Unless our pancreases are really spent, which we see in the late stages of type 2 diabetes, high blood sugar will tend to raise insulin levels. I got the idea for this article from discussing with some people the seemingly strange situation of eating a very low carb diet and having high blood sugar, something that is not actually so strange when you understand how the body works, and the effects that a high fat diet may have on this phenomenon.
If you haven't noticed already, I do preach carb restriction a lot here, but at the same time there are some issues that go along with this that we need to be aware of as well, and in spite of how well a lot of type 2 diabetics respond to low carb diets, it is certainly not a panacea and there are some folks, like myself I might add, that don't do so well when they restrict carbs too much.
I don't think it's the restricting carbs too much though that influences this all that much, although it is true that when you have a lot of liver dumping, you may not want to downregulate your insulin production too much, as this can result in even higher levels of glucagon and therefore even higher amounts of gluconeogenesis, liver dumping in other words.
So we know that there are two main sources of blood glucose and only one of them involves our diet, the other source is the glucose that our body makes from non glucose sources, this is what gluconeogenesis means, the manufacture of glucose.
So what can happen on a low carb diet is that you can reduce the amount of dietary glucose, which means from carbs, but you can still end up with high blood sugar if the amount that your liver makes exceeds your capacity for uptake.
We do vary in the amounts of this extra glucose that we make, but it can be a huge amount, way beyond what we could handle, and way beyond what we could even manage to eat even if we were on a very high carb diet.
So we do know that a low carb diet can precipitate some changes here, lower insulin levels may influence liver dumping, increasing glucagon, the hormone that works the opposite of insulin, and it can also cause other hormonal changes as we've discussed already, like raising cortisol and lowering active thyroid hormone.
I used to think that it was the increased insulin secretion that helped lower my blood sugar when I added carbs and protein, but now I realize that there's probably more to it than that.
There's another thing that can happen here and this relates not to low carb per se, but the higher amounts of dietary fat that we see with a lower carb diet. There's only so much protein you can handle, I eat a very high protein diet myself but with lower carb you're going to generally be getting a lot of your calories from fat, by default.
One of the reasons why a higher protein diet helps me is that I've found that I can manage my diabetes better when I substitute protein for fat, and to a certain degree when I substitute carbs for fat as well, although too many carbs have their own problems as well, but in certain situations, too much fat does as well.
We know that a high carb diet and a high fat diet do not mix, this causes all sorts of problems and one of them is that this makes diabetes a lot worse, and once again this is the diet given to rats to give them diabetes, and it works beautifully. It also works on humans as well, and there are a couple of main reasons for this.
First of all, a high carb diet does promote more fat in the blood because excess carbs get converted by the liver to saturated fat, and that gets released into the blood. A high carb diet, or high blood sugar actually, also raises insulin levels, and it's the insulin actually that fuels the process of this conversion from carbs to fat, so it both raises our free fatty acid levels in the blood, and causes too much of these fats to be taken in by the cells, and this is the central way that we become insulin resistant in fact.
So you might say, well I don't eat a lot of carbs, so I'm OK here. If you don't eat a lot of carbs and you don't have high blood sugar, and your insulin levels are therefore very good, you won't, and you can eat all the fat you want and this won't hurt you. You'll actually probably be burning a lot of fat for energy in this state and that's fine as well.
What happens though if you eat low carb and you have high blood sugar? Well high blood sugar leads to higher insulin levels, and eating low carb will downregulate this but only so much if you still have high blood sugar, and now we're more like the rats, with higher free fatty acid concentrations, and more of these fats being driven into our cells from this extra insulin that's secreted to manage our blood sugar, and that leads to more insulin resistance, which leads to higher insulin being needed to do the same thing, and so on.
There seems to be two camps here when it comes to fat, the camp that says dietary fat will make your diabetes worse, and the camp that says we eat all we want and if you go low carb you can do that and higher fat diets help not hurt, and it took me quite a while to even come up with some ideas as far as what goes wrong when you eat low carb and high fat does make you worse.
Once I realized that the people who do very well with high fat have great blood sugar, and those who don't have it don't so so well, it all started to make sense.
So what can be do about this? Well the first thing to realize is that the problem here is really with the liver, and we need to work on reducing the amount of gluconeogenesis we have, and this is where things like metformin, berberine, gynostemma, and some other things that increase AKPK and therefore reduce liver dumping come in.
This is really what is causing the high blood sugar in the first place here and therefore it's very important to address this first. Beyond that, we also need to realize that we may not be responding to low carb high fat like some other diabetics do, and in particular, we may want to play around with our fat intake and substitute protein and even some carbs to come up with the right mix for us.
This is no small task though and it is more involved than just checking your blood sugar after a meal, you will need to take a little longer term view than this, and some work is going to be involved on your part to try to figure this out for yourself. However, the first step is being aware, so I wanted to bring this to your attention in case you suffer from this phenomenon as well.