Throughout this article, we looked at the data and the principles behind how low-carb dieting affect patients with diabetes, but we never addressed what you can do about it directly. If you’d like to learn about practical strategies that may help you reverse insulin resistance and improve your blood sugar and HbA1C levels, I recommend reading these articles:


In fact, patients with gastroesophageal reflux disease (GERD) have been shown to improve after eating very low carbohydrate diets.31, 32 Another study found increased carb-intake worsened GERD, while a high-fat, low-carbohydrate diet reduced symptoms.33 And two studies have linked esophageal diseases, including Barrett’s esophagus (BE)34 and GERD,35 to sugar and carbohydrate intake.
On May 24, 2018, I had a 90-day follow-up appointment with my doctor. When he came to the exam room with my chart he immediately started to fist pump me with praise of congratulations, he was ecstatic. I am now at 233 pounds (106 kg)! I have lost 51 pounds (23 kg) and my girlfriend has lost 25 pounds (11 kg). I went from a 42-inch (107 cm) waist to a 38-inch (96 cm) waist. But, here’s the best part, my A1c came down to 5.7 and all my health markers have improved. He called me his poster child for being on the path to curing my Type 2 diabetes.
The scale is not necessarily your friend. You may want to lose fat – but the scale measures muscles, bone and internal organs as well. Gaining muscle is a good thing. Thus weight or BMI are imperfect ways to measure your progress. This is especially true if you’re just coming off a long period of semi-starvation (calorie counting), as your body may want to restore lost muscles etc. Starting weight training and gaining muscle can also hide your fat loss.
It’s time to focus on your lentil health. In one four-week Spanish study, researchers found that eating a calorie-restricted diet that includes four weekly servings of legumes aids weight loss more effectively than an equivalent diet that doesn’t include beans. Those who consumed the legume-rich diet also saw improvements in their “bad” LDL cholesterol levels and systolic blood-pressure. To reap the benefits at home, work lentils, chickpeas, peas and beans into your diet throughout the week.

Changing your body’s primary energy source from carbohydrates to fat causes an increase in ketones in the blood. This “dietary ketosis” is different from ketoacidosis, which is an extremely dangerous condition. When you have too many ketones, you may be at risk for developing diabetic ketoacidosis (DKA). DKA is most prevalent in type 1 diabetes when blood glucose is too high and can arise from a lack of insulin. Although rare, DKA is a possibility in type 2 diabetes if ketones are too high. Being ill while on a low-carb diet may also increase your risk for DKA.
I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.
If not managed correctly, high blood sugar in diabetics can damage blood vessels and lead to a variety of illnesses. Unmanaged diabetes doubles the risk of cardiovascular diseases such as coronary artery diseases and stroke. [3, 4] Diabetes can damage small vessels in the eyes, kidneys, and nerves and lead to complications such as blindness and kidney disease. [4]
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DASH was first introduced at a meeting of the American Heart Association in 1996 and later published in the New England Journal of Medicine in 1997. [2] The DASH trial randomly assigned 456 people to different diets to test the effects of dietary patterns on lowering blood pressure. The authors surmised that eating a diet with many different foods with blood pressure-lowering nutrients would show a greater effect on blood pressure than eating single nutrients, such as found in supplements or in a limited diet. Three diets were tested: 1) a control diet, or a standard American diet, 2) a fruits and vegetables diet, similar to the control diet but providing more fruits and vegetables and less snacks and sweets, and 3) a combination diet rich in fruits, vegetables, nuts, and low-fat dairy foods with reduced amounts of saturated fat, total fat, and cholesterol. The last two diets were richer in nutrients associated with lower blood pressure, such as potassium, magnesium, calcium, fiber, and protein. All three diets provided about 3000 mg sodium, which is more than the recommended amount from the Dietary Guidelines for Americans but less than the average sodium intake for Americans. [3]
“There are many diet plans on the market today that promote good health,” says Emily Kyle, RDN, who is in private practice in Rochester, New York. “The key is finding one that does not cause you stress or agony.” Ask yourself questions such as: Would the diet guidelines make you happy? Anxious? Stressed? Are you able to follow them long term? “Factors such as enjoyment, flexibility, and longevity should be strongly considered,” adds Kyle.
I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.
I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.

I do know a little bit about nutrition (what heavy person doesn't?). I wanted a plan that followed sound nutritional guidelines and had some research to back it up. This one does. Marla does a great job of explaining why the things I learned about nutrition in my 20s aren't working for me in my 40s, and then lays out, clearly, concisely, and with menus and recipes, what *will* work...and it did. I was nervous about cutting down on grains--I attempted the Atkins plan a few times and it just made me sick--but I felt fine. The menu plans are satisfying and tasty, and Marla has really helped me to re-frame the way I think about food.
Readers will enjoy a diet rich in fruits, vegetables, low-fat and nonfat dairy, lean meats/fish/poultry, nuts/beans/seeds, heart healthy fats, and limited amounts of whole grains. Banished are the empty calories from refined grains and added-sugars. The result: improved metabolism, lower body fat, improved strength and cardiovascular fitness--with the diet plan proven to lower cholesterol and blood pressure without medication, and without counting calories!
The keto diet has been shown to help people lose weight in the short term; however, the long-term benefits of the diet aren't as clear, according to the Mayo Clinic. The diet is named for ketosis, which is the condition the body goes into when following the plan. In ketosis, the body uses ketone bodies, or water-soluble molecules produced by the liver and the breakdown of fatty tissue for cellular energy as opposed to sugars from ingested carbohydrates. And in some people, this results in weight-loss.
Research is continuing. This was just a pilot study,1 Dr. Saslow says, so we could test the effects in a small group in order to see if working with patients online offered an effective way to have people follow a weight loss program. In her next study, she plans to break down the components of a program to determine which elements are responsible for the weight loss and the decrease in blood glucose and HbA1c.

