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Insulin Sensitivity 101: 7 Case Studies of the Effect of Low-Fat, Plant-Based, Whole-Food Nutrition

Article written and reviewed by Cyrus Khambatta, PhD
Published March 22, 2017

A few weeks ago, we completed another successful Mastering Diabetes Retreat in Idyllwild, CA. This was our 4th diabetes retreat, and the improvement in insulin sensitivity in our attendees with type 1 diabetes was very consistent.

Think of the Mastering Diabetes Retreat as insulin sensitivity bootcamp. Every day is packed with information, exercise, fresh food, laughs and plenty of high-fives. From Thursday night through Monday morning, we ensure that you get the personal attention you need to understand exactly how to incorporate a low-fat, plant-based, whole-food lifestyle for maximum insulin sensitivity.

How much insulin sensitivity can you gain in 4 days?

Most people think that 4 days is not enough to see dramatic improvements in blood glucose, energy levels or weight loss. I’ll be the first to admit that when we started our diabetes retreats, we thought the same thing.

However, after reflecting on the rapid improvements in blood glucose and speedy decreases in insulin need that many of our clients experience, it became obvious that rapid increases in insulin sensitivity are possible in as little as 24-48 hours.

Insulin sensitivity is calculated as the ratio of your total carbohydrate intake to your total insulin use (basal and bolus) in a 24-hour period. This number is calculated only when you maintain your blood glucose in the normal range (70-130 mg/dL) for more than 80% of the day. The calculation is shown here:

Insulin sensitivity equation

Our attendees results speak for themselves. In this article, we’ll share the change in insulin sensitivity that occurred at our last diabetes retreat in 7 insulin-dependent attendees living with either type 1 or type 2 diabetes.

Data Collection

We teach all of our attendees to fill out a daily Decision Tree, a food, exercise and medication dosing log that provides us with detailed information about their blood glucose patterns over the course of a 24-hour period. The process is designed to provide both the attendee and us detailed information about how their insulin sensitivity changes over time as they improve their eating and movement habits.

By analyzing this data on a daily basis, we are able to visualize how a low-fat, plant-based, whole-food diet can promote significant improvements in insulin sensitivity in a short period of time. This provides everyone with insight about how to reduce oral medication and insulin use while maximizing whole carbohydrate intake from unprocessed fruits and vegetables.

Please note that the names of each attendee below has been removed to protect their identity and personal health information. The data was recorded in detail over the course of the 4-day diabetes retreat, and all data are averages of the 4-day period. All personal information has been removed.

Attendee #1 Results


  • Age: 46
  • Sex: Female
  • Diabetes: Type 1
  • Year of Diagnosis: 2004
  • Most Recent A1c: 8.1%

Before the Diabetes Retreat

  • Carbohydrate Intake: 150 grams per day
  • Basal Insulin: 43.2 units per day
  • Bolus Insulin: 45.0 units per day
  • Starting Insulin Sensitivity: 1.7 g/U

After the Diabetes Retreat

  • Carbohydrate Intake: 257 grams per day
  • Basal Insulin: 31.6 units per day
  • Bolus Insulin: 27.0 units per day
  • New Insulin Sensitivity: 4.4 g/U
Insulin Sensitivity Attendee 1

Attendee #2 Results


  • Age: 50
  • Sex: Female
  • Diabetes: Type 2
  • Year of Diagnosis: 2007
  • Most Recent A1c: 7.3%

Before the Diabetes Retreat

  • Carbohydrate Intake: 125 grams per day
  • Basal Insulin: 40.0 units per day
  • Bolus Insulin: 10.3 units per day
  • Starting Insulin Sensitivity: 2.5 g/U

After the Diabetes Retreat

  • Carbohydrate Intake: 172 grams per day
  • Basal Insulin: 9.3 units per day
  • Bolus Insulin: 13.0 units per day
  • New Insulin Sensitivity: 7.7 g/U
Insulin Sensitivity Attendee 2

Attendee #3 Results


  • Age: 13
  • Sex: Female
  • Diabetes: Type 1
  • Year of Diagnosis: 2012
  • Most Recent A1c: 7.5%

