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Comment by m3nu | Hacker News Reader

For the case of T2D, eating fewer carbs may be more effective than later reducing it with expensive insulin and fancy MIT pills.

I often hear good stuff about these guys: https://www.virtahealth.com/ (no affiliation)

edit: clarify that Virta is treating T2D primarily.

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Eating fewer carbs is completely ineffective when your pancreas is not producing insulin in the first place.

I was talking about type 2 diabetes, not type 1. You're of course correct regarding type 1.

Speaking as a T1D, please always specify. It's a shame these two totally unrelated diseases have the same name.

They're not "completely unrelated" — they are an absolute and a relative deficiency of insulin production respectively. They do have significantly different aetiologies though, and the conflation is very unhelpful.

It's a good point too that taking insulin is associated with greater risk of obesity and further worsening of T2D in the long term. So dietary interventions (which are experiencing great success -- both Virta and also the work of Dr. Jason Fung et co at Intensive Dietary Management) -- often produce much better outcomes for type two than insulin (naturally no one should go off insulin without being under the guidance of a doctor of course)

Yeah, eating less carbs is great for T2s like me (I don't take insulin, I control my blood sugar with a keto diet and metformin).

For T1s, eating less carbs might reduce the amount of insulin they need, and make swings in blood sugar less likely, but they're still going to need some insulin.

This is a common but dangerous misconception. The human body needs insulin to function, even without dietary carbohydrate. This is why insulin dosing includes basal (continuous background) as well as mealtime insulin.

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