These medications have been heralded for their ability to suppress appetite and aid weight loss, but did you know that GLP-1 is a natural hormone you can stimulate without injections or prescriptions?

Glucagon-like peptide-1 (GLP-1) plays a vital role in regulating metabolism, the intricate system responsible for managing your energy, weight, and blood sugar levels.

With the right habits, you can enhance your body’s natural GLP-1 production, helping you manage weight and maintain overall health sustainably.

Understanding GLP-1s and their role

GLP-1 is a hormone released in the gut in response to eating.

It has several important roles:

• Regulating blood glucose: GLP-1 increases insulin secretion and reduces glucagon levels, keeping blood sugar steady.
• Controlling appetite: It signals your brain to reduce hunger and enhances feelings of fullness.
• Slowing digestion: By delaying gastric emptying, GLP-1 ensures a steady release of nutrients and energy.
• Promoting energy balance: GLP-1 helps the body decide when to store or use energy.

Medications that mimic GLP-1 can be effective for weight loss, but their side effects such as nausea, muscle loss, and gastrointestinal discomfort make them unsuitable for everyone.

Research published in The Lancet warns that 40% of weight lost using these medications is lean muscle mass which can be difficult to regain.

Additionally, weight often returns once the medication is discontinued.

Natural methods of enhancing GLP-1 not only sidestep these issues but also offer long-term benefits for metabolic health.

• Rise of dangerous weight loss black market sparks concern
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• MHRA: 68 people hospitalised with weight loss injections

How to naturally boost GLP-1 levels

Research suggests that lifestyle choices can significantly impact GLP-1 production and effectiveness.

1. Optimise your diet

Excessive sugar and refined carbohydrates flood your system with glucose, causing blood sugar spikes and crashes, so you want to reduce digestible glucose.

“Glucose rollercoasters” disrupts hormonal balance, including GLP-1.

Replacing sugary snacks with complex carbohydrates like whole grains, beans, and lentils can help stabilise blood sugar levels and improve GLP-1 activity.

2. Prioritise high-protein foods

Foods such as eggs, fish, poultry, and plant-based proteins are known to stimulate GLP-1 secretion.

Studies show that meals high in protein can significantly increase satiety by enhancing GLP-1 release.

Starting your day with a protein-rich breakfast sets the tone for steady energy throughout the day.

3. Increase fibre intake

Dietary fibre, particularly from fruits, vegetables, and whole grains, slows digestion and promotes the release of GLP-1.

Research from The American Journal of Clinical Nutrition highlights that fibre-rich diets not only support GLP-1 but also improve insulin sensitivity and gut health.

4. Engage in regular physical activity

Exercise is a powerful, natural stimulant for GLP-1. Studies in Diabetes Care have shown that both strength training and aerobic exercise can enhance GLP-1 levels improving appetite regulation and glucose metabolism.

Even simple activities like a brisk 10-minute walk after meals can help stimulate GLP-1 release.

5. Prioritise sleep

Sleep and hormone regulation go hand in hand. Poor sleep disrupts GLP-1 production and increases levels of ghrelin, the hormone that stimulates hunger.

Research from The Journal of Clinical Endocrinology & Metabolism suggests that getting 7–8 hours of quality sleep each night supports hormonal balance and reduces cravings.

6. Manage stress

Chronic stress elevates cortisol which can interfere with GLP-1 production and other metabolic processes.

Incorporating stress-relieving practices like mindfulness, yoga, or breathing exercises can help maintain a balanced hormonal environment.

• Reason why GLP-1 receptor agonists impact muscle mass explained
• Mounjaro comes out top in battle of the weight loss drugs
• Intermittent Fasting: Guide to Fasting and How it Works

Habits for long term GLP-1 optimisation

Changing your lifestyle can feel overwhelming but habit formation is the key to long-term success.

By linking new behaviours to existing routines – a technique known as habit stacking – you can make sustainable changes.

For example, pair your morning coffee with a short walk or add a handful of fibre-rich seeds to your breakfast.

It’s also important to rely on habits rather than willpower.

Research from Psychological Science highlights that willpower is a finite resource which diminishes throughout the day.

In contrast, habits are automatic behaviours that require less mental effort allowing you to maintain healthy routines effortlessly.

Boosting GLP-1 naturally isn’t just about appetite control; it’s about creating a lifestyle that supports your body’s natural processes.

One Meal A Day (OMAD) is a form of intermittent fasting that has gained popularity for its simplicity and prospect of significant health benefits.

Unlike traditional eating patterns which typically involve 3 meals a day, OMAD involves eating all of your daily calories in a single meal.

By doing this, you restrict food intake to a very short window of approximately 1 hour each day.

This is an extreme version of intermittent fasting, grounded in the belief that prolonged periods without food can lead to improved health outcomes and weight management.

• Time Restricted Eating: Beginner’s Guide
• Low Carb Diet and 7-day Meal Plan
• Carnivore Diet: The All Meat Diet

How OMAD works

The concept of OMAD is quite straightforward: eat once and then fast until the next day’s mealtime.

This approach is not just about limiting food intake to one meal a day.

It is also key to adhere to the same eating window daily to stabilise the body’s internal clock.

Flexibility in choosing the mealtime allows individuals to align their eating window with their lifestyle, making it a theoretically accessible approach to weight management and health improvement.

Advantages of OMAD

As with any eating approach, there are a range of potential advantages and disadvantages.

Potential for weight loss

OMAD’s restriction to a single daily meal can naturally lead to a reduction in calorie intake, thereby facilitating weight loss.

This aspect of OMAD can be particularly beneficial for weight management.

However, it’s important to acknowledge that OMAD may not suit everyone and that individual experiences can vary.

Limited research suggests that intermittent fasting can improve insulin sensitivity, thereby potentially aiding in blood sugar regulation.

• Intermittent fasting can help reach remission for type 2 diabetes
• Rishi Sunak follows intermittent fasting diet: “I don’t eat on Mondays”

Save time

Planning and preparing one meal a day is simpler and less time-consuming than traditional diets.

Disadvantages

Sustainability

The strict nature of OMAD makes it challenging for many to sustain long-term. Some people may find this approach leads to increased hunger.

Nutritional deficiency risks

With only one meal to provide daily nutrients, there’s a heightened risk of deficiencies.

Potential for binge eating

The restriction can lead to overeating during the eating window, negating some of the diet’s benefits.

Potential blood glucose fluctuations

For people with diabetes, OMAD poses potential risks including significant blood sugar fluctuations.

Lack of food intake for extended periods may lead to hypoglycemia (low blood sugar) while the consumption of a day’s worth of calories in one meal might cause hyperglycemia (high blood sugar).

Therefore, individuals with diabetes considering OMAD should do so under medical supervision.

Research

While studies on intermittent fasting show promise for weight loss and improved metabolic health, research specifically targeting OMAD is less abundant.

Some evidence suggests potential benefits in weight management and insulin sensitivity, which are critical for people with diabetes.

Nevertheless, the research is ongoing, and current findings should not be seen as conclusive.

• Beyond weight loss: health benefits of prolonged fasting investigated
• Fasting diet that concentrates on eating early in the day could lower type 2 diabetes risk
• Fasting-mimicking diet: how it benefits our heart health

While OMAD presents a simplistic and potentially effective approach to dieting, it requires careful consideration and is not universally suitable.

The diet’s extreme nature means it may offer benefits for some, particularly in terms of weight loss and metabolic health.

