There is a lot on the internet about the benefits of going low carb, and this is the case whether we're diabetic or not, and going low carb is also a great way to lose weight as well, since both diabetes and obesity are primarily caused by high insulin levels and there's no better way to lower insulin levels than reducing carb intake.
So you see sites promoting low carb, I do speak of carb reduction a lot on this site and the sheer importance of doing that, and this applies to non diabetics as well, we just eat way too many carbs as a species than our bodies can handle.
However I don't necessarily preach what people would consider to be low carb per se, and while we do need to restrict our intake of this stuff, particularly with certain types of carbs like sugar and grains, it's not quite so simple as just saying just reduce them as much as you can, although it surely would be nice if this was the case.
I did touch on this in the last article on macros, but this issue really deserves an article of its own, because carb intake is that important to managing our diabetes, and therefore we need to get this right, and getting this right just doesn't mean eat as little as you can manage.
There really isn't a lot of good information on this subject as views tend to be very polarized, pitting the low carb heads who just tend to look at the benefits without generally looking at the concerns, and the anti low carb movement which tends to make claims that usually aren't based upon facts, but mistaken beliefs, usually centering around beliefs about our alleged need for carbs and in particular our need for grains, which all comes off as biased and one sided.
There is bias on both sides actually, but we do know that as diabetics we really do need to practice some sort of carb restriction, although of course this needs to be done safely, in other words we should first be seeking a level which is going to maximize the benefits of such a plan, for instance lowering blood sugar, as well as successfully treating other conditions such as high blood pressure, obesity, chronic inflammation, insulin resistance, and other health conditions associated with a high carb intake.
So the goal here is to maximize these benefits and this doesn't necessarily involve going as low as we can, especially if you are a diabetic. People tend to forget or not be aware of the fact with with diabetes, there are two sources of blood glucose, and the glucose you get from eating is often the least significant of the two.
People who have less issues with this, for instance the more they lower their carb intake, the better their blood sugar is, may not even get this, but with some of us at least, we can lower our carb intake to the point where our blood sugar actually goes up.
This was definitely the case with me, I did terribly on very low carb, and then from there, the more carbs I added the better my blood sugar got, then I hit the ideal amount and beyond that it got worse as well from being too high. So blood sugar alone is a consideration here, but not the only one.
One of the things that happens when you go too low carb is that, for various reasons, you can go into a state where your blood sugar is higher from increasing the amount of glucose your liver puts out, and you can definitely get a net increase with this, meaning for instance you can consume 50 grams less glucose we'll say, but this may cause your liver to increase its output by 100 grams we'll say, and this means higher blood sugar.
Our main problem as type 2 diabetics isn't that we eat too many carbs, unless we're very bad off we could handle that much glucose, but what happens is that our liver gets out of whack and dumps huge amounts over and above what we eat, our bodies are only designed to handle so much, and this can exceed that amount by a huge margin, resulting in very high blood sugar.
By the way a lot of people think that when we have high blood sugar this means that the glucose isn't getting into the cells properly, but it's usually more a matter of our not being able to handle the amounts we get put into our blood, so what we need to do is to limit this amount, which does involve dietary management but also involves managing endogenous glucose secretion, primarily from our liver.
So there are a number of hormonal changes that going low carb can precipitate, and the big one where it comes to diabetes is increasing cortisol levels. The body actually can perceive low carb as stress, and to various degrees depending on the individual and the status of the health of what's called their HPA axis, hypothalamus-pituitary-adrenal health, various amounts of extra cortisol get released and the lower carb you go, the more that tends to get released.
Now nothing raises blood sugar like cortisol, it's primary role is to raise blood sugar, it commands the liver to do so and since this mechanism is designed to save our lives, the liver obliges. In a diabetic liver, well it's much more prone to secrete too much glucose in the first place, the house is broken in other words, and excess cortisol will be even more effective in spewing extra glucose we don't want or need.
So we need to pay attention to this, and watch our blood sugar, and don't just assume that less is better, although there are some things you can take to improve your hormonal system and this may end up making lower carb more tolerable. However, this is why we manage our diet, to see what the optimal amounts of each macro are. This is all going to depend on the individual, and some of us have more issues with cortisol than others, but we all need to pay attention to this to ensure we don't promote excess cortisol too much.
Raising cortisol is just one thing to look at though, and I will be looking into this further for you in the next article, where we'll see if there are any other issues we may need to pay attention to.