Based on my experience coaching 100s of people with diabetes I’m going to confidently speculate that 8/10 people want to get lean and have more visible muscle definition. Do strong abs, great shaped glutes (for the ladies) and well-shaped pecs and arms (for the guys) sound appealing?

Of course they do.

Which is interesting, because out of the two goals, is getting leaner harder than gaining weight and putting on size?

We all know what it it’s like to get lean…

You have to train hard, do plenty of cardio and deal with daily cravings for delicious food like pizza, chocolate and other great tasting desserts.

Whereas, when it comes to putting on muscle mass and getting bigger (which I appreciate isn’t everyone’s goal) – it’s a little easier, as there is way less cravings and lack of energy.

If your goal is to get leaner, would it be fair for me to say that you want to get results as fast as possible?

Who doesn’t?

We all want results tomorrow and we all want a crutch or, some secret pill to help us lose fat faster.

And a whole corner of the supplement store is dedicated to products – “fat burners” – promising to help you do just that.

Question is, can they?

Let’s have a look at the research and look at the practical use of fat burners in people living with diabetes.

What Are Fat Burners?

Let’s be clear at the start: “fat burner” is really an industry term, used to describe nutritional supplements that claim to help you reduce body fat levels at a faster rate.

From a physiological standpoint, what this means is actually a few different processes. You see, the “burning” of fat requires we break it down from storage, release it to make it available for use, and then in fact use it for energy.

The term “fat burner” refers to any compound that can enhance any of these processes, either enhancing the breakdown of fat, increasing the rate at which it is oxidised [the technical term for “burned”], or increasing energy expenditure [often by increasing thermogenesis, or the generation of heat in the body] (1).

Different compounds could do this directly, by acting on a fat cell to increase the release of stored fat, or indirectly, through increasing metabolic or hormonal activity leading to greater heat generation or fat utilisation (1).

But are they even effective, and can fat burners really help you to goal of summer shreds?  If you scrutinise the label of most commercial fat burners, you’ll see many of them boil down to the same few ingredients. Here’s a popular product as an example:

What you’ll see here is typical of most products in the industry as far as ingredients go: caffeine, yohimbine, green coffee extract, and forskolin. Other common compounds in many other products include green tea catechins, in particular EGCG, and bitter orange extract.

What we’re really looking at here is a stimulant. A lot of stimulation at that. So, before you take the plunge and turn yourself into a jittery, anxious mess, shouldn’t we take a pause and ask: are these products even worth it?

Do they work?

Are they safe?

And what kind of impact could they have on diabetic control?

As the main fat burning compounds in use, this article is going to keep the focus on caffeine, EGCG, yohimbine, bitter orange, green coffee extract, and forskolin. Scheduled compounds, like clenbuterol or ephedrine, will also be discussed.

Fat Burning Compounds: Mechanisms, Safety, and Considerations

Let’s start with the compounds with the most research, and the best available evidence overall: caffeine and green tea catechins.

Green Tea Catechins

‘Catechins’, which are polyphenolic compounds [a type of non-nutritive compound with biological activity] found in green tea, are interesting because their effect on fat loss depends on both interactions with caffeine, the type of catechin, the dose used, and also the type of exercise (2).

The first thing to separate out is the type. Most of the research shows that the most potent green tea catechin is epigallocatechin-3-gallate, or EGCG, and lower doses of EGCG have been shown to increase fat burning than total green tea catechins (3; 4). In fact, the total EGCG content within an overall dose of green tea catechins is what you want to look out for.

For example, one study comparing 600mg of EGCG used divided doses of 100mg throughout the day, and the increase in fat burning observed was only not significant (2). In another study, 270mg EGCG given in a single dose to elite male cyclists tested at 60% of their VO2max failed to increase fat oxidation (5).

On the other hand, giving 890mg total decaffeinated green tea catechins containing 366mg EGCG increased fat oxidation by 17% over a 30min test period at 60% VO_2Max in untrained males (3). In another study in untrained men, 571mg decaff green tea catechins, of which 400mg EGCG, increased fat oxidation by 25% from baseline during weekly cycling at 50% VO₂max (4).

There are two points to bear in mind from the above studies. The first is mentioning the training status of the subjects. Basically, the increases in fat burning noted in these studies could reflect an adaptation to aerobic training (4; 6). They got fitter, and better at burning fat.

The other point to note is that studies often used decaff green tea extracts. Now why might this be important? Because it appears that the beneficial effects of EGCG are specifically related to its interactions with caffeine. While green tea naturally contains caffeine, it is nowhere near the doses seen with coffee or energy drinks. In fact, a high habitual caffeine intake negates the effectiveness of green tea catechins and/or EGCG even at various doses of EGCG (7).

For example, combining doses of 270mg, 600mg, 900mg, and 1,200mg EGCG together with 600mg caffeine resulted in no effect on fat oxidation (8). However, some caffeine appears to be beneficial – perhaps reflecting the interactions of the compounds in green tea – as the combination of green tea catechins and lower caffeine levels increases fat burning by 4% more than caffeine alone (9).

Overall, the research shows that for green tea catechins/EGCG to be effective, an inverse relationship with caffeine is preferable, where the dose of green tea catechins/EGCG should exceed caffeine, and daily caffeine intake should remain around 300mg or lower. We’ll come back to this point later as to why this is important for diabetic management.

You could go drowning yourself in green tea every day, to the tune of up to 8 cups, to get the desired dose: supplementing is likely an easier route.

What about caffeine?

Caffeine

Caffeine is probably one of the most researched compounds around, and is the most widely used psychoactive drug in the world – we really love coffee. Caffeine has repeatedly been shown in research to increase sympathetic nervous system activity, boost resting metabolic rate, increase adrenaline output, and increase fat mobilisation (1; 10).

However, note two things about those effects of caffeine. First, they primarily relate to enhanced physical performance, particularly central nervous system drive and adrenaline output.

Secondly, and more importantly, caffeine promotes fat mobilisation, but not necessarily oxidation. In fact, the distinct performance enhancing and fat mobilising effects of caffeine have never been concretely linked to increased fat burning (10).

For example, a study using doses of 100mg, 200mg or 400mg caffeine found an increase in metabolic rate and in fat breakdown, but measurements of energy expenditure in the subjects showed that the increase in energy burning came from equal oxidation of carbohydrate and fat (41). Other studies using very high doses of caffeine – 6mg per kilo bodyweight – also failed to find any increase in fat oxidation during cycle tests for 45-60min at 70% VO₂max (10; 11).

One issue with caffeine in studies may be the timing of intake. For example, in the latter two studies caffeine was given 60-90mins before testing (10; 11). However, another study divided that dose into 3mg/kg 90min prior to testing, followed by another 3mg/kg 30mins after, and found fat oxidation remained elevated both during exercise and up to 2-hours post-training (12).

Another variable you may have noticed thus far is the use of a set VO₂max in studies. Why could this be an issue? Well, if a specific percentage of VO₂max is used, it may not in fact be a uniform intensity for the intervention group due to differences in fitness levels – different subjects may have different thresholds for exercise intensity (13).

Using lactate threshold to define intensity may be more effective, as this is the threshold where aerobic energy systems relying in fat metabolism are operating at their max capacity, and beyond that we shift into anaerobic metabolism and carbohydrate oxidation (13). In a study using 6mg/kg caffeine before 60mins cycling at the lactate threshold, measures of energy expenditure indicated a significant increase in fat oxidation (13).

Ultimately, caffeine is not the fat burner many think it is, and requires higher doses to achieve an effect: the issue is tolerance may negate performance benefits, and more is not better when it comes to caffeine and fat burning.

