat. But, this greedy world has polluted it so and our fast paced life style and WiFi’s are all killing us. So we have to do the best that we can! What helps one person may not help another.

    • He said several times in the article that it probably won’t work for everybody. Did you read the whole article? Every Paleo person I’ve ever talked to says the same thing – it doesn’t fix everything, and our food will never be perfect in our lifetimes – even “Organic.” But the simple point is, like you said, to do our best. So, if Paleo is pretty much as good as it gets for humans (and research shows that it is, at least for most people), except for the supplemental nutrients that aren’t there anymore (but that you can buy in any health food store for relatively cheap, if you know where to look) then if we’re doing our best, shouldn’t this be what we’re doing? And evolution or no evolution – read the studies. So if you’re not eating this way already, give it a go. If it doesn’t work for you, then you’ve proven the article you just slammed (he said at least twice that it’s not a substitute for needed medical help). And if it does work for you, then your life will be so much better! But please, as the proverb goes, “People who think a thing is impossible should get out of the way of those who are doing it.”

  2. The paleo diet has helped me stop prediabetes stone cold with no meds. I’m measuring fasting glucose changes from 120+ mg/dL down to 75-85. I’ve gone through a series of protocols with variations in the specific makeup of my paleo diet and have conducted rigorous glucose testing over a few years (fasting, different waking hours, postprandial, OGTT, A1C, etc.) My conclusion is that paleo is a major offensive tool that can combat prediabetes/diabetes, but there is a lot of potential for personal variation and optimization. This site and others in the paleo and ancestral health community has provided all the information needed.

    In my case, I must eat very low carb paleo, which ends up being typically <30 grams of carbs per day with some days being nearly 0. I can eat a few berries and some small pieces of fruit, but when I switch to eating full sweet potatoes and entire pieces of fruit daily, my fasting glucose starts creeping back over 100, and then it takes days to a few weeks to recover. Even the relatively low level of 75–100 g/d of healthy strict paleo CHO is still too much for me to do daily. However, a day or two of occasionally higher carb levels (even up to 150 g) is no problem when most other days are kept low. I'm in a natural state of intermittent ketosis eating meat and vegetables (not forced with excessive butter, oil, etc.), and I don't care if I pop in and out of nutritional ketosis. Any form of paleo is going to provide improvements for diabetes, but I have optimized it for my specific case.

    Sometimes when you are metabolically damaged, extra effort is required for the best glycemic control. I blame the Standard American Diet (SAD) for my impairment, but fortunately, I enjoy eating VLC paleo. There are so many different ways to mix up and cook fresh whole meats and vegetables with a bit of tubers and nuts tossed in, it will always be great tasting and enjoyable.

    This is only a summary regarding winning against diabetes with paleo. If I were to explain all of the other realized health benefits of paleo, I might break the blog.

    • Hey Jason. Great result with your blood sugars. I too was controlling my results with diet for a good while but was still metabolically compromised. In the long term control of blood glucose does very little for your long term health that is more influenced by blood pressure. I am now at the moment on a high carb diet as I reversed my diabetes with advice from Roy Taylor at Newcastle University. My fasting is now around 85 and OGTT at the GP came in at 93 which he stated was impossible, hba1c 5.3 (35).

      • What advice from Roy Taylor at Newcastle University are you following? After 7 months of low carb, testing BS several times per day, I did get my fasting BS down to the 90’s, but then started having all kinds of problems from lows, light headedness and chest pains in the early morning that sent me to the ER twice in a week. I’ve added more complex carbs in the form of mixed organic legumes and while I feel much better, my fasting BS was 149 this morning. During a low yesterday evening I did cheat and eat some food court rice, chicken and broccoli in Berkeley. It takes a plenty of planning to avoid non organic foods and food additives every day of the month.

        • For reference I’d add that I am thin and positive for IA-2 antibody. My GP doctor says that keeping blood sugar down will not stop type 1 from progressing. I’d love that to be wrong. I’ve never heard of anyone else with just the IA-2 antibody and none of the others… So will I need insulin? The different endocrinologists I’ve seen have different opinions.

          • If you were type 1 you would be on insulin already? You can have type2 and also the IA-2. Also there are other less common types of diabetes. However if you are type 2 then no matter what your thinness at diagnosis weight loss will resolve your condition according to ongoing clinical trials and past studies.Read this newly published study:”Why non-obese people develop type 2 diabetes
            Data from the United Kingdom Prospective Diabetes Study (UKPDS) helps to explain why non-obese people develop type 2 diabetes, in the article from Clinical Science (2015) “Normal weight individuals who develop Type 2 diabetes: the personal fat threshold”.published on: 13th January 2015Newcastle”http://www.ncl.ac.uk/magres/about/news/item/data-from-ukpds-help-to-explain-why-non-obese-people-develop-type-2-diabetes

            University researchers have also written some notes for you to take to your doctor. You will find all the info here. Good luck. http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

              • Thanks very much, Steven. Last two mornings were 103 and then 100 this morning. I feel good, no PVCs or chest pains, 7.25 hrs real sleep, two brisk walks yesterday: one in afternoon, one in evening, some push-ups, and sticking with Kresser’s 14four type meals seems to work for me, but avoid garlic. Yes weight loss by low carbing even for thin people works in my experience, but there is definitely a danger zone if you go too long too low carb. Small changes over time get lasting results. After a few days adjustment I seem to tolerate the slightly undercooked (non-soaked) organic mixed legumes well. Now, how do I add 5 to 10 lbs of muscle mass without messing up my now almost no longer impaired fasting blood glucose? That’s the next goal.

                • Personally I waited till I got down to a weight when I was truly normally glycemic with a fasting below 90 and normal hda1c off meds (took me 2 years) ( 231lb down to 170). Then I have spent 6mths adding carbs/calories back in and started bodyweight exercises push ups,burpees,pull ups. Now I do 100 pushups, 200 burpees and 50 pullups/day over the whole day in short sets up to 3000kcal most days. I have found this works for me and I have put on a ton of muscle and stayed the same waist size. If my hba1c or fasting bloods start rising then I will go back on diet but will have much more muscle that before. I’ve just started on whey protein as I am a veggie and it was hard to get enough.

