My grandmother had type 2 diabetes since before I was born. We were all very aware of it because she controlled it mostly through her diet. We knew she couldn't eat sweetened foods or if she did it was a tiny bit as a treat; rarely more than a mouthful. As far as I'm aware, she never developed any of the bad complications that come with having diabetes and she didn't even start using any medication to treat it until at least well into her 70s, perhaps not even until her 80s when she went into a residential home. She died in 2002 at the age of 86 and maintained her physical health well until around 2000 when she went into the aged care home.
My grandmother on her wedding day
This was the lens I saw diabetics through, so it was puzzling to me when I encountered diabetics who would still eat sugary foods, maybe less than non diabetics, but still at much higher levels than seemed reasonable given their condition. They instead chose to rely more on medication to try and control their blood sugar levels and quickly began to develop the complications that are known to come with diabetes. Initially I thought that this was a decision they were making despite doctor's advice, but recently I've begun to wonder exactly what the advice is these days from doctors and diabetics associations and I have to say that the associations' guidelines are rather confusing at best.
Diabetes and it's causes
There are two main types of diabetes, type 1 is an autoimmune condition where the pancreas doesn't produce enough insulin. With type 2 diabetes insulin is produced, but the cells have become resistant to it and it struggle to take up glucose for fuel. This leads to high glucose in the blood, so the body produces even more insulin to force glucose into the cells which respond by becoming more insulin resistant.
With type 1 diabetes patients generally require exogenous (outside) insulin in order to survive. While the right diet for this type of diabetes can reduce the amount insulin needed to be taken and give better control over blood sugar levels, it's unlikely to allow you to reach a point where you can do so without exogenous insulin.
With type 2 diabetes, the right diet can actually put it into remission. If you can bring glucose levels down to a level where cells won't be overloaded with more than they can handle, then their resistance to insulin will decrease.
My grandmother ate a mostly vegetarian, wholefood diet, avoiding any added sugars and limiting carbohydrate rich foods to low GI ones as best she knew how. She'd always eaten mostly wholefood anyway, so I wondered what might have caused her to develop this type of diabetes. After all, it's prevalence today comes mostly from the highly processed, high sugar diets most of us in the western world are consuming. At first I thought it might be the stress of living through WW2 and this could certainly have contributed. However, after talking to my mum we think a more likely cause was the steroid medications she was put on for her asthma and eczema. So it wasn't even her diet that caused the diabetes, but she was still able to control it with diet.
Guidelines from doctors and diabetes associations
I suspect guidelines from my grandmother's day were more diet related, but then we seemed to go through a period when the emphasis was on just taking medication. There is an indication that this could be turning around again with at least the American Diabetes Association putting some emphasis back on diet to control it.
From Diabetes Australia we have this:
"Eating a healthy diet helps to keep your blood glucose levels within your target range, which reduces the risk of developing diabetes-related complications."
This seems like good guidance, although it's rather confusingly followed by:
"There is no such thing as a diabetic diet. People living with diabetes can enjoy the same foods as everybody else."
I suppose this is also accurate to a point. The odd little bit of high glucose causing food is not going to make you completely lose control of your blood sugar, but this isn't made particularly obvious. Most people want to know clear cut boundaries otherwise they will take this and run with it in the wrong direction, especially if they don't really want to make changes. A friend of mine was told he could have the occasional beer when he was early into his diabetes diagnosis, but basically interpreted that as being able to drink however much he wanted. It wasn't long before the doctor gave up on any hope of him controlling his condition with just diet and decided to put him on tablets for it. He's in his mid 50s now and has bad teeth (they deteriorated rapidly once he went onto medication), circulation issues and is prone to getting infections from injuries.
Perhaps a bigger problem is that people rarely get full disclosure as to the outcome of not changing the way you eat and using medication to try and control symptoms of high blood sugar instead. If your cells are already resistant to insulin then adding more will only force the body to do something with the excess glucose and that will basically be putting it into fat storage. The ongoing problems of glycation from the excess glucose aren't being addressed and inflammation and cell damage will continue. You will also continue to develop further insulin resistance requiring more and more insulin.
