Supporting spouse with type 2


You mention that your husband is trying diet again. An important piece of info is the question of how many carbs he is eating? Also important is how many hidden sugars he is consuming. Even though you note that his A1c is at about 7.1, there are two ways to achieve that. First, you could take massive doses of insulin to keep the sugars down. The problem with that is that insulin is the fat storage hormone. The other drawback is that you could be cycling between extremes of high and low sugars to get that 7.1

The second approach is to lower the carb intake. This is the low carb-high fat approach. This will almost always lower insulin requirements. In fact, I would focus on lowering insulin requirements and let weight loss follow. If you and he don’t know how many carbs he is consuming, now would be a good time to learn!

Some good advice I’ve learned is to shop the outside aisles of grocery stores. That’s where you’ll find all the fresh vegetables, meats, cheeses, etc. If it comes in a bag and has ingredients you can’t pronounce, slowly back away from the shelf! The downside to all this is that you spend more time doing meal prep. But that sounds like a small burden compared to what is happening to you now. And you should never be hungry.

I also think finding some emotional help would be critical to making this work. We can make suggestions, but having someone local as a coach would be beneficial. Since money is an issue, I would suggest a pastor or a local charity. Some years back a friend was experiencing financial problems and I arranged for them to talk to someone at the Salvation Army. I don’t think there was any financial help, but just having someone to talk to was helpful. And even if you pick the wrong church or charity, they may be able to guide you to other resources. Don’t neglect the emotional aspect of your situation.

A couple of YouTube videos have been helpful for me. Look up Dr Robert Lustig, Keto Cooking with Kristie and Dot2Trot’s Low Carb Living. There are many more, but these are certainly worth exploring.

Continue to let us know how things are going.


Is there any chance that he could start to exercise a little? Exercise is a wonderful but often over looked mood, energy and health booster.

I’m not talking about anything strenuous. I’m talking about a brisk walk once a day in the fresh air. Ideally a half hour would be desired, but he could work up to that. Could he be talked into taking a walk with you after dinner or before you go off to work? Start slow and walk in a direction five minutes from the house, then turn around and walk back. Do that much until it feels comfortable then start lengthening it. Until you are walking a half hour every day at a good pace.

Exercise, especially walking, gets blood to your brain and fresh oxygen, it also gets blood to the feet and legs-very important when diabetes is involved. It lifts your mood. You can think better, sleep better and get a little help with the blood sugar control. He might even require less insulin and possibly drop a couple of pounds. And, walking is something that almost anyone can do. No special equipment needed, just a good pair of sneakers. It’s free too. I can’t say enough about it.

Is there any chance you could coax him out?


So sorry for what you and your husband are going through. You might like to look at The Mastering Diabetes website. It is run by a couple of type 1 diabetics. Many type 2’s follow this way of eating and some lose hundreds of pounds and get off all their meds. If insulin dependent the amount of insulin given can often be greatly reduced. It is a low fat plant based diet. As long as a person eats the correct foods, he or she can eat a whole lot of food. It is also a very supportive community. The diet lowers insulin resistance, so many more carbs can be consumed in the form of fruits, vegetables of all kinds including potatoes, beans, lentils etc.


I only took a quick look at this website (,) but I was underwhelmed by what I saw. They make a number of unsubstantiated claims. And they list experts that they rely on. There are nice photos of each, but zero info on who they are and what their expertise is. Of course, they have testimonials. But anyone can get testimonials for anything!

They claim that a low carb diet is harmful in the long term, but again provide no evidence. As many of our forum members know, Dr Richard Bernstein has been on exactly this diet for many years. I talked with him in 1976 and he had been following this diet for some years before that. He also conducts free monthly seminars and goes into far more detail than this website.

Maybe I’m jumping to conclusions, but I see neither the evidence nor the rational for the foods that get the red light or green light.


Sorry you were underwhelmed with the website. Actually the experts I listened to today were extremely qualified, as are the two young men who run the website. Both of them are type 1 diabetics. Cyrus Khanbatta has a PhD in Nutritional Biochemistry from Berkeley. He is extremely bright.