However, it also carries risks. Speak to your doctor before adopting this dietary approach.

Unlike time-restricted eating which focuses on eating within specific daily windows, intermittent fasting involves various patterns of eating and fasting cycles.

Fasting cycles can range from daily 16-hour fasts to full-day fasts a couple of times a week.

People with type 2 diabetes are known to use this approach to manage insulin levels and subsequently blood glucose levels, helping to support a healthy weight.

What is intermittent fasting?

Intermittent fasting refers to alternating periods of eating and fasting (not eating).

The aim is to time meals in a way that allows the body to use its stored fat for energy more efficiently.

Common intermittent fasting methods include:

• 16/8 method: fast for 16 hours and eat during an 8-hour window.
• 5:2 diet: eating normally for five days of the week while restricting calories on the other two days.
• Time-restricted eating: which focuses on limiting your daily eating periods to specific windows of time with less emphasis on what you eat and more on when you eat.

How does intermittent fasting work?

Intermittent fasting helps improve insulin sensitivity.

During fasting, insulin levels drop which prompt the body to switch from glucose to stored fat for energy.

This process burns body fat and supports weight loss.

During extended fasts, the body increases autophagy – the removal of damaged cell components – and increases growth hormone levels.

• Rishi Sunak follows intermittent fasting diet: ‘I don’t eat on Mondays’
• Fasting-mimicking diet: how it benefits our heart health

Benefits of intermittent fasting

Research indicates that intermittent fasting can improve various aspects of health.

These include:

• Enhanced insulin sensitivity and improved insulin resistance
• Lower blood sugar levels
• Improve blood pressure
• Reduce cholesterol levels
• Reduce inflammation
• Weight loss

This makes it particularly appealing for people with type 2 diabetes, or those seeking to lose weight.

Additionally, fasting can improve metabolic efficiency, reducing oxidative stress and inflammation.

Fasting for people with diabetes

Many people with and without diabetes practice fasting.

For people with diabetes, intermittent fasting can provide a method for controlling blood sugar levels and reducing dependency on medication.

However, it’s essential to approach intermittent fasting with caution and with medical supervision, especially for those on blood glucose-lowering medications in order to avoid hypoglycemia.

Tailoring fasting schedules to your health needs and monitoring your blood sugar levels closely are crucial steps for safely integrating intermittent fasting into your diabetes management plan.

• Water fasting: benefits of a water fast disappear soon after it ends
• Intermittent fasting can help reach remission for type 2 diabetes

Practical tips for success with intermittent fasting

To succeed with intermittent fasting:

• Start slowly with shorter fasting periods and gradually increase the duration as your body adjusts.
• Stay hydrated during fasting periods by drinking water, black coffee, or tea.
• Break your fast with balanced meals that include a mix of proteins, fats, and low in carbohydrates.
• Listen to your body and adjust your fasting schedule as needed based on how you feel.

Make sure you go at a pace that suits you, and speak to your doctor before incorporating intermittent fasting into your lifestyle.

Unlike traditional diets that focus on ‘what’ to eat, TRE focuses on ‘when’ to eat.

What is time-restricted eating?

Time-restricted eating is a dietary strategy that limits food intake to a specific number of hours each day.

The core principle is synchronising your eating patterns with your body’s circadian rhythms. The circadian rhythm is a natural process that regulates the sleep-wake cycle and repeats roughly every 24 hours.

By limiting the eating window, people can potentially improve their metabolic health parameters by aligning nutrient timing with the body’s internal clock.

Example eating windows:

Common frameworks within TRE involve 8-hour eating windows followed by 16-hour fasts (16:8 method), or more extended fasting periods such as a 20-hour fast with a 4-hour eating window (20:4). These are not one-size-fits-all, as the efficacy and comfort of these methods can vary significantly among individuals.

You may have heard of the 5:2 diet where calories are reduced for a number of days, rather than a number of hours each day.

How does time-restricted eating work?

During periods of fasting, the body shifts its energy source from glucose to stored fat, promoting fat loss.

The focus on time-restricted eating is not about reaching ketosis.

• Nutritional ketosis vs diabetic ketoacidosis (DKA)

Concurrently, aligning food consumption with daylight cycles optimises your body’s metabolic processes as the endocrine system and metabolic regulation are closely tied to circadian rhythms.

TRE works by minimising exposure to food and hunger hormones like ghrelin and potentially correcting insulin resistance by reducing the frequency of insulin release.

What does the science say?

Research into TRE has shown several potential health benefits:

• Fasting diet that concentrates on eating early in the day could lower type 2 diabetes risk
• Intermittent fasting can help reach remission for type 2 diabetes
• Combining time-restricted eating and HIIT brings health benefits for women with obesity
• Better benefits for fasting females discovered

Studies have demonstrated time restricted eating’s potential in reducing the risk of chronic conditions including type 2 diabetes, heart disease, and neurodegenerative diseases.

Beyond weight management and metabolic health, TRE has benefits, including:

1. Improved mental clarity and concentration due to the production of ketone bodies during fasting
2. Enhanced cellular repair and resilience through the removal of waste material from cells
3. Potential extension of lifespan and reduction in the risk of age-related diseases

While findings are promising, more extensive human studies are necessary to establish comprehensive guidelines and recommendations

What is autophagy?

One of the pivotal biological processes linked to TRE is autophagy.

Autophagy is a cellular mechanism that involves the breakdown and recycling of damaged cell components. Autophagy is triggered during periods of fasting and is akin to your body cleaning up  dysfunctional cellular components and reducing the likelihood of pathological cell growth.

This process is crucial for cellular rejuvenation, homeostasis, and defense against various diseases.

By promoting autophagy, TRE potentially supports the body’s natural defense mechanisms, contributing to overall health and longevity.

How do I break a fast?

Break your fast with nutrient-dense, low-carb, and real foods to maximise the benefits of TRE.

Ideal food choices include:

1. Lean proteins (chicken, turkey, tofu) to support muscle health.
2. Healthy fats (avocado, nuts, olive oil) for sustained energy.
3. Fibre-rich vegetables (leafy greens, cruciferous vegetables) to enhance digestive health.
4. Berries and other low-glycemic fruits for antioxidative benefits.

As with any dietary approach, consult your healthcare team before starting time restricted eating to ensure it aligns with your health and goals.

Is time restricted eating and intermittent fasting the same thing?

Time-restricted eating (TRE) and intermittent fasting (IF) are terms that are used interchangeably in the media but they refer to slightly different fasting strategies.

Time-restricted eating focuses on limiting your daily eating periods to specific windows of time with less emphasis on what you eat and more on when you eat. Most TRE protocols advise a fasting period of 12 to 16 hours, which includes the time you are sleeping, and a feeding window of 8 to 12 hours.

The primary goal of TRE is to align eating patterns with the body’s natural circadian rhythm.

Intermittent fasting comprises of a broader range of eating patterns that alternate between periods of fasting and eating.

These patterns can be daily, as in TRE, or over longer cycles, such as 24-hour fasts once or twice a week, or alternate-day fasting. This approach doesn’t always connect eating patterns to circadian rhythm. Instead, it focuses on longer periods of calorie restriction, which can lead to weight loss and other health benefits due to reduced calorie intake and factors like improved insulin sensitivity.

Time-restricted eating is essentially a form of intermittent fasting with a specific focus on circadian biology.

Low carb diets are flexible and can be followed by people with different types of diabetes.

