Jason was diagnosed with type 1 diabetes at the age of 12, and grew up eating a “balanced” standard American diet that included some fruit and vegetables, meat, and a moderate amount of starchy carbohydrates including rice and pasta.
As a competitive hockey player throughout high school and college, Jason looked healthy and fit yet his A1c told a different story. At the height of his college hockey career, Jason’s A1c had climbed to 9.2% even though he thought he was eating healthily and was very active.
In Jason’s owns words, he “felt pretty healthy.” But then he began to experience diabetic nerve pain, which caused him to reflect on how he had treated his body over the years.
This nerve pain served as a wake-up call for Jason – he wanted to start taking better care of himself, improve his blood glucose control, prevent permanent nerve damage, and ensure that he would never lose a limb or lose his eyesight – common complications of living with type 1 diabetes.
Then Jason received an unwanted “surprise” for the Christmas of 2017: painful kidney stones in his right kidney. He lived through it – an unhesitantly began following Mastering Diabetes lifestyle in January of 2018.
Jason had already been following a vegan diet, but it wasn’t until he started eliminating fatty foods from his diet that his A1c, fasting blood glucose, and insulin dosage began to significantly decrease.
This may be confusing information if you’ve been told that the key to lowering blood glucose and insulin requirements is to limit carbohydrate intake, not your fat-rich food intake.
Since blood glucose increases when you eat carbohydrates, the predominant conventional belief for many decades has been that people with diabetes should limit their carbohydrate intake in order to control their blood glucose in a narrow window.
More recent studies now show that either a high protein meal or a high-fat meal increases post-prandial (post-meal) glucose values, and also increases insulin requirements in insulin-dependent diabetes.
In one study, volunteers with type 1 diabetes wore continuous blood glucose monitors and consumed either a whey protein drink containing 12.5, 25, 50, 75, or 100 grams of protein, a control beverage (flavored water), or a glucose drink without insulin over the course of 8 days. Researchers found that protein loads over 75 grams resulted in delayed and sustained elevations in blood glucose 3 to 5 hours after consuming the protein.
This protein effect has been confirmed in numerous other studies, which clearly show that a high protein meal lowers blood glucose immediately after a meal, but then elevates blood glucose several hours later.
Instead of stabilizing blood glucose levels, high protein meals actually induce a blood glucose rollercoaster, with an extreme low followed by an extreme high. In people with type 1 diabetes, a high protein intake can make it very challenging to calculate and predict insulin requirements accurately.
It’s now also common knowledge in the scientific community that high-fat meals also increase blood glucose and insulin requirements, though through an entirely different mechanism – dietary fat strongly impairs insulin sensitivity and increases glucose production in the liver.
Continuous blood glucose monitoring and food log data in people with type 1 diabetes show that high-fat meals significantly increase insulin requirements and insulin resistance, which can manifest in many different ways including diabetic nerve pain.
Studies have shown that lowering blood glucose levels with increased insulin dosage or diabetes medications (such as Metformin), or with low carbohydrate diets, does not reverse or slow the progression of diabetic nerve pain.
However, significantly decreasing dietary fat and following a plant-based, whole-food diet can, in fact, reverse diabetic nerve pain.
Not surprisingly, Jason began to notice that his nerve pain began to reduce soon after decreasing his fat intake from 150 grams per day down to about 50–75 grams per day.
While this may still seem like a high amount of dietary fat (equivalent to about 3 handfuls of nuts), Jason is extremely physically active and eats at least 3500 calories per day, so his fat intake as a total proportion of his calorie intake is still quite low.
Jason increased his carbohydrate intake from 300 - 400 to 500 - 600 grams per day, and despite this, his insulin requirements dropped from 70 - 80 units per day to 20 - 30 units per day.
Take a look at the following table to see how Jason’s biomarkers changed between July 2017 and December 2018:
Dietary Carbohydrate (grams per day)
300 - 400
500 - 600
Dietary Fat (grams per day)
100 - 150
50 - 75
Total Insulin (units per day)
70 - 80
20 - 30
Fasting Blood Glucose (mg/dL)
180 - 288
72 - 145
Total Cholesterol (mg/dL)
LDL Cholesterol (mg/dL)
HDL Cholesterol (mg/dL)
Body Weight (lbs)
Blood Pressure (mm/Hg)
In order to fuel his active lifestyle, Jason likes to eat a big bowl of oatmeal with lots of fruit for breakfast. He gets his essential fatty acids from seeds and nut butter, varying the amounts based on his activity levels.
For lunch, he usually eats a large vegetable salad with a starchy carbohydrate such as sweet potato fries, rice, farro, corn, beans, chickpeas, and a handful of nuts of a small amount of avocado. His evening meal is usually very similar to lunch.
Throughout the day for extra fuel, Jason snacks on fruit. He loves watermelon, bananas, cherries, and pears, especially when they’re in season and grown locally.
Jason was excited to tell us the following: “Overall I feel so much better. I have way more energy now. My chronic pain from old injuries is diminishing and the injuries are healing. Neuropathy is pretty much healed. My kidney stones either dissolved or passed. Circulation to my hands and feet improved drastically. My gut microbiome went through a healing period and my digestion improved. My mental health and clarity is now as good as it has ever been. I am enjoying every day with my new lifestyle.”
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Jamie Koonce, DACM, L.Ac, Dipl.OM is the Digital Content Manager at Mastering Diabetes. She holds a Doctorate degree in Acupuncture & Chinese Medicine, a Bachelor of Arts degree in Biology & Anthropology from Hendrix College, and Certification in Plant-Based Nutrition through eCornell. Jamie has been enjoying a plant-based lifestyle since 1999. In addition to writing at Mastering Diabetes, she teaches continuing education courses to other health professionals on the science behind a low-fat, plant-based, whole-food lifestyle for specific medical conditions.
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