Before the Diabetes Retreat

  • Carbohydrate Intake: 200 grams per day
  • Basal Insulin: 28.0 units per day
  • Bolus Insulin: 32.0 units per day
  • Starting Insulin Sensitivity: 3.3 g/U

After the Diabetes Retreat

  • Carbohydrate Intake: 299 grams per day
  • Basal Insulin: 13.0 units per day
  • Bolus Insulin: 17.0 units per day
  • New Insulin Sensitivity: 10.0 g/U
Insulin Sensitivity Attendee 3

Attendee #4 Results


  • Age: 48
  • Sex: Female
  • Diabetes: Type 1
  • Year of Diagnosis: 1977
  • Most Recent A1c: 7.8%

Before the Diabetes Retreat

  • Carbohydrate Intake: 110 grams per day
  • Basal Insulin: 13.6 units per day
  • Bolus Insulin: 10.0 units per day
  • Starting Insulin Sensitivity: 4.7 g/U

After the Diabetes Retreat

  • Carbohydrate Intake: 208 grams per day
  • Basal Insulin: 11.9 units per day
  • Bolus Insulin: 15.7 units per day
  • New Insulin Sensitivity: 7.6 g/U
Insulin Sensitivity Attendee 4

Attendee #5 Results


  • Age: 40
  • Sex: Female
  • Diabetes: Type 1
  • Year of Diagnosis: 1999
  • Most Recent A1c: 6.4%

Before the Diabetes Retreat

  • Carbohydrate Intake: 275 grams per day
  • Basal Insulin: 17.0 units per day
  • Bolus Insulin: 20.0 units per day
  • Starting Insulin Sensitivity: 7.4 g/U

After the Diabetes Retreat

  • Carbohydrate Intake: 422 grams per day
  • Basal Insulin: 12.2 units per day
  • Bolus Insulin: 17.2 units per day
  • New Insulin Sensitivity: 14.4 g/U
Insulin Sensitivity Attendee 5

Attendee #6 Results


  • Age: 51
  • Sex: Female
  • Diabetes: Type 1
  • Year of Diagnosis: 1990
  • Most Recent A1c: 12.0%

Before the Diabetes Retreat

  • Carbohydrate Intake: 100 grams per day
  • Basal Insulin: 18.0 units per day
  • Bolus Insulin: 0.0 units per day
  • Starting Insulin Sensitivity: 5.6 g/U

After the Diabetes Retreat

  • Carbohydrate Intake: 142 grams per day
  • Basal Insulin: 14.8 units per day
  • Bolus Insulin: 8.3 units per day
  • New Insulin Sensitivity: 6.2 g/U
Insulin Sensitivity Attendee 6

Attendee #7 Results


  • Age: 29
  • Sex: Female
  • Diabetes: Type 1
  • Year of Diagnosis: 2003
  • Most Recent A1c: 7.5%

Before the Diabetes Retreat

  • Carbohydrate Intake: 100 grams per day
  • Basal Insulin: 10.3 units per day
  • Bolus Insulin: 12.8 units per day
  • Starting Insulin Sensitivity: 4.3 g/U

After the Diabetes Retreat

  • Carbohydrate Intake: 223 grams per day
  • Basal Insulin: 6.3 units per day
  • Bolus Insulin: 15.3 units per day
  • New Insulin Sensitivity: 10.3 g/U
Insulin Sensitivity Attendee 7

As you can see, the improvement in insulin sensitivity occurred in all individuals shown above, and did not depend on their sex, age, duration of time living with diabetes or baseline A1c value. The biology of insulin sensitivity is universal, and following a low-fat, plant-based, whole-food diet is the most effective eating pattern to reverse insulin resistance.

Take Home Messages

  • 24-hour insulin sensitivity is calculated by dividing your total carbohydrate intake by your total insulin use (basal plus bolus) over a 24 hour period
  • All of our insulin-dependent attendees experienced a significant increase in insulin sensitivity within 4 days in a retreat setting
  • A low-fat, plant-based, whole-food diet is your #1 most effective way to increase insulin sensitivity

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About the author 

Cyrus Khambatta, PhD

Cyrus Khambatta, PhD is a New York Times bestselling co-author of Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Prediabetes, and Gestational Diabetes.