It appears that caffeine is best used at higher doses, and during submaximal aerobic intensities. However, there are implications for blood sugar management with caffeine, which we’ll consider below. There are also implications for tolerance, and increasing dosage does not overcome tolerance to caffeine.

Yohimbine

Yohimbine is similar to caffeine in that it is a plant alkaloid, occurring naturally in a particular species of tree. It’s also similar in that it can increase levels of adrenaline in the body, however, a word of caution here: if you’re a caffeine-sensitive type, and get the jitters easy with coffee, yohimbine will have you crawling up the walls.

Yohimbine is a compound that acts both directly and indirectly to influence fat oxidation. In its direct effects, yohimbine acts on receptors on fat cells that normally act to suppress fat oxidation and inactivates those receptors (14). In doing so, it allows fat to continue to be oxidised without suppressing those mechanisms.

It also has an indirect effect, similar to caffeine, through increasing adrenaline levels, and adrenaline itself stimulates fat mobilisation and oxidation (15). Yohimbine is popular because the fat cells that it acts on both directly and indirectly through adrenaline are particularly concentrated in the thigh are in women and belly in men, i.e., “stubborn” body fat, and there is research supporting its fat burning effects in women (16), healthy men (17), and athletes (18).

However, a word of caution: yohimbine is highly, highly stimulatory. It’s also noted to have significant side effects – elevated heart rate in particular – and if you’re in any way an anxiety-type, then steer clear. Another issue is that there appears to be significant issues around labelling accuracy on supplements, and wide variability in the precise dose contained in a given product (19).

All in all, while effective, yohimbine simply comes with too much baggage.

Bitter Orange Extract

Bitter oranges contain a compound known as p-synephrine, which can increase metabolic rate in humans (20). It is important to note at this point that bitter oranges are not your average tangerine or satsuma in the shop, and are a rare enough form of citrus fruit with historical use in traditional Chinese medicine (21).

One of the interesting things about p-synephrine is that it increases metabolic rate independent of variables like diet and exercise. For example, one study using a single 50mg dose of p-synephrine found an increase resting metabolic rate by 65kcal over 75min post-ingestion (20).

In terms of underlying mechanisms, p-synephrine is in fact similar to ephedrine, only milder (and legal). It increases adrenaline and dopamine system activity, thereby increasing fat breakdown and metabolic rate (21).

It is also synergistic with caffeine, and of interest to the strength and performance-oriented athletes amongst you, p-synephrine and caffeine have been shown to increase power output in the squat (22). Studies using doses of 49-100mg p-synephrine have found increased energy expenditure, fat mobilisation and fat oxidation, with no adverse effects (23).

Indeed, the longest study in p-synephrine supplementation to date using 49mg doses for 60-days found no adverse effects across cardiovascular, liver, kidney and blood analyses (24).

The human research is thus far overall positive. One trial supplementing 51.5mg p-synephrine twice daily before meals found a reduction in appetite and improved eating control, in addition to increased energy expenditure (20; 24).

With a wide safety margin, p-synephrine is generally considered safe and effective at the doses commonly used (25).

Forskolin

Forskolin at this point remains a very intriguing research compound, but hard to say much more. For the physique-enthusiasts amongst us, we should cross our collective fingers in the hopes of further research into this promising supplement.

Derived from the herb Coleus forskohlii and with traditional use in Ayurvedic medicine, the primary mechanism of action of forskolin is to increase levels of a molecule in our cells called cyclic adenosine monophosphate [cAMP], which is important in regulating energy metabolism (26). Mechanistically, high levels of forskolin can increase the breakdown of fat from storage, however, the doses used to show this effect have not been replicated in humans (27).

The human research is relatively limited to date. A study in overweight women supplemented with a 10% forskolin extract (250mg twice daily) noted a protective effect against weight gain, with insignificant weight loss (28). An interesting randomised, double-blind and placebo controlled trial in overweight and obese men supplemented with 250mg (10% forskolin) twice daily for 12-weeks found a significant increase in lean body mass, reduction in fat mass, and increase in bone mass: all these results were confirmed by DEXA scans (29). There was also an increase in testosterone noted, which could explain the results but despite this being an RCT, and despite the quite profound results, we’re still waiting on this research to be replicated.

So, there’s a few caveats to the research to date. First, overweight and obese persons have lower levels of cAMP, and thus the effects of forskolin supplementation may be more pronounced in these populations (30). Secondly, the effects of increased testosterone may underscore the fat burning effect, as distinct from any direct fat burning effect of forskolin itself, an observation somewhat supported by the difference in the study in women [no significant effect] compared to the study in men [significant effect].

Fascinating compound. More research needed. And it may have caution in diabetics, for reasons explained below.

Green Coffee Extract

Green coffee extract is extracted from unroasted green coffee beans, as the compounds are largely lost in the process of roasting coffee beans (31). Green coffee extract is touted as a fat burning compound but we can be relatively brief with this: the evidence is weak.

A recent meta-analysis confirmed this (31). While there was an overall weight loss effect noted, the trials did not specify dosage used, and had significant methodological limitations which cast doubt on the results (31). Two authors of one study were also affiliated with a company selling a GCE weight loss product (31).

Aside from the methodological limitations of the studies on GCE to date, the results themselves are of questioning clinical relevance (31). Despite this being a common feature of many marketed “fat burner” supplements, all it’s going to give you is expensive urine.

Ephedrine and ECA

Ephedrine is a plant alkaloid derived from the Chinese herb, Ma Huang, and is about as potent a fat burning compound as you could find: the trade-off is you might have a heart attack. Ephedrine acts by both directly stimulating the production of heat in muscle cells, and by stimulating the breakdown of stored fat (42).

Ephedrine also boosts metabolic rate, an effect which is seen without exercise, in contrast to caffeine which is effective at mobilising stored fat but requires exercise to burn that released fat (42). Combined together, ephedrine and caffeine show distinct fat burning synergy, due to the effect that the class of compound which caffeine is, a methylxanthine, boosts the ability of ephedrine to increase metabolic rate (43).

The stack of ephedrine and caffeine, combined with aspirin, and known as ‘ECA’, is an effective fat burning compound due to the combination of ephedrine and caffeine, although there is evidence that aspirin enhanced the thermogenic response to feeding in obese subjects, but this effect was not found in lean persons (44).

There have been significant concerns, however, raised over the use of ephedrine and ECA: ephedrine and the combination of ephedrine with caffeine have been associated with increased risk for nausea, vomiting, anxiety, heart palpitations, and adverse cardio and cerebrovascular events (45).

So, is it worth it? Like most things, the dose makes the poison: the combination of 20mg ephedrine with 200mg caffeine taken three times per day has been shown to be well tolerated and safe up to 6-months use (46; 47). The issue for diabetics isn’t the tolerability, it’s the fact that ephedrine increases insulin and blood glucose levels (42).

So there are two caveats: one  is that it’s illegal in many jurisdictions now, the other is the effect on blood glucose and insulin. So, yes it can be safe, and it is certainly effective, but may place an added burden on diabetes management.

Clenbuterol

‘Clen’ is possibly one of the most popular fat burning compounds in the physique community for one reason: it works like little else. Clenbuterol is a synthetic drug that is currently illegal in most developed countries, but that hasn’t prevented its popular use.

Clenbuterol leads to significant improvements in body composition not solely attributable to fat burning, but also to lean mass increases (48). In the context of an energy deficit that is a pre-requisite for fat loss, clen preserves lean mass while significantly increasing fat burning (49).

