Lipotoxicity: Does Dietary Fat Intake Make Blood Sugar Control More Difficult?

Last year, Nicole started experimenting with multi-day fasts. No food. No juice. No supplements. No lemon-maple Kool-Aid. Just water.  As I related before, we were shocked to see her daily dose of Levemir drop from 16 units a day to 4 units a day. This was after we already fine-tuned her long-acting insulin needs with one-day fasts (so it wasn’t that her basal dose was covering meals).

C-Peptide tests showed she was still producing zero insulin of her own. So fasting hadn’t cured her yet. It seemed, instead, that the her body was absorbing glucose better and/or losing insulin resistance.

When Nicole went back to eating, the insulin needs went back up. We theorized that it may have been the lack of salt during the fast which reduced her insulin needs. Indeed, I found research to back this up. But eliminating salt from her diet didn’t produce such drastic results in blood sugar control (it certainly helped in other areas, however).

That’s when I remembered an interview I had seen a year or so earlier with Dr. Michael Greger. In it he said: “What causes insulin resistance? It’s intramyocellular lipids. It’s fat that is inside the muscle fibers that interferes with insulin signalling such that your body has to keep pumping insulin [or injecting in the case of people with T1D] to force it into your muscles (which use up about 85% of your blood sugars). Your blood sugars rise because they can’t enter into the cells. And not just any fat, particularly saturated fat is toxic. It’s actually called lipotoxicity. That’s the term used in the literature to describe the affect saturated fats have on producing insulin resistance.”

Since Nicole recently decided to remove all the animal proteins from her diet (to help her deal with kidney failure) we figured: Why not cut out all the fat, too? Let’s experiment for a few weeks. We brought her down to 60g (2 ounces) of nuts or seeds per day. The rest was a high-carb diet of whole grains, fruit, beans and vegetables (including potatoes). No oils. No avocados.

I didn’t look at her blood sugar log for a few days. I was dreading what I’d see. To my surprise, however, her log for the week looked more or less the same as on a low-carb diet. They weren’t perfect blood sugars. They never were with the low-carb approach either. Type-1 diabetes isn’t that easy to tame. But she was averaging blood sugars around 6mmol/L (108mg/dL). She swings a little high and a little low. If anything, though, the swings seemed less dramatic and didn’t last as long.

I think it took about five days of water fasting to clean her muscles of excess fat deposits. That’s why her insulin needs dropped while fasting. Just one low-fat meal isn’t going to show any difference on the glucometer. It takes days to clear out the excess. Now, by sticking to just low-fat, high-carb plant foods Nicole’s been able achieve and maintain these lower insulin needs.

In the end, it’s certainly easier to control type-1 diabetes without having to deal with a degree of type-2 at the same time. Stay subscribed to find out how this experiments unfolds in the long-run.

Thinking outside the T1D Matrix,
–John C. A. Manley

P.S. You may wish to check out the Diabetes Mastery Summit‘s collection of interviews with doctors focusing on the low-fat, plant-based, whole-food approach to balacing blood sugarsa.

P.P.S. For more on the negative side effects Nicole was experiencing, after four years on a low-carb diet, check out the previous post.

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