The Truth About Carbohydrate Intolerance 

Diabetes is an intolerance to carbohydrates.

In the physiological phenomenon called insulin resistance, the body no longer tolerates a normal load of carbohydrates from a meal or snack.

This leaves you feeling tired, irritable, and craving even more carbohydrates! What can you do to manage this?

In this article, we’ll dive more into carbohydrates, insulin resistance, and the relationship between obesity and diabetes.

Type 2 diabetes and other chronic diseases are directly linked to lifestyle.

While one indulgence won’t tip the scale, years and decades of dietary and lifestyle habits, unmanaged stress, toxic exposures, unbalanced hormones, and more, create physiological changes that cause chronic disease. However, it doesn’t have to be that way.

Understanding these processes in the body and how our daily choices impact our health is incredibly empowering. The answers to individual health issues may even prove to be more simple and realistic to implement than you may think. 

This article will address and answer the following questions:

  • What is insulin resistance and carbohydrate intolerance?
  • What causes carbohydrate intolerance?
  • What are the signs and symptoms of carbohydrate intolerance?
  • What is the conventional approach to diabetes AKA severe carbohydrate intolerance?
  • What role does the Paleo diet play?
  • Bonus: (Simple) tips for preventing and treating carbohydrate intolerance. 

Insulin Resistance And Carbohydrate Intolerance 

Insulin resistance takes years, and even decades, to develop before someone receives a diagnosis of type 2 diabetes. It doesn’t happen overnight, but it is more of an accumulation of day-in, day-out responses to diet and lifestyle choices. 

A diagnosis of metabolic syndrome or pre-diabetes often proceeds to a diagnosis of diabetes, but is also an indication that the process of insulin resistance and carbohydrate intolerance has begun.

These precursors often go undiagnosed, which is unfortunate because they are wonderful opportunities to address the root cause and begin on a path of disease reversal. 

What is insulin resistance? When you eat carbohydrates, the sugars, and starches found in plant foods, your blood sugar will go up. The pancreas releases insulin into the bloodstream to help move the sugar into the cells where it can be used for energy. This is a normal process. 

Where we get into trouble is when blood sugar is consistently high. Blood sugar spikes are greater from foods high in sugar and refined carbohydrates such as wheat flour, which are staples of a Standard American Diet (SAD). These foods include sweets, soda, cakes, breads, pasta, and all of the processed, packaged convenience items that have become the norm in our society.

Especially of concern are the “sweet fats,” such as pastry, cakes, and other foods high in sugar plus trans or saturated fat. The combo of sugar with high fat is very inflammatory and fast tracks insulin resistance. 

What goes up must come down. When blood sugar is high, it’s common to also experience lows and it’s the drop in blood sugar that can make us crave more sugar and carbs. After all, carbs are quick and readily available. The cycle is perpetuated throughout the day. 

Under these circumstances, over time, there is more sugar in the blood than the body can handle. The pancreas pumps out more insulin (insulin levels are measurably high), but the cells have become resistant to the signal.

Blood sugar is high, insulin is high, but the sugar has a hard time moving into the cells to be used for energy. This is insulin resistance. Essentially, the body has developed an intolerance to the high input of carbohydrates it is receiving.

Insulin resistance leads to obesity and diabetes, both of which are epidemic in the United States. Within five to seven years, the pancreas often begins to fail. Without intervention, insulin resistance lasts for the rest of one’s life. 

Carbohydrate Intolerance Causes

Several factors contribute to insulin resistance and intolerance to carbohydrates, including:

  • Visceral fat – Even as little as 2 to 6 pounds of excess fat around the abdominal organs contributes to both. 
  • Glucose toxicity – This is the high blood sugar that leads to insulin resistance that we’ve discussed. 
  • Inflammation – Chronic, subclinical inflammation is a major driver. 
  • Lipotoxicity – excess glucose is converted into free fatty acids that go into the muscles, liver and heart
  • Environmental toxicity – Many toxins are referred to as obesogens because they change metabolism and promote obesity. Examples of obesogens include plastics, BPA, pesticides, solvents, phthalates, and parabens.

Carbohydrate Intolerance Symptoms 

How do you know if you are intolerant to carbs?

Here are some signs and symptoms of elevated blood sugar and insulin resistance, signaling you may be losing tolerance to carbohydrates: 

  • Fatigue, especially after meals
  • Elevated triglycerides
  • Frequent headaches
  • Brain fog
  • Recurrent infections and illness
  • Sugar and carbohydrate cravings
  • Episodes of low blood sugar (hypoglycemia)
  • Increased thirst
  • Frequent urination
  • Elevated serum glucose, elevated insulin, elevated hgA1c

The Conventional Approach To Type 2 Diabetes 

Something is amiss in the conventional understanding of insulin resistance and diabetes. There are 42 different diabetes medications on the market today. Seventy-five to 85 percent of people with diabetes will die of a heart attack, something that medication can’t prevent. 

