Insulin resistance is when your cells become less sensitive to the effects of insulin. This means your body has to produce more insulin to lower your blood sugar after eating. Insulin resistance is a hallmark of type 2 diabetes and prediabetes. It’s also linked to obesity, high blood pressure, high cholesterol, and other metabolic issues.
Can eating fewer carbs help reverse insulin resistance and get diabetes under control? In this blog, I’ll go over the evidence and share my experience using low-carb diets to treat patients with insulin resistance and diabetes. There’s no one-size-fits-all approach, but a low-carb diet can be a powerful tool for many people.
What Is Insulin Resistance?
Insulin is a hormone secreted by your pancreas. Its main job is to allow cells throughout your body to take in glucose from your bloodstream and use it for energy.
With insulin resistance, your cells become less responsive to insulin. As a result, blood sugar stays elevated after meals or snacks because insulin can’t do its job properly.
Over time, your pancreas tries to compensate by producing more insulin. However, this excessive insulin production can’t fully overcome insulin resistance. Blood sugars keep creeping up, eventually leading to prediabetes or type 2 diabetes.
Insulin resistance is closely tied to excess weight, especially around the belly. Fat cells can become resistant to insulin too. The more overweight you are, the more insulin-resistant you tend to be. Genetics and family history also play a role.
How Low-Carb Diets Impact Insulin Resistance
When you eat carbohydrates, especially refined carbs, and sugars, your blood sugar rises. In response, your pancreas releases insulin.
The more carbs you eat in one sitting, the bigger the rise in blood sugar and insulin. Over time, these large insulin surges promote insulin resistance.
By restricting carbohydrates, a low-carb diet prevents these big spikes in blood sugar and insulin. This allows the pancreas to “rest” and insulin resistance to improve.
With better insulin sensitivity, your cells can once again respond properly to insulin. This helps normalize blood sugar levels.
A low-carb diet also curbs appetite hormones, leading to reduced calorie intake for many people. Losing excess weight, especially around the belly, directly lowers insulin resistance as well.
What The Research Says
Numerous studies show low-carb diets can reverse insulin resistance and lower blood sugars and HbA1c in people with prediabetes and type 2 diabetes:
– A 2018 meta-analysis in the British Journal of Nutrition looked at RCTs comparing low-carb diets to high-carb diets in people with type 2 diabetes. The researchers found that A1c dropped an extra 0.34% with low-carb eating. Insulin dosages also declined.
– Researchers did a 24-week study putting overweight adults with type 2 diabetes on a keto diet limiting carbs to 30 grams per day. The dieters lost weight, reduced their diabetes medications, and lowered their A1c from 7.6% to 6.3% on average.
– In one study, prediabetic adults cut carbs to 21% of calories and followed a Mediterranean eating pattern. After 12 months their insulin resistance declined significantly. Only 3% of the low-carb group went on to develop diabetes compared to 17% of the higher-carb group.
– Obese adults with insulin resistance were randomized to a low glycemic index diet or a low-carb Mediterranean diet providing less than 40 grams of carbs daily. After 24 weeks both groups saw improved insulin sensitivity, reduced insulin, and lower blood sugars.
The evidence is quite convincing – reducing carbohydrate intake can reverse insulin resistance and get diabetes under control for many people. It may not work for everyone, but it’s an effective dietary approach for a large portion of patients based on science.
My Experience as an Ayurvedic Doctor
In my clinic, I’ve seen many patients with type 2 diabetes improve dramatically by cutting back on carbs.
One of my patients is Sanjay, a 45-year-old engineer who was diagnosed with diabetes 3 years ago. His A1c was very high at 9.1% and he was on two medications prescribed by an endocrinologist – metformin and glipizide. Sanjay had not had success following general guidelines like eating whole grains, low-fat foods, etc.
I suggested Sanjay try a lower-carb diet – limiting starchy carbs and added sugars while emphasizing vegetables, legumes, nuts, fish, olive oil, etc. He gradually reduced his carb intake over a few weeks until he was eating about 90-120 grams daily.
Over the next 4 months, Sanjay lost 8 kilos. His blood sugars improved to the point where I was able to lower and eventually stop his glipizide medication. His energy and focus increased as his blood sugars stabilized. At his last appointment, Sanjay’s A1c had dropped to 6.2% just with the diet changes and ayurvedic medicine Madhumardana churna.
I have had many similar cases where a lower-carb diet turned around type 2 diabetes when other approaches failed. Of course, the response varies – a few patients in my practice did not see the same benefits. But for most overweight type 2 diabetics I work with, limiting carbohydrates has been crucial for getting their blood glucose in control.
Do You Have to Go Full Keto?
Some people think managing diabetes with diet means going full keto – eating fewer than 50 grams of carbs daily. However, this very low-carb approach is not necessary for many patients to improve their blood sugars.