On the positive side insulin isn't usually the first medical intervention for type 2 diabetes, that would be a metformin medication, as long as you don't have other conditions that it could negatively affect. This medication makes your cells more responsive to insulin, decreases the amount of glucose absorbed from food and the amount of glucose made by your liver. While this is likely a much better approach than going straight to just putting more insulin into your body, it's not without its side effects and it's still not addressing the root cause, as indicated by the fact that people will eventually still graduate to insulin if diet isn't addressed.
Was the historical approach better?
For decades before medical interventions were found, type 2 diabetics had good success with ketogenic diets and even today people who choose to go that route seem to do well with putting it into remission. There are those who don't find this dietary approach appealing for a whole host of reasons, however, and I think my grandmother was a good example that other dietary approaches work too.
That said, our modern food landscape is far removed from what it was 100+ years ago as is our way of life. We're flooded with an ultra processed, sugar filled plethora of offerings which are hard to resist and even when we think we're making healthy choices there are often hidden sugars we don't expect. We regularly don't have time to cook from scratch and it's just so much easier to grab takeout or heat something up after a long day at work. But if we knew just how severe the complications of diabetes were, would it help motivate us to navigate this minefield better and make the time to eat better?
Looking up diabetes complications can give you an idea of what you'd face in the future if you didn't control your diabetes, but just reading them doesn't really hit home. The way most sites list them you can convince yourself that they are possible rather than certain complications and you might not get them. However, the reality is that one of them will get you, it's just a matter of which ones. I recently watched a documentary about a chef who got a type 2 diabetes diagnosis and he went to visit some later stage diabetics in hospital who each had warnings for him not to take it lightly. At least one was having a leg amputation and one had lost his sight. The chef said that actually seeing the complications and how they affected people did more to hit home than just being told or reading about them.
I'd actually love to hear from diabetics what the current advice is. Is healthcare heading in the right direction or are they just throwing medication at it?
Seems the keto diet and the more extreme and more expensive carnivore diet are likely the best option both for diabetes and to pre-diabetis that I understand many more people suffer from and is a core cause of obesity. A big problem with both keto and carnivore though, next to afordability of a diet that doesn't get most of its calories from the usual cheap carbohydrate rich staples is the poor and conflicting science regarding fatty acid types. It is cool to be able to controll diabetes, fight obesity, and generaly improve your insulin related risk factors, but insulin sensitivity isn't the only diet related risk factor. Protein seems pretty much neutral as a macro (unless you believe some off-on-a-tangent vegans and their pseudo science), alcohol is agreed to be bas that most people don't even realize it's a macro at all, so with carbohydrates at a minimum that makes the choice of faty acid types pretty important. Problem though, half of the people in nutrition will tell you saturated fat is the bad one and you should reach keto through plant based low SFA oils for everything, including so the relatively affordable vegetable or "seed" oils because of LDL cholesterol, while the other half will tell you seed oils are the causo of chonic disease, unsaturated oils are the bad ones and aldehyde formation is the real risk factor from fatty acids. From a data perspective the LDL narative seems relatively shaky because LDL is a poor predictor of outcomes compared to other markers, and in contrast the pure deterministic mechanistical evidence for aldehyde formation is undeniable, but neither implies that any type of faty acid is safe to consume in copuous ammounts. So is Keto and/or Carnivore the answer? Probably. But what oils to use seems for a "safe" form of keto seems to be a question that is impossible to answer.
There actually seems to be a lot more studies coming out on dietary affects on the body now and it's been fascinating to see what's coming up. There finally seems to be more agreement that there isn't a one size fits all approach to eating and one thing that most researchers at least agree on fully is that our modern ultra processed foods are the worst thing for all chronic conditions.
There are those who say they've achieved good results on a low fat, high carb unprocessed mainly plant based diet for their diabetes. They tend to argue against the keto approach, but both are valid, in my opinion. There is certainly something to be said about avoiding mixing fats and carbs, at least in large amounts. I touched on this in a previous post, if you're interested.