                • Good exercise stats. I’ll see if I can get there. How to get 3,000 healthy kcals/day seems difficult, however.

                  In his information for doctors, Professor Roy Taylor is clear that weight loss (to reduce fat in the liver and pancreas so these organs respond correctly) won’t work the same for those with pancreatic, monogenetic, or slow onset type 1 diabetes. The fat in the liver and pancreas theory seems to explain some of my numbers and success with silymarin. (Silymarin for non alcoholic fatty liver disease reduces biochemical, inflammatory and ultrasonic measures of hepatic steatosis – Cacciapuoti, 2013)

                  I insisted on diabetes antibody and c-peptide tests because I was not seeming to respond to diet/exercise/sleep changes. I believe it is unusual to catch someone with type 1 antibodies while they are still pre-diabetic because doctors don’t typically see any value in testing. Doing the things that help type 2’s do bring me down into the 100’s, but if I just can’t get into the normal 80s and 90s without problems there may be autoimmunity at work as well.

      • Hello there. I have also been on the low calorie diet of Roy Taylor. I finished a week ago after 7 weeks. I began at 180 cm tall and weighing 73 kg, I finished weighing 62 kg. My glucose readings returned to normal over the 7 weeks but …… in the last week they have started going back up to diabetic levels again.I expected to have reversed my diabetes by now. I am vegetarian. I have added some eggs, some cheese, whole wheat grains (eg. oats, wheat bran, oat bran, wholemeal flour), coconut oil, flaxseed, some fruit, some plain low carb natural yoghurt and seeds and nuts. My body doesn’t seem to like the carbs (not sure if it it specifically linked to whole grains or wheat based grains). What are you eating on your higher carb diet?

        • The grains can do you in, even whole grains, there really isnt much difference btween whole & white when it comes to glycemic value. My body just doesnt tolerate any of the starchy carbs. Besides the yogurt, do you do any other fermented foods or probiotics? Ive also rebalanced gut bacteria and that plays a large part in digestion of carbs (or even craving for them!!). Diagnosed T2D about 8 years ago, went paleo/lchf about 18-24 mos. ago after following ADA guidelines. Dropped statin drug, a1c 5.6, truglycerides lowest in years. Lots of fiber from many sources and lots of fish oil 4800mg day also helped the trgs

  3. being a type 2 diabetic for many years, one of the hardest challenges for me is keeping my blood sugars balanced, and about 3 weeks ago I heard a radio show about a new plan that helped many reverse their diabetic condition, I subscribed to his plan out of curiosity ,will mention it below and my blood sugars have never been better, It is possible to reverse diabetes,by making some small diet and lifestyle changes.


  4. There are many posts now, and a healthy debate about what to eat seems the theme. In most cases, patients undergoing double Bariatric surgery are cured of type two diabetes within a fortnight, and the vast majority is still cured a decade later.

    After the operation these people are still obese! The amount they can eat is restricted,; not what they can eat. Most diets will work if calorie restriction is applied. Low carb diets are generally more satiating, and make it easier to eat just enough to maintain a healthy body weight (not ones current weight).

    Insulin resistance is a result of over eating; our cells simply screaming don’t give any more food, I’ve had enough, I give up, give me a break! Make your cells happy eat less; type II diabetes is primarily caused by overeating and treated by doing the reverse.

    Cheers Glenn

  5. Chris you reference 3 studies in your article. Regarding the 3rd study it says a modified Paleo diet reduced markers…
    Can you provide more information about that modified Paleo diet?

  6. Thanks for pointing out this hugely important factor, Chris. More often than not in my experience I’ve seen people write off becoming diabetic as an effect of aging or because the disease runs in the family, and do not take seriously addressing how they eat. I’ve had clients do as little as remove bread from their diet and start walking 3x/wk for roughly 30 minutes and receive huge benefits in their energy levels and weight loss.

  7. Hi all.
    I have had great success with a paleo lifestyle in reversing pre T2 diabetes over the last 15 months. As soon as I noticed positive changes, I started my full blown (although beginning stages) T2 mother on the lifestyle. It has worked miraculously in lowering her blood sugar levels to almost the point of normalcy.

    I hate to regurgitate another members ideas, but I have noticed if I deviate from the most basic protocols (ie: eat real food), mine and my mother’s sugar levels skyrocket quickly, and can remain high for days. So is the paleo “diet” a cure? Or is it just a bandaid for a wrecked body? If you can maintain good health by living this way indefinitely, despite possibly irreversible damage, does it really matter?

    By the way, just so you get an idea, after a year with paleo, my fasting blood sugar is mid 80’s, I am under 15% body fat (as of last dexa, which was a while ago, and I’m sure has improved since), with a bmi (terrible indicator at this point) of 24, and I am a power plant of energy and drive. 😉

    Good luck to all of those who are just starting this journey!

  8. Well,

    I am a diabete type 2, I am not fat, I practise Sport everyday (minimum 1/2 hour a day, swimming or biking).

    I have adopted a paleo diet.

    Sorry, but I haven’t improved my results.

    • Hmmm…this might do it for you.



      Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone. This was associated with decreased pancreatic and liver triacylglycerol stores. The abnormalities underlying type 2 diabetes are reversible by reducing dietary energy intake.

      • Hi Dr Jeff, I was wondering if you could point me in the direction of the research that concludes that fish oil worsens insulin resistance? I have only read research that concludes the opposite (or concludes that it has no effect on insulin resistance). Thanks!

      • Really? I’d like to learn more about this comment. Does it go the same for Krill Oil? And wondering – why?

        Thanks for any added information or direction to same that you can advise.

        • Here is a complete reference if you’re interested in the detailed biochemistry. http://dx.doi.org/10.4236/fns.2013.411147

          see also,

          Samuel E. Crockett, M.D., Director Emeritus of the Diabetes Institute, Florida Hospital/Orlando
          in the publication titled “Dose-Response Effects of Dietary Marine Oil on Carbohydrate and Lipid
          Metabolism in Normal Subjects and Patients With Hypertriglyceridemia,” Stacpoole, P, Alig, A.,
          Ammon, L, and Crockett, E., Metabolism, Vol. 38, No 10 (October), 1989, pages 946-956.