Yes, Dr Bernstein is doing extremely well on his low carb diet which I followed faithfully for 11 yrs with an A1c as low as 4.7. In the long run for me that woe didn’t work, because my LDL kept getting higher and I ended up with heart stents, kidney stones, and migraines.

I don’t agree with everything Cyrus and Robbie say and being young men trying to make a living their advice comes with a cost, although they are in the process of publishing a book. I gladly paid their fee and received much personal attention and encouragement as I was transitioning to their diet which made me much healthier and changed my ability to eat carbs. At 68 and having had type 1 for 60 yrs, I now ride my exercise bike 10 miles a day. For me, this woe greatly increased my energy levels.


Hi @Marily6,

I think we should move this discussion to its own thread if we want to go much further. However, I suspect we will just end up disagreeing about the topic.

You list some symptoms and outcomes after many years (e.g. stents.) But how do you conclude that those symptoms were caused by the low carb diet? People without diabetes or not on a low carb diet have those outcomes too. Are there any studies that show these outcomes are more frequent on this diet? The brothers don’t say if they have conducted any studies or where they gleaned their conclusions. They just assert because they said so!

A number of doctors and nutritionists are endorsing a low carb diet. And these people appear to be independent of Dr. Bernstein. At least he never mentions them on his website or free seminars. I’m not aware of any similar consensus for the two brothers. So the question is: where can I go to hear independent doctors or researchers to confirm these findings?

Nothing wrong with earning money for sharing important knowledge. But I think there has to be some basis provided in the free stuff to establish your credibility. So far, I’m just not seeing it.


Thanks for your input on the diets, etc. I think this also highlights the issues diabetics face in the real world - conflicting information, lack of information, etc.

At the end of the day, you have to be your own advocate. Only you know best what works for your situation. You have to be in the drivers seat, and take charge.


There was a typo in the call out for @Marilyn6; hopefully now she’ll see your message.


Good Morning Diabetes Oldie, I have been to the Mastering Diabetes website this morning, and am trying to figure out how to get the references Dr Khambata listed, for why he thinks the low carb diet isn’t healthy, from my iPad to this discussion. I am not very computer literate.
I will work on it. I might just have to send you to where I found them.

The Mastering Diabetes team are not brothers and have very different backgrounds. Cyrus Khambata is the one with the PhD in Nutritional Biochemistry.

I don’t know for sure why I have stents. It could be because of 22 yrs of urine testing and poor control during those years. I also have a grandfather who had a heart attack. Maybe the debilitating migraines, fatigue, horrible insulin resistance, eventual weight gain and kidney stones I had on the low carb diet were just coincidence, but I truly don’t think so.

I am in very good health with no complications of having diabetes for 60 yrs. No neuropathies that I know of. At 68, I feel better than I have ever felt since getting diabetes. My A1c is decent at 5.5.

A low fat vegan diet is another option for people with diabetes and it is the diet that I recommend.

Also, I found lots of free info that the guys at Mastering Diabetes offer.


Hi Marilyn6,

I’d enjoy reading what they have to say — a link would be fine.

Like you, I’ve been Type 1 for 60 years and only had the urine tape for the early years. I may have a touch of neuropathy in my feet, but can still pass the whisker test. Otherwise, I’m pretty free of complications. And I’ve not had any of your complications. But I’ve only been on low carb for perhaps 1.5 years, so not many data points there. Thanks for any info you can pass on.


Hi DO, I just listened to Joel Kahn, MD who is taking part in the seminar that the Mastering Diabetes team is giving this week. He is a well known cardiologist who is talking about studies which have been done on the low carb diet vs. low fat plant diet. I realize that if you go to YouTube and type in Joel Kahn, you can find what I just listened to. Joel Kahn, MD Mastering Diabetes 2019.

I think it is great that you are a fellow Type 1 of 60 yrs! I have no idea what the whisker test is. Since we were talking about neuropathy in the feet, is it the test for feeling? So far I can feel all the pin pricks.


If it isn’t legal for me to post this here, I assume it will be removed.

