Type 2 Diabetes, A Dietary Disease #311: How Can I Manage My Type 2 Diabetes?

Type 2 Diabetes is a Dietary Disease. Your blood sugar (glucose) rises and falls depending on what you eat. It’s that simple. When you eat carbohydrates, there is a direct and simple relationship to your blood sugar level. It goes up. And when you eat more protein than your body needs, there is, to a lesser extent, a secondary and delayed rise in blood sugar. Fat, the third macronutrient, has virtually no effect on blood sugar.

Carbohydrates – including simple sugars and more “complex” carbs, especially those in packaged foods that have been refined to the point where they are close to simple sugars – will have the most impact on your blood sugar. In contrast, unprocessed, whole vegetables, although also carbohydrates, will digest more slowly. However, all carbohydrates – simple, processed or “whole” (unprocessed) – will become glucose “under the curve” (in your blood) within an hour or two of eating. That’s better than a few minutes, but it’s still an elevated blood sugar.

So, for starters, you need to educate yourself about what carbohydrates are and what foods contain them. Do your homework! And you will need to study the Nutrition Facts panel on processed foods, paying attention to the carbohydrate grams. And don’t forget to check the portion size. It is usually much smaller than you will eat.

You will also need to learn what effect carbs have on your blood sugar. Everyone is different, depending on your degree of Insulin Resistance (IR). (To understand the relationship between IR and blood sugar, see “Type 2 Diabetes, a Dietary Disease #308.” As a frame of reference though, if you fasting blood glucose is not between 70 and 100mg/dl, you have a degree of Insulin Resistance. If it is between 100 and 126mg/dl, you are Pre-Diabetic. If your fasting blood glucose is ≥ 126mg/dl, you are, frankly, a Type 2 Diabetic. How do you know what yours is?

You’re thinking that your doctor will test your fasting blood sugar (or A1c) if he or she suspects you have IR or are Pre-diabetic or Diabetic . True, but he/she can only monitor your Type 2 Diabetes. Remember, Type 2 Diabetes is a Dietary Disease, and only you can manage your diabetes. And to do that you need to buy a meter and test.

First you need to test your blood after an overnight fast. And until you know how your blood sugar responds, you should test both before and after “test” meals. To find out how high your blood sugar spikes, test before and then 1 hour after starting to eat. To find out how close to “normal” it returns, test 2 hours after that meal. If your blood sugar doesn’t drop 2 hours postprandial (after eating) to near where you began, you are Pre-Diabetic. If it isn’t below 140mg/dl, you have Type 2 Diabetes and you have eaten too many carbs in that meal. Blood sugar in a “healthy” (non-insulin resistant) person never goes above 140mg/dl even 1 hour after a big carb load.

You will learn quickly what you should eat and what you shouldn’t. Carbs are hidden everywhere, especially in plain sight. Fruit, unfortunately, is just a simple carbohydrate: sugar (sucrose = glucose + fructose) and water. At least the whole fruit contains a little fiber and pectin, but it is otherwise not much different from a candy bar. Fruit juice is worse. Because it’s liquefied, and thus partially predigested, it is several candy bars at once! It will send your blood glucose through the roof. As will all fruit drinks and all other sugar laden soft drinks.

Bread has a glycemic index of 100, meaning it is the very definition of a high glucose food. The ingredients list of virtually all breads begin with flour (highly processed and 100% carbohydrate), then water, and then always sugar in some form. Even the “sprouted” grains in Ezekiel bread are just sugar. Sprouting or malting is just a method of breaking down the complex grains to simpler sugars. Wiki “malt” or “malting” if you don’t believe me.

Protein digests more slowly than carbohydrates, and has many bodily functions before the excess breakdown products of protein, amino acids, are shunted to the liver for storage. There they cannot be reconstituted as protein; however, the liver can make glucose from them. This secondary process, called gluconeogenesis, is a good thing. The body needs multiple ways to make glucose. Glucose is essential (in small amounts), whereas carbohydrates are not. But the liver of Type 2s makes glucose even when the body doesn’t need it. That’s why clinicians prescribe Metformin to Pre-Diabetics and to Type 2s: to suppress this unwanted glucose production.

So, to take charge of your Pre-Diabetes or Type 2 Diabetes, you need to monitor your blood sugar. And to do that, you have to manage what you eat and eat to the meter.  Test your blood sugar before meals and 1 hour after you eat to see your peak (and 2 hours to see how far it falls). It’ll take time to learn what affects your blood sugar level and by how much. How strictly you follow a Low Carbohydrate Way of Eating (WOE) will determine how your blood sugar responds. But you are in charge. Remember: Type 2 Diabetes is, simply, a Dietary Disease.