          • “The article titled “Why Fish Oil Fails: A Comprehensive 21st Century Lipids-Based Physiologic Analysis” [1], published in Journal of Lipids has been retracted as a result of an undeclared competing interest on the part of the manuscript’s author.”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220287/

            • That is true, but it was reviewed by the top lipid biochemist in the world and there are no factual inconsistencies in the article. It is a review of known biochemistry with well done scientific studies to back it up. The author is no friend of the fish oil industry and there is a lot of financial pressures put on these journals to conform to industry norms instead of scientific principals.

    • Chris also advocates not overdoing it. A half hour of intense exercise every day, depending on how you are doing it, could be damaging your system rather than helping it. We are supposed to be doing moderate exercise that keeps things flowing. Not going full force running for a half hour every single day. Your body, adrenals, and several other factors will suffer from that kind of exercise. Everything in moderation.

    • Paleo is one. Atkin is another. Well, these become labels (and then religions). You need to understand a bit of all including human physiology, biochemistry and anatomy without having a blind faith. It is a lot of effort and time consuming. I have compiled lot of these resources on my blog. But there is no shortcut. You have to understand it well. Once you come to grips with it you will save a lot of time and effort in terms of doctors visits. I am very confident that Type 2 D is reversible with diet alone.

    • Have you adopted a low carb Paleo lifestyle? Paleo is not necessarily LC. If you are consuming tubers and fruits you won’t see an improvement in numbers.

    • If you are truly not overweight, and eating Paleo, there is a chance that you might have adult onset autoimmune type I diabetes. Diet cannot fix this and it is a much more serious disease. Get your GP run the standard pancreatic enzyme tests to rule out this possibility. This type of type I diabetes is often misdiagnosed.

      • What enzyme tests? Do you mean ZnT8, ICA, IA-2 and GAD antibody tests? I’m “pre” 5.5 A1C, lost 20 lbs on LC, have no more to lose. Can’t get fasting glucose down. Typically 110 to 118 every morning. Trying everything, exercise, deep relaxation, fasting, meditation, sleep, diet, many different supplements and probiotics in different combinations and amounts, different macros, testing constantly tired many different meters. Only a few normal (86) readings over the past 6 months. IA-2 positive, low C-peptide. Endocrinologists are split on if I will progress to insulin. If a car accident, pesticide exposure, mercury leaking from a filling, fluoride poisoning, radiation from a barium swallow upper GI, cell phone/WiFi or a virus has caused physical damage to the pancreas and autoimmunity follows from long term inflammation, your body has a standing order to attack itself. Reversing that (type 1) problem and lowering glucose may require removal of inflammation and then re-educating the immune system. Keep trying things. Anyone else positive for only IA-2? Diabetes is a symptom with many different causes because blood sugar regulation can be broken at many different places in the system. The human body is awesome.

          • I’d love that to be true, but I’ve read much to the contrary. Mercola cites that people over 100 fasting BS have a 300% higher risk of heart attack, for example, compared to those with 79 fasting. Both low and high glucose creates reactive oxygen species leading to hardening of arteries so the less fluctuation the better. I started testing because I read that one thing people who love to be 100 have in common is excellent insulin sensitivity. I’ve read that 126 fasting is the marker for diabetes because below that you don’t see permanent damage in the retina. What molecular guidelines determine the cutoff for what is optimal long term? And genetically, I believe some people have smaller red blood cells. These people live longer. Is it possible that someone may be genetically set at 108 fasting and can stay at a 5.5 A1C with no ill effects for a long healthy life? I’d really like to know. Doing 23andme soon for more clues. One study found the more of several SNPs related to diabetes you have, the more you will be challenged. Great brain trust here, I’m excited to have found you all.

          • Hi, this is the beginning of my diabetes journey – my AC1 was only 5.8 but my 3 hr glucose fasting came back at 169, 247, and 242. I had a doctor last year (reproductive endocrinologist) for an IVF cycle who left the 5.8 alone. The IVF failed (no correlation per se, but I changed doctors.) The new doctor though 5.8 was elevated even if barely, and ordered the glucose fasting test. I am now waiting for my first appointment with a diabetes specialist at Cedars here in California, but I’ve been testing my blood all week. I wake up to 160. It spikes to over 200 15 minutes after breakfast. It’s at 120 by 2p. Back to 200 after dinner. I am so grateful someone looked past a barely elevated AC1 reading, otherwise I’d be doomed (42 yrs old now, still childless.)

        • Could sleep apnea play a part? Do you have access to a sleep lab? I wonder if testing your cortisol levels will indicate anything.
          Keep us posted!

          • Awaiting results of overnight apnea test. Fiancé says I no longer snore after I figured out that humming a certain way generates Nitric Oxide, a potent vasodilator. That and saline nasal rinse opened my right sinus overnight. Before that I was considering a deviated septum operation. I’m doing an hour hum-walk as I type this. One of my best BS was after this discovery. Could also be a mental thing. I can lower my reading by 10 to 30 points with a lying down deep relaxation technique. I don’t believe in this, but my lowest numbers in 6 months, were after a “body talk” session. I was lying down for an hour after dinner doing that, tapping a sore spot related to the pancreas between my left ribs. Had tacos that night, very surprised to see numbers in 80s then 70s. Lying down could have caused delayed gastric emptying that Bernstein talks about. Thanks for the ideas!

  9. Last year my doc told me to watch my sugar intake as I was prediabetic. I immediately did so but still could not keep it below 100. I knew I was heading for trouble as I was aware of all hidden sugars and was still unsuccessful. Crazy as it may sound, I saw a naturopath to identify some food sensitivities, but while I was there she worked on my “sugar metabolism” that she said was “off”. Worked like a charm!

  10. I have had insomnia for years, and believe that this is what is causing my downward spiral towards T2, despite being (low) average weight, eating paleo 80 – 90% of the time, lifting weights and following a high intensity training regime. The diabetic nurses refuse to acknowledge that insomnia is a causative factor. Whenever my blood sugar is tested, I get the same old tired advice –
    ” exercise more, avoid fats, eat more whole grains” – yikes! My 3 glasses of wine a year – yes, a year – were also frowned upon. I cannot alter my genetic predisposition it seems. I will keep doing the same things though – and won’t be taking any meds. I am 100% certain that diet is the solution for most of what ails us. Now if I could just get a good night’s sleep …..

