Diabetes is not a condition that originates in the gut. The Paleo Diet, however, goes a long way toward managing some of the key issues of blood sugar control, however, in ways that diabetes educators and nutritionists often overlook.
Normal Fasting Blood Sugar Levels Don't Mean Your Diabetes Is Under Control
Just about any version of the Paleo Diet is ideal for managing post-prandial blood sugar levels, the glucose levels measured by taking blood sugars about two hours after eating. Most diabetics begrudgingly measure their fasting blood sugar levels first thing most mornings, but it is actually the post-prandial blood sugar levels that make the biggest difference in the course of the disease for most diabetics.
When the pancreas is functioning normally, it makes and stores proinsulin, a protein bound form of active insulin, on a more or less continuous basis. When the pancreas receives a signal that the small intestine is receiving digested food from the stomach, it quickly “unzips” proinsulin so it can release a large amount of insulin to transport the sugars and fats released by the digestion of food.
In the early stages of type 2 diabetes, or in a condition called pre-diabetes, the pancreas cannot unpack proinsulin to release insulin fast enough to keep blood sugar levels down. While bloodstream glucose levels might rise to 140 mg/dl (a little under 8 mmol/L) in a healthy person, sugar levels might soar to 280 mg/dl (16 mmol/L) or even more in someone whose pancreas is in an early diabetic or prediabetic state. The pancreas may eventually release enough insulin to get blood sugar levels down to normal by the next day, so that fasting blood sugars are OK, but for a period of hours the concentration of sugar in the bloodstream may be very high. Most diabetics don't know their post-prandial blood sugar levels run high for the simple reason that most diabetics never measure them.
Glucose, Glycation, And The Downward Spiral of Diabetes
Why does that make a difference? Sugar in the bloodstream can “catch fire,” that is, oxidize, generating toxic free radicals of oxygen. Even when the cholesterol levels are normal or low, the release of free radicals of oxygen by glucose undergoing the process of autooxidation in the bloodstream can change cholesterol in the lining of the arteries into a dysfunctional form. This dysfunctional, oxidized cholesterol (oxycholesterol) attracts white blood cells, the immune system's cleanup crew. Large white blood cells known as macrophages imbed themselves in the lining of the arteries to feed on oxycholesterol, but sometimes they get stuck. They result is the “clog” that becomes atherosclerosis, which is so very common in diabetics.
Even if glucose does not “ignite” in the bloodstream through the process of autooxidation, it can “caramelize” the outer coatings of cells through a process called glycation. It is not unfair to compare glycation to caramelization. A sticky coat of sugar can engulf a cell, particularly nerve cells and red blood cells, so that cannot receive the oxygen, nutrients, and regulatory messengers that it needs to stay healthy. Red blood cells die early, and nerve cells slowly cease to function through the process of diabetic neuropathy. But those are not the only problems with high blood sugar levels after meals.
Glucose doesn't just “catch fire” in the bloodstream. There can also be excessive oxidation of glucose once it gets inside a cell. Energy production can overrun the cell's mitochondria, spilling free radicals into other parts of the cell, damaging the DNA.
Cells in the brain and, in women, in the ovaries, don't have a protective mechanism against this process. Cells in most of the rest of the body, however, can protect themselves from the effects of too much sugar in the bloodstream through a process called insulin resistance. They deactivate insulin-activated receptor ports that force them to receive both sugar and sodium. (Every cell has to receive three ions of sodium every time it receives one molecule of glucose, causing sodium and water to build up inside the cell.) This leaves more sugar in the bloodstream, so the pancreas tries to remedy the problem by releasing still more insulin.
The body doesn't just use insulin to regulate blood sugar levels. It also uses insulin to regulate the enzymes that fat cells use to break down stored fat. High blood sugar levels that lead to high insulin levels result in the inability of fat cells to release stored fat to be burned.
Unfortunately, this just makes insulin-resistant cells even more insulin-resistant. The process continues day and night until eventually the insulin-making beta cells of the pancreas “burn out,” and diabetes results. If blood sugar levels don't go up after meals, however, both blood sugar levels and blood insulin levels are lower.
Paleo Against High Blood Sugar Levels
How does a Paleo Diet keep blood sugar levels lower so the body does not fall into the destructive spiral of metabolic changes that lead to diabetes? There are five main ways:
- Authentically paleolithic diets usually include short, prescribed fasts of less than 24 hours. After all, our ancient ancestors could not raid the refrigerator for a midnight snack, and they had to endure periods of food shortage or even famine. If you aren't eating at all, there are no meals to cause your blood sugar levels to go up.
- Paleo diets usually include moister foods. Fritos, Doritos, and Ruffles with Ridges, for example, are not foods our paleolithic ancestors would have eaten. Neither are cheese and crackers or gingerbread (even if cut out into cute little shapes of cavemen and dinosaurs). The water content of food adds bulk so that the grinding function of the stomach takes longer. Anything that slows down the passage of food from the stomach into the intestines reduces the rate at which the pancreas has to unpack proinsulin into insulin.
- Paleo diets tend to be high in fiber from raw vegetables, nuts, seeds, and fruit. (There is no fiber in meat, dairy, or fish.) Fiber is a filler. The more fiber you eat, the less total weight of food you need to feel full. Eating less leads to lower blood sugar levels. Seaweed fibers are particularly useful for controlling appetite by filling up the stomach.
- Fruit and certain kinds of fruit juices actually lower the body's demand for insulin. Specifically, lemonade made with freshly squeezed lemon juice (especially when you don't add sugar, but even when you add up to 10 grams/2 teaspoons of sugar to an 8 oz/240 ml glass) slows down the transit time for food from the stomach to the gut and lowers demand on the pancreas to release insulin. Our paleolithic ancestors didn't have containers for making fruit juices until about 23,000 BCE, but even they would have responded in this way to tart, sour, juicy fruit, whether eaten whole or drunk as juice.
Eating the paleo way will bring your blood sugar levels down. In fact, for type 1 diabetics, paleo diets can work so well for diabetes that you may need to be extra-careful to measure your blood sugar levels and adjust your insulin dosage. If your doctor has not given you a scale for choosing the right dose of insulin based on your blood sugar levels, or if you aren't actually taking your blood sugar levels as often as your doctor directs, you actually should not do paleo as long as you are on insulin—and you should not go off insulin without your doctor's direction.
Small Inputs Lead To Small Errors
But the primary benefit of paleolithic-style dieting for diabetics is that truly paleo portions are small portions. And while some of our paleolithic ancestors did in fact chase rabbits, far more of our ancestors ate turtles.
Small amounts of food and small amounts of exercise lead to small changes in blood sugar levels. You can avoid the high blood sugar levels that are difficult to bring down and the low blood sugar levels that are hard to bring back up if you simply focus on small energy intake and small energy expenditure.
Like your paleolithic ancestors, take it easy. Don't get in a rush. Enjoy your food, savoring every bite. And know that your body will slowly reverse the process of insulin resistance that can complicate both type 2 and type 1 diabetes as you normalize your blood sugars.