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Hey everyone, I wanted to post this tomorrow on my blog, but wanted to give you all a sneak peek at what I have cooking. Let me know what you all think! - Jason


I want to start out this post by saying that I have the utmost respect for Robb Wolf. I have followed his podcast and his blog for over a year now, and his book “The Paleo Solution” has inspired me to look further into the Paleo lifestyle.

The Sugary Elephant in the Room
I came across a post a while back about a type 1 diabetic who found a new level of control by adopting the Paleo lifestyle. I think that’s great – but something caught my eye:

I’ve used only 10-12 units of insulin in 30 days versus a MINIMUM of 360 units (based on a minimum of 4 units per meal x 3 meals a day=12 units per day x 30). This is incredible writing down as I hadn’t quite done this math yet. 10-12 units of insulin in a month is unheard of! I’ve contacted my nutritionist and doctor, both of who I’ll see in August, during month three of paleo. In the meantime, my nutritionist suggested incorporating dairy for calcium, which is not something I am interested in doing.
I have had around 10 highs and one low in a month (high of 220 and lowest at 69). During our honeymoon, I was having high sugar readings almost every other day and during the 8 years of being a diabetic, highs were always lingering because matching insulin to food has been the worst guessing game I’ve ever played!

I’ve derived great pleasure from not having to poke myself every day and plan on keeping it that way.

Normally I would just leave it alone… chalk it up to another person misunderstanding the role of insulin in their treatment regiment. What bothered me is remembering about the other posts on Robb Wolf’s site about T1D management with the Paleo diet.

I Felt Compelled To Help
I left a response to the post:

I caution though - and this is a biggie...

You note that you are type 1, but have you had your C-Peptide tests to check the amount of insulin you actually still make? If you were diagnosed 8 years prior, that suggests you are a LADA diabetic.

The reason I feel compelled to write - you may still be in your honeymoon period. (Not from your actual honeymoon, just your pancreas may still be producing your own insulin.)

I feel this is important, because, the preservation of your pancreatic function is paramount to your life with diabetes. I don't think you are taking enough of your basal insulin to preserve that function. (You stated that you are taking 18 units in a month...)

At first, all may seem well, and great! You don't need that insulin, because of a Paleo diet!

What will happen though is your pancreas will start to burn out what function you have left, and then you will need even more insulin.

I wonder why the nutritionist hasn't alerted your endo to what is going on.

People need to be careful - you too, Robb Wolf - with what you are advertising here. Paleo is NOT a cure for T1 diabetes. There is no cure.

The best Paleo can do is to limit the need for insulin, but again, it's NOT a cure.

This story is like thousands that I have read before; a person is in the honeymoon stage of their diagnosis... they drastically reduce their insulin intake - and WOW! Things are great!

Then they get kicked in the ass with reality. They are a diabetic, and now they need EVEN MORE insulin in order to survive.

The Response
Back the hell up and READ the posts on Type 1 on this site.
All of them. listen to podcast 89. Get informed before you comment on this.

Now, you obviously do not understand that this honeymoon stage is an opportunity to actually restore pancreatic function. This is possible is the autoimmune reaction that is damaging the pancreatic beta cells is reversed. This paper will provide a primer on this concept:

Now, if folks do not have any pancreatic function they will still benefit from this type of eating as they will require less insulin and will show better A1c’s and signs of systemic inflammation.

I’m sorry I kickeed you in the balls on this but I’m dead tired of the hand-wringing Type-1 crowd that is “convinced” they cannot do anything to improve their situation. If you want to discuss this further please be articulate with the material I’ve provided. If you want to actually be of help to people, please be articulate with the material I’ve provided.

Oh Dear!
Well, Robb kicked me in the balls, (figuratively speaking of course.)

Robb. I respect everything that you do – but the reality is that diabetes is a degenerative disease. I have listened to all of your podcasts, and I have followed your site for over a year now. I just don’t agree with what you say about diabetes.

As for research – I have done more research than most about my condition. I have read all that I can get my hands on from low-carb, paleo, primal, and what the ADA, CDA, and other various associations have to say.

Here is what your abstract boils down to:

This new theory implies that once the autoimmune process is activated, it is not auto-perpetuating, but rather can be modulated or even reversed by preventing the continuous interplay between genes and environment. Since TJ dysfunction allows this interaction, new therapeutic strategies aimed at re-establishing the intestinal barrier function offer innovative, unexplored approaches for the treatment of these devastating diseases.

The “theory” is that removing the grains from the diet will reverse T1D. That’s great, if that’s the only thing that causes T1D. The reality is that there are multiple reasons a person will go into the autoimmune destruction of pancreatic function. Nowhere does this reference or abstract imply that insulin therapy is to be avoided.

Why is there a “fear” of insulin? Pancreatic function *could* be restored, by giving the pancreas a rest. You do that by putting the patient on insulin. There is nothing new about this – in fact, it is the main recommendation of Dr. Bernstein in his excellent book on diabetes, “The Diabetes Solution.” (Robb, if you have not read this book , it is the BIBLE on diabetes!) Trust me when I say to you that I trust a type 1 diabetic who is also a endocrinologist – who has been there, done that. (And also advocates for the Paleo lifestyle as well.)