    • re: I have had insomnia for years …

      If you’ve already eliminated all other suspects, go after the blue light at night problem (which is getting more severe, due to the phase out of incandescent bulbs).

      Get some eyewear that blocks blue around 460nm. The Honeywell UVEX brand has several models. Make sure you block both central and peripheral vision. Put them on at dusk or 2 hours before bedtime. Wear them if you arise during the night. Get blue light sources out of the bedroom.

      This is a well established physiological phenomenon involving melatonin suppression initiated at the recently rediscovered intrinsically photosensitive retinal ganglion cells (ipRGCs).

      • And you can download f.lux software to convert blue light into more orange tones at twilight. The software will need to know your geographic location in latitude/longitude.

        If doing graphics e.g. photoshop editing, you can turn it off temporarily etc.


        • re: Where did you purchase these glasses Don’t see them at Amazon?

          Got ’em at Amazon, ASINs: B000USRG90 and B003OBZ64M, under $10 each. They are very effective. Blue lights turn green or go dark completely.

          You can pay up to $80 for these same glasses on specialized blue-blocker sites. Those sites are, however, often worth reading for the topical content. Chris covered it here at:

          It’s trivial to control blue light at the eye. Controlling it at your light sources, alas, requires controlling it at ALL your light sources. Although f.lux is effective on some display types, like your OLED phone or tablet, it does nothing for that nasty blue indicator LED on the bezel. F.lux is also limited in effectiveness on most LCD displays, which always leak blue light.

    • Try to work on your good night sleep with herbs and tips and tricks. Also be sure to get a (few) second opinions from other doctors. Even the greatest doctor is just human and can have it wrong. I’ve seen it too often in personal circles. Good luck!

    • If you like, you could look at The Mood Cure, as she talks about sleep as well. I have improved my sleep with recommended supplements, including magnesium, although mentioning one supplement would be too simplistic. I recommend the book anyway, as it is thorough and has helped me very much.

    • Getting enough sleep plays a huge role. I too used to have insomnia so I removed caffeinated coffee from my daily diet, changed my exercise routine to nights (weight lifting, yoga, hour long walks) altered my dinner to include a higher percentage of healthy fats and I found that as soon as my head hit the pillow I was out like a light. If I happened to wake up during the middle of the night, I would just play a podcast and it put me right back to sleep , it took my mind off of whatever it was that I was obsessing about.

  11. re: Type 2 diabetes used to be a disease of the middle-aged and elderly.

    It used to be called “adult onset”. You won’t get the ADA to admit what’s changed, just as with the entirely distinct T1D that used to be called “childhood onset”.

    In my view, T2D is not even a “disease”. Like ALD (alcoholic liver disease) these are merely total optional ailments that are an almost completely predictable metabolic response to a chronic dietary insult (glucose sources in the case of T2D, booze in ALD).

    T2D is 100% avoidable via diet.
    T2D is 100% reversible via diet at the metabolic syndrome and pre-diabetic stages.
    T2D is reversible after that to the extent that its complications are themselves reversible.
    It is in any event managed with minimum or zero meds via diet.

    What diet? LCHF.
    “Paleo” may not fully get the point across on net carbs, the need to replace carb calories with fats, and keep the protein moderated, as excess protein can be metabolized to glucose.

    • > T2D is 100% avoidable via diet.


      > What diet? LCHF.


      That diet is a work-around, not a solution. It avoids the problem; it doesn’t solve it.

      High fat, more than 30 grams per day (both in the food and added), is the cause of insulin resistance.

      Following is a documentary film that I recommend.

      Simply Raw: Reversing Diabetes in 30 Days

      Joseph Leduc

      • Yes. When my glucose started going up (partly from having to take a couple courses of antibiotics), I tried LCHF and the glucose shot up. Probably still getting too much fat but I am cutting back.

      • And this right here is an example of what I have found so crazy-making ever since I’ve been reading about diabetes and diet. You have people like Dr Bernstein and his ilk swearing he reverses Type II diabetes, and lowers insulin doses and yet achieves normal numbers for Type Is with a very low carb, high fat/protein approach. Dr Cousins in this YouTube with a low fat approach. Paleo which advocates consuming animal proteins and is often low carb and high fat and Dr Furhman with his vegan approach, which given his sample menus I’d call high carb/low fat–all claiming impressive results.

        How is someone without a medical or scientific background supposed to separate the quack doctors and nutty neurotic from the healing? And if these doctors are telling the truth about such disparate approaches working for their patients, how do we know it’s their diet at work when there seems no point in common?

        • re: How is someone without a medical or scientific background supposed to separate the quack doctors and nutty neurotic from the healing?

          Personal research and personal results. On one side, consensus medicine and nutrition are slaves to their dogma, and don’t care if it kills you (you must have done the dogma wrong). The dissidents, on the other side, are all over the place; many merely mistaken.

          Seek those advocating approaches that have near term testable results. Look for track records.

          Let’s assume that the phenomenon of “physiological insulin resistance (PIR)” is a common feature of a low carb diet (and I’m not sure I buy that).

          If your diet puts your fasting and postprandial BG right where you want it (my target is under 90), and your HbA1c right where you want it (under 5.0%), at all times, how would you even know if you have PIR, and would it matter? That’s a legit, and not a rhetorical question.

          Glucometers are cheap. Everyone who cares about this issue needs one. Home A1c meters not so cheap, but are available.

          • I’ve had a glucometer since my diabetes diagnosis and my endocrinologist encouraged me to test my postprandial BG. She says it is indeed very individual how her patients respond–that some for instance find their BG rises above the recommended range with just black coffee, others with tomatoes or tomato products, while others of her patients don’t have that response at all.

            I’m the usual American mutt–Spanish ancestry on my mother’s side, Scott/Irish among other things (maybe even Cherokee) on my father’s, so knowing my family tree isn’t going to help much knowing what foods I can tolerate–I just have to test.

            What I don’t like about Paleo is that so few of its advocates have solid medical or research backgrounds, that it’s so outside the medical mainstream and that it has so many finicky requirements and seemingly paranoid restrictions (no microwaving! no GMO! Go Organic! Gluten is evil!) I associate with food faddism.

