Judging by some posts I gleaned from /r/diabetes with a quick skim just now, even Type 1's who regulate their net carb intake benefit by being able to reduce their required insulin. In the US, that is a very significant personal financial factor with our broken healthcare system.
That forum is littered with Type 1's sharing prices of their insulin medications. From what I read, there are many different kinds of insulin, and even the generic kind that WalMart sells without a prescription (in some states) is not cheap for middle-income households. And unless you have gold-plated medical insurance, the really nice insulin can run into low thousands per month, depending upon your required dosage.
Type 2 takes up a disproportionate amount of healthcare funds because for most patients diet and moderate exercise can mitigate it according to enough researchers that Sweden's national health system switched to advocating low-carb for Type 2 diabetics. Karl Denninger at Market Ticker is a vociferous advocate of low carb for Type 2's, based upon his first-hand experience, and has written a lot about the financial aspects.
EDIT: I'm guessing downvotes are from Type 2 patients here who get pissed off when told diet and moderate exercise can help them. I don't think folks in /r/diabetes, /r/fasting, /r/keto, Karl Denninger, Dr. Fung, etc. are saying you'll be cured; it sounds more like better control leading to fewer late-life complications (which is where the real healthcare expenses get out of control). I'm coming in at this from the life extension and the terrible US healthcare financial picture angle; I keep seeing interesting caloric restriction research intersecting with low-carb findings and keep running across diabetics fiddling around with the same protocols that caloric restriction life extension folks like me are experimenting with. As always, YMMV, but I keep seeing enough diabetics dabbling with low-carb and caloric restriction that it raises my eyebrow, and that Sweden thought it was enough to switch their recommendations should be given some consideration when putting together your own health plan.
For type 1 and type 2, the more insulin you take per day, the lower your blood sugar will be. If you a1c is too high, you unquestionably must take more insulin. Simple as.
Should you exercise more? Yeah. Should you eat better? Yeah. Should you cut refined carbs? Yes, you probably should. None of these are unique to diabetics, but they get levied on us when we talk about insulin prices or complications with our condition.
Also, you owe it to yourself to be extremely skeptical when looking at any "diet doctor" selling a book. Most stretch the cure factor of lifestyle far beyond its limit.
The advice to someone with a high a1c is the same in every case: take more insulin.
I gave you an upvote as I've been diabetic for 30 years (Type I) and what you say is perfectly reasonable, especially for Type 2s. I wish I'd been told of low-carb diets when I first developed it, but instead got the whole "simple carbs bad, complex carbs good" talk, which turned out to be BS once they actually did some actual research...
and the lack of any discussion about how mood disorders is a low level significant effect of chronic blood sugar chaos still annoys me as well. They are only really investigating that now, based on some study I glanced at. They should have emphasized that when I was younger, really emphasized it. But instead all I got was talk about effects that would be a long way off, when I was 50 and old and etc - so they were not really real. And high fat diets were used back in the 30s before they developed insulin, but zip was said about low carb diets. To hell with the ADA.
It is my fault for not developing good habits when I was younger, but also a lot of what I was told was BS. When I moved to the UK, I learned of a protocol that'd developed in Germany in the 70s that made more sense than the nth level of detail carb counting yadda yadda they taught in the States (don't know what it's like in America now, though I'm sure there is a lot more gadgets and etc available)
But insulin is free here and I have saved 60k in personal costs over the years. The US is ridiculous.
And no, insulin isn't the sole solution (replying to someone else). First you look at your behavior. Stop eating so much carbs. Carbs are basically poison to a diabetic (a loaded word, perhaps toxic is better). If you can't, then still adjust your diet and behavior as best you can. If you find you need lots of insulin because of insulin resistance or you are one of the small percentage who need 10x more insulin than normal, then do take it. Otherwise, get more exercise and lose weight if necessary. Blindly using more insulin only makes you get fatter and that should be a big concern, because the effects of that cascade into other problems. And caffeine... I have to cut that out, but ...I'm in IT dammit.
Treating diabetes first and foremost involves behavioral changes, not fancy insulin or more gadgets. But behavioral change is so hard. I can manage a low carb diet for so long and it works great, then stress and it all falls apart because of various personal failings, not because low carb is a bad idea. It is not a cure, but I really believe it could help so many people.
>Judging by some posts I gleaned from /r/diabetes with a quick skim just now
Well, at least you're being honest.
You're replying to some people who have been fighting this disease for close to their entire life and you're trying to tell them they're doing it wrong after skimming a few subreddit posts?