Insulin Resistance
Scientific Literature
Understand the TRUE Dietary Causes and Effects of Insulin Resistance in Type 1 Diabetes, Type 1.5 Diabetes, Prediabetes, and Type 2 Diabetes

The Causes of Insulin
Resistance in Type 1
Diabetes, Type 1.5
Diabetes, Prediabetes
and Type 2 Diabetes
Insulin resistance is the common thread that underlies blood glucose variability across all forms of diabetes. This document contains references from the evidence-based research about the true dietary causes of insulin resistance.
Below is a list of evidence-based research dating as far back as 1930, demonstrating that insulin resistance is caused by the accumulation of fatty acids in tissues that are not designed to store fat. Please feel free to read the references listed below for more information about the evidence behind this fascinating biological phenomenon.
Cyrus Khambatta, PhD Nutritional Biochemistry References

  1. Boden G. Fatty acid-induced inflammation and insulin resistance in skeletal muscle and liver. Curr Diab Rep. 2006 Jun;6(3):177–81.

  2. Boden G. Role of fatty acids in the pathogenesis of insulin resistance and NIDDM. Diabetes. 1997 Jan;46(1):3–10.

  3. Boden G, Shulman GI. Free fatty acids in obesity and type 2 diabetes: defining their role in the development of insulin resistance and β-cell dysfunction. Eur J Clin Invest. 2002 Jun 1;32:14–23.

  4. Boden G. Fatty acid-induced inflammation and insulin resistance in skeletal muscle and liver. Curr Diab Rep. 2006 Jun;6(3):177–81.

  5. Boden G, Shulman GI. Free fatty acids in obesity and type 2 diabetes: defining their role in the development of insulin resistance and β-cell dysfunction. Eur J Clin Invest. 2002 Jun 1;32:14–23.

  6. Itani SI, Ruderman NB, Schmieder F, Boden G. Lipid-Induced Insulin Resistance in Human Muscle Is Associated With Changes in Diacylglycerol, Protein Kinase C, and IκB-α. Diabetes. 2002 Jul 1;51(7):2005–11.

  7. Savage DB, Petersen KF, Shulman GI. Disordered Lipid Metabolism and the Pathogenesis of Insulin Resistance. Physiol Rev. 2007 Apr 1;87(2):507– 20.

  8. Xiao C, Giacca A, Carpentier A, Lewis GF. Differential effects of monounsaturated, polyunsaturated and saturated fat ingestion on glucose-stimulated insulin secretion, sensitivity and clearance in overweight and obese, non-diabetic humans. Diabetologia. 2006 Apr 5;49(6):1371–9.

  9. Wang P-Y, Kaneko T, Wang Y, Tawata M, Sato A. Impairment of Glucose Tolerance in Normal Adults Following a Lowered Carbohydrate Intake. Tohoku J Exp Med. 1999;189(1):59–70.

  10. Martins AR, Nachbar RT, Gorjao R, Vinolo MA, Festuccia WT, Lambertucci RH, et al. Mechanisms underlying skeletal muscle insulin resistance induced by fatty acids: importance of the mitochondrial function. Lipids Health Dis. 2012;11:30.

  11. Delarue J, Magnan C. Free fatty acids and insulin resistance. Curr Opin Clin Nutr Metab Care. 2007 Mar;10(2):142–8.

  12. Griffin ME, Marcucci MJ, Cline GW, Bell K, Barucci N, Lee D, et al. Free fatty acid-induced insulin resistance is associated with activation of protein kinase C theta and alterations in the insulin signaling cascade. Diabetes. 1999 Jun;48(6):1270–4.

  13. Yu C, Chen Y, Cline GW, Zhang D, Zong H, Wang Y, et al. Mechanism by which fatty acids inhibit insulin activation of insulin receptor substrate-1

