This is a detailed article about what happened when I tried to experiment with a low-fat, high-carb diet led by Cyrus Khambatta from Mastering Diabetes for “ultimate” sensitivity to insulin.
This is a lengthy post because I want to do the experience justice. I also want to give enough detail to give proper credit and acknowledgment to those who do enjoy and thrive while eating a high-carb, low-fat, plant-based diet.
But by Day 9 of this experiment, I’ve realized I’m not one of those people.
Before This Experiment
My “usual” over the past few years has varied between a low-carb diet (50 grams or less of carbs) or a lower-than-average carb diet (100 grams or less). And sprinkled in there are also indulgences like gluten-free pizza or the incredible gluten-free chocolate cake I made for my twin brother when he came to visit or gluten-free Christmas cookies. (Yup, diabetics can eat cookies!)
My point is: I save my carbs for the good stuff: pizza night, burger night, and occasional homemade desserts. Pizza night is probably 3x a month. Burger night is far rarer, 1x a month at most.
I’ve managed to keep my A1C between 5.5 and 6.5 with this flexible approach to eating mostly whole foods, mostly low-carb, and “saving” room in my “carb budget” for the carbs that I enjoy the most. This also makes blood sugar management around those treats easier because your low-carb choices all day required very little effort and insulin/carb juggling.
You can also keep your carb intake still relatively low if you’re just indulging once per day (or once per week, etc., your choice), so you’re preventing any feeling of deprivation but still eating a mostly lower-carb diet.
I was also a big fan of intermittent fasting prior to this experiment, and I continued to do 16-hour fasts while following Cyrus and Robbie’s program.
My insulin doses before this high-carb experiment
- My Tresiba (basal) dose was 10 units. (Prior to getting Norovirus, my Tresiba dose was at 11 units. But a week of consuming only Gatorade and rice cakes is inevitably going to bring that down.)
- My insulin-to-carb ratio using Humalog was generally 1:12 (1 unit of Humalog for every 12 grams of carbs).
- My correction factor was generally 1:100 (1 unit would reduce my blood sugar by 100 points).
Over the past 10 years: I’ve experimented with high-protein/low-carb plans, ketogenic eating, being pregnant & eating a giant bowl of cereal every day because otherwise my pregnant soul simply could not go on—seriously!
I ate lower carb during pregnancies than the average person, but it was still high-carb for me…and my A1c stayed between 5.1 and 6.1 because of diligent blood sugar checking and expected fine-tuning of insulin doses as pregnancy with type 1 diabetes progresses.
I’m a big, big, big believer that different phases of life call for different shapes of eating.
A sample typical day of low-carb eating, for me, looked like
- Fasting until 12 p.m. or 1 p.m. (Occasionally I would eat as early as 11 a.m. if the toddler and 10 months old were trying my energy and patience more than usual and I needed fuel ASAP).
- My first meal would be a flaxseed muffin in a mug with butter or peanut butter, OR a big green salad with 2 eggs OR sauteed/air-fried veggies (cabbage, broccoli, onion, carrots, etc.) with 2 eggs.
- My second meal would be an apple & 2 slices of cheese OR carrots & hummus OR homemade eggplant chips with olive oil, paprika & salt (made in the food dehydrator)
- Some days, I would strive to not eat again so that when my husband comes home from work, I could hop on the treadmill for fasted cardio which ensures I would burn fat for fuel rather than glucose if it had been 4 hours or longer since my last meal.
- Or if I was just plain hungry, I might have an Orgain protein shake with unsweetened almond milk & peanut butter (if I hadn’t had peanut butter already that day) OR sauteed tofu with salad OR homemade Psyllium Husk Rolls with butter…(which are awesome for your digestive tract, by the way! And require zero insulin).
- And lastly, dinner would be something as simple as steak and veggies OR low-carb BLTs OR edamame fettuccine with sautéed veggies and homemade meatballs OR a giant salad with (gasp) full-fat commercial salad dressing & a bunless hamburger OR a high-carb indulgent treat of tacos or pizza.
- During the month of March, my discipline in the treats and sweets department was pretty lacking. I ate low-carb during the day but indulged more nights than not in some variety of wine, chocolate, or a high-carb/high-fat dinner like pizza or burgers. That being said, I didn’t gain weight and my insulin needs didn’t change because the rest of my day was still very low-carb and consisted of whole foods.
In some order, which varies, those are my go-to meals lately.
Why I wanted to give High-Carb/Low-Fat a try
I began this high-carb, low-fat experiment on April 1st for a few reasons.
- I was feeling bored and unmotivated by my current eating. While I enjoyed all of those foods, it was very much tried and true and there wasn’t much “experiment” left to it. And I’m a girl who clearly loves to tweak and experiment and see what happens.
- I’ve always respected Cyrus Khambatta’s completely controversial passion for his plant-based high-carb, low-fat approach to thriving with diabetes. I published many of his articles at DiabetesDaily during my 5 years as Editorial Director, and stand by the fact that there is no one-size-fits-all diet for everyone. If you feel best eating beans and strawberries all day, good for you! I don’t need to convince you to eat my way if you’re enjoying eating yours. But hey, if you’re looking for help, I’m happy to share my two cents on what works for me and many of my friends.