With regards fats, that really is a fascinating, but highly argued topic. I agree that the cholesterol narrative certainly seems to be falling apart, despite the fact that many are desperately clinging onto it and everyone's doctors are trying to put them on statins. Some argue that it's saturated fat that causes diabetes, not carbohydrates, but I haven't managed to find any research that caused it without also including refined seed oils, which leads me to wonder if the culprit is in fact the refined oils. I recently came across a video claiming proof of those oils being the culprit, but didn't get chances to watch it and now can't find it again. It's something I want to look into, though.
Did you know that they recently discovered that there is an essential saturated fatty acid called C15? This is something else that goes against the old saturated fats being bad narrative.
I think fatty acids is a much more nuanced than demonising one type over another. There are plenty of good cold pressed plant oils and they're struggling to find any harm in animal products as well. It's only when the refined oils come into the equation that the evidence of harm starts to come in. A subject I want to research more.
Hello @minismallholding. I was diagnosed with Type 2 Diabetes in 2019 in my late 60s. When you've been accustomed to eating whatever whenever you want with no consequences your entire life, it's a difficult adjustment to make. I think of it as an addiction that must be broken. My diabetes is controlled with diet, exercise, and medication. If I'm to prevent my condition from elevating to Type 1, then I have no choice but to adhere to my doctor's recommendation. So far, I've been doing good. My two daughters and granddaughter keep me on track and encourage me to try alternate food items.
I'd love to be able to eat Tofu, but according to my doctor, it's not the best source of fiber and protein for Diabetes. My struggles are the underlying conditions from family histories of heart problems and HBP I had before my diagnosis.
Thanks for sharing this information. Take care.
!LADY
Thank you for sharing your experience with this. Changing lifestyle habits is not easy at all. I've been trying to make changes for a while and only a few really stuck. It wasn't until my 40s and peri-menopause hormone changes brought back my migraines and other issues that I actually got strict with myself and even then it took a few years and reaching a point where I was barely a week each month without a migraine or a migraine hangover before I did. I've since discovered I am or was likely insulin resistant.
I love that you have support from your daughter and granddaughter. I also ended up having to say to my family that I can't just keep eating anything and it's my daughter who supports me the most with that, always checking ingredients on things and suggesting alternatives.
How do you feel you are going with the diabetes now? Do you feel better in yourself since the changes compared to when you were first diagnosed?
I feel 80% better. I've learned what triggers my migraines, nausea and vomiting after each weekly Diabetes injection. But the most important thing is that I've lost 43 lbs. Seven more to go. Like your daughter, my youngest is always checking labels and sending texts on which foods will work with my symptoms. Exercise is a bit tricky because of arthritis in my knees, back, and shoulders. I try to push through.
I must admit that once I cut back on certain foods, adding less sodium, and reducing sweets, I do have more energy and feel less sluggish. My husband now brings me back from shopping items he's spotted in the grocers he thinks will work for sugarless desserts and snacks. He also agreed to reduce our dining out to twice a month.
When I began, I didn't feel that I could chance my lifestyle one iota. Now, it feels like second nature. My sweet attacks still come, but I look for alternatives instead of immediately giving in.
It helps to have food already prepared. When preparing a meal, I cook several different veggies and side dishes for variety each day.
Thanks so much for sharing your experiences. We can each learn something. Take care.
!LADY
@topcomment
I haven't heard of a weekly diabetes injection before. Do you know if it's a GLP agonist? It's the only one coming up as a weekly injection and they are fairly new. It also mentions causing nausea when you first start, which would fit with the symptoms you mention.
I've found my sugar cravings have mostly gone since changing the way I eat, but apart from at certain times of the month I've never been too drawn to sugary foods. I know some people get very intense sugar cravings and I don't envy having to fight that. I know of someone who eats keto because it's the only way he can stop the sugar cravings. If he eats any carbohydrates at all his cravings start back straight away and it takes 3 days without carbs for them to stop.
I took the following:
OZEMPIC
TRULICITY
and now
MOUNJARO
Yes, I have heard about eating the keto diet for low carbs. For me, I tried it, but it's high in cholesterol, and I'm taking meds for that underlying condition also. Everything has to work together to moderate all underlying conditions. If I take one thing to lower a condition, another is affected and rises.
