Type 2 Diabetes is a horrible disease. I would encourage you to look closely at how to manage type 2 diabetes with a plant-based diet. The long term implications of the disease and the side effects of the associated medications warrants making some drastic lifestyle changes in order to manage and reverse your diabetes. Some call it putting Type 2 Diabetes into ‘remission’.
Despite what you may hear from your doctor or from people that assume that diabetes is a result of carbohydrate overload, carbohydrates are not the problem. Doctors are taught to treat diseases and manage symptoms with medications like Metformin, Sulfonylureas, Meglitinides, Thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, and Insulin injections. The sad truth is that doctors receive less than 20 hours of nutrition education across four years of medical school, according to a 2010 report in Academic Medicine.
Type 2 Diabetes is Insulin Resistance. It means that you are producing enough Insulin, but the cells in your muscles, fat, and liver don’t respond well to the hormone Insulin and your cells don’t use glucose from your blood for energy. If you don’t uptake the glucose in your blood stream from the foods you eat, you end up with high blood sugar.
Medications will help you respond better to Insulin, or perhaps more Insulin in an injection will help you uptake the glucose into your cells. But it makes more sense to manage the first problem which is the lockout of glucose from your cells, rather than the symptom of high blood sugar by giving your body more hormone regulators or the hormone Insulin.
Choose Nutrition Over Pills & Procedures
If you do not take matters into your own hands and make lifestyle changes, you should understand the implications of choosing to live with Type 2 Diabetes.
Other health complications caused by Type 2 Diabetes:
- Neuropathy (which can cause numbness in the feet)
- Peripheral Vascular Disease which can cause gangrene in the extremities and lead to amputation.
- Diabetic ketoacidosis (DKA) is a serious condition that can lead to diabetic coma, or even death.
- Kidney Disease and Kidney Failure leading to dialysis.
- High Blood Pressure which raises your risk for heart attack and stroke.
- Gastroparesis which causes food to digest too slowly and may cause you to eventually need a feeding tube.
- Stroke – your chances of having a stroke are 1.5 times higher than in people who don’t have diabetes.
- Hyperosmolar Hyperglycemic Nonketotic Syndrome, or HHNS, is a serious condition which causes severe dehydration that will lead to seizures, coma and eventually death.
- Alzheimer’s Disease is now being called Type 3 Diabetes.
- Erectile Dysfunction – I have an article on Erectile Dysfunction Here
- Endothelial Dysfunction (And thus cardio vascular disease) – I have an article on Endothelial Dysfunction here.
Side effects of medications to manage Type 2 Diabetes:
- Metformin Poisoning can cause severe lactic acidosis, cardiac arrest, pancreatitis, hemolytic anemia, and gastrointestinal distress. Metformin can even cause severe gangrene (called Nectrotizing Fasciitis) of the genital and other areas! (See: https://www.livescience.com/63485-diabetes-drug-infection-warning.html).
- Insulin Injections cause weight gain, only to exasperate the problem and also has other side effects including headache, hunger, weakness, sweating, tremors, irritability, trouble concentrating, rapid breathing, fast heartbeat, fainting, or seizure (severe hypoglycemia can be fatal).
Carbohydrates Are Not The Problem
Because simple carbohydrates can cause a spike in your blood glucose levels, it is often thought that carbohydrates are the problem. Blood sugar spikes are the secondary problem, Insulin resistance is the first.
Many people including your doctors and the people that want to sell you their book on low-carbohydrate diets, will tell you that managing your diabetes with a low carbohydrate diet is the answer to the problem. Like Metformin or Insulin injections, utilizing a low carbbohydrate or keto diet is merely managing the symptoms of the disease and not treating the disease itself.
We have known for decades that Intramyocellular lipid droplets in our cells is what causes insulin resistance. See: Intramyocellular lipid droplets and insulin sensitivity, the human perspective https://bit.ly/2KVfnay
You are Insulin resistant because your cells are packed with fat which does not allow the glucose to get into your cells in order for the glucose to be used for energy. Your tissues are essentially saying “I’ve got enough energy here from all this fat, I don’t need any more”. And so, the glucose stays in your blood stream and causes high blood sugar and its associated complications.
A low carbohydrate diet is high in fat, and excess fat is the one thing that you do NOT need. In fact, saturated fat promotes insulin resistance by reducing adiponectin (insulin-sensitizing protein), and interfering with insulin-signaling Akt pathway.
Saturated Fatty Acid-Mediated Inflammation and Insulin Resistance in Adipose Tissue: Mechanisms of Action and Implications https://academic.oup.com/jn/article/139/1/1/4750865
Fiber and Type 2 Diabetes
We have known that lack of fiber in the Western diet is a major contributor to type 2 diabetes since at least 1974.