Clen enhances fat burning through the same mechanisms as yohimbine and ephedrine, stimulating fat oxidation (50). It also does not appear to have any impact on blood glucose levels, however, insulin disrupts the signalling of compounds like clenbuterol to fat cells, so there is a potential interaction that could be relevant to timing of use of both insulin and clen (51)

Potent fat burning compound, with the same caveats applying regarding legal status. If using, use wisely: there are plenty of ways to burn fat outside of prison.

Can Diabetics Take Fat Burners?

Ok, so some compounds can be effective – like EGCG and caffeine – and some are a waste of money – like green coffee extract. For those that may be effective, we need to consider the potential interactions of these compounds with diabetes management.

Let’s start with the obvious one: caffeine. Caffeine distinctly does increase blood glucose levels, through a combination of transiently reducing insulin sensitivity and prevent glucose disposal into muscle cells by 24% (32). The main effect of caffeine is interfering with insulin action on glucose disposal, not impacting on insulin secretion itself which is unaffected by caffeine intake (33). Timing caffeine use away from meals would be a good idea to avoid any interaction with post-prandial glucose metabolism.

Consider ephedrine here too: it has dose-dependent increases in insulin and blood glucose, so more is definitely not better, and caution is required when considering its use.

For caffeine, we are talking about caffeine and not coffee as a food supplement. Coffee intake is strongly associated with reduced risk of Type-2 diabetes, an effect which is more attributable to other compounds in coffee as the protective effect is also observed with decaff (34).

Thus, while coffee intake is itself a beneficial food product, it remains inadvisable from a blood sugar management perspective to supplement with isolated caffeine, which will increase blood glucose as a result of impaired glucose disposal (32; 33).

Green tea catechins may in fact benefit diabetics, although it should be noted that the research is in Type-II. A study in Type-II diabetics found 500mg of decaff green tea extract, of which 285mg EGCG, taken 3 times per day resulted in significant improvements in insulin sensitivity [measured via HOMA-IR], reduced insulin concentrations, and reductions in triglycerides over 16-weeks (35). The effect on improved insulin sensitivity is not always observed in Type-II diabetics (36).

However, green tea catechins may improve blood glucose regulation. Green tea catechins have been shown to improve post-meal glycaemic control in pre-diabetics by inhibiting glucose uptake, without impacting on insulin secretion (37). Brewed green tea may also increase glucose disposal and nutrient partitioning in monocytes over adipocytes, although this has yet to be demonstrated in humans (38).

Overall, supplementation with green tea catechins appears to be potentially favourable to diabetes management, without negatively impacting insulin secretion or action.

What about forskolin? There simply is no human evidence, but studies in cell cultures have shown that forskolin stimulates insulin release from pancreatic cells (39). In this context, and without any human research, the advice here would be to err on the side of caution and opt against supplementation with forskolin: we just don’t know what impact it could have on insulin and diabetic control.

A similar position can be taken with yohimbine: rat studies suggest it can increase insulin levels in diabetic rats (40). This was in fact considered a positive, as insulin secretion is suppressed by mechanisms which are inhibited by yohimbine, thus supplementation was normalising insulin function in diabetic rats (40).

Again, we have no human data on the potential interaction, and given the side-effects of yohimbine outweigh the efficacy, from a diabetic management perspective it is best to scratch this off the list.

P-synephrine, on the other hand, does not appear to negatively impact on blood glucose management or insulin function. A safety study looking at the effects of 49mg p-synephrine twice daily found no adverse effects after 60-days on blood chemistry, including blood glucose, albeit this was in non-diabetic subjects.

P-synephrine is considered to have a wide safety margin, and the lack of any observed effect on blood glucose taken with its observed increase in metabolic rate, suggest that this could be supplemented safely in diabetics.

Clenbuterol may have an interaction with insulin, insofar as elevated insulin may suppress activity of the drug: this is highly mechanistic and likely means clen should be taken away from meals.

Practical Application: Fat Burners, Diabetes and Blood Sugar Control

Ok, so we’ve established what works, what doesn’t, and what is safe for use in in the context of diabetic management. Let’s put this together into some action points.

1. Green tea catechins/EGCG and diabetes: Recall that the effectiveness of green tea is dependent on lower caffeine levels. This works nicely for a diabetic looking to enhance fat oxidation, as taking on supplemental caffeine is contraindicated for blood sugar management. So, as a diabetic looking for a fat burning boost, your best bet is to keep caffeine low and opt for more green tea.

Your dose: 500mg EGCG per day, with lower caffeine intake. A cup of coffee a day won’t hurt, but don’t be a habitual high-caffeine consumer or you’ll impair the effects of green tea on fat oxidation.

2. P-synephrine & diabetes: The increase in metabolic rate, fat mobilisation and oxidation, in the context of its established safety and lack of impact on blood glucose make this an attractive supplement.

Your dose: 49-100mg per day, ideally in divided doses separated 6-hours apart.

3. Caffeine, yohimbine, forskolin, green coffee extract and diabetes: Between the negative effects on blood glucose management of isolated caffeine, to the increased blood pressure and anxiety side effects of yohimbine, to the lack of evidence for interactions with forskolin, and lack of evidence overall for GCE, don’t waste your time with these options.

4. Clenbuterol, ephedra-caffiene-asprin (ECA Stack) and diabetes: You’re an adult, you can do as you like but I didn’t tell you one way or the other!

Also, final point to bear in mind: the greatest “fat burner” we know of is a calorie deficit in conjunction with a higher protein diet. Your final consideration is this: diet always comes first to any body composition goal.

How can people living with diabetics control their blood sugar levels when taking over the counter fat burners?

We asked John Pemberton, Head Coach at Diabetic Muscle and Fitness, for his thoughts on fat burners. He gave us options for how to adjust diabetes regimens to manage blood glucose levels when taking fat burners, from his ten years of clinical and coaching experience.

Here are his pearls of wisdom.

The safety and efficacy of the different fat burners have been laid out nicely in this article, and I agree with the conclusions. This was a great read.

I have detailed below some considerations on how to manage blood glucose.

1. Green tea catechins/EGCG with diabetes: EGCG should have very little impact on blood glucose levels, because it does not significantly increase stress hormones (Catecholamine’s & Cortisol). From my coaching, personal and clinical experience, no therapy adjustments are needed, but you always have to monitor and assess, we are all individuals.

a.  On a side note, EGCG is strong polyphenol that has been shown to activate the expression of your “Lean Genes”. By increasing Sirtuin Enzymes in the cells. I have written a comprehensive guide on how to “Activate your Lean Genes” in the Training Lab that covers this in great depth. This moves the conversation past fat burning, into discovering the wide range of benefits Polyphenols have for long-term health and getting a great looking body.

2. P-synephrine with diabetes: Technically you would expect this to raise blood glucose, because it activates the adrenergic receptors, which increase adrenaline, and should therefore lead to the liver pushing lots of glucose into the blood stream. However, the activation of the adrenergic receptors from P-Synephrine is weak, so the glucose impact is usually not an issue. Also, because the half-life is only 2 hours, the impact is very brief.

a.  If you find it increases your glucose level, a small dose of quick acting insulin upon taking P-synephrine will prevent a glucose spike. But like I said, you are unlikely to need this. Monitor first and adapt if needed.

