November 14 is World Diabetes Day
Type 2 Diabetes is the seventh leading cause of death in the United States. When left untreated or poorly managed the serious health complications further burden the healthcare system and severely reduce the quality of life of those struggling with the disease.
According to the Centers for Disease Control and Prevention (CDC), in 2017 diabetes affected over 10% of the population with 26.9 million people, including 26.8 million adults being diagnosed. It is further estimated that over 7 million people are undiagnosed.
Prediabetes affects over 34.5% of the adult US population with 24.2 million people aged 65 years or older having prediabetes
Diabetes develops when your body either fails to produce sufficient insulin or is unable to utilize the insulin that is being produced, causing sugar (glucose) to build up in the bloodstream.
There are two types of diabetes:
Type 1 diabetes is usually diagnosed in children and young adults. Previously known as juvenile diabetes, only 5% of those diagnosed with diabetes have this form of the disease. In type 1 diabetes, the body does not produce insulin, and one must supply the body with insulin instead as a prescription medication. It is important to note that Type 1 diabetes is an autoimmune condition where the pancreatic beta cells that produce insulin in the body have been destroyed.
Type 2 diabetes is the most common form of the disease, and occurs when your body is unable to effectively utilize insulin. This condition is often called insulin resistance. When insulin resistance begins, the pancreas can product extra insulin to compensate and force glucose into the cells, but over time, the pancreas cannot keep up with the amount of insulin required to stabilize blood sugar levels and keep them in a healthy range.
Type 2 diabetes does not always require medication as an adjunct to treatment; however, in Type 1 diabetes, insulin must be supplied to the body daily through a prescription.
Today we will be discussing Type 2 diabetes.
Diabetes is often diagnosed when blood tests indicate higher than normal fasting blood glucose levels. The pancreas, an organ that is positioned near your stomach, is responsible for the production of insulin, the hormone that is required to move glucose into your cells for efficient energy production and utilization.
The Role Of Insulin Resistance
Diabetes is often referred to as a “lifestyle disease” meaning it is caused by factors within a person’s control including diet and exercise. While additional risk factors such as obesity, lack of intentional exercise, poor stress management, and smoking are precursors for the Type II diabetes, dietary factors also appear to play a significant role.
After a meal containing carbohydrates, blood sugar rises, which signals insulin into action. In healthy individuals who tolerate carbohydrates well, insulin easily deposits blood sugar into cells all around the body. When insulin’s job is done and blood sugar levels return to normal, insulin levels also fall back to normal.
When blood sugar metabolism becomes dysfunctional, carbohydrate tolerance is decreased, resulting in blood sugar levels remaining elevated due to cellular resistance to insulin. Over time, worsening insulin resistance prevents blood sugar levels from returning to healthy levels, leading to diabetes.
Diabetes and Diet
A healthy diet is critical to the effective management of diabetes. Upon diagnosis, it becomes important to understand the role of food and its effect on your blood sugar.
Amongst all of the macronutrients, carbohydrates (starches and sugars) have the largest effect on your blood sugar. Whether you choose a Paleo diet or not, it is imperative to understand carbohydrates and their importance as part of blood glucose management and control.
Since type 2 diabetes is characterized by elevated blood sugar levels due to impaired insulin sensitivity, eventually accompanied by insufficient pancreatic insulin production, it seems intuitive that controlling dietary carbohydrates, the main nutrient that directly influences blood glucose, would be a good dietary approach for diabetes management.
Carbohydrates do not need to be totally avoided as part of a diabetic dietary protocol, though it may be easier to manage the condition through a reduced carbohydrate diet. This is one of the many reasons following a Paleo approach may be so beneficial and effective in stabilizing blood glucose. For the most part, following a Paleo diet eliminates refined sugars and grains. These are the foods that spike your blood sugar the most.
Although there is no consensus on the definition of a low-carb diet in terms of how many carbohydrates are required to properly stabilize blood sugar, the main objective of all dietary intervention should be to focus on increasing the consumption of nutrient-dense foods to ensure nutritional adequacy. A well-formulated Paleo diet is certainly capable of helping to do that.
The Paleo Diet And Diabetes
When it comes to diabetes, the goal of a well-structured Paleo lifestyle is to address all the factors that contribute to insulin resistance – carbohydrate, diet and lifestyle
A Paleo diet focusses on nutrient-dense foods, avoiding processed ingredients, sugar, and grains, and is often, by default, lower in carbohydrate content than a traditional western diet. Research suggests that minimizing the number of carbohydrates, while consuming more foods that are lower on the glycemic index, such as non-starchy vegetables, may help more effectively manage blood glucose levels.