(IRS-1)-associated phosphatidylinositol 3-kinase activity in muscle. J Biol Chem. 2002 Dec 27;277(52):50230–6.
14. Hirabara SM, Curi R, Maechler P. Saturated fatty acid-induced insulin resistance is associated with mitochondrial dysfunction in skeletal muscle cells. J Cell Physiol. 2010 Jan;222(1):187–94.
15. Shulman GI. Cellular mechanisms of insulin resistance. J Clin Invest. 2000 Jul;106(2):171–6.
16. Roden M, Price TB, Perseghin G, Petersen KF, Rothman DL, Cline GW, et al. Mechanism of free fatty acid-induced insulin resistance in humans. J Clin Invest. 1996 Jun 15;97(12):2859–65.
17. Silveira LR, Fiamoncini J, Hirabara SM, Procópio J, Cambiaghi TD, Pinheiro CHJ, et al. Updating the effects of fatty acids on skeletal muscle. J Cell Physiol. 2008 Oct;217(1):1–12.
18. Roden M. How free fatty acids inhibit glucose utilization in human skeletal muscle. News Physiol Sci Int J Physiol Prod Jointly Int Union Physiol Sci Am Physiol Soc. 2004 Jun;19:92–6.
19. Galgani JE, Moro C, Ravussin E. Metabolic flexibility and insulin resistance. Am J Physiol Endocrinol Metab. 2008 Nov;295(5):E1009-1017.
20. Yamamoto Noguchi CC, Kunikane N, Hashimoto S, Furutani E. Mixed model of dietary fat effect on postprandial glucose-insulin metabolism from carbohydrates in type 1 diabetes. Conf Proc Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf. 2015 Aug;2015:8058–61.
21. Sumiyoshi M, Sakanaka M, Kimura Y. Chronic Intake of High-Fat and High-Sucrose Diets Differentially Affects Glucose Intolerance in Mice. J Nutr. 2006 Mar 1;136(3):582–7.
22. Taylor R. Banting Memorial lecture 2012: reversing the twin cycles of type 2 diabetes. Diabet Med J Br Diabet Assoc. 2013 Mar;30(3):267–75.
23. Pańkowska E, Błazik M, Groele L. Does the fat-protein meal increase postprandial glucose level in type 1 diabetes patients on insulin pump: the conclusion of a randomized study. Diabetes Technol Ther. 2012 Jan;14(1):16–22.
24. Smart CEM, Evans M, O’Connell SM, McElduff P, Lopez PE, Jones TW, et

al. Both dietary protein and fat increase postprandial glucose excursions in children with type 1 diabetes, and the effect is additive. Diabetes Care. 2013 Dec;36(12):3897–902.
25. Paterson M, Bell KJ, O’Connell SM, Smart CE, Shafat A, King B. The Role of Dietary Protein and Fat in Glycaemic Control in Type 1 Diabetes: Implications for Intensive Diabetes Management. Curr Diab Rep. 2015 Jul 23;15(9):1–9.
26. Neu A, Behret F, Braun R, Herrlich S, Liebrich F, Loesch-Binder M, et al. Higher glucose concentrations following protein- and fat-rich meals – the Tuebingen Grill Study: a pilot study in adolescents with type 1 diabetes. Pediatr Diabetes. 2015 Dec 1;16(8):587–91.
27. Randle PJ, Garland PB, Hales CN, Newsholme EA. The glucose fatty- acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet. 1963 Apr 13;1(7285):785–9.
28. Demerath EW, Reed D, Rogers N, Sun SS, Lee M, Choh AC, et al. Visceral adiposity and its anatomical distribution as predictors of the metabolic syndrome and cardiometabolic risk factor levels. Am J Clin Nutr. 2008;88(5):1263–1271.
29. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu C- Y, et al. Abdominal visceral and subcutaneous adipose tissue compartments association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007;116(1):39–48.
30. Kim S, Cho B, Lee H, Choi K, Hwang SS, Kim D, et al. Distribution of abdominal visceral and subcutaneous adipose tissue and metabolic syndrome in a Korean population. Diabetes Care. 2011;34(2):504–506.
31. Liu J, Fox CS, Hickson DA, May WD, Hairston KG, Carr JJ, et al. Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factors: the Jackson Heart Study. J Clin Endocrinol Metab. 2010;95(12):5419–5426.
32. McLaughlin T, Lamendola C, Liu A, Abbasi F. Preferential fat deposition in subcutaneous versus visceral depots is associated with insulin sensitivity. J Clin Endocrinol Metab. 2011;96(11):E1756–E1760.
33. Ng JM, Azuma K, Kelley C, Pencek R, Radikova Z, Laymon C, et al. PET