In 1981 Harvard University Press published ‘Western Diseases, Their Emergence and Prevention’. Chapter 22, page 373-393 goes into great detail about our understanding of treating and preventing T2DM. See: https://bit.ly/2rZruxM It specifically states that dietary fibers delay the absorption of glucose. In studies, they were able to reduce insulin doses significantly by increasing fiber intake by just merely adding a few servings of crispbread! Even in 1978 we were successfully treating T2DM with HIGH CARB diets!
‘Western Diseases, Their Emergence and Prevention’ Page 378:
Why A Plant Based Diet Works
As noted above, you are cutting the saturated fat with a plant-based diet, and saturated fat DOES lead to Insulin resistance. You are also adding a lot of fiber which delays glucose absorption.
Let’s first be clear what I mean by a plant-based diet. A plant-based diet could mean fried foods, Oreo cookies, and Coca-Cola, and coconut oil (which is saturated fat). I am talking about a whole food plant-based diet with no processed foods or oil. Eating foods in their whole form and not bi-products like oil, sugar, or refined flour.
A whole food plant-based diet works because you are eating whole plant carbohydrates that burn slowly and very efficiently, and you aren’t adding additional fat to your diet.
In addition to not adding fat, there is something called Oxidative Priority. Oxidative Priority is a break down of what and how our bodies metabolize macronutrients. Alcohol – Protein (Amino Acids) – Carbs – Fat is the order of what the body burns for fuel. Type 2 diabetics should know first of all, that you should not drink alcohol at all if you want to reverse your Type 2 Diabetes. Alcohol is the first fuel source that your body will use, then amino acids, then carbs, then fat. (The science on Oxidative Priority: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326984/) (Further discussion on Oxidative Priority: https://podcastnotes.org/2018/02/16/the-rich-roll-podcast-ray-cronise-julieanna-hever-on-everything-plant-based-nutrition/)
It is important to note that ‘protein’ is NOT synonymous with meat. There are 9 essential amino acids that your body needs to derive from diet, and all of those amino acids are available via plants. The largest mammals on the planet including Gorillas, Giraffe, Rhinoceros, and Hippopotamus all eat only plants and get plenty of ‘protein’. Read: ‘But Where Do You Get Your Protein?’ if this is confusing to you. Read: ‘Do Gorillas Eat Meat?’ for more info.
So as Oxidative Priority goes, assuming you are not drinking alcohol, amino acids and carbohydrates are utilized by your body first. There is a caveat to this, carbohydrates metabolize as glycogen, and an excess is first stored in your muscles and burned later (known as glycogen stores). If it is not burned, it will store as fat. Note that any calorie excess, especially when combined with fat, that fat WILL get stored as FAT.
This is where Insulin resistance kicks in. Packing your cells with fat is what causes insulin resistance. And thus a high fat diet is perhaps the worse thing you could do to your Insulin resistant tissues.
Another reason a plant-based diet works is because of Calorie Density. An example of this would be that a 6 oz. steak is 460 calories, where as 6 oz. of broccoli is only 57 calories, and 6 oz. of lentils is only 194 calories. If you fill up on vegetables and lentils, your stomach feels satisfied without additional calories. Cheese is even more calorie dense than meat. I love this example from Forks Over Knives:
In addition to Oxidative Priority and Calorie Density, a recent study that reviewed the effectiveness of plant-based diets reports that “a plant-based diet could improve the overall quality of life, psychological well-being and chronic diabetic neuropathy in people with T2D”, and further goes on to state that plant-based diets have “greater adherence”, “significantly greater weight loss “, and that “participants in the intervention groups managed to better control their diabetes via the plant-based”, compared to other diets.
Effectiveness of plant-based diets in promoting well-being in the management of Type 2 Diabetes: a systematic review https://drc.bmj.com/content/6/1/e000534
Consensus statement by the American Association of Clinical Endocrinologists and the American College of Endocrinology on the Management of Type 2 Diabetes states: “All patients should strive to attain and maintain an optimal weight through a primarily plant-based meal plan high in polyunsaturated and monounsaturated fatty acids, with limited intake of saturated fatty acids and avoidance of trans fats. “
See: CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2019 EXECUTIVE SUMMARY https://journals.aace.com/doi/full/10.4158/CS-2018-0535?=
What Others Say
I don’t claim to be an expert in Type 2 Diabetes, but I do personally know many people that have reversed their T2D, I was pre-diabetic and successfully reversed my pre-diabetic state, and I also know several diabetes educators and doctors that have written scientific papers and books on the topic. So don’t just take my word for it.
How I Lost 168 lbs. on a Plant Based Diet:
My friend Eric O’Grey lost 165 lbs. and reversed his T2D:
My friend Jim lost over 130 lbs. and reversed his T2D:
In addition to these anecdotal stories, I have worked with Dr. Caroline Trapp whom is a diabetes educator, and Dr. Neal Barnard from the Physicians Committee for Responsible Medicine (PCRM). Dr. Barnard and Dr. Trapp co-authored the paper ‘A Plant Based Diet for Type 2 Diabetes’. I have also worked with Dr. Michelle McMacken who wrote the paper ‘A plant-based diet for the prevention and treatment of type 2 diabetes’ and has a guest post on this blog about the keto diet.
