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What if lowering your blood sugar by removing carbohydrates isn't the same thing as actually reversing insulin resistance?
In this episode, Robby Barbaro takes a closer look at one of the biggest debates in diabetes nutrition: whether keto, carnivore, and low-carbohydrate diets actually address the underlying cause of insulin resistance—or simply lower blood glucose by removing the foods that reveal the problem.
You'll learn why a lower A1C is absolutely meaningful, but doesn't necessarily tell you whether your muscle and liver cells have become more sensitive to insulin.
Robby also breaks down research comparing ketogenic diets with low-fat, whole-food approaches and explains why weight loss can make the results of low-carb studies more complicated than they initially appear.
You'll also hear the remarkable story of T, who started with an A1C of 15.5 and was prescribed insulin before every meal plus once daily. Within three months, she was off insulin, her A1C fell to 7.8 and later reached 6.5—all while eating carbohydrate-rich whole foods like bananas, blueberries, and potatoes.
In this episode, you'll learn:
- Why lowering blood sugar by restricting carbohydrates isn't necessarily the same as improving insulin sensitivity
- Why A1C tells you how much glucose has been in your blood—but not necessarily why it went down
- The important difference between clinical diabetes remission and restoring carbohydrate tolerance
- How insulin resistance affects your muscles, liver, and fat tissue
- Why excess fat inside muscle and liver cells can interfere with insulin signaling
- How weight loss may explain some of the improvements seen on ketogenic diets
- What happened when researchers tested ketogenic diets while keeping body weight stable
- Why a quiet glucose meter on a very-low-carbohydrate diet doesn't automatically prove insulin resistance has been resolved
- What the research on carnivore diets can—and cannot—tell us
- Why saturated fat may have a different effect on insulin sensitivity than other types of dietary fat
- What the Keto-Med Trial found when comparing a ketogenic diet with a Mediterranean-style, low-glycemic diet
- How low-fat, whole-food, plant-based diets have been shown to reduce fat stored inside the liver and muscles
- Why reducing intracellular fat can help improve insulin signaling
- How people eating a low-fat plant-based diet consumed fewer calories naturally in a tightly controlled NIH study
- How dietary fiber and the gut microbiome may contribute to better blood glucose control
- How T went from an A1C of 15.5 and multiple daily insulin injections to eating fruit and potatoes without insulin
- Why the ultimate question isn't simply how low your glucose is—but how effectively your body can process carbohydrate-rich whole foods
The goal isn't to build a smaller and smaller food cage just to keep your glucose meter quiet.
It's to improve the underlying insulin resistance so your body becomes better at processing the carbohydrate-rich whole foods it was designed to use.
By reducing dietary fat, keeping saturated fat low, eating fiber-rich whole plant foods, and reducing excess fat stored inside the liver and muscles, you can create an environment that supports greater insulin sensitivity and healthier glucose metabolism.
If you're following keto, carnivore, or a low-carbohydrate diet and wondering whether better blood sugar numbers mean your insulin resistance has actually improved, this episode will help you understand the important difference between controlling glucose and changing the underlying metabolic environment.
And remember: never change your diabetes medications on your own. Work with your healthcare provider, because medication needs can change quickly as blood glucose improves.
Keep your carbs high and your A1C low.
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