Justification for low/no carb: Curing T2 Diabetes starts with ignoring the guidelines

It's a little long, but this is interesting. Dr. Sarah Hallberg's TEDx talk has her citing numerous studies of the benefit of low/no carb but also an explanation of why/how insulin makes the obesity problem worse.

Thoughts?

I read more studies about that issue. It's  finally coming out. 

For years the "experts" have been saying that a "calorie is just a calorie, a carb is just a carb"...but it's NOT!  At least not for insulin-resistant people or Type 2 diabetics.  When the glycemic index became popular it provided more information on carbs but doctors still weren't insisting that their Type 2 patients cut back on carbs.  

In fact, 8 years ago when I went to my doctor-ordered nutrition appointment after being diagnosed, I was told to eat 45 carbs at each meal and 15 carbs at two snack times a day.  Now add that up:  that's 165 carbs a day!   And I continued to gain weight and need diabetes medication on that program.  I was well-controlled but I was never going to get well on that plan. 

Fast forward to two years ago when I had WLS and I came home from the hospital off all meds because I was eating little to no carb, especially in the beginning.  Even now I work to keep my carbs at 100 per day or below.  More than that and I can feel my glucose climbing and I start to feel like crap.  

My internist doesn't quite believe me that I can tell when my glucose gets above 120...but I can and I've proven it time and time again by poking my finger.  And it's ALWAYS the same things that make it climb:  all flour-based bread, rice, pasta, sugar.  

I won't say carbs are the "devil" because normal people's bodies can handle most carbs.  But something in my system is broken and just can't handle them.  In my case, simple carbs are a recipe for disease and early death.  

After watching the video, I told hubby that I suspect that I'm still insulin resistant which is why I can't ever go back to heavy carbs. What do the long timers think about this? 

I'm not a long timer but I firmly believe that just because I'm in remission from T2D that it doesn't mean I'm "cured".  If I go back to eating the same stuff I did before surgery, I'm going to get the same results.  I'll be having higher and higher A1c results until the day comes when I have to go back on the meds.  I've already seen my A1c rise from 5.1 to 5.5 in the last year of maintenance where I've indulged more in higher carb foods.  

I've seen a handful of WLS friends and spouses of friends who've gone down this path.  Three that I know of for sure - two had RNY, the "gold standard" for fixing T2D.  Two are back on insulin and one is back on oral meds.  And they ALL went back to eating high carb food.  

I am very carb sensitive and I have found out I really can't go back or there is weight gain. 

I saw my surgeon give a presentation on insulin resistance, diabetes, and WLS. It was obviously for laymen, but very interesting, and based on recent research.

He said that, once you became diabetic, your pancreas stops working normally, and starts pumping out insulin, to varying degrees for different foods. He said to think of the pancreas as a battery, with about a 7 year "charge" of insulin. The sooner you have WLS and go into remission, the longer that battery will last. If you drain it before surgery, you won't go into remission at all. If you wait most of that 7 years, you'll go into remission, but the diabetes can come back sooner.

And the thing that can run the battery down quicker is by eating foods like simple carbs, starches, and sugars, that put a higher demand on your reserves.

Obviously this is all oversimplified, and in real life it's very complicated. But I found the analogy useful.

This is a fantastic explanation that's easy to understand.  Thanks, Grim! 

The Cleveland Clinic has a "metabolic" diet plan for those of us who were interested in being a part of the endocrinological research study undergoing an RNY with T2D.  I chose this route because my major reason for wanting to lose weight was to be as healthy as possible to be around for my son's childhood.  I was a huge risk because I had become diabetic during my pregnancy, went into remission and became T2D within 10 months of his birth, and then insulin dependent within 4 years.  I had done numerous diabetic eating plans and had gained moderately "good" control while medicated -- but long term complications were definitely in my future.  More than that, I was gaining weight at about 10 to 20 pounds per year and insulin was making it nearly impossible to break that cycle.

In any case, the metabolic eating plan is considered very radical by many.  I eat under 45 grams of carbs, very little fruit with the exception of some berries, non-starchy veggies in small amounts and at least 80-90 grams of protein a day in the form of meat. There are very few limitations on fats -- in fact, we are discouraged from using low-fat options but discouraged from adding fat to anything. During weight loss, I am supposed to stay under 900 calories -- so by the time I eat my meat to reach my protein goals -- I don't have a lot left over for veggies anyhow... 

The metabolic diet excludes all flours, sugars, starchy veggies and most fruits.  

Interestingly, those of us on this diet have all stayed in remission with A1Cs under 5.2. Those who are at 2 to 3 years out (they only started this protocol 3 years ago) and have stuck to plan have the highest rate of weight loss and the least amount of regain. Several people in my RL support group who started at the same weight as me but took the typical post surgical plan option (whi*****ludes things like mashed potatoes, fruits, etc) have not only lost far less than me, but have also started complaining of re-gain.  

I think that any plan can work if it's the right one for that person's body -- but for me and my health history, there's no doubt that carbs work against my plan for long term health.