imaging reveals distinctive roles for different regional adipose tissue depots in systemic glucose metabolism in nonobese humans. Am J Physiol Endocrinol Metab. 2012 Nov 1;303(9):E1134-1141.
34. Amati F, Pennant M, Azuma K, Dubé JJ, Toledo FGS, Rossi AP, et al. Lower thigh subcutaneous and higher visceral abdominal adipose tissue content both contribute to insulin resistance. Obes Silver Spring Md. 2012 May;20(5):1115–7.
35. Gallagher D, Kelley DE, Yim J-E, Spence N, Albu J, Boxt L, et al. Adipose tissue distribution is different in type 2 diabetes. Am J Clin Nutr. 2009 Mar;89(3):807–14.
36. Azuma K, Heilbronn LK, Albu JB, Smith SR, Ravussin E, Kelley DE, et al. Adipose tissue distribution in relation to insulin resistance in type 2 diabetes mellitus. Am J Physiol Endocrinol Metab. 2007 Jul;293(1):E435- 442.
37. Choe SS, Huh JY, Hwang IJ, Kim JI, Kim JB. Adipose Tissue Remodeling: Its Role in Energy Metabolism and Metabolic Disorders. Front Endocrinol. 2016;7:30.
38. Terry RB, Stefanick ML, Haskell WL, Wood PD. Contributions of regional adipose tissue depots to plasma lipoprotein concentrations in overweight men and women: Possible protective effects of thigh fat. Metabolism. 1991 Jul;40(7):733–40.
39. Kelley DE, Goodpaster BH. Stewing in Not-So-Good Juices: Interactions of Skeletal Muscle With Adipose Secretions. Diabetes. 2015 Sep 1;64(9):3055–7.
40. Tran TT, Yamamoto Y, Gesta S, Kahn CR. Beneficial Effects of Subcutaneous Fat Transplantation on Metabolism. Cell Metab. 2008 May 7;7(5):410–20.
41. Porter SA, Massaro JM, Hoffmann U, Vasan RS, O’Donnel CJ, Fox CS. Abdominal subcutaneous adipose tissue: a protective fat depot? Diabetes Care. 2009;32(6):1068–1075.
42. Snijder MB, Visser M, Dekker JM, Goodpaster BH, Harris TB, Kritchevsky SB, et al. Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. The Health

ABC Study. Diabetologia. 2005;48(2):301–308.
43. Wildman RP, Janssen I, Khan UI, Thurston R, Barinas-Mitchell E, El Khoudary SR, et al. Subcutaneous adipose tissue in relation to subclinical atherosclerosis and cardiometabolic risk factors in midlife women. Am J Clin Nutr. 2011;93(4):719–726.
44. Funaki M. Saturated fatty acids and insulin resistance. J Med Investig JMI. 2009 Aug;56(3–4):88–92.
45. Pal D, Dasgupta S, Kundu R, Maitra S, Das G, Mukhopadhyay S, et al. Fetuin-A acts as an endogenous ligand of TLR4 to promote lipid-induced insulin resistance. Nat Med. 2012 Aug;18(8):1279–85.
46. Suganami T, Tanaka M, Ogawa Y. Adipose tissue inflammation and ectopic lipid accumulation. Endocr J. 2012;59(10):849–57.
47. Xu H, Barnes GT, Yang Q, Tan G, Yang D, Chou CJ, et al. Chronic inflammation in fat plays a crucial role in the development of obesity- related insulin resistance. J Clin Invest. 2003 Dec;112(12):1821–30.
48. Weisberg SP, Hunter D, Huber R, Lemieux J, Slaymaker S, Vaddi K, et al. CCR2 modulates inflammatory and metabolic effects of high-fat feeding. J Clin Invest. 2006 Jan;116(1):115–24.
49. Coenen KR, Gruen ML, Chait A, Hasty AH. Diet-induced increases in adiposity, but not plasma lipids, promote macrophage infiltration into white adipose tissue. Diabetes. 2007 Mar;56(3):564–73.
50. Lee JY, Plakidas A, Lee WH, Heikkinen A, Chanmugam P, Bray G, et al. Differential modulation of Toll-like receptors by fatty acids: preferential inhibition by n-3 polyunsaturated fatty acids. J Lipid Res. 2003 Mar;44(3):479–86.
51. Shi H, Kokoeva MV, Inouye K, Tzameli I, Yin H, Flier JS. TLR4 links innate immunity and fatty acid-induced insulin resistance. J Clin Invest. 2006 Nov;116(11):3015–25.
52. Capurso C, Capurso A. From excess adiposity to insulin resistance: the role of free fatty acids. Vascul Pharmacol. 2012 Oct;57(2–4):91–7.
53. Lionetti L, Mollica MP, Lombardi A, Cavaliere G, Gifuni G, Barletta A. From chronic overnutrition to insulin resistance: the role of fat-storing