The diet has allowed many people with type 2 diabetes to reverse type 2 diabetes, that is to get their blood sugar levels into a non-diabetes range without the help of medication.

People with type 1 diabetes have also reported much more stable blood sugar levels, making the condition easier to predict and manage.

The diet is a healthy way of eating as vegetables and natural, real foods are integral to the diet.

Low carb guidance and support

The low carb diet forum has been cited as a leading resource in providing support and encouragement for people that are looking to achieve lower HbA1c levels and sustain effective weight loss.[127]

Why follow a low carb diet?

Carbohydrate is the nutrient which has the greatest effect in terms of raising blood sugar levels and requires the most insulin to be taken or be produced by the body.

Lowering sugar levels is clearly a benefit for people with diabetes. Lower need for insulin is also particularly useful as lowering insulin in the body can reduce insulin resistance which can help towards reversing type 2 diabetes.

Insulin is also the fat storage hormone in the body, so reducing insulin in the body with a low carb diet can help with losing weight.

Benefits of low carb diets

The benefits of a low carb diet typically include:

• Lower HbA1c
• Improved weight loss
• Less chance of high sugar levels occurring
• Lower risk of severe hypos
• More energy through the day
• Less cravings for sugary and snack foods
• Clearer thinking
• Lower risk of developing long-term health complications

What counts as low carb?

Low carb is a flexible way of eating that allows you as an individual to choose a level of carbohydrate that works well for your diabetes and lifestyle.

The following brackets are used to categorise daily carbohydrate intake:

• Moderate carbohydrate: 130g to 225g of carbs
• Low carbohydrate: under 130g of carbs
• Very low carbohydrate: under 30g of carbs (also known as a ketogenic diet)

Generally speaking, the lower your carbohydrate intake, the more likely you are to lose weight and the lower sugar levels you are likely to have.

It’s important you choose a level of carbohydrate that works well for you.

For example, people with type 1 diabetes that do not need to low weight may wish to aim for a low or moderate carbohydrate intake.

Someone with type 2 diabetes, or needs to lose weight, may wish to aim for a low carbohydrate intake.

Take precautions

It is important that you speak to your doctor before significantly lowering your carbohydrate intake.

This is especially important if you are on medication that can cause hypoglycemia (low blood sugar), such as insulin, sulphonylureas or glinides.

How carbohydrates affect the body?

Carbohydrates, as do proteins and fats, provide energy so they help to fuel the body.

Carbohydrate is broken down into glucose so when carbohydrates are consumed, an increase in blood sugar levels occurs to a greater or lesser extent according to the amount of carbohydrate.

By reducing carbohydrate intake, you can help to reduce the rise in blood glucose levels after meals.

How will low carbing affect my weight?

Low carbohydrate diets have been found to be successful in aiding weight loss.

The reduction in carbohydrates means that people need not produce, or inject, so much insulin.

As insulin helps to store fat, less circulating insulin could help to prevent, reduce or reverse weight gain.

Also, by restricting the amount of carbohydrates, people often lower their calorie intake at the same time as the focus on eating real foods and the satiating effect of fat means people are less likely to snack and overeat in general.

How to follow a low carb diet

A healthy low carb diet should have the following features:

• Strong vegetable intake
• Modest increase in fat intake from natural sources
• Moderate protein intake
• Low reliance upon processed food, sugar and grains

Read more on following a healthy low carb diet.

Low carb meal plan

You can browse a range of free 7 and 30 day low carb meal plans and cookbooks as a free Diabetes.co.uk member.

The Low Carb Program is an NHS-trusted app for people with type 2 diabetes and prediabetes shown to support weight loss, improved diabetes control and reduction in type 2 diabetes medication through adoption of a low carbohydrate diet.

The program was developed with Dr David Unwin and uses a real food approach, minimising ultra-processed and refined foods where possible.

Fats and protein

If you are significantly reducing the amount of carbohydrate in your diet, you may need to make up some of the reduced calories with either protein or fat.

It is advisable to ensure the fat content of your diet comes from natural sources, such as:

• Meat
• Fish
• Dairy
• Eggs
• Nuts
• Avocado
• Olives
• Olive oil

Natural sources of fat, such as the above, will provide a balance of monounsaturated, polyunsaturated and saturated fat.

Try to avoid processed foods and takeaways as the fat in these are generally either man made or highly processed.

When choosing protein, aim to have unprocessed cuts of meat as processed meats have been consistently linked with higher rates of heart disease and even insulin resistance.

What is the argument against low carb diets for people with diabetes?

If low carb diets can help to reduce blood glucose levels and aid weight loss, then why are low carbohydrate diets not advocated by the NHS? The truth is, they are – the Low Carb Program is an NHS certified education programme and used in the NHS.

The reason that is commonly cited is that there is not enough evidence to support the effectiveness and safety of low carbohydrate diets.

The question is a hotly debated one which has seen disagreement from both sides as to which diet is more safe and effective.

However, research in favour of low carb diets is growing and consistently shows low carb diets are superior to the low-fat diet typically advised by the NHS.

Further research demonstrates:

• Low carb diet shown to reduce high blood pressure
• Low carb diet could prevent type 2 diabetes even without weight loss
• Low carb diet to combat type 2 diabetes and obesity

What side effects exist on a low carb diet?

Side effects that can be commonly experienced on a low carb diet include:

• Fatigue
• Brain fog
• Headaches
• Constipation
• Possible nutrient deficiencies

Hypoglycemia (low blood sugar) may occur if you take insulin or tablets that can cause low blood sugar.

If you take medications that can cause hypos, it’s particularly important to discuss precautions to prevent hypos before starting a low carb diet.

• Read more on Low Carb Diet Side Effects

Is a low carb diet suitable for everyone?

Low carb diets are suitable for most people. As noted above, if you’re thinking of reducing your carbohydrate intake by a large amount, it’s best to check with your doctor if any precautions need to be made.

If you are pregnant, or planning pregnancy, a very low carb diet may not be appropriate as the safety of very low carbohydrate diets in pregnancy is not currently known.

For other questions, ask the low carb diet community on the Low Carb Forum.

The dietary advice generally given to people with type 1 diabetes is not much different to the dietary advice for people without diabetes.

The main issues to consider are how sharply different foods are likely to impact on your blood glucose levels and how to balance the quantity of carbohydrate with the right amount of insulin.

Carbohydrate counting

Carbohydrate counting plays a key role in helping to balance insulin intake with the food you eat.

A number of carbohydrate counting courses are available including the

DAFNE course
(dose adjustment for normal eating) which is widely recommended by people who have been on it.

Another carbohydrate counting resource which is quickly growing in popularity is the

Carbs and Cals
book which shows, in pictorial form, how many carbohydrates are in a huge variety of different meals and portion sizes.

Healthy eating for type 1 diabetes

Eating healthily comes highly recommended and can play a part in helping to prevent the development of complications.

Eating a balanced diet, containing a variety of different vegetables, will help to provide many nutrients that the body needs.

Try to include foods containing unsaturated fats such as nuts, avocados and oily fish.

We recommend limiting the amount of

processed foods
you eat and try to include home prepared or freshly prepared food wherever possible.

• Read more on
  
  healthy eating for diabetes

Low carb diets and type 1 diabetes

Some people with type 1 diabetes may wish to adopt a reduced carbohydrate diet. Low carb diets can be helpful for people who are struggling to keep control on a carb centered diet or for those who are otherwise looking to tighten their control.