- I had just gotten Norovirus (most likely from the local children’s library), and after 5 days of eating nothing but Gatorade and rice cakes, I realized I was perfectly primed to give Cyrus’ approach a shot. He had explained to me earlier that it’s essential to give your body a bit of “transition time” if you were previously eating a lot of fats. Your liver and your muscles are (in layman’s terms) storing a great deal of extra fatty acids, and switching suddenly to high-carb isn’t gonna be pretty if you rush that transition phase.
- I did still want to lose those remaining 10 lbs. And while eating clean and low-carb has always worked well for me in the past (my postpartum weight loss being the most recent case in point), I was ready to be open-minded and experiment with something new.
The “Mastering Diabetes” High-Carb, Low-Fat, Plant-Based Program
In a nutshell, (because if you really want to try it, you should become a member and learn from the experts, not me), Cyrus Khambatta, Ph.D. and Robbie Barbaro teach an approach to diabetes management and nutrition that is the direct opposite of a ketogenic diet.
You should know: Cyrus and Robbie are two of the most upbeat, positive, and passionate nutrition coach fellas you could find. They are 100% dedicated to their mission of teaching people how to achieve healthier lives with diabetes through their program, and that dedication is admirable.
I have a great amount of respect for both of them even if I don’t feel that their program is right for me.
The gist: Achieve ultra-sensitivity to insulin through an extremely low-fat diet that is high in carbohydrates from “plant-based, whole foods.”
Your daily fat intake goal is between 20 to 30 grams of fat. While 30 is considered within the goal, Cyrus emphasized that keeping your fat intake down at 20 grams per day leads to mega-mega changes in insulin sensitivity and insulin resistance.
Confused?
Yes, eating a low-carb diet reduces your need for insulin, but overall, Khambatta and Barbaro teach that it can make you more insulin-resistant because fats “blunt” our sensitivity to insulin.
A ketogenic diet (or low-carb diet) works because even if you are technically more resistant to insulin due to the high-fat intake, your carb intake is low enough that your insulin needs are still plenty low regardless.
If you’ve ever tried this approach, you know that when done properly it makes nearly non-diabetic blood sugar levels practically effortless–taking 1 unit here and there for low-carb meals of protein/fat and veggies.
Cyrus and Robbie, on the other hand, teach folks to severely reduce their fat intake with a goal of 20 to 30 grams total daily, and thus make your insulin needs for large quantities of carbohydrates much lower.
A bowl of bananas and mangos for breakfast? A lunch of beans, corn, spinach, oranges, and berries? A dinner of brown rice and more veggies and more fruit? You bet. Tons of carbs. It took 300 grams easily for me to meet my nutritional needs as a 5’2 female. Easily 600 grams for active males.
A sample day of high-carb eating for me looked like
- Fasting until 1 p.m. (this was harder on this diet, I felt pretty damn hungry by 11 a.m. and waiting impatiently to end the fasting window
- Oat bran with blueberries, salt, and cinnamon
- Homemade 3-bean salad with sautéed veggies (onions, celery, corn)
- Apple, strawberries, and a couple times I had gluten-free Fig Newtons to treat lows
- Protein shake of Orgain protein powder with unsweetened almond milk
- Black bean pasta with tomato sauce & salad OR potatoes with green beans
Their client testimonials include a variety of type 1 and type 2 diabetics who have reduced their insulin usage, reduced their A1c levels, and are eating 300 to 600 grams of carbs per day. This clearly has worked well for a variety of people.
Like all extreme diets, the question we can never answer for sure is how long people continued to follow this diet (or a keto diet) after a testimonial was written.
Regardless, when you severely reduce any one macronutrient, you’ll need to compensate by drastically raising your consumption of another macronutrient.
- In the bodybuilding world, it’s usually fat that’s decreased. Protein goes up dramatically and carbohydrates are carefully placed for maximum usage for recovery.
- In Khambatta and Barbaro’s approach, fat is severely decreased. Carbohydrate consumption rises dramatically, and your protein consumption is more moderate.
- In the low-carb/ketogenic world, carbohydrate consumption is severely decreased. Fat consumption rises dramatically, and protein consumption is more moderate.
An aspect of their philosophy where I really disagree with Cyrus and Robbie is here: Within their program, you can find a detailed explanation of non-diabetic blood sugar “norms” and A1c goals vs. diabetic blood sugar “norms” and A1c goals.
They argue that non-diabetics have blood sugars fluctuating up to 140 mg/dL regularly. If this were the case, however, non-diabetic A1c levels wouldn’t be in the low 5s and high 4s. This argument, seemed to me, like an attempt to dismiss the issue that carbohydrates do in fact raise blood sugar more than any other food.