3. Caffeine with diabetes: The drug of choice slurped down every morning by most people. Especially fitness enthusiasts who use it as a “performance enhancer” or “Fat burner”. At doses needed for a “performance” or “fat burning” effect (2-3mg/kg or 1-1.5mg/lb) it is unlikely to increase glucose levels. However, at does above this (5-6mg/kg or 2.5-3mg/lb), you are likely to get a glucose spike from insulin resistance and increase liver output of glucose, which can last 4-6 hours. On a practical note, don’t take a high dosage past 2pm, otherwise you will disrupt your sleep and recovery. How would you manage a high caffeine dose?

a.  If you are doing aerobic exercise such as running, it’s likely your glucose level will stay stable rather than drop. Some use this as hypo prevention strategy.

b.  If you are doing anaerobic exercise such as heavy weights, it’s likely your glucose level will spike more than usual. You may need an insulin before you start your heavy lifting

c.  In the Training Lab, I have developed a guide on how to manage different types of exercise with Diabetes. This covers how to calculate how much insulin to give before anaerobic exercise.

4. Yohimbine with diabetes: Very similar to caffeine, except the exact dosages are a little hit and miss as it’s a plant alkaloid. The potency of the supplement will vary according to manufacturing processes. So, it’s going to be a bit of trial and error, just like everything else with diabetes!

5. Ephedrine & ECA stack with diabetes: This will 100% increase your blood glucose. Unlike P-synephrine, ephedrine is a potent activator of the adrenergic receptors. It will spike adrenaline, which will spike liver output of glucose. Ephedrine has a half-life of 6 hours, so you can expect high glucose level for a long period. From my clinical and coaching experience you will need more insulin, a lot more, for a long period. Here are some options to consider, but always check with you medical team and monitor aggressively.

a. If on an insulin pump increase the basal rate to 150% for 6-8 hours.

b.  If on split background insulin (NPH, Levimer), increase the morning dose by 25-50%.

c.  Increase insulin doses for meals by 25-50%.

d.  Correction doses every 2-3 hours.

5. Clenbuterol with diabetes: Works in a similar way ephedrine, but not as potent. It does however have a half-life of 26 hours! So if it causes your glucose level to rise, you will be on the celling for a long-time. From my experience, the most effective way to manage this is to increase the background insulin. Here are are some options to consider, but always check with you medical team and monitor aggressively.

a.  If on an insulin pump increase the basal rate to 120-130% for 24 hours

b.  Increase background insulin doses by 20-30%.

One final note from me.

You should only be considering “fat burners” if you have optimised;

• You caloric intake according to your fat loss goals.
• You have 7-8 hours quality sleep per night.
• You diet is full of real foods and you’re having 1.8–2.2g/kg protein (0.7 – 1.0g/lb) spread over at least 4 meals.
• You are resistance training at least three times a week.
• You are walking 10,000 steps per day.
• You are accountable to someone for hitting all of these goals.

If you have not got the above on point, you are barking up the wrong tree. Get the basics in place and you will see it’s actually easy to shred body fat.

You would be better advised to spend your money on a high quality coaching program or selection of calorie controlled meals plans that will give you a clear plan of action and keep you accountable by looking after all the essentials! That’s why I created Diabetic Shred – a 112-day fat loss system for men and women living with diabetes. It contains everything you need to know about eating, training and living to get lean. You get weekly meal plans tailored to your metabolism and over 50 challenging workouts.

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21. Haaz, S., Fontaine, K., Cutter, G., Limdi, N., Perumean-Chaney, S. and Allison, D. (2006). Citrus aurantium and synephrine alkaloids in the treatment of overweight and obesity: an update. Obesity Reviews, 7(1), pp.79-88.
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24. Kaats, G., Miller, H., Preuss, H. and Stohs, S. (2013). A 60day double-blind, placebo-controlled safety study involving Citrus aurantium (bitter orange) extract. Food and Chemical Toxicology, 55, pp.358-362.
25. Stohs, S. (2017). Safety, Efficacy, and Mechanistic Studies Regarding Citrus aurantium (Bitter Orange) Extract and p-Synephrine. Phytotherapy Research, 31(10), pp.1463-1474.
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29. Godard, M., Johnson, B. and Richmond, S. (2005). Body Composition and Hormonal Adaptations Associated with Forskolin Consumption in Overweight and Obese Men. Obesity Research, 13(8), pp.1335-1343.
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31. Onakpoya, I., Terry, R. and Ernst, E. (2011). The Use of Green Coffee Extract as a Weight Loss Supplement: A Systematic Review and Meta-Analysis of Randomised Clinical Trials. Gastroenterology Research and Practice, 2011, pp.1-6.
32. Greer, F., Hudson, R., Ross, R. and Graham, T. (2001). Caffeine Ingestion Decreases Glucose Disposal During a Hyperinsulinemic-Euglycemic Clamp in Sedentary Humans. Diabetes, 50(10), pp.2349-2354.
33. Keijzers, G., De Galan, B., Tack, C. and Smits, P. (2002). Caffeine Can Decrease Insulin Sensitivity in Humans. Diabetes Care, 25(2), pp.364-369.
34. van Dam, R. and Feskens, E. (2003). Coffee consumption and risk of type 2 diabetes mellitus. The Lancet, 361(9358), p.703.
35. Liu, C., Huang, C., Huang, L., Chen, I., Chiu, J. and Hsu, C. (2014). Effects of Green Tea Extract on Insulin Resistance and Glucagon-Like Peptide 1 in Patients with Type 2 Diabetes and Lipid Abnormalities: A Randomized, Double-Blinded, and Placebo-Controlled Trial. PLoS ONE, 9(3), p.e91163.
36. Hsu, C., Liao, Y., Lin, S., Tsai, T., Huang, C. and Chou, P. (2011). Does supplementation with green tea extract improve insulin resistance in obese type 2 diabetics? A randomized, double-blind, and placebo-controlled clinical trial. Altern Med Rev., 16(2), pp.157-63.
37. Butacnum, A., Chongsuwat, R. and Bumrungpert, A. (2017). Black tea consumption improves postprandial glycemic control in normal and pre-diabetic subjects: a randomized, double-blind, placebo-controlled crossover study. Asia Pac J Clin Nutr, 26(1), pp.59-64.
38. Ashida, H., Furuyashiki, T., Nagayasu, H., Bessho, H., Sakakibara, H., Hashimoto, T. and Kanazawa, K. (2004). Anti-obesity actions of green tea: Possible involvements in modulation of the glucose uptake system and suppression of the adipogenesis-related transcription factors. BioFactors, 22(1-4), pp.135-140.
39. Hermansen, K. (1985). Forskolin, an Activator of Adenylate Cyclase, Stimulates Pancreatic Insulin, Glucagon, and Somatostatin Release in the Dog: Studies in Vitro*. Endocrinology, 116(6), pp.2251-2258.
40. Sandberg, M., Pettersson, U., Henriksnäs, J. and Jansson, L. (2012). The α2-Adrenoceptor Antagonist Yohimbine Normalizes Increased Islet Blood Flow in GK Rats: A Model of Type 2 Diabetes. Hormone and Metabolic Research, 45(03), pp.252-254.
41. Astrup, A., Toubro, S., Cannon, S., Hein, P. and Madsen, J. (1991). Thermogenic synergism between ephedrine and caffeine in healthy volunteers: A double-blind, placebo-controlled study. Metabolism, 40(3), pp.323-329.
42. Astrup, A., Toubro, S., Christensen, N. and Quaade, F. (1992). Pharmacology of thermogenic drugs. The American Journal of Clinical Nutrition, 55(1), pp.246S-248S.
43. Astrup, A., Toubro, S., Cannon, S., Hein, P. and Madsen, J. (1991). Thermogenic synergism between ephedrine and caffeine in healthy volunteers: A double-blind, placebo-controlled study. Metabolism, 40(3), pp.323-329.
44. Swan, P. (1996). THERMOGENIC RESPONSE TO EPHEDRINE+ CAFFEINE IN OBESE WOMEN WITH DIFFERENT PATTERNS OF REGIONAL ADIPOSITY 259. Medicine &amp Science in Sports &amp Exercise, 28(Supplement), p.44.
45. Shekelle, P., Hardy, M. and Morton, S. (2003). Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance. ACC Current Journal Review, 12(3), p.29.
46. Molnár, D., Török, K., Erhardt, E. and Jeges, S. (2000). Safety and efficacy of treatment with an ephedrine/caffeine mixture. The first double-blind placebo-controlled pilot study in adolescents. International Journal of Obesity, 24(12), pp.1573-1578.
47. Hallas, J., Bjerrum, L., Stovring, H. and Andersen, M. (2008). Use of a Prescribed Ephedrine/Caffeine Combination and the Risk of Serious Cardiovascular Events: A Registry-based Case-Crossover Study. American Journal of Epidemiology, 168(8), pp.966-973.
48. Kamalakkannan, G., Petrilli, C., George, I., LaManca, J., McLaughlin, B., Shane, E., Mancini, D. and Maybaum, S. (2008). Clenbuterol Increases Lean Muscle Mass but Not Endurance in Patients With Chronic Heart Failure. The Journal of Heart and Lung Transplantation, 27(4), pp.457-461.
49. Maltin, C., Delday, M., Watson, J., Heys, S., Nevison, I., Ritchie, I. and Gibson, P. (1993). Clenbuterol, aβ-Adrenoceptor Agonist, Increases Relative Muscle Strength in Orthopaedic Patients. Clinical Science, 84(6), pp.651-654.
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It’s not, there is a time and place for low carbohydrate eating. But, in the context of people who lift x3-7 times per week (like you guys) Carbohydrates are pretty darn important, for feeling muscle performance.

