So I was just told by my doc that I have type 2 diabetes - had a fasting BG of 193 and A1C of 9.0. We discussed a low carb diet - he suggested south beach, but I've done Atkins before so right now that's what I'm going with. What I'm wondering is - is this the best for me. I'm not trying to start a debate at all. I've read research online and basically I'm confused! Ha! The other issue is my triglycerides were over 500! My total cholesterol was 207, LDL was 77, and hdl was 24. I dint know what I need to avoid so to speak to lower the triglycerides. My first thought is fat - but can I do both LC and low fat?

Help!?

To lower your triglycerides quickly and decisively, avoid carbs. I would suggest you re-read Atkins if that is to be your plan, both to bone up on the fine points and to re-learn the many health benefits.

Low carb + low fat is a prescription for lack of satisfaction and unsustainability. And it's simply not necessary.

Another sound low carb plan, specifically for diabetics, is Dr Richard Bernstein's. It limits you to 30 total grams of carbs per day, spread among 3 meals. It's very rigorous and very effective.

Thanks Liz53. I'll do some refresher on Atkins for sure. Reading on dr Bernstein's plan as well. Been a lot to take in lately! Ha. I've done Atkins before and lost 90 pounds before so I am comfortable with it I guess u could say. Just trying to figure out what is "best".

I do high fat atkins. Most people do. On a regular atkins diet you almost have to.

Last time I had my triglycerides checked they were 40. That's right, 40. Atkins forces your body to live off of fat in the blood. Your fat cells see this lack of fat in the blood and also low blood sugar and release their fat for fuel.

Huh? I've done a lot of reading and have never read that - I could easily have missed something. Do you have a source for that?

IMO -
Atkins/ Low Carb is definitely the best thing you can do.

I just had a long chat with my Dr. this week. I'm not T2, but classified as "pre-diabetic" Basically if I keep eating crap it will develop.
I let my Dr. know that I was NOT doing low fat, and he barely blinked. It was sooo nice to find someone who "gets it" !!

I hope you have great success, and that you find what works for you!!!! This can be a great way to manage things.
good luck!

When I started Dr. Richard Bernstein's plan. My trigs went down by 50%...

My overall cholesterol still wasn't good because of my HDL. But my Cholesterol and Trigs where normal.

http://eatingacademy.com/weight-los...ons-of-fat-flux

Note the "Insulin-" in red causing the TAG -> fatty acids to break down and enter the blood stream.

Edit to add Attia's explanation:

Insulin does the following:

1 Upregulates lipoprotein lipase (LPL), an enzyme that breaks down TAG so they can be transported across cell membranes. Since TAG are too big to bring across cell membranes, they need to be “hydrolyzed” first into free fatty acids, then re-assembled (re-esterified) back into TAG.

2 Translocates GLUT4 transporters to the plasma membrane from endosomes within the cell. In other words, insulin moves the GLUT4 transporter to the cell surface to bring glucose into the cell.

3 Facilitates lipogenesis, that is, facilitates the conversion of glucose into acetyl CoA which gets assembled into fatty acids along with glycerol.

4 Facilitates esterification, that is, facilitates the process of assembling fatty acids into TAG (3 fatty acids per TAG).

5 Inhibits hormone-sensitive lipase (HSL) and adipose triglyceride lipase (ATGL), two important enzymes that breaks down TAG into fatty acids and glycerol such that the fatty acids can be released from the fat cell. Once bound to albumin the free fatty acids are free to travel elsewhere in the body for use (e.g., to the liver for conversion to ketones, to the heart muscle or skeletal muscles for conversion to ATP).

6 Though not shown in this figure, insulin appears to indirectly act on malonyl-CoA, a potent inhibitor of CPT I, one of the most important mitochondrial enzymes that facilitates the oxidation of fatty acids. (CPT I is what enables fatty acids to be shuttled into the mitochondria for oxidation, the process which releases or liberates their energy through electron transport.)

"Wheat Belly" is written by a doctor who is a cardiologist. He's been treating people with lipid issues through diet for a number of years now.

But yes, your HDL is dangerously low, triglycerides horrible. Both will be fixed by a serious low carb diet. Your situation doesn't call for half-measures. I'd look into the Bernstein diet or the Wheat Belly diet and go to the lower end of carbs on "Wheat Belly".

Thanks, inflammabl, I do remember seeing that on Attia's website - and I find that particular diagram to be more mystifying than explanatory. I might describe the process illustrated a little differently than you, and find Taubes' explanation in GCBC more understandable than Attia's, but I think we agree on the principle that removing carbs lowers trigs pronto.

I lowered my trig. from 175 to below 100 likely by adding fish oil. I used Carsons which is just about all Omegha-3s. Now I just use Costco pickled herring for snacks (may be an acquired taste - for me about age 3). Costco's are lower carb and cheap.

TBH I conflated blood sugar with insulin so you have a point. They are almost 1 to 1 but not quite.

One more thing is that Attia tends to use double negatives i.e. "it's not that fat won't increase", which makes him hard to read sometimes.

Thanks for all the replies folks. Trying to sort it all out again I guess us could say!