While I absolutely believe people with diabetes should strive for A1c levels that feel safe and sustainable to them, there is no denying that an A1c of 6 percent is still much higher than a non-diabetic would see from “perfect” blood sugar levels.
Within the first week of eating high-carb/low-fat: After two or three days, I dropped my 10-unit Tresiba dose down to 9. On Day 3, I went out to dinner with my husband for our anniversary and ate gluten-free pizza and gluten-free beer and gluten-free cake! It was delicious. But obviously didn’t follow the program at all.
I did a 24-hour intermittent fast that day to help compensate for the extra load of indulgent calories, carbs, and fat. But it was delicious and worth every unit of insulin.
By the next morning, I was back to business and ate following the program: loads of veggies, some grains, no added oils (even in salad), and fruit. And potatoes!
I could definitely feel my body burning through the food I was eating. And to be honest, food was all I could think about during my non-fasting window of about 1 p.m. until bedtime. As Cyrus warned me, when you’re eating this way, it takes a lot more calories and larger quantities of food to feel full and get what you need.
“If you’re hungry, eat,” he encouraged. And I was. Very.
By Day 5: Eating oat bran (rather than oatmeal) was starting to give me that same lethargic feeling that oatmeal and rice have given me in the past. I just don’t feel good when I eat those foods. It’s more extreme with the oatmeal but I was feeling it with the oat bran, too. My body is not fond of grain. Even in a low-fat diet.
I did notice that when I did need to correct a high blood sugar, it came down much more quickly than when I was eating a diet lower in carbs. With so little fat in my diet, my insulin worked much more quickly in my system and affected my blood sugar much more quickly, too.
By Day 6: I had lost 1 pound according to the scale. I was feeling some momentum, and I clearly hadn’t even done it 100%. I was also enjoying the challenge of minimal fat intake.
But I should add that I’ve never been a “gassy” person and holy moly, the daily bean intake was making me extremely gassy. I eat a lot of fiber in my usual diet, so my digestive tract is plenty accustomed to high-fiber intake, but the beans are another story.
And this gassiness continued on every day. It also made me feel surprisingly constipated — something else I’d never felt on my usual nutrition plan.
By Day 7: Despite seeing clear evidence of mega insulin sensitivity, this is when things started to unravel a bit, including my enthusiasm.
My insulin doses after 1 week this high-carb experiment
- My Tresiba (basal) dose was down to 9 units.
- My insulin-to-carb ratio using Humalog was clearly 1:25 during the day and possibly as high as 1:30 in the evening. (I would’ve needed more time to experiment and confirm the exact gram ratio but it was clearly much, much higher.)
- My correction factor was the same at 1:100 but as mentioned earlier, it did seem like my corrections took effect much faster now.
- My weight loss was still at the 1-pound lost mark mentioned earlier. (Which, considering it’s only been 7 days, seems pretty reasonable and what Cyrus advocates in his program for weight-loss pace.)
Despite my declining insulin needs, I was noticing that I felt like my blood sugar was high even when it wasn’t. I felt that sort of lethargic, thirsty feeling that comes with blood sugars around 250 mg/dL or higher.
I was checking my blood sugar more often to see if I was indeed high, but I wasn’t. Even at 90 mg/dL, I just felt that icky high blood sugar feeling. And brain fog like whoa.
I also had developed a headache that wouldn’t budge with more water or Asprin. Can I say that this headache was absolutely the result of this high-carb diet? No, but headaches are a truly rare thing for me, and this was the only change in my life at this time.
And, my digestive tract was continuing to fight off all the legumes. Gassy to the max. And while I was (TMI alert) pooping twice a day in my previous low-carb diet, I was now only pooping once a day and it was not an effortless poo, I’ll just put it that way.
But I continued to follow the program, eating entirely vegan all day long, whole foods.
Your goal on their program is to eat fewer than 30 grams of fat per day. And that might sound easy at first, but simply eating an entirely vegan diet up until dinnertime could add up to 17 grams of fat (yup, even oat bran has 4 grams of fat).
The idea of striving to meet their ultimate goal of only 20 grams of fat seemed pretty impossible, and I am amazed that women following this program can do that while still getting enough fat to maintain proper hormone levels and menstruation.
Then I ate cheese at dinner!
What I wasn’t aware of when I headed into this experiment is that the program expects your 20 to 30 grams of fat to be made up of entirely vegan foods. Using the remaining 15 grams of fat in my total allotment on Day 6 in the form of cheese for tacos in which steamed purple cabbage was my substitute for ground beef was actually not okay.
The entire rest of my day was vegan but the presence of 10 grams of fat from cheddar cheese (which put my fat quantity at 31 grams) was not allowed because it’s not “plant-based.”
(Neither were the corn tortillas because they are processed. It didn’t matter that the rest of my day was whole foods I cooked myself…the expectation was zero processed foods.)
My understanding was that as long as my fat intake was 30 grams or below (yes, I went 1 gram over), it was up to me how that dietary fat allotment was spent. But their definition of “plant-based” actually meant vegan.