capacity and inflammation. Nutr Metab Cardiovasc Dis NMCD. 2009 Feb;19(2):146–52.
54. Song MJ, Kim KH, Yoon JM, Kim JB. Activation of Toll-like receptor 4 is associated with insulin resistance in adipocytes. Biochem Biophys Res Commun. 2006 Aug 4;346(3):739–45.
55. Unger RH, Zhou YT. Lipotoxicity of beta-cells in obesity and in other causes of fatty acid spillover. Diabetes. 2001 Feb;50 Suppl 1:S118-121.
56. Cline GW, Petersen KF, Krssak M, Shen J, Hundal RS, Trajanoski Z, et al. Impaired glucose transport as a cause of decreased insulin-stimulated muscle glycogen synthesis in type 2 diabetes. N Engl J Med. 1999 Jul 22;341(4):240–6.
57. Byrne CD, Olufadi R, Bruce KD, Cagampang FR, Ahmed MH. Metabolic disturbances in non-alcoholic fatty liver disease. Clin Sci Lond Engl 1979. 2009 Apr;116(7):539–64.
58. Asrih M, Jornayvaz FR. Diets and nonalcoholic fatty liver disease: the good and the bad. Clin Nutr Edinb Scotl. 2014 Apr;33(2):186–90.
59. de Wit NJW, Afman LA, Mensink M, Müller M. Phenotyping the effect of diet on non-alcoholic fatty liver disease. J Hepatol. 2012 Dec;57(6):1370– 3.
60. Ferramosca A, Zara V. Modulation of hepatic steatosis by dietary fatty acids. World J Gastroenterol. 2014 Feb 21;20(7):1746–55.
61. Nakamura A, Terauchi Y. Lessons from mouse models of high-fat diet- induced NAFLD. Int J Mol Sci. 2013;14(11):21240–57.
62. Ress C, Kaser S. Mechanisms of intrahepatic triglyceride accumulation. World J Gastroenterol. 2016 Jan 28;22(4):1664–73.
63. Tessari P, Coracina A, Cosma A, Tiengo A. Hepatic lipid metabolism and non-alcoholic fatty liver disease. Nutr Metab Cardiovasc Dis NMCD. 2009 May;19(4):291–302.
64. What Factors Slow the Absorption of Carbohydrates? [Internet]. [cited 2016 Mar 6]. Available from: absor…

  1. Ang M, Müller AS, Wagenlehner F, Pilatz A, Linn T. Combining protein and carbohydrate increases postprandial insulin levels but does not improve glucose response in patients with type 2 diabetes. Metabolism. 2012 Dec;61(12):1696–702.

  2. Protein controversies in diabetes - ProQuest [Internet]. [cited 2016 May 17]. Available from:

  3. Haber EP, Ximenes HMA, Procópio J, Carvalho CRO, Curi R, Carpinelli AR. Pleiotropic effects of fatty acids on pancreatic beta-cells. J Cell Physiol. 2003 Jan;194(1):1–12.

  4. Haber EP, Procópio J, Carvalho CRO, Carpinelli AR, Newsholme P, Curi R. New insights into fatty acid modulation of pancreatic beta-cell function. Int Rev Cytol. 2006;248:1–41.

  5. Kraegen EW, Cooney GJ, Ye JM, Thompson AL, Furler SM. The role of lipids in the pathogenesis of muscle insulin resistance and beta cell failure in type II diabetes and obesity. Exp Clin Endocrinol Diabetes Off J Ger Soc Endocrinol Ger Diabetes Assoc. 2001;109 Suppl 2:S189-201.

