I was diagnosed with type 2 diabetes about two and a half years ago. After doing some research, I put myself on a strict keto diet. Within about a month, my A1C went from over 13 to hovering around 6 and has stayed there. Never took any diabetes medication.
I do give myself a "vacation" from the diet about once a month, which I usually reserve for a special occasion.
Eating out isn't as bad as you think when in that position. Get a steak with some low-carb vegetables on the side. You can still have blackberries and raspberries and if you really need to "cheat" you can find some deserts that are no carb. Although best to limit those types of sugars. Use an app / website to track carbs for the first few months.
Just remember you're either in ketosis or not. There's no such thing as a "cheat" day on Keto as going over carb amount can kick you out.
Also the binary nature of either being in ketosis or not is somewhat disappointing. I unfortunately find it impossible to be on a keto diet for long periods of time due to social situations and eating out. Do you have any advice?
Societal pressures can be challenging but it's really not that bad. We ate out quite a bit because of birthdays and such. If you're at a nice restaurant, get a steak and a low-carb vegetable. At Ruth's Chris we did Tomahawk steak with mushrooms. Drink club soda with lime or lemon. Chipotle is a good meal. Chicken steak, guac, cheese, salsa (check their site)
Wingstop was also goto for us. They have quite a few sauces that have no carbs. Eating out is planning. Check the menu; if it's not a chain, you might have to call. We did that a few times. Ask if they put sugar in certain things. Burger with bacon and cheese no bun is also an option. You have to be careful with chicken dishes because they might put a sauce on it.
Remember, it's low-carb, not no-carb, so if you accidentally eat a few pieces of bacon with sugar in it, it's not the end of the world. It's probably not going to be enough to kick you out.
When I'm on my deathbed, I'm far more likely to regret the things that I did eat opposed to the ones I didn't
I actually think this is an important part of cultivating healthy relationships with food. I needed to stop thinking about boring meals as missed opportunities for consumption.
A diner breakfast of eggs and bacon or sausage will do as well. Just don't eat the starches.
I'm much less strict now than I was, because I am comfortable going into ketosis and losing a few pounds if my clothes start getting tight. But in the beginning, I aimed for 10 g of carbs, assuming that due to wrong estimates and "hidden carbs" (anything with less than 0.5 g per serving can be listed as 0 carbs) I'd still likely be under 20 and definitely under 40.
Some would say that's not a varied diet. I would argue that eating a different dessert at every meal isn't all that much variation except in taste - which is not to be laughed at, but I've always been the kind of person who would rather have more steak or hollandaise than a dessert. Poached eggs on ham, covered in hollandaise, is not exactly an ascetic diet.
I stayed on this for seven years until I finally had to go on insulin.
Because that’s accurate. Someone following this treatment plan is still at elevated risk of recurrence. Once you’re cured of the flu, your ex ante chances of catching it again are no higher. (We don’t have a cure for diabetes per se. Insulin controls but doesn’t cure it.)
And maybe the secret is the no sugar nor simple carbs
Try a book like "fiber fueled". That's a diet that is actually sustainable.
Prehistoric humans however (that is, before the agricultural revolution) consumed most of their carbs through fruits, nuts, and vegetables. It's estimated their diet probably consisted of around 100 grams of fiber a day, as opposed to the typical 2 grams people eat today. Fiber slowly the blood glucose elevation by quite a lot.
I don't think simply cutting out carbs is the answer or even sustainable. I think it makes much more sense to gravitate towards a diet of more whole food, which contain more fiber and thus don't raise blood glucose as severely. Carbs are important, and we've been eating them forever.
For virtually all of human history, the human diet was whatever people could get their hands on. That meant as much meat as they could hunt or raise plus whatever else. Most regular people barely stayed ahead of starvation and they couldn't afford to be picky. Insulin resistance only becomes a problem when consuming excessive amounts of carbs over a long period, which only even became widely possible after 1913 due to the Haber-Bosch process making farming more productive.