One of the benefits of reducing your

intake of carbohydrate
is in reducing the extent of post meal high blood sugar levels.

Lower carb diets will require a reduction in insulin and could result in hypoglycemia if doses are not changed correctly. It is recommended to speak to your doctor before going onto a significantly different diet.

Carb counting is a way of better understanding how carbohydrates affect your

blood sugar, medication requirement and insulin requirement.

For people with type 1 diabetes and those with type 2 diabetes who require insulin, carbohydrate counting is a way of matching insulin requirements with the amount of carbohydrate that you eat or drink.

For people with

type 2 diabetes
who don’t require insulin, carbohydrate counting is a way of regulating the amount of carbohydrate you consume and monitoring how this affects your blood glucose control,

weight management
and medication intake.

Carbohydrate counting requires patience and diligence. Learning it successfully means understanding carbohydrates, learning how to adjust your

insulin
or medication accordingly, and measure your blood glucose levels regularly for clarity.

What are carbohydrates?

Every carbohydrate we eat is converted into glucose and has an impact on blood sugar levels.

Carbohydrates are commonly found within the following foods:

• Grains (breads, pasta, cereals)
• 
  Fruits
• Vegetables
• Root crops (potatoes, sweet potatoes, and yams)
• Most alcoholic drinks (
  
  Beer, cider, lager, most cocktails)
• Desserts and sweets
• Most dairy products, except cheese,
• 
  Sugars
  including sucrose, fructose, dextrose, maltose

How should I count carbohydrates?

Most people count carbohydrates using grams, with one serving equal to 15 grams of carbohydrate.

Most foods are only partially carbohydrate (although some foods are entirely carbohydrate), but the effect of 15 grams carbohydrate will be the same whether it is from bread, biscuits or other foods.

To ascertain the

carbohydrate content
of these foods, it is necessary to use food labels, reference books or computer programs, and a scale and list of carbohydrates.

There are two methods of counting carbohydrates: basic carb counting and consistent carb counting. Both ways involve calculating the total carbohydrate of a food, knowing how many carbs you can eat, and then matching this up with the portion size and any medication you take.

Basic carb counting

Basic carb counting can help you learn how certain foods affect your

blood glucose levels, and the aim is to eat a consistent amount of carbs each day. This is most likely to be adopted by people with non-insulin treated type 2 diabetes.

A dietitian can advise you on how much carbohydrate you should eat at each meal based on your medication, weight goals and overall diabetes control. In the interim, you could ask your doctor for an appropriate amount of carbs (e.g. 45-60 grams per day) to eat at each meal before your meeting with a dietitian.

Consistent carb counting

Consistent carb counting, also known as advanced carb counting, can be used by people with diabetes who are treated with rapid-acting insulin. To count carbs, you will use an insulin-to-carb ratio, which calculates how much insulin you need to cover the carbohydrate in your meal.

A commonly used ratio is one unit of rapid-acting insulin per 10g of carbohydrate, or 1:10. This can vary from person to person, and your ratio might end up being 1:15, 2:10, or something else. So, if your ratio was 1:15, eating 45g of carbohydrate with a meal would require you to inject three units of insulin.

You can also have different ratios for different times of day.

Carb counting example

John has the following insulin to carb ratios.

• 
  Breakfast:
  
  2 : 10 (2 units of rapid acting insulin per 10g of carbs) [space either side of colon because I’ll introduce a decimal point next which might cause confusion in too cramped a ratio]
• 
  Lunch:
  
  1.5 : 10 (1.5 unit per 10g carbs)
• 
  Dinner:
  
  1: 10 (1 unit per 10g carbs)

Your health care team should help you assess your own insulin-to-carb ratio. Make sure you log your blood glucose levels to see how your ratio affects your readings. It may be you need to inject correction doses of insulin in case your blood sugar climbs too high. You should discuss correction doses with your doctor.

Counting carbohydrates can take a while to become competent, and for some time it will be necessary to weigh and measure

foods

What carbohydrate counting equipment do I need?

Many people with diabetes have scales, as well as weighing and measuring equipment to measure volume. Mostly, food labels give both

weight and volume measurements, but some do not.

The following techniques can help in understanding carbohydrate counting:

• Use of food labels, scales and a calculator make it possible to identify carbohydrate content in food.
• Using a scale is useful for measuring carbs in a range of different foods from fruit and vegetables to rice and cereal. Refer to the food packaging or you can get carb counts from nutrition books or the Internet.
• Take your time with carb counting as it is easy to make mistakes if maths is not a strength or if you’re rushing.
• Be aware that some foods have different carb counts depending on whether the food is cooked or uncooked. This can sometimes make a big difference so be careful with this.
• Nutrition books and online resources can provide useful information and a quick and easy way to look up brand-name food information. Many recipe books include detailed
  
  carbohydrate information

• The

  Carbs and Cals
  book (or app) is a popular book for helping with carb counting as it provides images of a range of foods and serving sizes along with the associated carb counts.

There is a vast amount of real-life experience on the topic of carb counting in the

Low Carb Forum

How do I understand more about carbohydrate counting?

The best way to learn carbohydrate counting is to take part in a carbohydrate counting course.

If you are on insulin, would like to go on a carbohydrate counting course and have not been on one of these courses in recent years, your GP, diabetes consultant or diabetes specialist nurse can refer you onto one of these courses.

Examples of nationwide carbohydrate counting courses include:

• 
  Low Carb Program
• 
  DAFNE
• 
  X-PERT
• 
  BERTIE

Your diabetes health team should also be able to arrange one-to-one guidance on carbohydrate counting if you need help at any time.

The

Low Carb Program
is an online education program that is used in the NHS to support people with prediabetes and type 2 diabetes control and potentially reverse their condition through a low carbohydrate diet.

What the community have to say about carbohydrate counting

• Carbsrok: You need to be counting the carbohydrate in your food. Please go back to your Diabetes team and say: ‘look, I am completely confused. I need help sorting this.’ Take pen and paper with you so you can write things down. Ask for guidance on Carbohydrates. And how to match your insulin to food intake. A low GI/ Glycaemic load need to be considered. Take one day at a time otherwise you will feel completely overwhelmed by it all.
• Copepod: Most food packets have carbohydrate content in the nutritional information – you need to count total carbohydrate, not just the sugar, and also bear in mind some foods have different values for raw & cooked food. Having said that, once I’ve weighed a food once, I just estimate by sight after that, which is useful when eating away from home. For fruit and vegetables, you’ll need a guide, either book or online.
• Gazhay:I would highly encourage every diabetic to go on DAFNE course, even the ‘carb counting haters’. As it can be a very individual thing, and surely getting all the education about it is a good thing, whether you choose to continue it or not.
• Wallycorker: Over the last 5 months after attending sessions on carbohydrate management she had attained a magnificent HbA1c of 5.6 – down from readings near to – or in – double figures. What’s more by following the techniques explained to her she had lost a massive five stones in weight in the same period of time. Yes five stones in five months – I am certain that is what she said – just through carbohydrate management or carb counting as it is sometimes known.
• Hellsbells: I was diagnosed with T2 almost 2 years ago. I waited 5 months to see dietician who advised me to eat carbohydrate based meals. In fact, when I told her I was carb counting as a way of controlling my bg levels she told me my medication (metformin) would not work if I didn’t eat plenty of carbs! I also asked about portion control. She replied that she would discuss this with me at our next meeting which would be in 3 months time. Needless to say, I didn’t go back.

