Diabetic with high triglycerides

Refined carbohydrates (flours, sugars, etc.) are the absolute WORST thing for triglyceride levels. Higher-carbohydrate diets have been shown in numerous studies to increase fasting triglycerides.

Diabetes, simply put, is a condition marked by impairment in carbohydrate metabolism. The vast-majority of diagnosed diabetics also have high triglycerides, simply because they've been eating too many carbohydrates for their biochemistry.

Studies universally show the BEST diet for glucose control is a VLCKD (very low-carb ketogenic diet).

I typically eat under 75g of CHO a day, sometimes as low as 20 or 30g. My last HbA1c was 5.2% (absolutely normal) and my fasting blood glucose is almost always well-under 100mg/dl (5.5mmol/L for those not in the USA).

At diagnosis my HbA1c was 12.2% and my fasting BG was 268 mg/dl (14.8 mmol/L)... Not bad considering I take no medication...

Check out http://www.diabetes-low-carb.org/ who explains it better than I can.

Refined carbohydrates (flours, sugars, etc.) are the absolute WORST thing for triglyceride levels. Higher-carbohydrate diets have been shown in numerous studies to increase fasting triglycerides.

I thought the worst thing for triglycerides was a diet high in fats? Fats that don't breakdown easily so they stay in the blood. And a diet low in lipase?

Refined carbohydrates (flours, sugars, etc.) are the absolute WORST thing for triglyceride levels. Higher-carbohydrate diets have been shown in numerous studies to increase fasting triglycerides.

I thought the worst thing for triglycerides was a diet high in fats? Fats that don't breakdown easily so they stay in the blood. And a diet low in lipase?

Triglycerides enter the body through dietary fat, but they are broken down by glycolysis. I am not 100% sure on this but I think a diet high in carbs/sugar would mean those would be preferentially broken down, (and if you're insulin resistant this pathway already has problems functioning efficiently) which means the triglycerides will hang around longer.

I bet you could get them down in an otherwise healthy person by cutting fats hard. They won't take in so much and their metabolism can cope with upping the carb a bit to compensate. BUT for an insulin resistant person, that method would be a disaster. They can't take that hit to their blood sugar and further resistance. So you need to work with the other side of the coin- using the metabolism to break down the fats.

Triglycerides enter the body through dietary fat, but they are broken down by glycolysis. I am not 100% sure on this but I think a diet high in carbs/sugar would mean those would be preferentially broken down, (and if you're insulin resistant this pathway already has problems functioning efficiently) which means the triglycerides will hang around longer.

FYI there's TWO measurements of triglycerides. Being diagnosed as having hypertriglyceridemia (high triglycerides) is done via a FASTING test. Researchers will also sometimes measure serum triglycerides after meals.

What's found is diets high in dietary fat but lower in carbohydrate will increase non-fasting serum triglycerides slightly after meals, however the FASTING triglyceride levels are reduced - which means the body is more effectively utilizing the ingested calories, especially the ingested dietary fat.

However diets high in carbohydrate and low in fat (regardless of the source of either) will reduce post-prandial (after-meal) levels of triglycerides, but INCREASE the fasting triglyceride levels - because ultimately the ingested carbohydrate (which in the bloodstream is glucose) is metabolized into triglycerides, and quite often will be stored as fat.

I bet you could get them down in an otherwise healthy person by cutting fats hard. They won't take in so much and their metabolism can cope with upping the carb a bit to compensate. BUT for an insulin resistant person, that method would be a disaster. They can't take that hit to their blood sugar and further resistance. So you need to work with the other side of the coin- using the metabolism to break down the fats.

First, an "otherwise healthy person" doesn't have high triglycerides. If you mean someone that is in good physical condition but has high triglycerides, "cutting fats hard" will increase fasting triglyceride levels. It's been shown in about 2 dozen clinical studies in the past 20 years.

Whether insulin-resistant or not, cutting fats and increasing carbohydrate (regardless of source of carbohydrate) will increase your serum triglycerides.

Studies such as ...

"Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation"

"Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet"

... show this quite clearly, as do low-carb / diabetes studies such as ...

"Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal"

... which is a study-review that includes multiple studies confirming that "substitution of fat for carbohydrate is generally beneficial for risk of cardiovascular disease", including serum triglyceride levels AND cholesterol ratio.