            What I do like–and I like this about Chris’ book especially–is the emphasis on testing–and that different individuals may thrive on different foods.

            And btw, the food that got me the worse response? The breakfast involving plantains in Your Personal Paleo Code. I hadn’t seen such high blood sugar readings since coming off steroids–not with oatmeal, not with any grain. But then as my aunt pointed out—that was a BIG plantain and the half I used was as big as many whole ones. I probably had consumed two cups. It was a lesson to me–don’t go by “half” of a fruit or something–go by weight or volume measure.

            So I’m still testing things out—my last A1C about 4 months ago was 5.1 and I’m due for the next in two months and my typical fasting readings these days are in the mid 80s–that’s on moderate carbs and NOT doing Paleo. I’m checking each meal out individually before trying it out for a month–we’ll see if I can do even better. At least with diabetes you *can* test how well things work.

          • Oh yeah, I see one of George’s links is to that “normalisation of beta cell function” I mentioned on this comment page. That study was publicised in a New Zealand national magazine.

          • “Whereas what this diagnosis should mean is this; you have glucagon dominance. You have a genetic adaptation to a diet low in carbohydrate but high in fat and protein, with periods of fasting. If you go with the flow of glucagon dominance, if you feed yourself on the foods that are glucagon metabolism substrates and avoid the insulin metabolism substrates, and if you go hungry some of the time, you will likely get better.”

            Interesting–and a logical explanation for why some are diabetics. But it doesn’t explain why say Furhman’s diabetic patients get better on his diet despite consuming upwards of 60 grams of carbs a meal (I calculated this based on his menus and recipes because he doesn’t give a macronutrient breakdown) while Bernstein’s patients do well on 30 grams a day–and my BG normalized with a daily carb consumption of around 150 grams.

            So even if the above is right, it doesn’t answer the question of how low carb to go–and whether the TYPE of carbs are crucial. Furhman claims success in reversing diabetes with a diet that emphasizes “greens and beans” and lots of grains (especially oatmeal) and fruit–pretty much the opposite of LCHF and paleo.

            I mention Furhman because basically his book “The End of Diabetes” was the first I found in stores about diabetes and diet after my diagnosis, although I didn’t find his advocacy of basically a vegan diet convincing.

            The Joslin Clinic also claims success in reversing diabetes–and they don’t use a Paleo approach–I’d say they’re moderate carb/low fat.

            But if by pointing me to that you mean the explanation is found in our genetic diversity–that there may be different kinds of diabetics that respond to different protocols–not one size fits all–that I could buy.

            • I think I can answer that. On a very low fat vegan diet you would have minimal physiological (fat induced) insulin resistance. So you could conceivably use less insulin for the relatively high carbohydrate intake,
              My question would be, what % of a randomised group of subjects could follow this diet for a long time?
              It is likely results only relate to self-selected subjects, especially as time goes on. Whereas LCHF and lower carb paleo (and ketogenic mediterranean) diets have good long term adherence when randomised.

              • If you look at the Robert Unger video I linked to in my last post, a different mechanism can be extrapolated:
                Glucagon dominance is the result of alpha cell resistance to insulin, this is caused by lipid accumulation, and without dietary fat it is hard for lipid to accumulate from high carb diets.
                Also, vegan diets of the hardcore Furhman type are usually low calorie diets because the food is bulky and poorly absorbed. You can check this by looking at images of Furhman, Barnard, Campbell et al. on Google.
                Thus a non-junk food vegan diet has the merits of any diet that reverses weight gain and keeps calories low, including LCHF and paleo, and similar odds of reversing type 2 diabetes.
                But perhaps not malnutrition.

                The Unger video is included here:

                • Interesting–and plausible. I came across an article in the June 2013 Smithsonian Magazine, “The Mind on Fire” about how cooking made us human:

                  “It is literally possible to starve to death even while filling one’s stomach with raw food. It is literally possible to starve to death even while filling one’s stomach with raw food. In the wild, people typically survive only a few months without cooking, even if they can obtain meat.
                  Wrangham cites evidence that urban raw-foodists, despite year-round access to bananas, nuts and other high-quality agricultural products, as well as juicers, blenders and dehydrators, are often underweight. Of course, they may consider that desirable, but Wrangham considers it alarming that in one study half the women were malnurished to the point they stopped menstruating.”

                  I’ve actually in past months found it a challenge to NOT lose more weight, and have even been trying to gain some back. I’m not a vegetarian or raw foodist, but I consume a lot more veggies—and a lot more salads than I used to, which is my go-to lunch. That may be why I’m finding it more challenging to gain than it was to lose–NOT something I ever thought would be a problem.

                  And I can easily believe that the weight ioss itself could lead to reversing diabetes despite a relatively high carb content. Especially I guess if much of it was fiber, which IIRC, Kresser doesn’t think we should count anyway toward carb limits.

            • It’s possible the higher carb diet you mention is causing beneficial changes in gut flora via the increased intake of prebiotics in the beans and grains . . I’ve seen some people experimenting with various prebiotics and they do affect blood sugar. But so far everything seems to be very n=1 so I don’t have any recommendations for what to try.

              There does seem to be a dysbiotic gut flora associated with diabetes though. I’d say it’s worth looking into for people who see their fasting glucose levels rising when they do low carb. T2 diabetes seems to have many contributing causes; maybe some people are just genetically suited for a higher protein/fat diet, while others actually need a higher carb diet, but have a dysbiotic gut flora contributing to the diabetes via an inflammatory pathway. They both get labelled with T2, even though the causes are different and so are the treatments . . just speculating here.

        • I suggest that you test for yourself what works. Eat four different breakfasts that have the same energy content, use nutritiondata.com to do the energy calculations. Take your sugars before breakfast and then again 50 mins after the meal.

          I am not diabetic and my fasting sugars are always below 5mlm/m. Bacon, eggs and mushrooms raised sugars by 16%, whole-meal toast, butter and tomato by 32%, a popular cereal and whole milk by 92% and macadamia nuts reduced sugars by 2%.

          Don’t just believe what you read test yourself, and don’t overeat else you will be wasting your time no matter what you eat.