Diets for type 2 diabetes should be built around the principles of healthy eating with a focus on foods that do not adversely affect

blood glucose levels

As a general guide, your diet should include a good variety of vegetables, sources of unsaturated fats such as nuts, avocados and oily fish, while processed foods should be avoided.

Type 2 diabetes and the NHS diet

NHS

diet advice
generally recommends eating starchy carbohydrates with each meal, as well as more fruit and vegetables, at least two portions of oily fish a week, and less saturated fat, salt and sugars.

The most disputed part of the advice is the recommendation to eat starchy carbohydrates at each meal.

Many people with type 2 diabetes find that even

low GI sources
of starchy carbohydrate (such as basmati rice and whole grain bread) tend to significantly increase blood glucose levels.

Performing blood glucose tests before and two hours after meals can help you see which foods, and in what quantities, are appropriate for you.

• Read more on
  
  pre and post meal blood testing

Low-carb diets and type 2 diabetes

Low-carbohydrate diets tend to be popular with people with type 2 diabetes, with many people reporting improved blood glucose levels on a

low carb diet, which can also help to reduce dependency on medication.

But despite their popularity and apparent effectiveness, low-carb diets, have yet to be endorsed by the NHS. Read more about

low-carb diets and NHS recommendations.

The

Low Carb Program provides education on diet and in particular a lower-carb lifestyle which helps people with type 2 diabetes reduce their HbA1c and weight and is the highest rated diabetes app used in the NHS.

People who are taking medication for type 2 diabetes should be aware that low-carb diets could raise the likelihood of

hypoglycemia
so it’s recommended to speak with your doctor before starting such a diet.

Raw food diets and type 2 diabetes

Raw food diets can be viewed as effective detox diets.

Some of the health advantages of

raw food diets
are a result of the reliance on freshly prepared food and the high amount of fruit and vegetables involved.

Raw food diets are quite restrictive and it’s recommended that you check with your doctor before starting a raw food diet to ensure you get a good balance of nutrients.

Very-low calorie diets and the Newcastle study diet

A study known as ‘the Newcastle diet study’ showed that a very-low calorie diet could be particularly effective at reversing the symptoms of type 2 diabetes. Then, in 2016, the diet was shown to

reverse type 2 diabetes for up to six weeks

Since the results were published, a significant number of people with

type 2 diabetes
have been keen to give the eight-week long diet a try.

Very-low calorie diets such as the Newcastle diet are viewed as being quite extreme and are not recommended without supervision from a doctor.

• 
  Very low calorie diets
• 
  The Newcastle diabetes diet

Effective
management of diabetes cannot be achieved without an appropriate diet.

People with diabetes represent a large subsection of society and there will be range of variety in terms of dietary requirements from person to person.

As a result, there is no one diabetic diet that will work for everyone and people should pick a diet that matches their individual needs.

Ideally, patients with

newly diagnosed diabetes
should receive advice from a dietitian soon after diagnosis.

Which diet is right for me?

There are a wealth of diets that have proved to be either popular with or of interest for people with diabetes.

We’ve compiled some of the more prominent of these diets, looking at both the benefits and disadvantages of each diet.

• 
  Diet for type 1 diabetes
• 
  Diet for type 2 diabetes
• 
  5:2 diet
• 
  Acid-alkaline diet
• 
  Atkins diet
• 
  Carbohydrates and diabetes
• 
  Carnivore diet
• 
  DASH diet
• 
  Detox diet
• 
  Dukan diet
• 
  Gluten free diet
• 
  Glycemic index diet (GI diet)
• 
  Glycemic load
• 
  Ketogenic diet
• 
  Low calorie diet
• 
  Low carb diet
• 
  Low carb high fat diet
• 
  Low fat diet
• 
  Meal replacement diet plans
• 
  Mediterranean diet
• 
  Newcastle study diet
• 
  NHS diet advice
• 
  Paleolithic diet
• 
  Raw food diet
• 
  South beach diet
• 
  Vegan diet
• 
  Vegetarian diet
• 
  Very low calorie diet
• 
  Zone diet

What are the aims of dietary advice?

When you receive advice from your doctor or diabetes team about your diet, they will often make suggestions in order to:

• Provide a knowledge of healthy eating
• Encourage lifestyle changes in order to reduce obesity and
  ensure optimal weight
• Maintain blood glucose and lipids as near normal as possible
• Reduce the acute (short term) complications of diabetes such as
  
  hypoglycemia
  and
  
  hyperglycemia

Dietary
Goals

• Ensure an adequate and balanced nutritional intake
• Limit rapidly absorbed carbohydrate intake
• Monitor body weight encouraging weight maintenance and weight
  reduction when necessary
• Avoid hypoglycemia

Weight Reduction

If you are carrying extra weight, and are classed as either

overweight or obese, weight loss has been shown to improve insulin sensitivity and glucose tolerance.

Modest weight loss of 5-10 kg in one year can significantly improve health outcomes.

General guidance on healthy eating

General guidance on healthy eating from the NHS will generally be based upon the following set of guidelines:

• Increasing intake of
  
  low GI carbohydrate
  foods
• Increasing fruit and vegetable intake.
• Reducing
  
  saturated fat
  intake
• Reducing sugar intake
• Reducing salt
• Safe and sensible alcohol consumption

The NHS advice on carbohydrate intake in particular has met a fair amount of criticism from people with diabetes.

Read more on the

debate surrounding NHS dietary advice

Lifestyle

Patients should follow dietary advice as part of lifestyle modification
including appropriate exercise regimes and smoking cessation.

Studies have shown that the diet helps with weight loss and may also reduce insulin resistance, both of which are of particular interest for many people with type 2 diabetes or borderline diabetes.

One reason for the popularity of the diet is that it allows a certain amount of flexibility, in comparison to low calorie diets, on most days of the week. Many people use fasting alongside a low carb diet.

Theory behind the 5:2 diet

The idea of the diet is that short periods of fasting prompt the body to repair damage but not enter a starvation mode of conserving energy.

Whilst the theory has yet to be conclusively proved, clinical studies have shown promising results for the diet, however it has only been examined over relatively short time spans, of less than a year. There are several ways that intermittent fasting can be used to manage blood glucose levels, however this guide focuses on the 5:2 approach.

How the 5:2 diet works

The 5:2 intermittent fasting diet is based on a simple idea. For 5 days a week you stick to meeting the daily calorie intake advised for people of a healthy weight, that being:

• 2,500 kcal per day for men
• 2,000 kcal per day for women

For the other 2 days each week, the diet stipulates that you have only around 25% of the values above, which is equal to:

• 600 kcal on these days for men
• 500 kcal on these days for women

The fasting days can be taken at any time during the week as long as you do not take 2 fasting days consecutively.

Benefits of the 5:2 diet

Clinical studies have shown that the benefits of intermittent fasting are largely similar to those of a calorie restricted diets.

The most commonly reported benefits among people from following the 5:2 diet:

• Weight loss
• Decreased levels of triglycerides and LDL cholesterol
• Reduced blood pressure
• A reduction in insulin resistance

Research has shown that periods of fasting can help to improve life expectancy and decrease risks of diseases including nerve disorders, Alzheimer’s disease and cancer.

However, whether these benefits apply to a 5:2 fasting diet cannot be confirmed as long term clinical studies have yet to be performed.