In this video, I explain how people with diabetes can eat carbs, get lean, build muscle and still control their diabetes.

If you liked this video and want to learn more about exercising with diabetes. You need to check out the Diabetic Muscle and Fitness Training Lab.

It contains a vault of in-depth knowledge and resources you can’t find anywhere else on the internet. You’ll gain valuable new found knowledge on diabetes, nutrition, training, mind-set and more.

Join 1000s of other diabetics just like you and start building muscle, shredding body fat and build the best version of you.

Do you think it will work with Diabetes?

If so this quick read is a must for you.

Let’s start by classifying some key terms.

Nutritional Ketosis:

1. Purposeful reduction of carbohydrate to less than 50g. Protein ~0.7 – 1.5g/kg and, ~70-80% of energy intake through fat.
2. Purposeful reduction of insulin, BUT still taking background insulin and usually small boluses for protein. YOU STILL TAKE INSULIN. There is enough insulin to prevent excessive ketone production and therefore stops acidic blood which is the main issue with DKA.
3. Blood ketones ~0.6-3.0mmol/l (can go up to 7mmol/l if extremely strict with the diet and in a negative energy balance, but unusual) – because the liver has to convert fat into ketones to provide fuel for the brain and muscles, because fat in its original state cannot be burned quick enough to provide the requisite energy.
4. Most people following a diet they believe to be KETO are not in nutritional ketosis, especially type 1 diabetics, because their circulating background insulin is higher than people without. The only way to know is to test blood ketones daily to see if in the sweet spot of ~0.6-3.0mmol/l. It’s easy to knock out of nutritional ketosis from treating hypos, eating too much protein, having a background insulin too high. Don’t fool yourself thinking you are there. Keeping in nutritional ketosis is as much art as it is science!
5. A normal blood PH (measure of acidity)

Diabetic Ketoacidosis (DKA)

1. Lack of insulin or, no insulin in the body.

Can be from:

1. The person not taking purposefully, (teenagers mainly)
2. Insulin is faulty and the person does not know.
3. Severe illness when insulin requirements ramp up massively.

2. Blood ketones greater than 7mmol/with a very acidic PH in the blood.

Risk of death if insulin is not given quickly, requires hospital treatment.

PROS of Nutritional Ketosis (Keto)

1. Will get a very good HbA1c – low carb = low fluctuation.
2. Some people find a ketones level of ~0.6 – 3.0mmol/l helps curb appetite and support fat loss efforts.
3. Often people like the tight feeling of not carrying extra water that is accompanied with high glycogen stores in the muscle and liver.
4. Can help with keeping to a calorie deficit because the food choice is very limited.
5. Can be effective for long distance and ultra-long distance endurance events – iron man etc. due to the energy systems involved.

CONS of Nutritional Ketosis (Keto)

1. Highly Restrictive Diet. A challenge for most usual social occasions unless you are in a keto community.
2. Reduced performance. Particularly, for individuals participating in activities that require fast energy burn, team sports, bodybuilding, 10k run, track cycling. Due to the carbohydrate-dependent (glycolytic) nature of the activities, individuals consuming a keto-based diet will not be able to perform OPTIMALLY. They will still be able to perform well, but not OPTIMALLY, because they do not have the glycogen (stored carbohydrate) to fuel those activities.
3. Electrolyte deficiencies in potassium, magnesium, and sodium can be common, especially in the early stages. Supplementation is worthwhile.
4. If you aim is to gain muscle mass and size, the results will be slower. This is because the protein intake has to be capped at 1.5g/kg, full muscle glycogen stores significantly greater muscle protein synthesis, and you will not be able to push out those last few reps to get as much progressive overload.
5. Dyslipidaemia – Unfavourable fatty acid levels in the blood. If you are genetically susceptible and choose saturated fats primarily, your LDL cholesterol may rise high, which is negative if the particle number increases. Choosing monounsaturated fat options can help prevent this – macadamia nut oil, olive oil and avocados etc.
6. Potential to downregulate thyroid function, especially reverse T3. It is important to monitor this Biomarker when on a ketogenic diet.

Personal Case Studies

Phil Graham – Founder Diabetic Muscle and Fitness

The idea of eating fatty foods like bacon, whole eggs, steak, chicken with the skin on, nuts, whole butter and cream, whilst getting lean sounded too good to be true. I was desperate to experiment.

In 2014 I went all in and lived the ketogenic life for 6 months in between Magazine Photoshoots and Bodybuilding Contests.

At the time, my body fat wasn’t high. In fact, it was relatively low. I was just after competing and wanted to use the ketogenic diet to maintain low levels of body fat between my events.

I had experience of eating low carb before, especially in the final weeks leading up to my contests, where calories were ultra-low. Carbs were the main macronutrient I cut out. I always liked the dry look low carb eating brought to my physique. For those of you not familiar with bodybuilding language. ‘Dry’ simply refers to low levels of water retention and bloat.

The ketogenic diet took my lower carb experiences a step further. I kept my intake strictly under <50g CHO for 6 months flat with the odd refeed day every once in a while (when I felt like it).

Let me bullet point my experience.

• My blood glucose control was the best ever. My HBA1C was 5.5%.
• My blood glucose levels would go high the odd time. This was mostly due to acute periods of stress from training and after consuming red meat. Regardless, I always corrected.
• The food choices were awesome (at the start), but I admit I did get bored quickly. The last 3 months were a mental challenge. I missed fruit, oats, bread and milk massively.
• My performance dropped. I struggled to get a pump when weight training.
• My muscles did not look as full and pronounced.
• Social events were awkward. I felt awkward going to dinner parties or just out for dinner. I always had to ask, ‘What had my meat been cooked in?’, ‘May I have the sauce separate please?’ etc.
• My hunger was blunted to a degree. But, in no way did the ketogenic diet bulletproof my hunger in the long term.
• I took one full day to refeed carbs when I felt I needed it. Getting back into ketosis after this was relatively easy. I did look forward to the carb refeeds.