Moderate carb restriction can reverse insulin resistance for a majority of people with prediabetes or type 2 diabetes. This level allows for more dietary flexibility while still stabilizing blood sugar.
I typically recommend patients aim for 100-150 grams of carbs per day to start. This eliminates sugar, refined grains, and many high-carb junk foods while keeping plenty of vegetables, fruits, beans/lentils, nuts, seeds, and whole grains in the diet.
We monitor their blood sugar response and adjust the carb intake up or down as needed. This moderate carb approach is sustainable and effective for most of my patients over the long run.
Some patients do require a stricter keto diet under 50 grams of carbs daily to normalize blood sugars. This may include patients who need to get off insulin or individuals who do not lose weight easily on higher carb intake. But many can improve their diabetes without going full keto if carb intake is managed properly.
Other Dietary Approaches
Though carbohydrate restriction is central, other aspects of diet matter too for managing diabetes.
Emphasize High Fiber –Getting adequate fiber slows carb digestion and absorption, helping control blood sugar spikes. I advise patients to eat plenty of non-starchy veggies, berries, nuts/seeds, beans, lentils, and whole grains like oats.
Healthy Fats – Monounsaturated and omega-3 polyunsaturated fats from olive oil, avocados, nuts, fish, etc. support metabolic health. I limit saturated fat to 10% of calories or less.
Lean Protein – Getting 15-25% of calories from lean protein foods helps preserve muscle mass when losing weight and keeps you feeling full between meals. Lean meats, seafood, eggs, legumes, and nonfat dairy are good sources.
Mindful Eating –Practicing mindful eating techniques can curb overeating, reduce insulin spikes, and promote weight loss. I encourage patients to slow down, minimize distractions, pay attention to hunger/fullness cues, and chew food thoroughly.
Portion Control – Using smaller plates, measuring proper serving sizes, and stopping eating before fullness can prevent portion creep. This helps reduce calorie intake for weight loss.
Physical Activity – Regular exercise like brisk walking, cycling, strength training, etc. makes cells more insulin sensitive independent of any weight loss. I advise 150+ minutes per week.
Pros and Cons of Low-Carb Diets
Potential Benefits
- Lower blood sugars and A1c
- Reduced diabetes medications
- Improved insulin sensitivity
- Weight loss, especially belly fat
- Lower triglycerides and better cholesterol
- Reduced appetite and cravings
- More predictable glycemic response
Potential Drawbacks
- Difficult long-term adherence for some
- May increase LDL cholesterol short term
- Constipation without enough fiber
- Reduced energy initially
- Social restrictions – dining out, etc.
- Need to take a multivitamin
- Not preferred by everyone
The benefits outweigh the drawbacks for most patients. But a low-carb diet can be challenging to stick to forever. I work closely with patients to find a sustainable level of carb restriction tailored to their preferences and health needs.
Tips for Starting a Low-Carb Diet
If you and your doctor decide a low-carb or keto diet may help manage your insulin resistance, here are some tips to get started.
- Set a carb target – Try around 100-150 grams daily at first if you have diabetes
- Calculate carb intake – Weigh foods and track carbs to stay under your target
- Limit added sugars – These spike blood sugar super fast
- Reduce starchy carbs – Bread, pasta, rice, potatoes, etc. convert quickly to glucose
- Load up on low-carb veggies – They provide fiber and nutrients with fewer digestible carbs
- Focus on healthy fats and proteins – These keep you feeling full and stabilize blood sugar
- Drink lots of water – Staying hydrated is important on a low-carb diet
- Take a fiber supplement if needed to stay regular
- Try intermittent fasting – It complements low-carb eating for better blood sugar control
- Exercise regularly – This makes your cells more insulin-sensitive
- Monitor progress – Track A1c, blood sugar, weight, etc. to adjust carb intake as needed
- Get support – Low-carb diets are easier to stick to with a doctor or health coach guiding you
Conclusion
The research shows that lowering carbohydrate intake can reverse insulin resistance and help manage type 2 diabetes for many people. Reducing carb intake reduces blood sugar spikes and insulin demands on the body. This allows insulin sensitivity to improve over time.
In my clinic, I’ve seen many patients achieve better A1c, weight loss, and reduced medication needs with a low-carb Mediterranean-style diet. For the majority of my diabetic patients, limiting total carbs to 100-150 grams daily turns out to be optimal in the long run.
Of course, the response varies individually. I work together with patients to find their ideal carb threshold for maintaining normal blood sugars while allowing maximum dietary flexibility. Some need keto under 50 grams daily, others do well at 100-120 grams.
There’s no one perfect diabetes diet. However given the strong scientific evidence and results in my practice, a low-carb or ketogenic diet can be a very effective approach for reversing insulin resistance and managing type 2 diabetes.
I hope this blog has provided a balanced overview explaining how low-carb diets impact insulin sensitivity and blood sugar control.