Is the 5:2 diet suitable for people with diabetes?

Whilst shorter term studies have displayed promise for intermittent fasting diets, long-term safety of the 5:2 diet is yet to be determined.

As with any diet plan, you should always consult your GP or diabetes health team before making any significant changes to your diet as they could affect blood glucose levels or impact on your medication.

Type 2 diabetes and the 5:2 diet

The fact that intermittent fasting shows evidence of improving insulin sensitivity may be an attractive option for people with a BMI over 25, borderline diabetes (prediabetes) or with type 2 diabetes but not on blood sugar-lowering medications.

The diet may be good for people who can handle single days of significantly restricted calorie intake in preference to modest calorie restriction every day.

On fasting days, the body will be forced to use stored energy from the body, fat and stored sugar (glycogen), which can help with weight loss and may improve blood glucose and cholesterol levels.

If you are on insulin, or hypo causing medication, such as sulphonylureas or glinides, an intermittent fasting could significantly increase the risk of hypos. Your doctor should advise you on whether the diet is appropriate.

Type 1 diabetes and the 5:2 diet

If you have type 1 diabetes, following a 5:2 diet could make diabetes management more difficult to achieve and could significantly increase the risk of hypoglycemia.

If your health team are happy for you to start an intermittent fasting diet, they may wish to monitor you more closely to reduce the likelihood of hypoglycemia or increased ketone levels occurring.

Evidence of the 5:2 diet

A study published in 2010 reviewed 107 women, between the ages of 30 and 45, with BMI values ranging between 24 and 40.

The participants were randomly assigned to one of two diets, either continuous energy restriction (CER) or intermittent energy restriction (IER). The CER dieters had a reduced calorie intake of 1,500 kcal through the week, while the IER diet group followed the 5:2 fasting plan.

At the end of the study, both sets of dieters lost a similar amount of weight on average, and similar improvements were also seen in levels of triglycerides, LDL ‘good’ cholesterol and blood pressure.

One area, however, where intermittent fasting was shown to be stronger than continuous calorie restriction was in reducing fasting insulin levels and insulin resistance.

How to follow the 5:2 diet

Depending on your outlook, the 5:2 diet may be seen as more or less practical than a continuously reduced calorie diet.

The benefit being that on most days you needn‘t consume less than the daily recommended calorie limit. However, some people may find that calorie intakes of 500 or 600 calories a day are too low to be practical.

For best results, it’s recommended to follow basic healthy eating rules, such as having a good intake of vegetables, fruit, and limiting intake of processed foods where possible.

During the fasting days, you will need to rely on very low calorie meals to stay within the daily 500 or 600 calorie counts.

Read recent research to support the benefits of fasting:

• Eating a big breakfast aids in appetite control and weight loss
• Better benefits for fasting females discovered
• Fasting helps men at risk of type 2 diabetes control blood glucose levels, study reports

5:2 diet fasting meal plan

An example of good meal picks on fasting days include those based low fat foods such as:

• Eggs (65 kcal per medium egg)
• Grilled chicken breast without the skin (190 kcal per 100g)
• Prawns (105 kcal per 100g)
• Non-battered white fish (135 kcal per 100g)

Vegetables tend to be low calorie but if you need very low calorie vegetables, the following vegetables are particularly good options:

• Cucumber (15 kcal per 100g)
• Celery (20 kcal per 100g)
• Bell pepper (26 kcal per 100g)

A low glycemic index diet can be particularly effective for people with diabetes if portion control is also applied to those foods with higher carbohydrate content.

This is the basis of working out a food’s

glycemic load

Low GI diets are diets which incorporate foods which are more slowly converted into energy by the body.

The NHS notes that low GI diets can be a suitable option for people with diabetes as they can help to

blood glucose levels
more stable than diets based around high GI foods.

What does low and high GI mean?

The glycemic Index ranks food depending on the rate at which the body breaks it down to form

glucose

High GI foods are those that are quickly broken down into glucose. Typical examples of high GI foods include white bread, sweetened drinks, biscuits, potatoes and oranges.

Low GI foods are those that are broken down more slowly by the body. Typical examples of low GI foods include whole grain bread, milk, beans, leafy vegetables and berries.

What do low GI foods do in relation to diabetes?

As low GI foods tend to break down more slowly, they are less likely to cause a rapid increase in

blood sugar levels
compared to high GI foods and therefore they are a better option for keeping stable blood glucose levels.

Favouring low GI foods over high GI foods leaves you feeling more satisfied over a longer period of time, and less likely to feel hungry before the next meal.

What do high GI foods do in relation to diabetes?

High GI foods break down very quickly causing blood glucose levels to rise sharply. People with diabetes refer to sharp rises in blood sugar levels as ‘spikes’ in blood sugar.

Furthermore, for those who produce their own

insulin, high GI foods can force the body to try to produce a surge of insulin to counteract the quick acting carbohydrates and a common consequence of this is a feeling of hunger within 2 to 3 hours, which can leave the dieter craving more food.

For people with diabetes, this can be particularly dangerous as the ability of the body to control

blood glucose levels
is reduced or non-existent.

For this reason, people with diabetes have to be careful when it comes to eating high

GI foods

Benefits of low GI diets

Low GI diet generally have the following benefits:

• Have a higher nutritional value than higher GI equivalents
• Provide prolonged release of energy
• Reduce the immediate demand for insulin following eating
• Allow for a varied diet to be eaten
• Glycemic index charts make food choices easy to follow

Disadvantages of low GI diets

The main disadvantage of low GI diets for people with diabetes comes if the overall

carbohydrate
content of meals is too high for the body to comfortably cope with.

For example, a large portion of a bran based cereal for breakfast will typically be low GI but could contain a relatively high value of carbohydrate.

In this case, the carbohydrate content of the meal could be too high for some people with diabetes, causing their blood glucose levels to rise too high over a period of hours.

However, this needn’t be such a problem if

portion control
is applied to any foods that have a higher carbohydrate content.

When the glycaemic index value of a food and its carbohydrate content are taken into account together, this is the basis of working out the glycemic load of a portion.

What foods are considered low GI?

Low GI foods that are considered suitable for people with diabetes include

• Some
  
  fruit
• 
  Non-starchy vegetables
• 
  Whole grains
• Nuts
• 
  Lean meats
• 
  Unsweetened dairy produce
• legumes

Care should be taken with fruits and vegetables as the GI value of these food groups can vary quite significantly.

• 
  Lower GI fruits
  
  include berries, plums, kiwi fruit and grapefruit.
• 
  Higher GI fruits
  
  include bananas, oranges, mango, grapes, raisins, dates and pears.
• 
  Lower GI vegetables
  
  include lettuce, broccoli, cabbage, cauliflower and peppers.
• 
  Higher GI vegetables
  
  include carrots, potatoes, parsnips, beetroots and sweetcorn.

Gluten-free diets can be challenging, but are essential for people with coeliac disease and diabetes. Coeliac disease and

type 1 diabetes
are both autoimmune diseases.

Therefore, it is not uncommon for someone to have both conditions.

For people with diabetes,

coeliac disease
presents an extra difficulty with making food choices to avoid foods with gluten.

On the plus side, the need to avoid many pre-prepared foods can be a positive way of maintaining a healthy diet.

What is gluten?

Gluten is a

protein
present in foods made out of grains such as wheat, barley and rye.