Several studies have been conducted to evaluate the effects of the Paleo diet on type 2 diabetes management, demonstrating the potential health benefits of the diet. It has been found that adhering to a Paleo diet is effective in lowering body weight and important blood markers in patients with type 2 diabetes. Eating a Paleo diet, even for a short period, can result in improved insulin sensitivity and lipid profiles.
Although low-carbohydrate diets have been shown to be particularly effective for people with insulin resistance, “low-carb” in these studies can be up to 40% carbs by calories, which is medium-high carb by Paleo standards.
Although some people might do very well on a very low carbohydrate or ketogenic diet, others might feel better with more carbohydrates, especially in the context of other anti-diabetic lifestyle factors.
Fats eaten together with a refined carbohydrate can also be problematic and poor-quality fats are legitimately dangerous: trans fats are inflammatory and do contribute to metabolic problems. However, studies have shown that a Mediterranean-type diet with lots of olive oil was actually better than a lower-fat diet for preventing Type 2 Diabetes and that in humans, saturated fat has no affect insulin sensitivity.
A lower-carbohydrate (40% or lower, not necessarily super-low), higher-fat diet may be helpful for most people. This is often where most people naturally fall when following a Paleo diet. Some people might feel best on a very low-carb diet, but not everyone needs to go there.
This still does not imply that carbohydrate consumption causes diabetes. It does mean that for people who are already metabolically sick, reducing carbohydrates can be a therapeutic option to treat the existing problem.
A Paleo diet is also helpful for diabetes because it reduces or eliminates other foods that contribute to inflammation, including
- Soybean oil, canola oil, “vegetable oil,” and other industrial seed oils
- Trans fats
- Refined sugar
- Additives, preservatives and artificial ingredients
- Gut irritants (in grains and legumes)
A Paleo diet also emphasizes foods that help with healing from inflammation, healing the gut, and restoring insulin sensitivity, including
- Probiotic and fermented foods
- Bone broth
- Vegetables(vegetables contain important nutrients for insulin metabolism and fiber to effectively feed the gut microbiome)
- Well-sourced protein and healthy fats
Although a Paleo diet can help many people manage diabetes without any special modifications, a few changes can make the diet even more powerfully therapeutic for this disease. Those changes include:
- Limiting or avoiding higher-glycemic and tropical fruits, including dried fruit (dates, raisins, dried figs, dried apricots and the like), watermelon, pineapple, and mango.
- Avoiding Paleo friendly sweetenerslike maple syrup, honey, sucanat, Muscovado/Barbados sugar, and molasses (or using them very sparingly).
- Consuming foods high in naturally occurring sugar or starch with an acidic ingredient (vinegars, lemon or lime) or with higher-fiber foods (above-the-ground vegetables), which lowersthe glycemic response.
- Emphasizing fiber-rich foods, protein, and Paleo, nutrient dense sources of fatto help prevent blood sugar and insulin spikes and keep blood sugar levels at an even keel throughout the day
- Swapping out freshly-cooked potatoes for potatoes that have been cooked and then cooled down (re-heating them afterwards is fine); the cooling process increases their resistant starchcontent and lowers their glycemic index.
Paleo also focuses on lifestyle choices like movement (even gentle exercise helps improve insulin sensitivity) getting adequate sleep and managing stress. A Paleo diet is also an effective weight management tool which helps with losing belly fat (an independent trigger of inflammation and insulin resistance).
The Paleo diet and lifestyle encompass positive modifications that are beneficial for people with diabetes. With regards to carbohydrate tolerance, the Paleo diet can be as high-carb or as low-carb as you need it to be to achieve improved blood sugar control.
Choosing an ancestral or Paleo dietary approach is proven to be an effective strategy for improving blood sugar, insulin dysfunction, and outcomes those with diabetes. A Paleo diet is not a magical diabetes cure-all. The latest research into diet and diabetes does support a low to moderate-carbohydrate, nutrient-rich, fiber-rich Paleo-style diet over the standard recommendations when combined with lifestyle modifications including movement, sleep and stress reduction.
If you’re on insulin and/or other medications for type 2 diabetes, and you are new to a Paleo protocol, it is important to work with your health care practitioner to customize your treatment plan to your specific needs.