          • I’ve been doing that. My endocrinologist gives the “safe” range as anything from 140 to 180 but I read below 140 is normal–and I found doable. And I don’t care for the mainstream dogma that diabetes is inevitably progressive and I’ll eventually get worse–and back on insulin–no matter what I do. That’s what’s pushing me beyond the “mainstream”

            And yeah, I basically have found that I can do grains and fruits and starches–but have to take them in very measured portions and make sure I have enough protein and fiber with it. (And eggs are my friends). As long as I do, I get post-prandial readings that are blessedly normal.

            So far, anyway, and after having lost 77 pounds and having added moderate, regular exercise to the mix. I can’t deny changing how I’ve eaten has made a big difference.

        • Need to be careful, VLC Paleo messed my gut after 11 yrs. trying to add more fibre like sweet potato but humpback my bg. There is no easy way with a broken metabolic system so some Dr who have just treated diabetics but never lived it don’t really know. You must become self directed and create your own program. Vegan diet or juicing or just raw foods shoots my BG.Now ai am focusing on gut issues from 11 yr of VLC. I lost 80 lbs, hit a stall, have adrenal fatigue. Severe gut issues and don’t see a good program out there. Adrenal Reset maybe.

        • I love this discussion. So, thanks Lisa for the comment.

          I have successfully followed a LCHF diet to help control my Type 1 diabetes for 11 years. So, I was definitely in that LCHF camp for all diabetes. Then, I read Denise Minger’s book, Death by Food Pyramid. She has an excellent discussion of the issue you describe in your comment. Basically, Denise concluded that science does not know enough to answer the question for each and every person. So, as others have commented, test yourself. Blood glucose testers are not expensive though the test strips can be relatively expensive.

          Also, Dr. Gardner’s A to Z Diet Study found that most people had better results with the Atkins diet than the Ornish diet, BUT that some others did better on the Ornish diet. Go figure.

          Anyway, I’m happy that our discussion is getting so refined that we can at least see the possible issue.

          • I love this discussion too–it is beginning to clarify things for me–that maybe the explanation for the diversity of protocols claiming success has to do with the diversity among diabetics–and we respond differently to different diets–and we just have to test things out for ourselves to find what works. Crazy-making and scary trying to sort it all out. But what you said Minger discusses in her book does resonate with me,

        • Sigh, right there with ya. Really confused that so many diametrically opposed theories exist. None of which are working for my pre-diabetes. Did one year of different kinds of diets, one seemed to actually have made me WORSE. Gave into metformin. Have higher and higher fasting, when I started monitoring 2 years ago was at 125 fasting, now seeing 145 highs. ( A1C went from 5.8 to 6.1) Don’t even get me started on meter variability – WTH! I’m so confused I don’t even know what to eat anymore. My latest New Year’s diet has gained me 7 more pounds. I wish I had a million bucks so I could be like The Amazing Randy, and offer that money to someone who could actually make me lose weight and keep it off. (The Amazing Randy was a magician who offered that money to anyone with paranormal abilities which he couldn’t disprove with magic.) I’ve been on a diet merry-go-round for 30 years and I want OFF!!

      • That is so wrong, I can’t believe it has been said. Insulin resistance is caused by ingestion of adulterated fats or fish oil. Proper fat intakes LOWERS insulin resistance. Look it up.

        • Dr Jeff do you mean fish oil is no good because it is adulterated or because of what it is in itself? And what do you mean by proper fats? Can you recommend some reading, as everyone has a different opinion on what they are. I am interested in your comment as the fish oil being detrimental is a new one to me and we are told to give it to our kids, take it for good moods etc.

    • Sorry but you’re wrong. My pre-diabetic wife (5.9 A1C) is not overweight (105 lbs on 5’1″ frame), exercises daily and has done so for decades, has been almost gluten-free for two years, iis on a very-low-sugar diet for seven months, almost never eats processed grains, eats wild salmon twice a week and sardines once a week. Diet is not her problem. But thanks for trying.

      • Has she been tested for autoimmune antibodies and to see what her C-peptide is? I feel in a similar boat. Diet buys more time, but only to a point. Same with exercise, enough sleep, deep relaxation, digestive enzymes if you need them, cinnamon, chromium, bitter melon, fenugreek, bilberry, and gymnema, the right B vitamins, magnesium, coQ10, l-Carnitine, and DHEA. Apple cider vinegar and a good extra virgin olive oil help me as well. 60 push-ups before breakfast. Mostly standing at work. Afternoon walk. Evening walk. If I do everything right, I can get into the low 100s. If I stop trying, I climb higher and higher. Around 130 to 140 three hours after a meal, the. I get disoriented, shaky, sometimes string chest pains, very uncomfortable feeling. No option but to keep trying to figure this out. Perhaps it’s all some purposeful genetically engineered virus infection orchestrated by the multibillion dollar diabetes industry. 😉

        • Hi Joe Scuderi

          Have you tried eating raw, uncooked plantain? Try it and see if it works for you. Eat one or two before each meal. The astringency from the tannins is not nice but tolerable. Do not throw away the peels. Cut them up and immerse in 3 cups/coffee mugs of water . Leave overnight and drink 3 cups per daily. Change to new batch of peels on alternate days. Plantain contains lots of resistant starch and help to establish and maintain gut microbiome. According to Dr. David Perlmutter, the microbiomes of diabetics are often abnormal and the lack or absence of one species namely B. Plantarum appears to be linked to T2D. Green, uncooked plantain is used widely in Nigeria to tackle diabetes. There are some research papers on the subject at PubMed. It’s been found that an extract from green, uncooked plantain not only lowers BG but also increase insulin sensitivity [IS]. It’s about time that people shift away from IS to Leptin sensitivity or resistance as it appears to the master control hormone, which controls Glucagon, which controls insulin! R. Unger has demonstrated in the lab that when Glucagon is removed, insulin becomes superfluous – it is not even needed. Looks like Leptin is pivotal for it can be used to control Glucagon. The proof of concept already exists. Looks like researchers until recently have been barking up the wrong tree. There are at least 5 hormones involved in glucose homeostasis – Insulin, Glucagon, Amylin, Ghrelin, Leptin and the monohormonal model of insulin that has been foisted on the unsuspecting public stinks. Yes, they have quietly moved to the bihormonal model, i.e. incorporating insulin and glucagon as in the new class of agents called the incretin mimetics to address the deficiency and lack of success due to the older model. Unger has been succeeded in introducing a trihormonal model – bringing the new drug Metreleptin into the picture. Not sure if the later has been successful of not.