I personally do not recommend Ketogenic dieting for highly active people with type 1 diabetes who have a goal of building muscle and strength. It can be used in the short term to drop some body fat. But, don’t expect miracles.

 

John Pemberton – Head Coach Diabetic Muscle and Fitness

I followed KETO for 6 months in 2016 and results were:

1. HbA1c 5.3% – the best it’s ever been.
2. Low frequency of hypos because just had background insulin covering most of needs (80%) with small boluses for protein (20%)
3. Weight stable at 92kg with a ripped look at 6% body fat. Good for the beach.
4. Gym performance average, 1 RM decreased as did my 4-8RM – I did not like this.
5. My LDL rose from 2.5 to 5.5 but after changing to monounsaturated fats back to 3.5 (my dad has cholesterol of 9.0 so likely a genetic issue)

Contrary, following a 35% protein, 40% carb, 25% fat for the last year led to the following observation:

1. HbA1c 6.0% – a slight increase but still in a very good range
2. More hypos because of bigger insulin doses at meal times and therefore more unpredictability, but still only 3-4 a week, which I can manage with some dextrose.
3. Weight 102kg at 9% body fat – gained 8-9kg lean tissue (probably 2-3kg water and glycogen).
4. Big improvement in 1 rep max (RM) and 4-8RM on all lifts
5. Can engage easily in social functions, rather than glugging olive oil at the back. This was due to my lack of imagination with food choices. I am a simple man.
6. Not always looking as ripped by the end of the day – water accumulation.

I think the best questions you can ask yourself when considering starting a Ketogenic diet are:

1. Are my aims gains and high energy performance, and am I happy to put more effort into diabetes management?

If so, KETO is probably not for you. You need more carbs.

or

2. Is my focus optimal on diabetes control with less requirement for management, whilst knowing my physique progress will not be optimal but can still perform?

If so KETO may be worth a trial for you.

There is no right or wrong answer, just the one that suits you.

Just be sure to do your homework before you try, and consult with a professional who has experience in type 1 and KETO.

If you liked this article and want to learn more about nutrition and living with diabetes, you need to check out the Diabetic Muscle and Fitness Training Lab.

It contains a vault of in-depth knowledge and resources you can’t find anywhere else on the internet. You’ll gain valuable new found knowledge on diabetes, nutrition, training, mind-set and more.

Join 1000s of other diabetics just like you. Ask questions, learn and start building the body you have always dreamed of. 

It’s beautiful.

What else feels this good right after a long day at work, and hard gym session?

The warm plates are sitting out, the food is on the table and your family (or better half) mumbles with a half-eaten piece of pizza in their mouth, ‘Sit down and have a few pieces, there’s dessert too.’

You really wish you could, but there’s one big problem…

You are 2 weeks into your new fat loss diet and want to be in the shape of your life for once.

You know this type of food isn’t going to help you. It’s one of the reasons you need to lose weight in first place.

Add to that, you know this food and diabetes don’t get along. You’re anxious about the amount of insulin you are going to inject for the massive blood sugar spike you are about to experience.

But, in the famous lyrics of R.Kelly – Bump N’ Grind. Your mind is telling you no, but your body is telling you YES!

See, our food environment is a pretty big deal.

As humans, we make hundreds of decisions about food every single day¹. This tends to get more challenging when you start dieting and get ‘hangry.’

When you live with your family, a partner or friends you are exposing yourself to their way of eating. This can be a problem…

Like I say in my book if you live with three other people who eat crap and don’t value a lean healthy body, there is a high probability that you will become the fourth person in the group.

Cooking and eating food has a massive social element that many people overlook. This is one of the biggest challenges when it comes to food environment.

Just think of how awkward the following circumstances can be when you are trying to diet.

• Being asked out to a buffet meal with friends and family.
• Cuddled up on the couch for a movie with a brand new date who brought you a share size bag of M&M’s to enjoy.
• Eating at a restaurant with a group of friends and the breadboard comes out.

Then there are other factors like convenience and prevalence of junk food in your fridge or naughty cupboard.

IT’S EASY TO FEEL GUILTY

… when you turn down someone’s cooking efforts, the surprise pizza order or that share size bag of M&M’s.

It’s easy to become overwhelmed, give in and say, ‘I’ll start back on the diet tomorrow,’ which, of course, rarely ever happens.

Willpower Has a Fuse

It can run out, especially when you are under stress, and have to make hundreds of decisions about food on a daily basis.

When you’re tired and running low on calories, you are much less likely to exert willpower and far more likely to jeopardize your fat loss efforts by indulging in excess calories. Especially, if they are ‘offered on a plate’ or just down the stairs.

This relates to the model of behaviour known as “Ego depletion” ²

A large amount of scientific evidence (meta-analysis) by Hagger et al in 2010 showed that:

• Ego depletion significantly affected self-control task performance.
• Ego depletion was significantly affected by the degree of effort, perceived difficulty, perceived negative effects and subjective fatigue.
• Low blood glucose levels affected ego depletion negatively.

Given the fact that willpower is a limited resource,

it makes sense to elevate your food environment and improve it by either removing unhelpful food choices that are contradictory to your end goal or simply not putting yourself there in the first place.

Changing Your Environment Can Help

Let’s take the same situation you were in earlier on, but this time you don’t smell pizza or brownie, nor get tempted to ‘have a piece’ because you know your family, or better half sits down at the same time every single week to eat a takeaway.

Eating a filling meal before you arrive home grants you permission to use the, ‘I’ve eaten already’ excuse.

Or, if you live with a partner, you could tactfully plan your daily calories around the takeaway meal using an intermittent fasting style approach, backloading your calories into the evening. Another solution would be to ask your better half to have a friend round to eat with.

Losing body fat is a process that requires food restriction.

Sacrifices have to be made if you want to look a certain way or want to hit a target bodyweight. If your friends and family can’t support your goal, educate them on why you’re doing it and how it will improve your quality of life. In turn, letting you live life to the fullest.

If they can’t accept that, stick to your guns.

No one needs to eat pizza and brownies to fit in.

Having competed as a bodybuilder for many years I know too well how to enhance my food environment for muscle gains and fat loss.

Try any of these tactics if you suspect your environment is holding you back

• Empty your naughty food cupboard of sweets and confectionary. Out of sight, out of mind. Just make sure you keep some fast-acting sugars for hypo prevention. Sports drinks are perfect as they are the least likely food product to be consumed when you are bored or hungry.

• Diet soft drinks are great for killing a sugar craving and support fat loss due to their zero calorie content.

• Equip yourself with great tasting diabetic friendly recipe and snack ideas. That’s why I created the Ultra Lean Diabetic Cookbook – it’s loaded with 100 delicious diabetic friendly recipes you will love including Tortilla Pizzas, Protein pancakes and much more. All the calories and macronutrients are outlined for you – they even come with a Myfitness pal barcode for easy food tracking.

• If you use flexible dieting as an eating strategy, keep all junk food in opaque tins at the top of a cupboard so they are hard to see and reach.

• When the share board comes out, excuse yourself and nip out to the toilet. Tell the table to “eat away” and by the time you get back most of it will be gone.

• Avoid going shopping when hungry.

• Avoid hoarding junk food when it is on offer at your local supermarket. Before you place it in your trolley, ask yourself, ‘Do I need it?’

• Don’t walk down the sweetie isle when dieting. That’s just torture.

• Don’t watch Man Vs. Food or any form of bakery program when dieting. It might push you over the edge and cause you to say, ‘F**k it, let’s eat!’