Cyrus later explained that they don’t use the term “vegan” when describing or teaching their program because of the negative connotations that can go along with it. Honestly, had I known he expected 100 percent veganism, I wouldn’t have signed up for it because I firmly disagree with it — but I’m not going to start a debate on that here — it’s unnecessary and my thoughts on it aren’t unique.
Not knowing veganism was the expectation, I posted a picture proudly of my corn tacos with water-sautéed purple cabbage, cheddar cheese, and taco seasoning. I posted this picture in the Members Only “Mastering Diabetes” Facebook group.
Many of the reactions were positive and supportive–congratulating me for skipping the beef and embracing the vegetables. And sharing their personal approaches that they used to eat cheese, but over the course of weeks or months, they gave it up and don’t miss it. Along with meat, too.
(I would love to quote some of the incredibly kind and supportive comments from other members but I left the group and therefore don’t have access to those direct quotes anymore.)
And some of the reactions–primarily from coaches of the program (there are additional coaches besides Robbie and Cyrus)–came in the form of lectures that cheese is absolutely not part of this program. As well as several directions to “The goal is 20 to 30 grams of plant-based fat. Go back and review the course materials to learn how to construct a perfect dinner.”
This language and expectation of 100 percent compliance within the first week of the program left me feeling incredibly alienated and criticized. I knew that even while continuing with the program, I wouldn’t be posting any more pictures or trying to engage in discussion about my personal experience.
I want to note that this same kind of unfriendly interaction could easily happen in a ketogenic group if someone said they ate fruit. It’s a “100% or nothing” kind of mentality that simply doesn’t work well for me, but it does work well for some others.
Anyway: I went to bed that night with a blood sugar of 60 mg/dL, which I treated with 8 grams of carbs and went to bed.
I woke up in the morning with a blood sugar of 350 mg/dL–which was clearly a direct result of the cheddar cheese. When I told Cyrus about this spike, he assured me that’s incredibly normal and what he would expect to see when you eat 10 grams of fat from saturated fat rather than plant-based fats. The fat, simply put, cause a tremendous spike in my blood sugar over the course of hours.
Do I want to be on a diet that makes my body overreact so severely to saturated fat that one serving of cheese suddenly spikes my blood sugar by 200 points?
This is another area where I really disagree with Cyrus’ and Robbie’s approach in that they’ve concluded that this means people with diabetes shouldn’t eat saturated fats or even most sources of fat because clearly, they raise blood sugar.
But I can tell you that in my normal low-carb eating approach, I could easily eat 10 grams of cheddar cheese and my blood sugar would not rise at all. Instead, the carbs would be what caused a dramatic spike in blood sugar.
- The extreme route with the ketogenic diet is to wipe out all carbs because “they raise blood sugar.”
- The extreme route within Cyrus and Robbie’s approach is to wipe out all fats because “they raise blood sugar.”
In reality, it seems to me that the extreme reaction from one macronutrient is a direct result of the extreme consumption of another macronutrient.
I could easily argue that Cyrus and Robbie’s approach to eating so many carbs makes me way too reactive to fats, which raises my blood sugar and thus means I shouldn’t eat so many carbs.
By Day 9: I felt like one big starchy bean. My blood sugar felt high all day even though it wasn’t. I felt foggy and thirsty. And I was confident in what was causing this: this high-carb diet. I felt like my veins were full of starch. And that headache that started on Day 7 was still rocking hard.
And that’s when I decided that starting on Day 10, I would transition back to a lower-carb eating with a newfound understanding of/or appreciation for:
- Using my new air-fryer! (I have been cooking nearly everything in this and I love it! )
- Feeling incredibly grateful for the clarity and constant energy that comes with a disciplined lower-carb diet
- Make an extra effort to ensure that my low-carb eating consists of lots of vegetables
- Cyrus talked to me in great detail about the immense value of making sure you are rotating your insulin injection (or pump) sites. The more you inject into one area, the more scar tissue and thus insulin resistance will result. I’m pretty lazy about rotating, so this is a valuable lesson and reminder that I will strive to carry forward.
- Feeling re-motivated to reduce the treats I was eating in March and lose that final 10 pounds that’s clinging mostly to where those two babies of mine were pulled from via c-section. Losing those 10 lbs would get me to a leanness that would enable me to see my abs and that’s simply a fun goal.
By Day 10: I fasted until 1 p.m. and then ate a meal of 2 eggs over-hard with a giant bowl of veggies from my air-fryer (which I would normally have just steamed and lightly oiled in a pan). I didn’t feel hungry again for hours after that meal. By the time 4 p.m. came around, that thick starchy feeling was subsiding and I was starting to find my natural energy and clarity from a lower carb approach to eating.
I realize that I definitely did not give this approach of eating as much time as Cyrus would have preferred before I came to any conclusions, but I honestly felt so lethargic and “starchy” that I couldn’t keep doing it. It’s not the right fit for me. And YES, it absolutely did make me more sensitive to insulin but the trade-off, for me, wasn’t worth it.