Oats are a grey area as it contains a protein that is similar to gluten which some people with coeliac can tolerate but others may not.

How does avoiding gluten help in coeliac disease?

As the body recovers from coeliac disease and eating gluten, it will absorb food in a different way, which can make it more difficult to

manage your diabetes

Untreated coeliac disease means that when gluten is eaten the lining of the small intestine becomes inflamed and less productive in absorbing food.

When a gluten-free diet is properly followed, the intestine starts to heal and the ability to absorb food increases.

Who else may follow a gluten free diet?

Other people who may be sensitive to gluten are people with wheat or gluten allergies. Coeliac disease is not an allergy.

Which foods need to be avoided in a gluten free diet?

Foods that will typically need to be avoided include those made with flour such as bread, pasta, breakfast cereals, bagels, pies, biscuits and cakes.

However, many pre-prepared foods contain gluten as a binding agent which can greatly reduce the number of options available.

The range of foods which may contain gluten can include:

• Soups
• Sausages and processed meats
• Curries
• Ready meals
• Ice cream
• Many sauces and dressings

Even

vitamins
may include gluten so people who need to follow a gluten free need to be particularly aware when making food choices.

To help people with gluten sensitivity, packaged foods in the UK must by law indicate if they contain gluten.

Which foods are gluten free?

You might be asking yourself, at this point, “What can I eat?”. There is still a range of food that can be eaten. As much of the pre-prepared food may contain gluten, you may find you need to eat more home cooked food.

Fruit, vegetables, meat, fish, beans, nuts and most dairy produce can be eaten and rice and potatoes are available on a gluten free diet too.

As coeliac disease is relatively common (affecting about 1% of us), a number of specifically gluten free produce exists, such as gluten free breads and gluten free flour.

Look out for packaged foods that have a ‘crossed grain’ symbol or use the terms:

• Gluten free
• Suitable for coeliacs
• Suitable for a gluten free diet

The coeliac disease charity Coeliac UK regularly updates a directory of suitable foods.

Do I qualify for food on prescription?

People with coeliac disease are able to claim certain gluten-free staple foods, such as:

• Gluten-free bread
• Pasta
• Flour
• Crackers on
  
  prescription

Speak to your doctor about what is available. The charity Coeliac UK also has useful information in their Food and Drink Directory.

How does a gluten free diet affect blood sugar levels?

Generally people with diabetes on a gluten free diet should not experience a great change in

blood sugar levels

The same amount of food in someone who has stuck to a gluten-free diet will be absorbed to a greater degree than those with coeliac disease who are not on a gluten-free diet.

This can mean that insulin requirements may be slightly higher and it can also mean that in some people there may be less chance of hypoglycemia occuring.

What side effects might I need to be aware of on a gluten free diet?

Nutrient deficiencies can be a potential side effect when observing a gluten-free diet. As a result, your doctor may need to prescribe supplements to you or prescribe specialist gluten-free products to help avoid deficiencies.

Whilst nutrient deficiencies are possible on a gluten-free diet, it should be noted that deficiencies of not following a gluten-free diet will be much greater if you have coeliac disease.

A low calorie diet gives a target intake of calories each day.

A low calorie diet, which may also be referred to as a calorie restricted diet, provides a steady way to achieve

weight loss
and is usually a key part of weight loss plans such as those used by slimming clubs.

A low calorie diet is commonly advised for anyone people with diabetes that is overweight to some degree.

What is a low calorie diet?

The NHS defines a low calorie (

kcal

) diet of:

• Between
  
  1,000
  
  and
  
  1,500
  
  calories per day for
  
  women
  
• Between
  
  1,500
  
  and
  
  2,000
  
  calories per day for
  
  men
  

The calorie target is designed to be less than the calories your body will expend (through organ functions and activity) through the day, therefore causing your body to break down body fat to cover the calorie short fall.

Because of its broad definition, there can be many different types of low calorie diet. So, any low fat diet or any low carbohydrate diet, as examples, that meet the low calorie diet criteria would also be low calorie diets.

Steady weight loss

A low calorie can help you to lose weight at a steady level over an extended period of time and some weeks may produce less pronounced

weight loss
than other weeks.

A low calorie diet is generally not designed to achieve rapid weight loss, but to achieve success over a longer period of time.

A low calorie diet can therefore have long term success particularly if you are willing to accept it as part of your every day routine.

Balanced diet

It is important to aim for a balanced diet whilst following a low calorie diet to ensure you are not missing out on the right vitamins.

Don’t fall into the trap of focusing too much on calorie counts and missing out on nutrients from important

food groups
such as fruit and vegetables as a result.

Unless additional restrictions are applied, a low calorie diet will usually allow enough room for the intake of a good range of vitamins and minerals from a variety of food sources.

A dietitian can help you to ensure that your diet is well balanced.

Counting calories

Packaged foods are required to include calorific information, however, in some cases you may need to weigh the food and/or use mathematics to figure out the calorie content of the portion you have.

For non-packaged foods like fruits and vegetables, there are a good number of available sources of calorie counting tables which range from books to

smartphone apps

Full calorie counts are available at some

restaurants
whilst some restaurants may list which meals are less than a defined calorie value. If the calorie content is not provided, you may need to try to form a best estimate.

Note that when we refer to calories, we are referring to kilocalories, often denoted as

kcal

Watch out for the other measurement of energy kilojoules (

kJ

). 1 kcal is equal to over 4 kJ so it is best not to mix these up. Always look for the energy value in

kcal

Book review:


Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting

Exercise

The NHS recommends that we take 2 and 1/2 hours of

exercise
a week. Exercise acts as a good compliment to a low calorie diet as it encourages the body to better metabolise the food we take in.

When we exercise, we use a form glucose (glycogen) stored in our muscles as well as glucose from our blood.

After exercising, these muscles will continue to take glucose from the blood to replenish their stores of glycogen. Therefore as well as supporting weight loss, exercise can also help to keep

blood glucose levels
down.

Slimming clubs

Many of the slimming clubs in the UK advocate low calorie diets to achieve steady and achievable weight loss.

Slimming clubs will often provide meal plans and exercise targets in addition to offering social support and motivation from others taking part in the club.

• Read more on
  
  slimming clubs

Extreme low-calorie diets, such as the 600 calorie diet studied by Newcastle University have been hailed as extremely effective in helping people with diabetes to control their blood glucose levels.

In some instances, reports of temporary

diabetes cures
have been reported from following an extreme low-calorie diet for a short period.

Is this the 600 calorie diet that was in the news?

A Newcastle University study, funded by

Diabetes UK, examined 11 people with diabetes who slashed their food intake to 600 calories per day for 8 weeks.

Three months later, 7 of the 11 people studied were free of diabetes.

As with other

very low calorie diets, you should consult a doctor before undertaking such a diet.

What was involved in the diet used in the study?

The diet was predominantly based around:

• Optifast meal replacement sachets, which provided 75% of the calories (600 cals)
• The other 200 calories came from non-starchy vegetables.

Note:

The diet is referred to as the 600 calorie diet (rather than the 800 calorie diet) due to the meal replacement aspect of the diet totalling 600 calories.

How does an extreme low-calorie diet affect the body?

An extreme low-calorie diet (usually based on diet drinks and non-starchy vegetables) reportedly prompts the body to expel fat clogging the pancreas, helping people with

type 2 diabetes
to ‘wake up’ their insulin producing cells.

So low-calorie diets bring blood glucose levels down?

