Type 2 Nutrition #456: “Why am I taking insulin?”

You’re a newly-diagnosed type 2, and you’ve proved to be intolerant of a couple of oral prescription meds, so you’ve been prescribed a basal (once-a-day) insulin injection to lower your blood glucose levels. You know this, but it seems to contradict the advice you’ve heard that the dietary goal of eating Very Low Carb (VLC) to self-treat type 2 diabetes is to lower your blood insulin, so you ask, “How will this “lower your blood glucose?”

Treating an elevated blood glucose with injected insulin will lower your blood glucose, temporarily, but by continuously keeping your blood insulin level high, with a long-acting (24hr) insulin, 1) your insulin will “progress” to larger doses, 2) your Insulin Resistance will worsen, leading to the dreaded complications, and 3) you will gain weight – remember, “insulin is the fat storage hormone.” And that’s the establishment’s advice.

You reply, “So If reducing insulin according to this is the answer, then more sugar will be channeled into the bloodstream.” Do you see the fallacy? You’re making a logical error. “More ‘sugar’ [glucose] will be channeled into your blood stream only if you eat more ‘sugar’ [carbohydrates]. On a VLC diet, you eat far fewer carbs.

If you are eating far fewer carbs, your blood glucose and blood insulin will both naturally lower, because endogenous insulin (secreted by the pancreas) is the transporter of glucose in the blood. But if you are injecting a long-acting insulin, your blood insulin level will remain high all day and night, even as your blood glucose level comes down. Eventually, if you eat VLC at all meals, your blood glucose level will be so low that you will have to reduce the amount of insulin you inject to prevent hypoglycemia (too low blood sugars).

If you don’t eat VLC and continue to inject insulin (the establishment way), you will have all the consequences described above: 1) worsening IR, 2) higher insulin doses and later complications, and 3) weight gain.

So, you’re “taking insulin” now to lower your blood glucose because your doctor knows that untreated high blood glucose is very dangerous for your health, long term. She is treating your symptom (high blood “sugar,” caused by Insulin Resistance). By self-treating your disease at the cause, a diet high in “sugars” and refined carbs, your aim is to reverse the metabolic dysfunction caused by your diet and put the disease in remission.

And you can do it yourself.  Here’s how: 1) accept that you need to change your “lifestyle” (at least with respect to what and when you eat), and 2) learn about carbs and other things that raise your blood sugar, 3) commit to adopt this Way of Eating, and then, 4) #justdoit. This last is perhaps the hardest, but there’s lot of help out there: mentors, books, blogs, and Facebook pages and groups. For the last 16 years I’ve used them all, to great advantage.

Two of the very best websites are 1) Andreas Eenfeldt’s www.dietdoctor.com (500,000+ subscribers) and 2) the Intensive Dietary Management (IDM) program run by Megan Ramos out of Jason Fung’s Toronto office. Fung’s book, “The Obesity Code,” is one of my favorites. Another: “The Art and Science of Low Carbohydrate Living,” by Volek and Phinney. Another, Richard Feinman’s, “The World Turned Upside Down.” All good reads.

Two programs I can recommend are Eric Westman’s healclinics.com at Duke Health, and Phinney and Volek’s Virta program (virtahealth.com). Eenfeldt, Fung, Phinney and Westman are MD’s. Volek is a widely published PhD exercise physiologist, Feinman is a PhD researcher/activist, and Ramos started out as Fung’s patient.

Tweeters I try to follow include: Nina Teicholz (@bigfatsurprise), Franziska Spritzer (@lowcarbRD), Dr. Eric Westman (@drericwestman), Dr. Feinman (@DrFeinman), Dr. Zoe Harcombe (@zoeharcombe), Dr. Jason Fung (@drjasonfung), Dominic D’Agostino (@DominicDAgosti2), Andreas Eenfeldt (@DietDoctor1), Thomas Dayspring (@Drlipid), Tim Noakes (@ProfTimNoakes), Tom Naughton (@TomDNaughton), gary taubes (@garytaubes), Georgia Ede MD (@GeorgiaEdeMD), Adele Hite (@ahhite), Marika Sboros (@MarikaSboros), Dr. Jay Wortman (@DrJayWortman), Amy Berger (@tuitnutrition), Dr. Aseem Malhotra (@DrAseemMalhotra).