UPDATE: By Day 20: Transitioning back to my usual eating took a little “eating anything” route for a few days (maybe days 11 thru 14) where I just truly felt like my body wanted to eat anything that was gluten-free and calorie-dense, perhaps to compensate for the ultra low-fat intake of 10 days.
A rebound, for sure. But, I also started exercising again–only then did I realize that during my high-carb, low-fat experiment was my energy feeling a bit more precarious and I hadn’t had the energy stores to feel like jumping rope regularly. I could feel my body so thoroughly burning through everything I ate, the idea of exercising was just passively unappealing.
By Day 15 of eating “my” way, I was jumping rope again every day, for up to 45 minutes and feeling very energetic. (I recently realized I can do this form of exercise in my living room, while the baby is napping and the toddler is playing, while fasted, and it doesn’t cause any issues with my fibromyalgia sensitivities!)
Insulin Doses, Weight-Loss, etc.
- I’ve also lost another pound, down to 123. Eating between 1600 to 2000 calories based on how much jump-roping I did and overall hunger cues!
- I raised my Tresiba background insulin dose to 10 units initially, but I’m back down to 9 units. I’m considering dropping to 8 units as I type this because I’ve had recurring lows over the past 24 hours.
- My carb ratio is about 1:15 or 1:20 depending on when I last jumped rope!
- My correction factor is out of control sensitive which is why it’s definitely time to first adjust my basal insulin dose (mentioned above) and then see where my correction factor is. A correction factor of 1:150+ is a big, big sign that there’s too much basal on board.
- I’ve been eating my whole-foods, fairly high-fat diet. Carb intake is about 100 net carbs, but I’ve had a few days that were higher, too, around 150 net carbs.
- Real food. Plenty of fats. Lots of veggies. Some meat. Some fruit. Avoiding sugar or “treats” except for the weekend and those are treats I baked myself. Or my favorite gluten-free pizza! PIZZA! AHHH! I love pizza.
- ..TMI…my bowel movements are back to their usual, effortless, happy selves. (Yes, I just gave bowel movements their own identity and emotion.)
By Day 25: Eating delicious things like homemade pumpkin chocolate mousse (with real sugar), my background insulin dose is now down to 7 units…because of jumping rope for 30 to 45 minutes a day! Holy insulin sensitivity, Batman! Why bother with an extremely restrictive diet when jumping rope makes insulin like super juice? Loving it.
In a sense, it comes down to which argument you like best because we can find a zillion studies that support each side’s argument: eat less fat and more carbs vs. eat more fat and less carbs.
Cyrus and Robbie argue that ketogenic and low-carb diets that consist of large quantities of fat lead to heart disease, high triglycerides, and high cholesterol but there are plenty of cases of research proving this to be an outdated myth and misconception.
Pro-Fat Arguments, Studies & Experts
Here are just a few of those studies and arguments from experts why fat does not raise your risk of heart disease and cholesterol…
A great place to start reading is how the philosophy of low-fat philosophies actually began in this document from the History of Medicine & Allied Sciences.
- The Diet-Heart Myth: Cholesterol and Saturated Fat Are Not the …
- Cholesterol | The Nutrition Source | Harvard T.H. Chan School of …
- Rethinking dietary cholesterol. – NCBI
- Why Eggs Don’t Cause Heart Attacks – DiabetesDaily
- Everyone Was Wrong: Saturated Fat Can Be Good for You | Greatist
- Large diet study suggests it’s carbs, not fats, that are bad for your …
There are tons and tons of people who are thriving on low-carb or ketogenic diets. Their lab work easily disproves the myth of “dietary fat raises cholesterol levels.”
We could go on and on arguing about this but the fact is that people have now been eating this way for years and many are reporting great results and great health.
Pro-Carb Arguments, Studies, and Experts
And then, there are a variety of arguments trying to make the case for a low-fat diet, too…and with that are tons of people who feel best on this type of eating rather than low-carb eating!
- The China Study – T. Colin Campbell Center for Nutrition Studies
- Q & A with Dr. Neal Barnard – Vegetarian Times
- The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease
- Interview with Cyrus Khambatta on Treating Diabetes with High-Carb/Low-Fat
- Doug Graham’s Raw Food Philosophy
- (I honestly had trouble finding more studies because every time I googled “low-fat diets and high cholesterol,” I just got more results for why dietary fat does not lead to high cholesterol.)
So, Can’t We All Just Get Along?
Does there have to be only one way to eat for health? Must we promote our own approach only by bashing someone else’s?
I do wish that Cyrus and Robbie would consider offering a more middle-ground approach for people who want to learn how to better incorporate carbs in their diet without becoming a severely low-fat vegan. And that their online community, in general, would be open to “less than perfect” meals so that those who aren’t on board with being fully vegan could still be part of that higher-carb community and supportive discussion.
I also wish that both sides could appreciate the simple fact that there is more than one way to be healthy in life with diabetes. Your plan does not succeed based on the failure of another plan. We all respond differently to different approaches…and that’s really okay.
