Q&A: Type 2 Diabetes, Carb Count and the Paleo Diet

This blog is actually in answer to an email I received, that I thought was probably relevant to many more of you, so I’m publishing my response here:


The question:

“My doctor told me that counting carbs was critical to managing my diabetes, how do I count carbs on the paleo diet?”


My response:

Fundamentally, It is my opinion that macro counting and calorie counting are not necessary for the average person (in other words, not someone just starting out. I reserve macro counting for the more experienced person trying to finely tune their diet, biohacking, and the professional athlete, etc). I just think it’s too confusing and further perpetuates our negative relationship with food. Beginning a paleo template is enough of a change to your lifestyle and has it’s own learning curve, further complicating that is senseless.

I believe, and my experience has shown, that tracking carbs, once you’ve removed all grains, isn’t necessarily a requirement at all, because you’ve already removed the offending type of carbohydrates and it’s important to NOT limit your vegetable sources of carbohydrates.

While on Paleo diet, the carb count is actually not critical to diabetes management. The reason for that is that the paleo diet uses real food, vegetables primarily, fruits secondary and very little but some natural sweeteners like raw organic honey. Type 2 diabetes is an auto immune condition linked to/ caused by leaky gut and results in hormonal spikes that include insulin response but also the cortisol and leptin cycle. By removing all grains, dairy and legumes and all processed sweeteners; the paleo diet itself is diabetic friendly and removes the need to track macronutrients entirely.

I’m not saying ditch your doctor and throw your medications down the toilet, I’m saying learn to use food as a tool and wean yourself off of the daily regimen you are currently on with the help of a qualified professional.

Two excellent books to read would be “The Paleo Approach” by Sarah Ballantyne, PhD and “It starts with Food” by Dallas and Melissa Hartwig. The first, discusses auto immune conditions at length and goes into great detail about Diabetes. The second, discusses the role of food and the unfortunate amount of misinformation surrounding food in the management of disease. It also discusses very clearly in lay terms the hormone cycle being perpetuated by the standard american diet that plagues diabetics and how the insulin cycle can be re-set through diet.

This is a recently published medical study on the role of the paleo diet for type 2 diabetes.

Here is also great article by Chris Kresser about the paleo diet and diabetes.

Diabetics may find that they need to go on a low FODMAP diet (Paleo with low fructose) and that’s entirely possible, primarily by limiting fruits. A list of the low FODMAP foods can be found in Sarah’s book, but also here.

By removing all processed foods, and additionally removing things like dried fruits. A basic, strict paleo guideline will go a long way to healing your gut and managing your diabetes.

Remember, that no two people are identical and while the paleo diet provides a great template to start from, there will be individualization. It’s a great idea to work with a health coach or nutritional therapist who can help you navigate the changes and be your partner on this journey.



About Leanna Cappucci

I am a woman, a mother, a wife, an entrepreneur and I have worn a hundred different hats in my lifetime. I've recreated myself when I've needed to, I've gleaned from the experiences I've been lucky enough to have - both positive and negative, and they have impacted the person that I am today. Like you, I've succeeded and failed and I will continue to do so, because failure is simply the precursor to success! As a coach, as a blogger and as a friend; I am just who I am. I will ramble, I will be honest, I will be emotionally invested and I will say it like it is. I am not a sugar coater, I value honesty. I am not afraid to disagree or have conflict, as those are both healthy and vital to individual growth. I enjoy teaching, learning, discussing and collaborating. As a mother, there is nothing more important to me that the responsibility I have been given to shape the lives of my children, to empower them, to protect them and to help them learn to be strong and independent adults some day.