  6. Kusminski CM, Shetty S, Orci L, Unger RH, Scherer PE. Diabetes and apoptosis: lipotoxicity. Apoptosis Int J Program Cell Death. 2009 Dec;14(12):1484–95.

  7. Manco M, Calvani M, Mingrone G. Effects of dietary fatty acids on insulin sensitivity and secretion. Diabetes Obes Metab. 2004 Nov;6(6):402– 13.

  8. Poitout V, Robertson RP. Minireview: Secondary beta-cell failure in type 2 diabetes–a convergence of glucotoxicity and lipotoxicity. Endocrinology. 2002 Feb;143(2):339–42.

  9. Robertson RP, Harmon J, Tran POT, Poitout V. β-Cell Glucose Toxicity, Lipotoxicity, and Chronic Oxidative Stress in Type 2 Diabetes. Diabetes. 2004 Feb 1;53(suppl 1):S119–24.

  10. Sharma RB, Alonso LC. Lipotoxicity in the pancreatic beta cell: not just survival and function, but proliferation as well? Curr Diab Rep. 2014 Jun;14(6):492.

  11. Shimabukuro M, Zhou YT, Levi M, Unger RH. Fatty acid-induced beta cell apoptosis: a link between obesity and diabetes. Proc Natl Acad Sci U S A. 1998 Mar 3;95(5):2498–502.

  12. Unger RH, Grundy S. Hyperglycaemia as an inducer as well as a consequence of impaired islet cell function and insulin resistance: implications for the management of diabetes. Diabetologia. 1985 Mar;28(3):119–21.

  13. Unger RH. Lipotoxicity in the pathogenesis of obesity-dependent NIDDM. Genetic and clinical implications. Diabetes. 1995 Aug;44(8):863– 70.

  14. Cnop M, Hughes SJ, Igoillo-Esteve M, Hoppa MB, Sayyed F, van de Laar L, et al. The long lifespan and low turnover of human islet beta cells estimated by mathematical modelling of lipofuscin accumulation. Diabetologia. 2010 Feb;53(2):321–30.

  15. Rabinowitch IM. Effects of the High Carbohydrate-Low Calorie Diet Upon Carbohydrate Tolerance in Diabetes Mellitus. Can Med Assoc J. 1935 Aug;33(2):136–44.




  19. Kempner W, Peschel RL, Schlayer C. Effect of rice diet on diabetes mellitus associated with vascular disease. Postgrad Med. 1958 Oct;24(4):359–71.

  20. Anderson JW, Ward K. High-carbohydrate, high-fiber diets for insulin- treated men with diabetes mellitus. Am J Clin Nutr. 1979 Nov;32(11):2312– 21.

  21. Anderson JW. High carbohydrate, high fiber diets for patients with diabetes. Adv Exp Med Biol. 1979;119:263–73.

  22. Holt SH, Miller JC, Petocz P. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr. 1997 Nov;66(5):1264–76.

  23. Wolpert HA, Atakov-Castillo A, Smith SA, Steil GM. Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients With Type 1 Diabetes Implications for carbohydrate-based bolus dose calculation and intensive diabetes management. Diabetes Care. 2013 Apr 1;36(4):810–6.

  24. Bell KJ, Smart CE, Steil GM, Brand-Miller JC, King B, Wolpert HA. Impact of Fat, Protein, and Glycemic Index on Postprandial Glucose Control in Type 1 Diabetes: Implications for Intensive Diabetes Management in the Continuous Glucose Monitoring Era. Diabetes Care. 2015 Jun 1;38(6):1008–15.

  25. Gormsen LC, Nielsen C, Jessen N, Jørgensen JOL, Møller N. Time- course effects of physiological free fatty acid surges on insulin sensitivity in humans. Acta Physiol Oxf Engl. 2011 Mar;201(3):349–56.

  26. Hirabara SM, Silveira LR, Abdulkader F, Carvalho CRO, Procopio J, Curi R. Time-dependent effects of fatty acids on skeletal muscle metabolism. J Cell Physiol. 2007 Jan;210(1):7–15.