In the aforementioned study, people with diabetes who did not get the special diet were also assessed.

After one week, those on the extreme low-calorie diet had pre-breakfast

blood glucose levels close to normal
This was in line with decreasing fat levels in the pancreas.

So the study cured people of type 2 diabetes?

The study showed marked improvements in blood sugar levels to the extent where the participants appeared to be cured.

However, as is the case with

pre-diabetes, those participants who benefitted the most from the study will still need to be disciplined with their diet and exercise to prevent or delay the return of diabetes symptoms.

Were there any side effects of the diet?

A number of side effects were observed in participants during the first few days of the diet, such as:

• Headaches
• Dizziness
• Hunger
• Tiredness
• Cold

People involved in the study were advised to keep up their fluid intake and wrap up to keep warm.

Since the initial study, a significant amount of research has been funded by Diabetes UK into the very low calorie approach, which has demonstrated that it can support remission of type 2 diabetes, even for people who are considered ‘skinny’.

• ‘Game-changing’ study suggests type 2 remission possible even at lower body weight

Can people with diabetes use a vegan diet to improve blood glucose control? Absolutely.

By eating a healthy vegan diet low in

cholesterol
and saturated fat, but balanced enough to include fibre and protein, blood glucose levels can be made easier to control.

This type of diet, particularly when combined with

exercise, can help to lower blood glucose levels and better manage diabetes.

What is a vegan diet for diabetes?

A vegan diet effectively means cutting out meat, dairy and animal products whether you have diabetes or not.

So what do you eat?

Vegan diets, whether for people with diabetes or not, are usually based around plants. Particular foods eaten include vegetables, fruit, grains, legumes.

Animal products such as meat and dairy are avoided, as are added fat and sugar. People on vegan diets often take vitamin B12 deficiency supplements.

Isn’t a vegan diet for diabetics hard to stick to?

Eating a vegan diet does require some compromise, but getting the right diabetes recipes and planning your diet well will make following a vegan diet for diabetes easy. When planning your vegan diet, you need to make sure that protein,

carbohydrates, fat, vitamins and minerals are balanced.

Vegan diets do not usually demand that portions be stuck to or calories counted, making them easier to follow than some diabetes diets.

Can I lose weight using a vegan diet?

Many people with diabetes, particularly type 2 diabetes, have a firm goal to lose weight. Weight loss is well understood as one of the best ways of achieving diabetes control. Vegan diets with a lower

glycaemic index
and a higher level of fibre are an excellent way of losing weight and improving

body mass index

Is there any scientific evidence to support a vegan diet for people with diabetes?

Studies in the past have shown that those people who follow a low-fat vegan diet, avoiding meat and dairy, lower blood sugar levels very efficiently and lose weight. Researchers have shown that people with diabetes who eat a vegan diet also lower their cholesterol and improve

kidney
functioning.

It is possible to control type 2 diabetes well enough that you can come off diabetes medication. This is diabetes remission and low-carb is one of the best methods to achieve this.

A number of people with type 2 diabetes have reported that they have been redefined as having ‘resolved diabetes’ by their doctors as a result of achieving remission through low-carb.

There a number of advantages of achieving remission. Aside from being a clear sign that health has improved, not needing to take diabetes medication prevents their side effects, which can include weight gain and hypoglycemia, from occurring.

Definition:

Remission is said to occur if

blood glucose levels
return to normal without the need for diabetes medications.

Low-carb increases likelihood of remission

A number of research studies have shown that low-carb is a particularly effective method of controlling type 2 diabetes without the need for medication.

One of the studies compared a

low-carb Mediterranean diet
to a low-fat diet. The results showed that remission rates were much stronger within the group following low-carb.

Additionally, there have been hundreds of anecdotal reports from people that have successfully resolved their diabetes through low-carb.

To see examples, take a look at the

Diabetes Forum’s Success Stories
and check out a video of Mark Chadbourne who resolved his diabetes by following the Low Carb Program and losing an incredible 50kg in just 6 months.

Mark was surprised how easy low-carb was to adjust to. If you’re interested in following his footsteps,

join the Low Carb Program today

Benefits of remission

Remission is one of the clearest signs that you are on the road to much better health. Achieving healthy blood glucose levels will give you more vitality, clearer thinking and a much lower risk of developing

long-term health complications of diabetes

Not needing to take diabetes medication eliminates the risk of the side effects that diabetes medication brings. Given that some of the drugs used to treat diabetes often lead to increased weight gain, hunger and

hypoglycemia
(too low blood sugar levels), you can see how beneficial remission can be.

In people that are overweight, remission is typically accompanied by significant

weight loss
which means greater mobility and reduced risk of developing a number of health conditions which range from osteoarthritis through to heart disease and Alzheimer’s.

How low-carb works

Type 2 diabetes occurs when the body has developed

insulin resistance
This is when the body struggles to respond to the effects of insulin.

Research has identified that people with

high levels of insulin circulating in the blood
are at a much greater risk of developing insulin resistance and type 2 diabetes. If you want to decrease insulin resistance, you need to reduce your insulin levels.

Out of the three main energy-providing macronutrients, it is carbohydrate that has the greatest impact in raising both blood sugar and insulin levels. This means that, if you can reduce your

carbohydrate intake, you should start to experience lower blood sugar and lower insulin levels.

People that maintain a healthy low-carb lifestyle over a number of weeks or months then typically start to experience improved

insulin sensitivity
Some people may then find that their insulin sensitivity has improved sufficiently well to no longer need to be taking diabetes medication.

Lowering insulin levels also helps towards weight loss and most of the people that have achieved remission of type 2 diabetes have also lost a large amount of body weight thanks to their low-carb lifestyle.

How to achieve remission

Whilst remission isn’t guaranteed, it is certainly possible for some people and the beauty of low-carb is how simple it is.

Many people can get their sugar levels in a healthy range, with no need for medication, simply by cutting out starchy foods, such as bread, rice, potatoes, pasta and cereal, and avoiding sugary foods such as sweet drinks, biscuits, most fruits, fruit juices and

processed foods

Note that processed food is a sneaky source of sugar. These foods may not look like they have much

sugar
but most of them have more than you’d think and this can add up to a lot if you tend to rely on processed foods.

Is remission possible for me?

Research indicates that people with

type 2 diabetes have very good prospects for achieving diabetes remission if they take on effective lifestyle changes.


^[332]

UK GP, Dr David Unwin, has achieved much with his patients with type 2 diabetes. By helping them to avoid starchy and sugary foods, he states that around a quarter of his patients are able to achieve remission after following a low-carb lifestyle for 15 months.


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People that have been living with type 2 diabetes for many years may find remission more difficult to achieve as

high blood sugar levels
over many years can reduce the body’s ability to produce insulin.


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However, there are no hard and fast rules and it may be possible to achieve remission even if you have had diabetes for many years, particularly if your diabetes has been fairly well controlled.

Also, even if you do not achieve, there are still many benefits of following low-carb which include improved blood glucose control and reduced dependency on medication, which means either lower doses of medication or less need to take the stronger medications that have greater side effects.

Remission in people with type 1 diabetes

People with type 1 diabetes may be able to achieve temporary remission. Whilst this is relatively rare, it is more likely if a diagnosis of type 1 diabetes was relatively recent and occurred later in adulthood. Type 1 diabetes diagnosed later in adulthood is sometimes referred to as

latent autoimmune diabetes of adulthood (LADA)