What The Science Says
In addition to the 3 papers already mentioned, there are many scientific papers on reversing Type 2 Diabetes on a plant-based diet. I want to highlight a current ongoing study called the Natural Food Interaction (NFI) Protocol Diet. The protocol is currently being tested in a large clinical trial in Europe where the tailored meal plans have resulted in a 96.5% type 2 diabetes remission rate after only 20 weeks with ALL patients off medications.
Here is the NFI Protocol Diet Press Release: https://www.plantbasednews.org/lifestyle/55-diabetes-patients-lose-2000lbs-20-weeks-nfi-protocol
Here is the recently published initial pilot study published in the peer-reviewed Diabetik Forum journal in Slovakia: Plant-based diet according to the NFI protocol in patients with type 2 diabetes mellitus: pilot study https://www.forumdiabetologicum.sk/casopisy/forum-diabetologicum/2020-1-27/plant-based-diet-podla-nfi-protokolu-u-pacientov-s-diabetes-mellitus-2-typu-pilotna-studia-122684/download?hl=cs
Here are a few more studies if you care to read them:
- A Plant-Based Dietary Intervention Improves Beta-Cell Function and Insulin Resistance in Overweight Adults: A 16-Week Randomized Clinical Trial https://www.mdpi.com/2072-6643/10/2/189
- A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. https://www.ncbi.nlm.nih.gov/pubmed/16873779
- Gut microbiota and Ma-Pi 2 macrobiotic diet in the treatment of type 2 diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398897/
- Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies. https://www.ncbi.nlm.nih.gov/pubmed/27299701
- Vegetarian Diets and the Risk of Diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153574/
- Plant versus animal based diets and insulin resistance, prediabetes and type 2 diabetes: the Rotterdam Study https://www.ncbi.nlm.nih.gov/pubmed/29948369
- A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. https://www.ncbi.nlm.nih.gov/pubmed/19339401
- The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes https://www.nature.com/articles/nutd20173
- Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional (diabetic) diet in subjects with Type 2 diabetes. https://www.ncbi.nlm.nih.gov/pubmed/21480966
- Vegetarian Diets in the Prevention and Management of Diabetes and Its Complications. https://www.ncbi.nlm.nih.gov/pubmed/28588373
- A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. https://www.nature.com/articles/nutd20158
- Impact of a Plant-Based Diet and Support on Mitigating Type 2 Diabetes Mellitus in Latinos Living in Medically Underserved Areas. https://www.ncbi.nlm.nih.gov/pubmed/28503930/
- Effect of a Brown Rice Based Vegan Diet and Conventional Diabetic Diet on Glycemic Control of Patients with Type 2 Diabetes: A 12-Week Randomized Clinical Trial. https://www.ncbi.nlm.nih.gov/pubmed/27253526/
- Clinical Trial in process, results should be reported soon: An Intensive Lifestyle Intervention to Treat Type 2 Diabetes in the Republic of the Marshall Islands: Protocol for a Randomized Controlled Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560078/
- Just published 07/22/19 – Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes – A Systematic Review and Meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2738784 (” Plant-based dietary patterns, especially when they are enriched with healthful plant-based foods, may be beneficial for the primary prevention of type 2 diabetes.)
- Just Published 11/30/20 – Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults – A Randomized Clinical Trial https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773291 (Findings: In this 16-week randomized clinical trial, a low-fat plant-based dietary intervention reduced body weight by reducing energy intake and increasing postprandial metabolism, which was associated with reductions in hepatocellular and intramyocellular fat and increased insulin sensitivity.)
The ‘How To’
The first step in managing and reversing your Type 2 Diabetes is making the lifestyle CHOICE to chose health and chose nutrition over pills and procedures. The next step is taking a plunge into plant-based eating. Give it a 60 day go and see what happens.
The quickest way to reverse type 2 diabetes is by increasing fiber intake and cutting saturated fat (especially from dairy). Whole intact grains and lentils are very good for blood sugar control.
If you need a little help, I have list of resources as well as a ton of article on this blog and I also do coaching. I encourage you to sign up to receive my newsletter that I only occasionally send out.
In addition, the Ma-Pi2 Macrobiotic diet foods can be found in this PDF: Click to download.
One of the important items is learning to cook without oil as vegetable oils are not good for weight loss or Insulin resistance. Read ‘Cooking Without Oil, Tips and Tricks‘.
I would also recommend a couple of good books:
Dr. Neal Barnard’s ‘Program For Reversing Diabetes’ available on Amazon.
‘Idiot’s Guide To Plant Based Nutrition’ available on Amazon, by Julieanna Hever & Ray Chronise.
As always, please feel free to reach out to me directly if you have any questions about my content at ctiexec @ gmail