• Increase your protein, and fiber intake when dieting to keep hunger under control.

• Coffee (pre 5 pm) can help suppress appetite.

• Master your insulin dosing. Be mindful that a hypo will require you to eat. Keep your food environment in mind and do your best to consume straight sources of glucose rather than cakes and crisps which contain a lot of excess calories.

• Sugar-free jelly is ultra-low in calories and provides a temporary fill me up.

• You can also use the good old diabetes excuse and tell people that junk food doesn’t have a place in your diet. Obviously, make sure your friends and family know what a hypo is and what foods are best to treat it.

There are many other strategies you can use, but these are great examples.

While you are here, make sure to check out the Diabetic Shred Guide a 112-day fat loss system for men and women living with diabetes. It contains everything you need to know about eating, training and living to get lean. You get weekly meal plans tailored to your metabolism and over 50 challenging workouts.

• Insulin and amino acids play an important role in assisting with muscle growth.
• Glucose and amino acids are both insulinogenic and have the potential to increase blood glucose.
• When glucose and amino acids are consumed together they require more insulin, than if consumed alone.
• Adequate medication must be given to accommodate the blood glucose increasing effects of these two macronutrients.
• Hyperglycaemia is highly detrimental to muscle protein synthesis.
• Besides focusing on carbs and protein alone, it’s important to see the bigger picture and consider all the other important factors that influence rate of muscle growth, of which there are many.

What you’re in for?

• 600 Words
• Reading Time ~ 8 minutes

  SHOULD TYPE 1 DIABETICS EAT CARBS AND PROTEIN TOGETHER IN AN ATTEMPT TO BUILD MORE MUSCLE?

Insulin is considered an anabolic (constructive) hormone. When protein is consumed the B-cells of the pancreas secrete insulin to shuttle amino acids into cells for anabolism. Insulin has been shown to play a role in the creation of new proteins across the body as well as inhibiting muscle protein breakdown ¹.

All the amino acids that make up protein impact insulin secretion differently. Certain amino acids are more potent at stimulating insulin secretion than others, especially leucine ². This explains why whey protein, one of the richest sources of leucine, increases insulin secretion more than any other protein source ³ , and, why the food insulin index considers the insulin requirement for foods as a whole (inc. protein and fat) rather than just their carbohydrate content ⁴.

The synergistic combo of glucose and amino acids signifies a high energy state (compared to one macro nutrient alone) leading to elevated insulin secretion. This is what promotes anabolism, glycogen storage and synthesis of fat tissue (if excess energy is available). Eating protein alone would not yield as much of an insulinogenic or anabolic response compared to a matched meal of protein and carbs.

Besides focusing on carbs and protein alone, it’s important to see the bigger picture and consider all the other important factors that influence rate of muscle growth including, but not limited to,

• Overall diabetes management
• Overall calorie intake
• Body composition
• Stress
• Sleep
• Training frequency
• Progressive overload
• Use of ergogenic aids (PED, Supplements like creatine etc.)
• Other diseases and illness

Should type 1 diabetics pair carbs with protein to maximize protein’s anabolic effect?

The most popular approach to mealtime insulin dosing is counting carbohydrate and applying an insulin to carbohydrates ratio. Most people with type 1 diabetes believe they are only giving insulin for the carbohydrate; however, the insulin dose calculated from the Insulin to carbohydrate ratio actually takes into account the insulin requirement for usual protein portions. Carbs and protein are rarely consumed in isolation. It is much more likely that both macronutrients will accompany each other at mealtimes ⁵.

Provided essential amino acid needs are met across the day, the primary responsibility for someone living with type 1 diabetes is to dose enough exogenous insulin to accommodate any increase in blood glucose.

References

1. K N Frayn and P F Maycock. Regulation of protein metabolism by a physiological concentration of insulin in mouse soleus and extensor digitorum longus muscles. Effects of starvation and scald injury. Biochem J. 1979 Nov 15; 184(2): 323–330. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1161767/
2. Gannon MC, Nuttall FQ. Amino acid ingestion and glucose metabolism–a review. IUBMB Life. 2010 Sep;62(9):660-8. doi: 10.1002/iub.375. https://www.ncbi.nlm.nih.gov/pubmed/20882645
3. Nilsson M, Stenberg M, Frid AH, Holst JJ, Björck IM. Glycemia and insulinemia in healthy subjects after lactose-equivalent meals of milk and other food proteins: the role of plasma amino acids and incretins. The American Journal of Clinical Nutrition. 2004; 80: 1246-53.
4. Bell, K. et al (2016) Algorithms to Improve the Prediction of Postprandial Insulinemia in Response to Common Foods. Nutrients 2016, 8, 210; doi:10.3390/nu8040210
5. Smart CEM, Evans M, O’Connell SM, et al. Both dietary protein and fat increase postprandial glucose excursions in children with type 1 diabetes, and the effect is additive. Diabetes Care 2013;36:3897–3902

• Women with Diabetes can develop a great looking body, they just need to think differently, and require unique information and support.
• Improving your body is more challenging if you have diabetes. There are many important nutrition considerations.
• The best fat loss and body sculpting diet plan for females with diabetes is the one that fits your lifestyle and isn’t difficult to manage from a diabetes perspective.
• Improving your body involves set periods of eating a calorie surplus and deficit.
• 99% of women looking to lose fat and develop their shape prioritise the wrong things when it comes to diet.
• If you don’t assess your diet you won’t reach your ideal shape.
• You need fewer supplements than you think. Women do well with whey and creatine, and these are valid options for people with diabetes.

What you’re in for?

4,000 Words

Reading Time ~ 22 minutes

Before we begin, let’s get straight with each other why you’re reading this exact article.

You’re a female living with diabetes who wants to look better naked and buy a completely new wardrobe?

You’ve tried to lose weight and get in shape countless times but you still aren’t happy.

No matter how many diets you have tried, you keep asking yourself,

‘What do I need to eat?’

‘How much do I need to eat?’

‘Am I allowed to eat this? Am I allowed to eat that?’

‘What should I do for this night out I have coming up, will my diet fail?’

‘Why am I constantly hungry?’

‘Is diabetes the reason I’m struggling to lose weight and get in shape?’

‘Dieting downright sucks and I have no hope of building a body that men will bow down to.’

Ok, Stop.

Panic over.

If you have struggled to find decent diet information for creating a better-looking body with diabetes, you’ve come to the right place.

This article is grounded on ten years of academic learning, 1000s of blood glucose tests, 1000s of hours in the gym and over 700 client transformations.

You will learn many new things and discover various aspects you haven’t considered before. You’ll walk away equipped with the right knowledge to make massive changes and create the body you always desired.

I’m all for creating a great looking body as fast as possible. However, to achieve this, your diet MUST be set up correctly.

There is a fine line between…

• Eating too much vs. eating too little.
• Taking too much insulin vs. taking too little.
• Training too much vs. training too little.

Overlook one detail and you run the risk of burning out, losing shape, gaining waist inches and looking the same (or worse) from year to year.

Sound familiar?

Let’s look at how we can fix it.

In order to build a great looking body, you’ll need to build muscle and lose body fat.

Nutrition, in conjunction with a well-structured training program and dedicated periods of rest are essential in every woman’s journey to creating the perfect looking body.

This article focuses on the nutritional aspect of developing a great looking body.  If you want to learn more about the training, make sure you read this article after.

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The diabetic body is governed by a different set of rules and requires a much more tactful approach to diet than would be advised by the mainstream fitness media or your local gym hero.

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Let’s look at the challenges females with diabetes face in their quest to build a better-looking body.