I’ve been directing people to Cyrus’ site for years whenever I hear come across someone expressing frustration that low-carb isn’t working for them or that they simply don’t want to eat that way. I wish the two extremes of eating could respect each other’s differences and appreciate each other’s passionate devotion to what works best for them.
I tip my hat to all the high-carbers and all the low-carbers, because both require tremendous discipline.
Personally, I’m finding the extreme swing in either direction to be the biggest turn-off for me at this time in my life, and in my own health, it feels unnecessary. There is a middle ground. It’s very possible to eat a lot of plant-based foods on a lower-carb diet. Which personally feels far more balanced to me. And why on earth must I completely give up gluten-free pizza just to obtain ultra-sensitivity to insulin when I wasn’t struggling with insulin resistance in the first place?
FACT: Carbs do raise blood sugar. But it’s very easy to survive without them because your body will convert more protein into glucose for additional fuel, and burn ketones for fuel if carb intake is low enough. Burning ketones for fuel has proven to be very safe and effective, even treating conditions like epilepsy. Babies are in and out of ketosis regularly, even when breastfeeding.
- At the same time: there are many people for whom a low-carb or ketogenic diet simply doesn’t work for any variety of reasons. They thrive eating this high-carb, plant-based, low-fat approach. And that’s great!
FACT: Fats do cause varying degrees of insulin resistance. But does that mean fats are the enemy? The body cannot function without fats. This is a fact.
- And there are many people for whom eating a vegan diet led to a variety of extremely negative symptoms. Eating a low-carb, higher fat diet leads to awesome energy, better blood sugars, and sustainable weight loss. And that’s great, too!
Fortunately, you get to choose how you eat. You get to experiment and see what feels right to you. Why must everyone follow the same protocol?
Achieving ultra-sensitivity to insulin does not automatically equal health in the same way that achieving flat-lined blood sugars through a ketogenic diet doesn’t automatically equal health. Your health is more complex than that.
I’m happy I was open to experimenting, but what I’d love to see next is how my pal Cyrus felt on a low-carb diet! Although, I think asking him to try that might be asking too much.
Regardless, I admire Cyrus and Robbie’s passionate dedication to their own philosophies on food and thriving with diabetes. They’re clearly helping many people with their program–and that’s what matters! Find what works for you, be open to experimenting, and never stop learning and studying your own diabetes.
If you are interested in eating a high-carb, low-fat vegan diet, I highly recommend checking them out at MasteringDiabetes.org. They are passionate, genuine and eager to teach more people their unique approach to eating.
Personally, I think a large majority of people don’t do well with the extremes of ketogenic or this low-fat vegan approach. Both eliminate tons of different types of food, are hard to sustain long-term, make social food-related gatherings feel awkward and impossible, and heck, they take a lot of the FUN out of so many delicious foods the world has to offer!
I think a large majority of us, diabetic or not, would thrive from focusing on a few simple things:
- More veggies
- More whole foods
- Fewer processed products
- Less alcohol
- Fewer $7 coffees from Starbucks that contain 80 grams of sugar
- Just more real food in thoughtful moderation with a twist in quantity that you know works well for you.
- And room for the occasional treat like ice cream, pizza, or tacos! If that’s what works for you!
What works best for YOU? Listen to your body and create your own success.
Jon
Great article, very detailed. My 8 year was recently diagnosed and my wife is reading the book *The Diabetes Solution* so I’ve been trying to understand it better and others experiences.
As for a vegan diet. My wife used to be more vegan and, consequently, I ate that way most of the time. My cholesterol was actually low after many years of that diet with meat interspersed sporadically. Granted I have Hashimoto’s so that might have been part of it or maybe my liver just didn’t kick into gear for some reason. Vegans can actually have high cholesterol since their liver over compensates not having enough meat products. Just google that :-). Also, it doesn’t seem like a very natural diet since you will need to take B12 supplements in order to stay healthy and you need to make sure your cholesterol levels are healthy, as I mentioned before.
Also, do you know if someone is living a strict low carb diet do they need a pump? It sounds like you use one. I was thinking a pump makes it easy to change the basal rate for when you are sick rather than doing 2 long acting shots every day. With a pump you can make the change and within two hours its working at the new rate. We will probably do Medtronic 670 since that is what our insurance covers and it has the hybrid closed loop system. I imagine that my daughter won’t be perfect as we move her to a more strict diet – granted it will probably not be super strict maybe closer to yours at first where special treats once a day or every few days is OK. Granted I won’t know until I get her buy in if we actually do it.
Ginger Vieira
Jon!
So I do NOT actually use a pump, but I did for the first 7 years of my life with type 1 (going on year 20 with T1 now). I do think everyone should try a pump if they can (for people without insurance, this is nearly impossible).
I prefer MDI (multiple daily injections) with Tresiba and Novolog now because no method of insulin delivery is perfect. For me, the stress that comes with pump-site failures and the high BGs that come with that were far more stressful for me than having to take 8+ injections a day and having less flexibility.