Your baseless claim that cutting out carbs isn't the answer or even sustainable is directly contradicted by clinical research. Many patients have literally put type-2 diabetes into remission through nutritional ketosis. That diet isn't recommended for everyone, just patients who already have insulin resistance (with appropriate medical supervision). Regardless of what you "think", that is the reality. After the patient's metabolism has been somewhat repaired it may be possible to reintroduce limited carb intake without triggering a relapse. Fiber is certainly helpful in this, and no one is seriously suggesting to eliminate fiber.
The human diet has been a very, very small minority meat. Because meat is hard to get.
And prehistoric game meat is also not the same as farm meat. Beef and pork contain high amount of saturated fat, but game antelope would contain much less and would have unsaturated fat. Meat of that time is really closer to avocado than meat of our time.
> Regardless of what you "think", that is the reality
I'm glad to see everyone is being civil.
But if we come back down to Earth, you'll realize diabetes is reversed 95% of time when Ozempic is used.
Do those people eat carbs? Yes, they do. Is 95% a higher success rate than whatever pathetic adherence rate a miserable existence like ketosis has? Yes, it is.
If for 99.9999% of all of human history our diets consisted of almost exclusively carbohydrates, I don't think we're following the right path here.
Just because ketosis reversed diabetes DOES NOT mean it address the root cause. It could be purely incidental. And it's also a piss-poor treatment. Because it sucks, and nobody wants to do it, so they try it and then lose a foot or two.
We should stick to real medications, such as insulin and Ozempic. The granola-brained can continue their keto.
Wild meats have very different ratios of fats that farmed meats, but mostly in the opposite direction you are saying. Because (especially non-ruminant) animals take most of their fat from their diet, rather than synthesizing it directly, farmed meat closely mirrors the ratios of fats fed to them via diet- and using seed oils in animal feed makes them have much more omega-6 polyunsaturated fat, and much less saturated, monounsaturated, and omega-3 fats.
Overall a high omega-6 intake is a huge problem as it alters our cellular lipids in a way that impairs a lot of systems, as is eating muscle meat only which has weird amino acid ratios compared to our needs. Weird amino acid ratios in diets have different usually undesirable drug like effects. Both are major issues for anyone trying to do a 'high meat' diet in modern times. As with vegans, if you deeply understand this stuff and have the time and money you can probably make it work.
> whatever pathetic adherence rate a miserable existence like ketosis has
Ketosis seems pretty effective for some people and not for others. I did it for many years and felt amazing- it was in no way "miserable" but eventually got into competitive sports where my performance just wasn't as good with a restricted diet. If I were diabetic, there is no way I'd rather be insulin dependent than do a ketogenic diet, assuming it actually worked that way for me. I know several people that permanently solved major mental health issues that didn't respond to other treatments by staying on ketogenic diets.
For many people, I do thing higher carb diets actually are better for diabetics, because low carb induces extra insulin resistance and raises blood sugar levels. The most effective diets I have seen in peer reviewed research for diabetes treatment seem to be something like "high carb paleo" diets with lots of starchy root vegetables. However, if it makes it easier to lose weight and eat less for someone, ketogenic diets will help.
Moroeover- and this is little known I think- ketosis and low carb are really totally independent things. Ketosis occurs anytime there are excessive acetyl groups in the TCA cycle, which happens under various conditions unrelated to carb intake.
Most people on low carb diets never get into ketosis unless they also severely restrict protein, because we make a ton of glucose from protein (via gluconeogenesis). People eating mostly lean wild animals are unlikely to ever reach ketosis- you'd have to be eating mostly things like seal blubber.
However, many people on high carb diets, especially things like raw vegan diets or diets with lots of resistant starch, e.g. from potatoes and rice are in ketosis, because resistant starch gets ultimately metabolized as ketones. The so called "keto diet" is probably not actually a ketogenic diet but "raw veganism" and the "potato diet" probably often are ketogenic diets.
I don't really have a high vs low carb bias or preference but think it is fascinating how adaptable metabolism is (and it is what I research professionally).
Which is rather a short time in our evolution, compared to virtually all of human pre-history. During which the human diet was most likely not mainly carbohydrates.