Read his amazingly detailed post at Diatribe. Adam, who has type 1 diabetes, figured out during his college days that eating no more that 30 grams of carbs at a time was “a complete gamechanger” for improving his blood sugars. He experimented on himself to see if there was a difference between his usual lower-carb diet (146 grams/day) versus 313 grams/day.
To my utter surprise, both diets resulted in the same average glucose and estimated A1c. But there were major tradeoffs:
The higher-carb, whole-grain diet caused four times as much hypoglycemia, an extra 72 minutes per day spent high, and required 34% more insulin. (A less healthy high-carb diet would have been far worse.)
Doubling my daily carbs also added much more effort and produced far more feelings of exhaustion and diabetes failure. It was not fun at all, and the added roller coaster, or glycemic variation, from all the extra carbs made it more dangerous.
See more at: http://diatribe.org/low-carb-vs-high-carb-my-surprising-24-day-diabetes-diet-battle#sthash.pZOgCWVl.dpuf
I think the lower-carb approach is healthier over the long run. Check with your own healthcare provider before making any drastic change in your diabetic diet.
Hi Dr. Parker,
I am prediabetic, with normal postprandial BS, but mildly elevated FBS. (105-120). I am also probably 30 pounds overweight and mildly insulin resistant.
I have been following the KMD for almost 4 weeks now. Not the exact plan in the Cordoba study, but your modified plan including 1 ounce nuts, up to 3 ounces cheese, etc. Rarely, I drink red wine. I love the olive oil! I keep to 1500 kcal/day and religiously weigh and track my food on an app called lose it, eating no more than 30 grams of total CHO per day, I monitor my BS 4x/day and check for urinary ketones 2x/day. I like to bio-hack and watch for results. I am sorry to say, I barely can achieve ketosis, fall out of it easily, feel crappy, gained 2 pounds and my blood sugars are now worse….fasting the same but 90 minute postprandials elevated. Maybe I need to cut back on protein…although only getting about 25% calories from protein.
I have been sleuthing online and come to the conclusion all the saturated fat from coconut oil, grass fed beef, butter and cheese is actually causing central insulin and leptin resistance in the hypothalamus. That is well established in rat models.
I plan on cutting most of the saturated fat, but see the diet will become very boring and difficult toachieve ketosis if 80% of calories will have to come only from olives, olive oil, flax, avocadoes, macademia nuts. Have you seen this phenomenon before? Could a wholefoods plant based diet be more effective for folks who seem genetically predisposed to dificulty in switching to fat burning? SOmething like ornish or Ma-Pi diet? Once I run out of shiritaki noodles and finish my full f weeks I might do a crossover study and and eat macrobiotically for a 4 weeks and see how I do.
Anyway, thanks for your blog, I think science is stumbling towards a future when we can really personalize diet recommendations based on genotype and phenotypic expression.
I apologize for my delay in approving your comment for public viewing. I’ve been too busy at the hospital over the last month.
I don’t have an explanation for your lack of results on the Ketogenic Mediterranean Diet. Clearly, it’s not for everybody. I like your proposed dietary changes and the fact you monitor yourself. You seem very intelligent.
Are you exercising? If you have to choose either aerobic or resistance training, I’d go with resistance.
I’d love to hear back from you as you find something that works. My email is steveparkermd At Gmail dot com.