Pumps are ABSOLUTELY still an option if your daughter eats low-carb. Personally, I think it’s great to focus some meals on low-carb, but especially for children, I think a super strict low-carb diet sets them up for disordered eating and unhealthy relationship with food as they grow. If my daughter had diabetes, I would want to teach her how to balance her BG and insulin dosing around cupcakes at a birthday party rather than telling her she can’t have any. But I would try to make sure her breakfast was low-carb so she started the day off on the smoothest step. Personally, I eat low-carb during the day but if I want fruit in the afternoon, I eat it and dose for it. And I eat some form of carb every day in dinner or homemade desserts if I make them.
I’ve done the strict low-carb thing for years, and find it’s just not right for me at this time. For someone as young as 8, I think choosing the carbs that she loves the most and then focusing on lower-carb options for other meals would be the healthiest (mentally and physically) way to go. Just my two cents! There’s lots of parents who disagree with me…but I don’t think those parents grew up with type 1 diabetes like I did!
(p.s. on the cupcake thing, when it comes to meals that are HIGH in fat and HIGH in carb, like cupcakes or lasagna or pizza, it’s all about remembering how slowly that food digests. I take a small bolus when I start eating, and then I take a much bigger bolus 3 or 4 hours later. Trial and error, take good notes, and try again.)
Suzanne
Great article!! I’m not diabetic, but data and body composition obsessed and have spent the last 3.5 years eating to various programs. I spent 6 months in strict nutritional ketosis (1.5mmol – 4.5mmol), another 18 months eating LCHF (.5 to 1.0mmol), then did a 10 day water fast at TrueNorth Health Center followed by 2 months of Cyrus-style eating: WFPB very low fat. I lost no weight during that 2 months (I’m 123 pounds but striving to drop below 20% body fat and neither weight nor body fat budged), however I lost 2 pounds in the 5 weeks that followed….in Italy and Spain…eating loads of fish, fruit and olive oil.
In the last 6 months I’ve learned I’m extraordinarily insulin sensitive (2 OGTT’s with insulin max’s of 20 and 30 commensurately both led to hypoglycemia, and a 14 day CGM showed 17 incidents of hypo lasting on average 353 minutes) and now your article sheds light on why that might be. YOu wrote: “when I did need to correct a high blood sugar, it came down much more quickly than when I was eating a diet lower in carbs. With so little fat in my diet, my insulin worked much more quickly in my system and affected my blood sugar much more quickly, too.”
This could be exactly my issue, except my insulin is endogenous, not exogenous, i.e. with so little fat in my diet, I need only a tiny amount of insulin to bring my blood sugars back in line, and even low relative insulin levels, the over-corrections are too much for me. I think I need more fat, but not as much fat as I was eating in a LCHF or Keto environment.
I’m currently eating 120g protein, 150g net carbs and between 20-40g of fat, but I’m still going hypo at night. I know this because I wake up hot, startled and ravenous. So I’m going to up the fat to the 40g marker and see how I fare. So grateful for you sharing openly and in great detail!!
I also agree with you about diet wars. It’s time we get passed the chest thumping and pulpit pounding. Keto works well for some people. LCHF works well for others. A zone diet works for some. And a Low-fat, WFPB diet works for others. Anyone who sticks to any of those diets (or to a combination over time), who maintains a healthy weight and great biomarkers should be commended!!
Thanks again!
Ginger Vieira
Hi Suzanne! Wow, thanks for sharing your very detailed and interesting results from experimenting with your macros! I’m curious to know if your hypoglycemia subsides by eating less fat? The non-diabetics I know who have hypoglycemic episodes find they are triggered by eating very carb-laden foods. By avoiding those carbs, their hypos are far less frequent. Let me know how it goes for you!
Thanks for reading!
Michael
Question for you: When you say your carb ratio was 1:25, sometimes 1;30, are you talking
about 1 unit of humalog to 25 carb choices, or 25 grams of carbs, (15 grams being i carb choice)
Ginger Vieira
Hi Michael! A “1:25 ratio” means….1 unit of fast-acting insulin for 25 grams of net carbs. Net carbs implies I’ve subtracted dietary fiber before determining my insulin dose and total carb-count. Does that clarify for you?
Cazt
I found this a very interesting article because I have been considering switching from LCHF to a WGPB diet to try to influence a stubbornly prediabetic HbA1c result. In June I discovered from a routine blood test that my HbA1c was 43 mmol and resolved to get it down with diet and even more exercise as I was already pretty fit. I read widely and went with the LCHF diet. I lost half a stone making my BMI 18.5 but, three months later, my HbA1c was identical to the previous test which was really demoralising. I find it hard to believe that switching to a HCLF diet would make much difference in my situation and this article tends to reinforce my views. I’m not sure which way to turn now so will discuss events with my doctor.