    • Well said! I couldn’t agree more. I have prevented familial Type II with a LCHF diet since 2000. Most recently, I have gone ketogenic which has allowed me to thrive and be very healthy and active with low-triglycerides and high HDL and normal blood sugars both fasting and post-prandial. I am almost 62 and cycled nearly 5000 miles this year with energy to spare. My sister, on the other hand, was diagnosed full-fledged Type II in 1999 and despite following a similar diet, has not normalized her bloods sugar. (I think she eats too little fat and too much protein, but her carbohydrate intake is very low). She has shockingly high first morning sugars – as high as 300, which fall throughout the day and don’t seem to be affected by what she eats. She says that she has resorted to eating next to nothing – coffee with butter in the morning, no lunch, and a small dinner of meat and some low-starch vegetables. She has a stressful job, doesn’t do formal exercise, and does not sleep well, so I suspect high cortisol levels and night-time gluconeogensis by the liver. She does take medication – I believe metformin and a SGLDT (she recently had a bad bout of urinary track infections – surprise!) and a beta-blocker for high blood pressure and migraines. She still holds onto the idea that her doctor has some credibility. She saw Mary Vernon in Kansas a few years ago (and it appears that Mary is in big trouble for tax invasion – I was not impressed with my sister’s experience there) and we have posted on blogs for years trying to see if anyone has an answer. Any input would be helpful because this has been a mystery. As a huge proponent of using diet as the answer to most health issues, it is rather an embarrassment for me!

      • Peggy, let me try to explain it for the benefit of your sister based on my research and handling T2 diabetes for couple of people in my family who are responding fairly well.

        First, your sister needs to understand that LCHF also includes low Protein. Your body’s first preference is glucose for energy. When it doesn’t get glucose it will burn fat for ketone energy. But before that it will try its best to get glucose which it gets through breakdown of Protein. If you don’t eat Protein while on Low Carb diet then it will breakdown your body muscles to get it (call it cannibalization). To avoid this muscle wasting you need to supply it moderate amounts of dietary Protein in the early stages of LCHF regime while it also burns Fat. In couple of weeks, it will become “ketone adapted” and stop looking for glucose. But if you eat Protein it will have to break it down to digest and in the process feel tempted to draw glucose from it. It will delay or interrupt with your “ketone adaptation” while giving spikes of glucose.

        Go to http://eatingacademy.com/ and read 3 articles of Dr. Peter Attia on this explanation. These are also listed on my blog http://yrusick.wordpress.com/. Chances are my explanation here may not be quite correct as I am not qualified enough to understand or explain it scientifically.

        Since she is eating low Fat as well so it is double whammy for her. She has to become “ketone adapted”. For this she has to eat High Fat to provide alternative source of energy. Coconut oil should be the preferred one for its MCT which turns into ketone energy even if you are not “ketone adapted”. Watch Dr. Mary Newport’s and Dr. Bruce Fife’s interviews on my blog and also visit http://www.coconutketones.com/. Starvation is not an answer and dinner of meat may explain her morning highs.

        And while she is doing all this she needs to be continuously monitored by her physician as well as use glucometer extensively. Being on medication like Metformin and following this regime may have its own challenges. Fighting diabetes is a long term battle. Hypoglycemia is a greater danger than hyperglycemia in my opinion as you may not live another day to continue the fight. So watch for it first and foremost throughout.

        Hope it helps.

      • hi Peggy, that is a shame about your sister. We want our loved ones to have the same success as we’ve had. I do believe in diet being a massive contributor to health; it’s completely logical, but I suppose it’s really about the whole organism functioning in balance, of which diet is a huge part, and what we don’t put in is as important as what we do (nutritional deficits and maybe other neurochemical supplements). And of course stress. I find myself promoting this book embarrassingly, but it answered a lot of questions for me, and takes a whole view of the body and health and mental health, including sleep and our reactions to stress – The Mood Cure by Julia Ross. There’s a website where you can do some reading before buying the book. I wish you and your sister the best.

  12. Hi Chris,
    This probably isn’t the right place for this since it really isn’t diabetes related, but your mention of nighttime waking triggered some thoughts for me. I’d love to see you write something like the Healthy Mama Code. There are so many issues unique to motherhood (adrenals, fluctuating hormones, postpartum thyroiditis) that remain unexplored.

  13. Not buying the either/or approach. I take Metformin, which is a Biguanide. It is generally considered one of the best meds out there. Recent Swedish research suggests that it is not a problem for people with mild to moderate kidney impairment. It also seems to help people with Alzheimer’s.

    There may well be less polarized info in the Paleo Cure bonus chapter but I doubt that I will be buying that.

  14. I completely agree with this blog. I am a provider in family medicine and see SO many patients with insulin resistance issues. I have started recommending your book to all of them! I only have 15 minutes with patients and can’t possibly go into all of the details, but your book incorporates all of the key elements for a well-balanced body and spirit. Thank you!!!

    • Some of the commenters here have asserted that a low carb approach “causes” insulin resistance. But, as you have said, most patients come to you already WITH insulin resistance and they are clearly not following a low carb paleo diet at diagnosis. So would you agree with the statement that low carb “causes” insulin resistance?

      • Insulin resistance is caused by high fat and high animal protein — the usual paleo diet and SAD.

  15. Chris doesn’t mention the possibility that maybe ALL those drugs mess with the gut flora thus preventing the absorption of nutrients and increasing digestive problems.

    Vitamin B12 is one of those most frequently being mentioned as low. I’ll bet almost all vitamins and minerals are not being absorbed well.

  16. I was diagnosed as a Type 2 diabetic last year with a A1C of nearly 13. This was discovered in the process of staging breast cancer, which required chemo, including steroids, so I was put on insulin right away.

    Just from following the advice of the Diabetes Educator and cancer center nutritionist to limit portions–basically the plate method with starches taking up a quarter of a plate–I reversed my diabetes within months. Just doing that I was losing weight, and I would eventually lose 77 pounds. An overwhelming percentage of Type II diabetics are overweight–85 percent I’ve read. Losing weight makes you less insulin resistant.

