Our primary problem as type 2 diabetics is Insulin resistance. You have to try to visualise what this actually means, to the CICO model.
Fats consumed are either used up as fuel, (in the absence of too many carbs), to help the absorption of essential nutrients and support the functions of cells, it also helps to regulate the blood pressure and control the Cholesterol level. The excess is supposedly converted to body fat. But many of us here, have found for us at least this simply isn’t true.
Protein for the most part, is used to manufacture, Hormones, Enzymes and Haemoglobin. It is also used to maintain and build muscles and various cells throughout the body. It is only used as fuel and converted to Glucose when there is a CALORIFIC DEFECIT. If you consume sufficient calories for your bodies needs, it doesn’t get converted and eventually stored as fat. Any excess is expelled from the body.
Carbohydrates however are converted to Glucose and used solely for fuel. This is where Insulin resistance rears it’s ugly head. Since we all have different levels of resistance it is nigh on impossible to calculate the extent of the problem regarding carbs. If we eat for the sake of argument 2000 calories a day, according to the NICE guidelines that’s about 1200 calories from carbs. But with Insulin resistance our bodies cannot use that amount. If we are capable of handling 1000 calories worth, that leaves an excess of 200 calories, and because we are not getting enough fuel from what we eat, we are effectively in calorie deficit, so Protein is converted to Glucose, which adds to the problem. So even with just the 200 calories of excess Glucose, the only place it can go, is to pee out as much as the body can manage, or convert it to fat and store it away from where it is causing a problem. If we manage to pee out half of that, that leaves 100 or so calories worth to be stored away. 100 calories of body fat is approx’ 11 grams , this equates to over 4Kg a year. And that is sticking religiously to the official guidelines.
For a person with this scenario, lowering carb intake, by 200 calories worth each day, and replacing with fats and Protein would be enough to stabilise blood sugars, and maintain weight. But as we’re all different, the reduction needed is specific to our own bodies.
Due to the Insulin resistance, our bodies answer, is to ramp up Insulin production. The immediate solution, store it away as fat, we’ll worry about that later.
So for a type 2 it all boils down to Insulin levels, with higher blood sugars, we have higher Insulin levels, this increases the fat storage rate, and reduces the stored fat use rate. In the absence of raised Insulin levels, a calorie deficit will result in weight loss. But reducing carb levels rather than fat and protein, will result in even lower levels of Insulin, less fat storage and increased fat store usage. The level we need to reduce carbs by, is individual to us all. Keto is effectively lower carb on steroids, Insulin levels are on the floor, and stored fat usage is turbo charged as a result. Inevitably we end up eating less without realising because the fat store supplements the calorie deficit seamlessly.
A reduced calorie diet, by it’s very nature, is a reduced carb diet, if you restrict your diet by 500 calories a day, that is going to be 300 calories of carbs gone. That is the driver of the weight loss. As many of us here know by removing those 300 calories of carbs from our diets, and replacing them with fats and protein, we can get the same outcome, without restricting our calories.
My weight loss came long before any diagnosis, I reached the point where I just needed to lose some weight, at my peak I was 115kg. Looking back now I was showing some diabetic symptoms, carb comas, already diagnosed with Peripheral neuropathy. Funny turns which I now know were false hypos, but the doctors couldn’t care less, as my Hba1c was just about pre diabetic.
As most “diet” food didn’t appeal to me in the slightest, I researched and found Keto. To start with everything was very strictly logged on My Fitness Pal, this was when i ditched milk in coffee, as i was shocked by the affect it had on the figures. My BMR was around 2400 cals. I initially reduced my intake by 400 calories, the weight began to fall off, to the point I relaxed the reduction. Snacked on cold sausages, hard boiled eggs with loads of Mayo, cheese, loads of lovely fatty chicken thighs. My calorie count climbed to over 2800. The weight continued to go at the same rate, eventually reaching 25Kg in 4 months, (looking back now I realise it was actually 30kg), I ended up at the weight I was when I left school, over 40 years before.
When I reached the weight I was happy with, the hard part was balancing my carb intake, so as to have no loss and no gain in weight.
So in my position carbs were the sole factor in weight loss, calories were immaterial.