Bariatric surgery is offered as an obesity and diabetes treatment. This surgery, which may lead to lifelong malabsorption of essential nutrients, has been shown to produce short-term weight loss and disease reversal, but what are the long-term consequences of not addressing the root of insulin resistance? 

A 2013 study compared bariatric surgery to simply following the very low calorie diet required after bariatric surgery. Both produced similar short-term improvements in diabetes patients, cluing us in that it is really about diet and not the surgery itself.

The conventional nutrition approach to diabetes is focused on counting carbohydrates and keeping them consistent throughout the day, more than reducing carbohydrates or distinguishing different types of carbohydrates.

It’s common for a person with diabetes to get the prescription to eat 45 grams of carbohydrates with 3 meals per day and include 15 grams of carbs with each snack. 

Even though this carbohydrate amount may be lower than a Standard American Diet it is still a fairly high carbohydrate diet and one that would likely perpetuate the diabetes disease process. 

Feeding a high carbohydrate diet to someone who doesn’t tolerate carbohydrates simply doesn’t make sense. 

The Paleo Diet

Changes in human health correlate with the movement away from an ancestral eating pattern and toward the modern, industrialized diet.

A modern diet increases oxidative stress and inflammation, changes the microbiome, and activates the sympathetic nervous system, the body’s stress response. This creates a perfect storm that helps drive the epidemic of obesity, diabetes, and chronic illnesses that we see today. 

Today’s food environment is a desert (not to mention a sedentary lifestyle, high stress, lack of sleep and toxin exposures) and doesn’t support our genetics, which leads to unfavorable epigenetic expression that, unfortunately, is passed through generations. 

The good news is that our current patterns are often reversible by bringing our diet and lifestyle back in line with our genetic makeup. This is how we can prevent (and treat) the diseases of civilization, including type 2 diabetes. 

The Paleo diet offers a helpful starting point as it is based on the diets of our hunter-gatherer ancestors and eliminates the problematic highly refined carbs and processed foods. The Paleo diet includes whole sources of slow burning carbs balanced with protein and healthy fats. 

A small study compared 14 people with type 2 diabetes eating a Paleo diet consisting of lean meats, fruit, vegetables and nuts while avoiding grains, dairy and beans. These participants were compared to 10 controls following the American Diabetes Association recommendations that emphasize whole grains, beans and low-fat dairy.

While both groups showed improvements from baseline, the Paleo group saw greater benefits in terms of blood sugar control and improved insulin sensitivity.

In another small study, 32 participants followed a Paleo diet for 12 weeks. Half of the participants were given exercise recommendations while the other half received three training sessions per week.

This study is interesting because both groups showed improvements in insulin sensitivity and blood sugar control, which was attributed to diet alone and not the differences in exercise. Exercise correlated to increased cardiovascular fitness, especially for men, in this study.

Larger studies would be helpful to gather more data, but similar results are reported by those throughout the Functional Medicine space.

Overall, shifting away from processed foods and back to a whole food diet will lower carbohydrate intake, increase fiber, and provide more nutrient density that supports root cause health. 

Tips For Preventing and Treating Carbohydrate Intolerance

1. Adopt a Paleo diet. This is a great first step in shifting the diet away from a disease-promoting SAD diet and toward an anti-inflammatory healing one. 

2. Personalize your diet. An active person may have a different carbohydrate intolerance than someone with insulin resistance. Work with your Functional Medicine provider or dietitian to dial in the best approach and daily carb tolerance for you.

3. Measure your results with a continuous glucose monitor. You can take real-time action to know which foods to eat, and which to avoid to minimize blood sugar elevations.

4. Get regular screenings. Wellness visits are important. Routine labs such as fasting blood sugar, fasting insulin and Hemoglobin A1C may start trending up well before a diagnosis of pre-diabetes or diabetes is made. Catch the trend early and reverse it. If you have insulin resistance you may need more regular check-ups or at home blood sugar monitoring. 

5. Strength train. Strength training helps to preserve lean muscle mass, support metabolism and even decrease visceral fat. Make it a part of your weekly routine. 

6. Walk. Our ancestors did a lot of walking. Even a 10-minute walk after meals has been shown to lower blood sugar. Blood sugar moves into cells without insulin when exercising! 

7. Manage stress. Stress increases hormones that increase fat around the midsection and raises blood sugar. Don’t underestimate the power of regular stress management tools for helping to prevent chronic disease. 

8. Sleep. Lack of sleep increases stress, increases blood sugar and has us reaching for those quick carbs for a boost in energy when what we really need is a nap. 

9. Clean up. Reduce toxin exposures as much as possible. Get started here

If someone isn’t tolerating carbohydrates, keeping carbs high and trying to medicate the issues away simply doesn’t make sense.

We need to get to the root of the problem, which is our modern, highly processed food supply that wreaks havoc on our genetics, creates insulin resistance and makes us sick.

Returning to a whole, balanced diet and incorporating simple, healthy lifestyle tools provides a solid foundation for both disease prevention and reversal.

It may not be as easy as popping a pill, but it will lead to a more fulfilling and quality life