    Once chemo was over and I no longer had to take steroids my insulin dosage zeroed out (at one point I was taking 20 units) and after my next A1C test I was taken off my one oral med (Januvia). Three months later–without meds, my A1C was 5.1—in the normal range.

    And yes, I eat grains, I eat bread, I consume legumes and dairy. I’m not on Paleo. I’m also not eating vegan the way Dr Furhman recommends in the The End of Diabetes. I average about 1,800 calories, 150 to 170 carbs a day. I’m not low fat either–but I am cautious about saturated fats and average about 90 grams of fat a day.

    Yes, I’m aware a lot in the Paleo community advocate for a A1C even lower than the normal range–5.0. My experience certainly makes me curious about the effect of diet on health–I wouldn’t be on this board if I wasn’t at least curious about Paleo.

    But I see all sorts of conflicting claims about how to eat as a diabetic, and my own experience makes me skeptical about the merits of any particular diet. I suspect any restrictive diet will give diabetics good results at least in the short term–because you’ll lose weight, and your pancreas will love you for it–but I’m far from convinced grains are evil.

    • I keep reading that there are conflicting diets for diabetes that are promoted by various doctors. that may well be true but people are all different. I believe it has to do with what your ancestors ate and what genes were passed onto you. Like if you have the genes of your ancestors who were cattle herders in Europe somewhere (humor me) maybe dairy is ok for you as you have been given a system that can digest dairy as your ancestors adapted to it. If you didn’t and inherit genes from those who rarely were able to find it and have it, chances are that you won’t be able and are a more likely pale candidate.

      One common thread in all, I believe, is low processed carbs.

    • Lisa,

      This is second best:
      Eat only whole foods.
      Eat no gluten, dairy, or red meat.
      Eat whole grains, legumes, vegetables, fruits, without restriction.
      Eat fish, fowl, or eggs once a week.

      This is the best — the key to life.
      Eat only whole raw foods.
      Blatant Raw Foodist Propaganda

      Joseph Leduc

      • Plenty of people on this board are reporting success with reversing diabetes with Paleo and diets including animal protein. And certainly I encountered your approach early on–it never made sense to me, given human evolution and anatomy that the “key to life” is raw foods and avoiding red meat.

        I might add my own experience–and my glucometer–demonstrate that for *me* anyway, eating grains (even “non-glurten” grains), legumes, starchy veggies and fruits “without restriction” is a disaster. I eat all those things–but in carefully controlled amounts with other foods that ameliorate their blood-glucose raising effects. And my glucometer tells me that red meat, dairy and eggs are my friends.

        Maybe your diet works for you and for could work for others–but it sure isn’t for me.

        • Lisa, I find your responses very engaging and helpful. I think the right steps for diabetes management through diet are:

          1. Educate yourself as much as you can and keep doing it
          2. Experiment with different approaches including mix and match
          3. Use the Glucometer on regular basis. For some it may be too expensive to afford. But there is no real way around it at least in the experimentation stage till you find the right mix. Later HbA1C once in 3 months may be sufficient.
          4. Personally, I find Michael Pollan’s words my guiding principle which should be applicable to healthy living generally : Eat (Real) Food. Not too much. Mostly plants

          • “Eat (Real) Food. Not too much. Mostly plants”

            That’s as close to a consensus as I’ve found. Dropping the packaged junk for real food by and large was the biggest change I made–that and portion control.

            Glucometers btw are usually covered by insurance in the United States if you’re diabetic and my endocrinologist is generous with prescriptions for the strips. I’ve read you can get glucometers (and strips) really cheaply at Walmart FWIW–I’m not sure about their affordability outside the United States.

            They can be tricky to use without training though. I was in blood stick hell before my Diabetes Educator showed me how to do it properly.

            • Regarding blood sugar testing at home, the Food and Drug Administration (FDA) require 95 percent of all glucometer test results to be within 20 percent of the actual blood glucose level for results greater than 75 mg/dl and within 15 mg/dl for values below 75 mg/dl. So a blood glucose that in reality is 100 mg/dl could show on a meter as being between 80 and 120 mg/dl—and still be considered accurate.

    • Excellent interview by Prof. Noakes. I have added another lecture of his under Education Videos on my blog. Although it didn’t add much to what I already know, it is good to hear confirmatory messages.

      I have tested it on my two close relatives and it has worked for both. Unfortunately, there are others who are just wedded to Health Canada or USDA or their counterparts in other parts of the world like India where I originally come from. They would not be willing to give up insulin and, of course, they won’t then be able to give up carbs to save themselves from hypoglycemia. This is such a vicious cycle they can’t break free from. It will take many lectures like these ones, if they spare time to watch, to drill home the message in their heads. My compilation on the blog is an effort on my part to at least provide them these resources in one condensed place.

      Let us all keep spreading the message!

  17. Isn’t it interesting that our “better living through chemistry” has backfired on us? We no longer die of plagues and sanitation issues, but now life long enough to determine the long-term effects of poor diet and stress. Like Grandma said, eat your dinner first, then we’ll see about dessert. Dilution was the solution there, and portion control.

    • Can’t agree more.. we are actually overdoing the sanitation issues. Recent studies prove that the hand wash we use can lead to lot of diseases. The best way is live a life that is close to nature.

  18. Another great article Chris- shared it on my FB page. Getting antsy to hear more about the provider functional medicine training program!

  19. I absolutely vouch for it. A close family member was on insulin for 30 years. Now absolutely without it. No reading anytime of the day is more than 10. Mostly between 6 and 9. HbA1C is <7. Small indulgences of bread are done with only Einkorn flour. Bloodwork showed trace amount of Ketones which is proof that the body is "ketone adapted". Not to be confused with DKA. Read Dr. Peter Attia's articles on Ketones and diabetes published on http://eatingacademy.com/nutrition/is-ketosis-dangerous. An absolute must read. Then watch a CBC documentary, My Big Fat Diet", on Youtube by Dr. Jay Wortman. All the above also compiled on my blog: http://yrusick.wordpress.com/. Kudos to Chris for spreading the word. We all need to do the same in our own small ways. We owe it to ourselves.

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