It's a delicate balance that my doctors have spent considerable time mixing and matching to achieve success.
Thanks for your suggestions. Take care.
!LADY
I'm currently researching vegetable oils and there seems to be a big correlation between obesity, chronic illnesses and the rise in our consumption of these, which makes me wonder if the wrong types of fats got the blame for heart disease.
Have you come across the opposite of keto and cutting out fats for high carb instead? It tends to be more wholefood plant based. Mixing fats and carbs seems to be the the most problematic. Both diets are extremes in their way and probably hard to stick to, though.
Anyway, thank you again for sharing your experiences, it's been enlightening. I hope you continue to manage your symptoms well.
Yes, I have read and practice a diet that is the opposite of KETO. Those diets emphasize more carbohydrates and fess fat and protein. Both of those I don't need. It's the Atkins Diet. It's so easy because I love carbohydrates. But with their gradual increase in the carbs, I can handle it.
I have my 3-month follow up on my lipid and other test in May. Trying to stay focused.
Thanks so much for the insight and encouragement. I appreciate it. You too stay encouraged. Take care.
!LADY
Keep up the diet and exercise, works for me too.
I will. Thanks for letting me know your regimen is working. It's tough some days with the severe arthritis in my knees, back, and shoulders, but I try to get in 3 days a week during non-flare ups. I appreciate your visit, engagement and encouragement. Thanks so much and have a good start to your weekend.
Take care.
!LADY
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A lot of people are borderline and don't even know it, I could be one of them, eeek
Very true. Since looking into this I've discovered that I had a lot of symptoms of insulin resistance which had likely been building up for some time. I can barely tolerate any refined sugars without migraines and inflammation now. I've cut out all highly processed foods and I'm doing so much better.
In my personal experience (my dad was diabetic, and mom is too), type 2 diabetes responds well to stevia consumption, but natural, unprocessed stevia. In addition to sweetening foods and reducing cravings for sweets, it also has the ability to control blood glucose levels.
I understand, although I haven't read the scientific studies, that stevia (natural, unprocessed) helps regenerate pancreatic cells.
And yes, diabetics tend to ingest higher than average amounts of sugar because, as a result of the deterioration of the nervous system, they lose their sensitivity to flavors. That's why they like extremely sweet, salty, or acidic foods.
That's fascinating and something to look into. Thank you for sharing.
I'm currently listening to a doctor turned researcher who has been finding a lot of evidence connecting consumption of refined vegetable/seed oils to the rise in obesity and these chronic illnesses like diabetes, heart disease and cancer. He started by looking into what could be causing the rise in macular degeneration.
Natural medicine is the basis for all healing, and prevention is the basis for good health.
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Like all chronic diseases, diabetes is one in which patient discipline and self-care are critical to an acceptable quality of life.
It seems to me that diet plays an essential role and that information and dissemination sometimes depend on economic interests, which explains why, for example, at a certain stage medications have predominated.
Your grandmother was an example of this.
Very good article.
Happy day.
Cheers and greetings.
I think we're starting to realise that diet has a much bigger impact on chronic disease than we ever expected and I agree, economic interests certainly muddy the water. I don't believe any medication can make a significant impact when it comes to chronic disease.
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What a testament to the power of diet and lifestyle management...Your grandmother's story is incredibly inspiring and shows how proactive choices can significantly impact long-term health, even with a condition like type 2 diabetes.
She was a big inspiration in my life. It can take a lot of self discipline to do this kind of thing and she certainly had that, which has helped me to learn how to apply it in my own life.
In my own personal experience, diabetes is not good. My mom is suffering from it and I can tell you that when he is still experiencing her pain and other medications, I used to pity her so much. She constantly advice me to run away from sugary contents
That must be awful to see. I'm sure she doesn't want to see you going through the same.
I'm just starting to come across information that the cheap refined seed/vegetable oils could actually be doing even more to cause diabetes and other chronic illnesses than sugars. Are they used much in your country? They are very prevalent in first world countries and hard to avoid.
Thanks for this information, is very important.
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You were able to enjoy your mother for many years, that was wonderful.
Es realmente interesante, gracias por este post.