November is National Diabetes Month
I blinked and November arrived! Every November is American Diabetes Month. Diabetes is one of the reasons I became a dietitian. My dad was diagnosed with type 2 diabetes when he was 40- the year that I was born. I always harbored this guilt that I had something to do with it.
I became interested in nutrition as I watched my dad manage his diet for years. Part of his routine included skipping birthday cake, opting for fruit, taking multiple medications, and going for walks in the mall after retirement. My mother developed diabetes later in life and as a health professional with a normal BMI, I now have prediabetes. Genetics are against me.
Does Low-Carb Help?
Much as I love pasta, bread, fruit, and other carbs, a small study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism suggests that adults with type 2 diabetes may better manage their blood sugar and potentially stop diabetes medication using a low-carb diet. This is due to improved beta cell function, the cells in your pancreas that create and secrete insulin.
Over 38 million Americans have diabetes with more than 90% of them with type 2 diabetes. The development of type 2 diabetes is more often seen in people over 45 but children, teens, and young adults are also being diagnosed with diabetes.
Individuals with type 2 diabetes have impaired beta-cell response to blood sugar, which could be related to consuming too many carbohydrates. In addition to beta-cell failure or lack of beta-cells, insulin resistance is the main culprit in the development and progression of type 2 diabetes.
Insulin resistance happens when enough insulin is made in the body, but cells in the body don’t respond to it. This causes the pancreas to secrete more insulin, but blood sugar does not come down from it.
Barbara Gower, Ph.D., of the University of Alabama at Birmingham in Birmingham, Ala notes, "This study shows people with type 2 diabetes on a low-carbohydrate diet can recover their beta-cells, an outcome that cannot be achieved with medication. People with mild type 2 diabetes who reduce their carbohydrate intake may be able to discontinue medication and enjoy eating meals and snacks that are higher in protein and meet their energy needs."
Who was Studied?
The researchers collected data from 57 White and Black adults with type 2 diabetes. Half were following a low-carbohydrate diet and the rest were on a high-carbohydrate diet. The researchers evaluated their beta-cell function and insulin secretion at the start and after 12 weeks.
Meals were provided for all of the subjects. Those on a lower-carb diet consumed 9% carbohydrate and 65% fat. Participants on the high-carb diet consumed 55% carbohydrate and 20% fat.
Improvements in the acute and maximum beta-cell responses were discovered by the researchers for those on a low-carb versus high-carb diet, 2-fold and 22% greater, respectively. Black subjects adhering to a low-carb diet experienced a 110% greater improvement in the acute beta-cell response while white participants showed improvements in the maximal beta-cell response that were nearly 50% compared to those on the high-carb diet.
Gower noted that "Further research is needed to determine if a low-carbohydrate diet can restore beta-cell function and lead to remission in people with type 2 diabetes.”
If you have diabetes or prediabetes, below are tips to reduce carbohydrates in your diet:
1. Focus on nutrient-dense foods. Reduce intake of “fluff” such as sweetened beverages, high-sugar desserts, candy, pastries, and other treats. If nothing else, don’t consume them daily.
2. Include protein in all meals and snacks. Including protein at meals helps to stabilize blood sugar and prevents spikes. Eggs, lean meat, dairy products, fish, and poultry are good sources of complete proteins. Tofu and edamame count, too.
3. Eat healthy fats. Fats used to be vilified but should be included as part of a healthy diet. Avocados, chia seeds, ground flaxseed, olives, olive oil, nuts, seeds, and nut butter are welcome.
4. Manage weight. A small weight loss is beneficial in improving insulin sensitivity. A 5-7% loss may be the difference of taking or avoiding medication for some people.
5. Get moving after meals. Post-prandial blood sugar is better if you walk or do another aerobic activity for 15 minutes after eating.
6. Sleep enough! Aim for 7 to 8 hours of sleep per night. When sleep is poor, blood sugar goes up.
7. Eat more low-carb vegetables and smaller servings of grains and other carbs. Asparagus, Brussels sprouts, cabbage, celery, kale, mushrooms, onions, peppers, spinach, and zucchini are low in carbs. Make half of your plate veggies.
8. Snack on low-carb foods versus crackers, pretzels or chips. Nuts and seeds are low in carbs, too. Enjoy fruit with fat (like nut butter) or protein (such as cheese or a hard cooked egg).
9. Include a few servings of high-fiber carbs per day such as rolled oats, whole-grain bread, brown rice, or quinoa.
10. Monitor your blood sugar with regular check-ups, finger stick checks or a CGM (continuous glucose monitor). Ask your doctor or healthcare provider what’s right for you.
Reference:
Barbara A Gower, Amy M Goss, Marian L Yurchishin, Sarah E Deemer, Bhuvana Sunil, William T Garvey. Effects of a Carbohydrate-Restricted Diet on β-Cell Response in Adults With Type 2 Diabetes. The Journal of Clinical Endocrinology & Metabolism, 2024; DOI: 10.1210/clinem/dgae670