A review published in December 2015 in the journal Diabetes Therapy suggested ultra-low-carb diets were effective at managing blood sugar, decreasing weight, and managing cardiovascular risk in individuals with type 2 diabetes in the short term, but the benefits were not sustainable over the long term. When compared with higher-carb diets over a period of longer than about 12 weeks, the health results were similar.

Many CDEs actually have diabetes…it’s what draws them to choose this career…to help others with diabetes, to share their knowledge. Most already wear an insulin pump and continuous glucose sensors (CGMs) also. When I first became certified on each new pump and CGM, I would wear them (and check my BG 4-6 times per day) for 2-3 weeks, not only to learn the technology really well, but to gain a sense of how my patients must feel having to wear them 24 hours per day. Since, I’ve started a 6 month old baby on a insulin pump and CGM all the way up to a 89 year old…there are no boundaries for people with diabetes!


Yet it’s an incredibly well-rounded way to lose weight that ditches gimmicks and doesn’t require calorie or macronutrient counting as other diets do. And with the emphasis on healthy fat, it’s satisfying, too. That said, the 2019 U.S. News & World Report Best Diets ranked the Mediterranean diet as No. 1 for Best Diets Overall and it ranks 17 in their list of Best Weight-Loss Diets. (3) The reviewers note that it’s not a slam dunk, and all depends on how you eat. Even healthy diets like the Mediterranean aren’t free-for-all eating plans.

While the American Diabetes Association notes that many individuals with the disease or its precursor, prediabetes, employ carb counting to control their blood sugar on a regular basis, others have turned to ultra-low-carb diets as a way to manage their symptoms. These diets are highly restrictive and often limit followers to consuming no more than 20 grams (g) of carbs per day, usually with no added sugar, and, depending on the diet, increased protein and fat. Experts say they rarely have patients who ask about following a ketogenic diet or a modified paleo diet long term, but they can be useful for short-term weight loss if done properly.


Luckily today, we do not have to treat any type of diabetes with this barbaric method. There are so many healthy food options for most people today in modern society. In America, most of us are blessed to have access to healthy food options. I did see the research that Dr. Westman has completed at Duke University and did reference one of his articles above (reference #7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029/). I have no doubt the diet works, I’ve done it and lost weight really fast, so I know from firsthand experience that it works. You will lose weight which will have wonderful effects on every aspect of your health. The problem I have is, can anyone go the rest of their life without consuming anything white EVER? Do you think every author of all those books actually does that? I would offer to put them all on a lie detector to prove that they haven’t lived 40 years without consuming one white thing or one fruit or anything with sugar in it. My question is, what quality of life do they really have if they have? I for one will NOT be giving up my or my family’s birthday cake!
To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet. That’s what’s called optimal ketosis.

The keto diet is NOT what you seem to picture. I laughed at your description as I was eating lamb chops, cauliflower rice, broccoli, followed by cheesecake. How deprived I was! You should relook at what the diet really is. By the way, my cardiologist highly recommends keto. Most people see a drastic decrease in their triglyceride/HDL ratio. Looking at total cholesterol or LDL alone is 20 years out of date! Even the AHA has caught up, and now says that it’s NOT how heart health should be judged.

On the flip side, hypos can be an issue, especially early on…and if you treat them too aggressively, they could knock you out of ketosis. I remember my first 3 weeks on keto, my CGM trend line hugged a blood sugar of around 80.  It was glorious, but I had to reduce insulin substantially through trial and error and felt like I was low every five seconds.
WY conceived, designed, and coordinated the study; participated in data collection; performed statistical analysis; and drafted the manuscript. MF assisted with study design, performed data collection, and helped to draft the manuscript. AC analyzed the food records. MV assisted with study/intervention design and safety monitoring. EW participated in the conception and design of the study, and assisted with the statistical analysis. All authors read and approved the final manuscript.

Thank you for your comment and your kind words Beverly! The diet you follow is quite restrictive and restricts most foods that are part of the Mediterranean diet. I have not seen any evidence of such a diet being anti-inflammatory. A traditional Mediterranean diet is considered an anti-inflammatory diet. The arthritis foundation also recommends a Mediterranean diet (https://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/anti-inflammatory-diet.php). You can also check this article from Harvard for additional insight: https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation

Meat – like grass-fed selections – and fresh veggies are more expensive than most processed or fast foods. What you spend on Keto-friendly foods will vary with your choices of protein source and quality. You can select less-expensive, leaner cuts of meat and fatten them up with some oil. Buying less-exotic, in-season veggies will help keep you within budget.
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