Macronutrient Management With Diabetes








I've spoken a little already about some things we need to consider when we look to balance the levels of macronutrients in our diet as type 2 diabetics, which are of course carbohydrate, protein and fat.  This also applies to type 1 diabetics as well by the way, just because you are using insulin doesn't mean you don't need to pay close attention to what you eat, and if you mess this up, this will make you require too much insulin, make it harder to control your blood sugar, and make you too fat as well.

There is definitely something to be said about Dr. Richard Bernstein's law of small numbers, meaning that the less carbs you eat, the easier it is going to be to manage your blood sugar with insulin.  Now his diet is too extreme for most people but it does tend to work in a lot of patients, although it's sometimes not as simple as merely lowering carb intake to a bare minimum as he suggests.

I'm going to talk a little about all 3 macros in this article, so let's start with carbs.  Now we can very easily consume more than our bodies can handle, and a lot of non diabetics do the same thing, and eating too many carbs is definitely implicated in diabetes, it doesn't cause it directly but it certainly contributes to it.

People who eat too many carbs also get fat, and being fat is another big contributor to becoming diabetic, and it's definitely carbs that make people fat, not calories, although people should still pay attention to not eating too many calories either, and a more moderate caloric intake does make managing diabetes easier.

Our bodies should be able to handle a moderate amount of carbs though, but as diabetics our ability to do this is diminished, so we have to pay even more attention to not getting too much of this.

On the other hand, we also want to make sure we get enough, and what is enough does tend to differ among diabetics.  A very low carb diet and even just a low carb diet can cause some issues that must be paid attention to, for instance low carb raises cortisol levels and decreases thyroid hormone conversion, and if you have issues with either or both, you may be making yourself sicker by going too low.

This certainly happened to me, when I first started treating my diabetes I went very low carb and got pretty sick and my blood sugar was poor as well, and I also lost a lot of weight, way too much.  I had to increase carbs to a more modest level to be OK and this also lowered my blood sugar, which I found to be curious at the time but I now understand why.

Aside from the hormonal changes, low carb does downregulate insulin levels, which is a good thing generally, but if you have a lot of liver dumping then the liver dumping can actually get worse, which can happen if you don't eat as well.

So it's a matter of experimenting to find what your optimal carb intake is, mine is around 150 grams, that's higher than most people's seem to be, but when I get less than this I get sluggish and my blood sugar goes up.  So you have to play around with this to see what suits you best, all carbs are not created equal by the way, but you test yourself and monitor things over time and you'll come to get a better and better idea of how to manage your carb intake.

With protein, there are people who claim protein puts their blood sugar up, but protein isn't used like carbs is, it becomes available later as a source of liver glucose through gluconeogenesis, but the thing that people get confused about is that the body doesn't need protein for gluconeogenesis, and the amount of protein you eat doesn't affect this process in a dose dependent manner either.

However, one of the things that very few people know about is that if you eat a lot of meat, it is high in purines which elevate uric acid levels.  This is the case with fructose, and fructose elevates uric acid as well, and elevates it a lot actually, which means things like sugar and especially high fructose corn syrup, and even fruit, needs to be paid attention to.

I get some sugar, not a lot but a reasonable amount for a diabetic, I do eat berries every day, and I eat a lot of meat, so I need to pay attention to my uric acid levels, so I take Goutrin, which is a supplement with black cherry extract in it.  You don't need to have gout by the way to need to worry about this, most people with high uric acid levels don't have any symptoms, although this stuff causes a lot of insulin resistance and is even being looked at now as a major causal factor in diabetes.  If you already have diabetes though you don't want the extra insulin resistance this provides.

In fact, there are diabetics who claim that eating more than a little meat will put their blood sugar up, it's probably the case though that it is elevating their uric acid levels, and therefore worsening their insulin resistance, and seeing the blood sugar elevations as a result of that.

We do have to eat though and there are potential issues with all three macros, it's a matter of managing these risks, and you can manage the potential negative effects of a higher protein diet by taking things like black cherry extract and other supplements which help prevent this.

Finally, we'll talk about fat, and fat is by far the most interesting of the three when it comes to diabetes.  The major cause of insulin resistance is actually excess free fatty acids in the blood, I've spoken about this a little already and I will be speaking more about this later, as fat plays a big role in our disease and a lot bigger one than most people realize.

This is pretty complicated in fact but we can say here that there is quite a bit of variation among diabetics, some diabetics can handle a very high fat diet with no issues at all, other diabetics can have some real problems with this, and it then can come down to choosing between the evils of fat versus carbs, and use that to balance your macro intake.

While most of the problem here does seem to lie in the liver, and dietary fat is a minor player in this game compared to that, high fat levels in the blood can be problematic, and if you have problems with this than you can struggle more on a high fat diet.  High blood levels of fatty acids is very bad for diabetics, and to give a rat diabetes, they merely feed them a high fat diet and it works quickly and like a charm.

My point here is to make you aware that it's not quite as simple as a lot of people think, just do low carb and don't worry about the other macros, or do moderate protein and very high fat or whatever, we need to be at least a little aware of what happens with these macros and also pay close attention to what particular ratios and amounts are doing to us.

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