  27. Paterson MA, Smart CEM, Lopez PE, McElduff P, Attia J, Morbey C, et al. Influence of dietary protein on postprandial blood glucose levels in individuals with Type 1 diabetes mellitus using intensive insulin therapy. Diabet Med J Br Diabet Assoc. 2015 Oct 26;

  28. Astrup A, Larsen TM, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? The Lancet. 2004 Sep;364(9437):897–9.

  29. Bravata DM SL. Efficacy and safety of low-carbohydrate diets: A systematic review. JAMA. 2003 Apr 9;289(14):1837–50.

  30. Fisler JS, Drenick EJ. Starvation and Semistarvation Diets in the Management of Obesity. Annu Rev Nutr. 1987 Jul;7(1):465–84.

  31. Gannon MC, Nuttall FQ. Effect of a high-protein, low-carbohydrate diet on blood glucose control in people with type 2 diabetes. Diabetes. 2004 Sep;53(9):2375–82.

  32. Garg A, Grundy SM, Unger RH. Comparison of Effects of High and Low Carbohydrate Diets on Plasma Lipoproteins and Insulin Sensitivity in Patients With Mild NIDDM. Diabetes. 1992 Oct 1;41(10):1278–85.

  33. Larsen RN, Mann NJ, Maclean E, Shaw JE. The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomised controlled trial. Diabetologia. 2011 Jan 20;54(4):731–40.

  34. Nolan CJ, Ruderman NB, Kahn SE, Pedersen O, Prentki M. Insulin Resistance as a Physiological Defense Against Metabolic Stress: Implications for the Management of Subsets of Type 2 Diabetes. Diabetes. 2015 Mar 1;64(3):673–86.

  35. Taegtmeyer H, Beauloye C, Harmancey R, Hue L. Insulin resistance protects the heart from fuel overload in dysregulated metabolic states. Am J Physiol - Heart Circ Physiol. 2013 Dec 15;305(12):H1693–7.

  36. Connor T, Martin SD, Howlett KF, McGee SL. Metabolic remodelling in obesity and type 2 diabetes: pathological or protective mechanisms in response to nutrient excess? Clin Exp Pharmacol Physiol. 2015 Jan;42(1):109–15.

  37. Kahn HA, Phillips RL, Snowdon DA, Choi W. Association between reported diet and all-cause mortality. Twenty-one-year follow-up on 27,530 adult Seventh-Day Adventists. Am J Epidemiol. 1984 May;119(5):775–87.

  38. Song M, Fung TT, Hu FB, Willett WC, Longo VD, Chan AT, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med. 2016 Aug 1;

  39. Djoussé L, Gaziano JM. Egg consumption in relation to cardiovascular disease and mortality: the Physicians’ Health Study. Am J Clin Nutr. 2008 Apr;87(4):964–9.

  40. Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Low-carbohydrate diets and all-cause and cause-specific mortality: Two cohort Studies. Ann Intern Med. 2010 Sep 7;153(5):289–98.

  41. Noto H, Goto A, Tsujimoto T, Noda M. Low-Carbohydrate Diets and All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies. PLoS One [Internet]. 2013 Jan 25 [cited 2014 May 9];8(1). Available from:

  42. Levine ME, Suarez JA, Brandhorst S, Balasubramanian P, Cheng C-W, Madia F, et al. Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population. Cell Metab. 2014 Mar 4;19(3):407–17.

  43. Rohrmann S, Overvad K, Bueno-de-Mesquita HB, Jakobsen MU, Egeberg R, Tjønneland A, et al. Meat consumption and mortality–results from the European Prospective Investigation into Cancer and Nutrition. BMC Med. 2013;11:63.

  44. Orlich MJ, Singh PN, Sabaté J, Jaceldo-Siegl K, Fan J, Knutsen S, et al. Vegetarian Dietary Patterns and Mortality in Adventist Health Study 2. JAMA Intern Med. 2013 Jul 8;173(13):1230–8.

Diabetes Nutrition
If you’re looking for education, guidance, and accountability to help your patients transition to a plant-based diet for the BEST diabetes health you’ve ever had, consider joining our thriving online coaching program for type 1, type 1.5, prediabetes and type 2 diabetes.


Hi Diabetes Oldie, I forgot to tag you. I should have started a new topic, but didn’t think of it when I last posted.

Here is the information that you requested. Don’t know if you are still interested.