Christel Oerum
I think talking it over with your doctor is the right move. You might benefit from wearing a professional CGM for a few days. It’s a device your doctor inserts in the office and you just wear it for 5-7 days. Back in your doctor’s office he/she takes it off and can then see how your blood sugars have fluctuated when you wore the CGM. That could help your doctor determine if you’re running high all night (so not food related), which could be a reason for the continued elevated A1C
Martha zabarain
Loved the article, I learned a lot of thing. there are so many options of great food so why not have fun eating.
Lisa Painter
Great article showing both “sides”. Having lived w/ T1 for 53 yrs now I think I’ve also done every diet…and it sure has changed since 1965! I’m currently doing the Mastering Diab program and have really enjoyed eating good, healthy carbs. To me, it seems a more healthy diet for my heart/liver/kidneys/blood sugar (just can’t go w/ the whole high fat/meat thing!) but you’re right – it is restrictive when you add the low fat part. I do my best and don’t stress over the fact that I still have half & half in my beloved coffee. My little rebellion since I’ve been restricting myself my whole life ?. My carb:insulin ratio has improved dramatically – from 10-12:1 to 25-30:1. My basal has decreased some and – best of all – I’ve lost ~ 13#. Are my blood sugars stable/perfect? Sadly no, but this is the way I’m choosing to eat and I feel great. Yes, diet is very individual and we should all just get along! Thanks
Christel Oerum
I could not have said it any better! Thanks for sharing and YES! let’s all just get along despite different diets 🙂
Brook
Thank you thank you thank you. I’ve been tracking my eating in an app for years, and vacillated between a lot of weird/irrational eating rules. As a type 1 diabetic with multiple food allergies, it’s been a struggle. Recently, I realized that while I was keeping myself in a calorie deficit (eating around 1500 – 1600 calories per day and working out upwards of 12-15 hours per week, my body was just not having it. I started looking closer at my macros and realized I was in the range of 300+ carbs per day and taking tons of insulin, with terrible blood sugars, and had the early signs of diabetic retinopathy.
I decided to try the ketogenic diet but it was just too much for me. Too extreme, too difficult to maintain, especially with a large amount of cardio and weight lifting thrown in there too. My body was just weak and my muscles kept failing during workouts, along with a lot of lethargy and brain fog.
I switched to a moderately low carb diet, moving my calories up to between 1600 and 2000 (depending on my workouts) and my carbs staying under 120g per day. I feel much better on this diet and my eyesight stopped declining as well, even 3 months into this shift.
I was worried that I was doing something wrong by not pushing myself to maintain either extreme, so it’s great to hear that someone else found success on roughly the same macro distribution. My biggest issue now is trying to get my Tresiba down. When I switched back to MDIs after 10 years on the pump, they started me on 40 units of Tresiba daily. I’m down to 34 now, but I can’t seem to get it any lower.
Christel Oerum
I’m so glad to hear that you found what works for you!! You feeling better and being stronger is such a great testament to the fact that we all need to find what works for us, and not necessarily for everyone else.
As for the Tresiba, not sure you “need to” lower it further. Since it’s your basal insulin it should only take care of what’s going on in the background, so as long as it keeps you steady you’re at the right level
Daphne
Ginger, Thank you for this article. I’ve tried all the diets to help get my diabetes in control. On the low carb, I had beautiful b/g numbers but my weight, triglycerides and cholesterol went way up. After two years eating this way, I went cold turkey from LCHF to essentially vegan, and my triglycerides dropped, my weight – somewhat – but the biggest difference was in my cholesterol. It dropped by over 100 points. I felt better. Began exercising again and lower my IC ratio. I don’t stick to extremely low fat. I love nuts too much. For the most part, I can handle my b/g, but being perimenopause as well, nothing is 100% fail proof. And now moving into (Texas) summer my body needs more insulin.
I agree that everyone needs to find what works best for them, what gives them the energy to workout. Like Angela M says, exercise is a major key for insulin sensitivity.
I find it equally important to find what b/g numbers you can be happy with. For me, that’s an ongoing struggle. When your diabetic, it’s more than just the way you eat.
Angela M
Thanks for writing this! I was fascinated by the idea when you tweeted, and I love how detailed it is. I think, like you say, extremes at either end aren’t for me, but I loved reading such a thoughtful description of your trial. I went low carb at the end of my pregnancy, and that was enough to tell me I can’t manage that level of low carb long term, but this has prompted me to try some experiments with what I’m eating. It’s also reminded me that, no matter what I’m eating, exercise is the key to insulin sensitivity for me, so I should really make more of an effort on that front!
Ginger Vieira
Angela! So so so glad to hear that you’re gonna experiment and find the right fit for you. I really really really REALLY believe that aspects of a low-carb diet can be incorporated into a low-ish carb diet (like 100 to 150 grams) for many people is really doable! Hope you find a good balance for you! Thanks for reading…and commenting!
Ivan
I just eat a well balanced diet which includes all food groups and I have perfect health after 41 years of type1 diabetes.
Ginger Vieira
EXACTLY! Congrats to you for 41 years of T1D! And many more to come!