I am cautious about advocating a “cure” by diet alone when it comes to T1D. It may work for T2D where a person has the chance to manage it by diet alone.

Let’s look at reality here. When you are in your honeymoon phase, your pancreas reacts to the insulin you introduce to your body by functioning more effectively. It is the calm before the storm. The story with T1D is almost ALWYAYS the same, (especially if they are younger at diagnosis.) They find that their insulin ratios go way down; they get the illusion that they don’t need insulin anymore. They stop taking it, and one day their pancreas burns out.

As for hand-wringing? I’ll tell you one thing – I HAVE been active in my treatment.

I have a healthy skeptical mind. I question everything I read, and I’ll tell you that I was the one that took control of my disease, and that I enjoy pancreatic function 1.5 years later AFTER my diagnosis with a combination of diet and insulin. (The usual length of the honeymoon period is 6 months.) This despite a diagnosis with an A1C of 17.1%, and average blood sugars of 24.4 mmol (440 mg/dl.) I managed to get my A1C down to 5.0% in less than 3 months, and maintain a BG level of 4.9 mmol (less than 90 mg/dL) through the combination of insulin/exercise/diet. And yes, I follow a Paleo/Primal WOE.

I plan to keep my pancreatic function for as long as I can (by giving my pancreas a rest.) If I can, it will be until the end of my days.

Why The Fuss? Why Bother?
The last thing I want to see is another person led down a path that they will end up paying for later. The reality is that Robb Wolf is not the one whose life is on the line. If it ends up that the person loses all pancreatic function at a later date despite the option of preservation through insulin therapy, then it will turn out that the recommendation to manage the condition through diet alone will have been an irresponsible one.

In this case, the lady admits that she doesn’t want to “keep playing the ridiculous guessing game of insulin matching.” That suggests to me that she doesn’t have all the information that she needs to make a clear, conscientious choice.

My goal in that response was to get her to THINK. I find that the first reaction of most newly diagnosed diabetics is knee-jerk; they look to avoiding the insulin therapy altogether. They miss out on the opportunity to help themselves – and are looking for ANYTHING as an alternative.

What do you think, dear reader?

Views: 218

Tags: Diet, Paleo, Solution, T1D

Comment by bardowlatry on August 29, 2011 at 9:57am
Thanks for this post!
Comment by Natalie ._c- on August 29, 2011 at 2:16pm
I have very mixed feelings about this. First off, I don't think there is any reliable information that says that taking insulin and keeping BG in normal ranges will stop or even delay the autoimmune attack, although there is a proven honeymoon period during which the cells that were not actually dead do produce insulin after they recuperate from glucotoxicity. In fact, there was a trial many years ago that tried oral insulin to try to stop the attack, and it was a dead failure. I'm not sure this guy even had diabetes in the first place, or whether maybe he has some form of MODY that doesn't really require insulin. Sulfonylureas might work just as well for him.

On the other hand, I have had success with limiting carbs by cutting out grains, potatoes, rice, etc. That doesn't mean I'm off insulin, but my dose is down, my lipids are the best ever, and I've lost weight without feeling hungry. I know darn well that if I eliminated insulin, even without eating carbs, that my BGs would go up, and I would get very sick. I'm not willing to try it.

So, basically, I don't care what one person says anecdotally -- I don't know the full facts about his situation, and I am not HIM. He shouldn't be blathering on about something that may not be applicable to the vast majority of diabetics, especially Type 1's with little to no endogenous insulin production. He shouldn't be practicing medicine without a license!
Comment by Jason Sandeman on August 29, 2011 at 3:49pm
@Natalie - BINGO! Your thoughts mirror mine, which is why I felt compelled to put myself out there in the first place. In the end, all I want is for a potential noob diabetic to know the risks associated with following this protocol.
Worse yet, knowing just enough about endocrine system to be dangerous does not replace a medical protocol. It's fine to test n=1 on yourself, but when it comes to parading a story as a "cure," I get nervous thinking on how much damage this misinformation could actually cause.
Comment by BadMoonT2 on August 29, 2011 at 5:57pm

Amy Kubal, who is the person posting the original miracle cure story, claims to have been on the paleo diet for only 30 days as of August 15, 2011. Yet if you follow this link you find out she also has a full blown paleo diet consulting business. So we must believe that she was consulting others to eat paleo while she herself was apparently following the standard ADA advice. She says "I was taught to eat anything in moderation." Or alternately, she became a highly paid consultant after only 30 days experience with her new diet. Am I missing something here?

Nice job keeping your cool Jason and presenting your arguments in a calm and rational manner, despite Mr. Wolf's baiting. Although I don't follow paleo myself I think it is interesting and could well be beneficial, but these folks trying to make a buck of of it need to tone down the hyperbole.

Comment by Chris Reid on September 1, 2011 at 5:18am
Agree. If you are Type 1 then you can reduce the amount of needed insulin through a low carb or paleo type diet, but you CANNOT stop taking insulin. You die. Your body doesn't make any, you have to have it.

If you are a Type 1.5 then that might work for a little while but not forever. Worse the stress upon the pancreas might make the degeneration process happen faster. If your a Type 1.5 then low carb + insulin might be the best thing to try and maintain pancreatic function for as long as you can, but it will only buy you so much time.


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