He is the co-founder of Mastering Diabetes and Amla Green, and is an internationally recognized nutrition and fitness coach who has been living with type 1 diabetes since 2002. He co-created the Mastering Diabetes Method to reverse insulin resistance in all forms of diabetes, and has helped more than 10,000 people improve their metabolic health using low-fat, plant-based, whole-food nutrition, intermittent fasting, and exercise.

Cyrus earned a Bachelor of Science in Mechanical Engineering from Stanford University in 2003, then earned a PhD in Nutritional Biochemistry from the University of California at Berkeley in 2012. He is the co-author of many peer-reviewed scientific publications.

He is the co-host of the annual Mastering Diabetes Online Summit, a featured speaker at the Plant-Based Nutrition and Healthcare Conference (PBNHC), the American College of Lifestyle Medicine Conference (ACLM), Plant Stock, the Torrance Memorial Medical Center, and has been featured on The Doctors, NPR, KQED, Forks Over Knives, Healthline, Fast Company, Diet Fiction, and the wildly popular podcasts the Rich Roll Podcast, Plant Proof, MindBodyGreen, and Nutrition Rounds.

Scientific Publications:

Sarver, Jordan, Cyrus Khambatta, Robby Barbaro, Bhakti Chavan, and David Drozek. “Retrospective Evaluation of an Online Diabetes Health Coaching Program: A Pilot Study.” American Journal of Lifestyle Medicine, October 15, 2019, 1559827619879106. https://doi.org/10.1177/1559827619879106

Shrivastav, Maneesh, William Gibson, Rajendra Shrivastav, Katie Elzea, Cyrus Khambatta, Rohan Sonawane, Joseph A. Sierra, and Robert Vigersky. “Type 2 Diabetes Management in Primary Care: The Role of Retrospective, Professional Continuous Glucose Monitoring.” Diabetes Spectrum: A Publication of the American Diabetes Association 31, no. 3 (August 2018): 279–87. https://doi.org/10.2337/ds17-0024

Thompson, Airlia C. S., Matthew D. Bruss, John C. Price, Cyrus F. Khambatta, William E. Holmes, Marc Colangelo, Marcy Dalidd, et al. “Reduced in Vivo Hepatic Proteome Replacement Rates but Not Cell Proliferation Rates Predict Maximum Lifespan Extension in Mice.” Aging Cell 15, no. 1 (February 2016): 118–27. https://doi.org/10.1111/acel.12414

Roohk, Donald J., Smita Mascharak, Cyrus Khambatta, Ho Leung, Marc Hellerstein, and Charles Harris. “Dexamethasone-Mediated Changes in Adipose Triacylglycerol Metabolism Are Exaggerated, Not Diminished, in the Absence of a Functional GR Dimerization Domain.” Endocrinology 154, no. 4 (April 2013): 1528–39. https://doi.org/10.1210/en.2011-1047



Price, John C., Cyrus F. Khambatta, Kelvin W. Li, Matthew D. Bruss, Mahalakshmi Shankaran, Marcy Dalidd, Nicholas A. Floreani, et al. “The Effect of Long Term Calorie Restriction on in Vivo Hepatic Proteostatis: A Novel Combination of Dynamic and Quantitative Proteomics.” Molecular & Cellular Proteomics: MCP 11, no. 12 (December 2012): 1801–14.
https://doi.org/10.1074/mcp.M112.021204





Bruss, Matthew D., Airlia C. S. Thompson, Ishita Aggarwal, Cyrus F. Khambatta, and Marc K. Hellerstein. “The Effects of Physiological Adaptations to Calorie Restriction on Global Cell Proliferation Rates.” American Journal of Physiology. Endocrinology and Metabolism 300, no. 4 (April 2011): E735-745. https://doi.org/10.1152/ajpendo.00661.2010




Bruss, Matthew D., Cyrus F. Khambatta, Maxwell A. Ruby, Ishita Aggarwal, and Marc K. Hellerstein. “Calorie Restriction Increases Fatty Acid Synthesis and Whole Body Fat Oxidation Rates.” American Journal of Physiology. Endocrinology and Metabolism 298, no. 1 (January 2010): E108-116.
https://doi.org/10.1152/ajpendo.00524.2009