• Increased levels of muscle protein breakdown.
• Reduced strength.
• Decreased joint and muscle mobility due to glycation.
• Increased potential for injury.
• Increased fatigue.

These challenges are real.

However, they only become a serious problem to creating a great body when blood glucose levels are not controlled. You can safely say diabetes is not an advantage, BUT, with the right knowledge, plans and guidance, diabetes DOES NOT have to be a disadvantage.

The more you know about diet, the better you will control your blood glucose levels.

GETTING STARTED:

THE BODY SCULPTING DIET PLAN FOR FEMALES WITH DIABETES.

When it comes to creating your own diabetic fat loss diet plan a number of factors need to be considered. Some are more important than others and must take priority. It’s easy to get excited and place more attention on the small details like the newest supplement, diabetic special food or the best time to consume your whey protein, rather than prioritizing the more important (yet sometimes boring) aspects like the ‘WHY’ behind eating better, overall, calorie intake or diabetes management.

THE DIABETIC MUSCLE AND FITNESS NUTRITION PYRAMID

The Diabetic Muscle and Fitness Nutrition Pyramid (pictured below) outlines all the nutritional aspects of building a successful fat loss diet for females living with diabetes. The most important factors are at the bottom and the least important factors are at the top.

Structure your nutrition like this and you can guarantee high-quality results.

This is the exact hierarchy of importance I have incorporated into my 112-Day Female Focused Fat Loss Transformation Guide for Females. 

1. PERSONAL VALUES FOR HEALTH AND FITNESS.

Your personal values for health and fitness are your WHY behind your HOW TO.

Find as many reasons as you can to support why improving your diet will enhance the quality of your life. These answers are the driving force behind your daily attitude and actions.

Confidence, better sex, tastier fashion, job opportunity, and improved quality of life are all obvious benefits of losing fat.

2. DIABETES MANAGEMENT.

Even if a diet is comprised of the best quality and freshest food or most expensive supplements on the planet, poorly controlled diabetes can predispose individuals to malnutrition, a condition where the cells of the body cannot utilise fuel properly.

Malnutrition resulting from poorly uncontrolled diabetes adversely affects body function, well-being, predisposes individuals to disease and delays recovery from illness.

Your diabetes must be exceptionally well controlled in order to reap the full benefits of healthy eating.

3. ADHERENCE.

Whether your goal is to shred pounds of body fat, create a perfect body shape or maintain body weight, your diet plan must be able to accommodate social occasions, days off, and the odd slice of pizza when you fancy it. Yes, a diabetic just said pizza.

The best body sculpting diet plans for females with diabetes incorporate a little give and take. If set up correctly, the total number of calories you consume will allow you to achieve your goal without restricting the foods you love.

Eating ‘clean’ doesn’t mean you’re doing things optimally. This is especially true if you find yourself craving the foods and macronutrients you restricted.

What good is a diet that drives you crazy?

You’ll struggle to get results, never mind maintain them.

Besides being ultra consistent with your calorie intake and essential nutrient targets, the secret to developing a better-looking body is eating a diet you enjoy. Adherence is everything. This viewpoint is also supported by the Journal of the American Medical Association who researched pretty much every fat loss diet on the planet and found ‘adherence’ was the most significant factor behind a diet’s success ⁹.

How many massively restrictive diets have you started, only to stop once your burst of enthusiasm has been replaced by pure monotony? Time to re-think things?

As for training. It’s only the fun part.

I take dietary adherence seriously. I’ve even incorporated detailed instructions and principles on how you can eat the foods you love, and still get in amazing shape in my breakthrough fat loss diet and training guide for females living with diabetes. 

Forget overly restrictive, dull, boring chicken, broccoli and rice diets, carb cycling, detoxes and super expensive supplements.

Focus on sustainability and killer consistency.

Once you’ve identified the goal of fat loss you will need set yourself a time frame, measure your progress and get accountable.

1. SET A TIME FRAME

You need to set yourself an adequate time frame for getting in shape.

How long will depend on how much progress you want to make.

There is a huge difference between,

• Losing 10lbs of fat vs. 100lbs

While developing a great looking physique takes years, generally speaking, 16 weeks is enough time to make significant body transformation changes. This is the exact length of Diabetic Shred – the breakthrough fat loss diet and training plan for women with diabetes.

2. MEASURE YOUR PROGRESS

If you aren’t assessing you’re just guessing.

To get the most out of your body sculpting diet plan, you must learn to evaluate and measure your food intake.

“Tracking food may seem like a mundane task”

Think again, tracking allows you to build portion control habits, and eat more flexibly in relation to your body transformation goals.

Fat loss requires eating less than you burn off. Overeating will hinder your fat loss efforts, while under eating will increase your chances of muscle loss and fatigue.

Far too often people blindly drop their calories and increase their training when there is no need. You must adjust when the time is right. How will you know? Tracking of course!

Having worked with 100s of females in the pursuit of getting a great looking body, I know too well how confusing it can be when it comes to making decisions about when to cut calories and where from. I paid great attention to this dilemma when developing Diabetic Shred.

The plateau is usually the time when people give up on their goals. Diabetic Shred outlines a crystal clear decision process for when and where to adjust your calories, once you hit a plateau.

Having a clear set of questions and actions like this saves hassle, gets better results, and most importantly keeps you progressing not quitting!

3. GET ACCOUNTABLE

To get the most out of your body sculpting diet plan, you must get accountable.

Hiring a coach or personal trainer with a proven track record who understands diabetes management will be worth its weight in gold, especially if it is your first time getting serious.

A good coach will give you that much-needed push during training, along with good honest critical feedback on your development and shape.

Now let’s get into the nitty gritty of nutrition and talk calories, carbs, protein, dietary fat and supplements.

4. Energy Balance

The first place to start when building your diet plan is calories.

Calories play a crucial role in everyone’s attempts to get a great looking body¹.

If your goal is to lose body fat or develop your shape, you must first establish how many calories you need to maintain your current bodyweight, and then work from there.

How do I work out my maintenance calories?

Record your body weight and calorie consumption over 14 days. Total the values up and divide each of them by 14 to get your fortnightly calorie and body weight average. Compare this value to your starting body weight…

• If your body weight has gone up, this indicates a calorie surplus.
• If your body weight has gone down, this indicates a calorie deficit.
• If your body weight has remained the same, this indicates maintenance calories.

Oh, and if the idea of weighing yourself seems daunting, here are some useful tips on how to weigh yourself properly.

Another way to calculate maintenance calories is by using a calorie calculation.

These aren’t 100% bulletproof, but they do get you on the right path.

Once you’ve established a maintenance level of calories, you’ll need to adjust it to your goal.

Generally speaking, for fat Loss – eat slightly fewer calories than you need to maintain your body weight.

 5. MACRONUTRIENTS.

Everyone gets confused about macros. It’s no surprise considering the vast amount of conflicting and over-complicated information found online and in the papers.

Low carb,

High carb,

High fat,

Low fat.

Which macro split is best for diabetes?

Here’s what you need to know about macros…

Certain macro nutrients are essential, others not.

Protein and the essential fatty acids (Omega-3 and Omega-6) need to be consumed via the diet.

Carbohydrates and other forms of fat are non-essential as the body can produce them by itself.

The best diet contains all the macronutrients in the right amounts specific to your overall calorie goal for fat loss, shape development or body weight maintenance.

What ratio of macronutrients you decide to eat is largely down to personal preference once you have met your essential needs for protein, essential fatty acids and carbohydrates for hypo treatment/prevention purposes.

How much protein do I need?

To keep it simple, 1.4-2.0g per Kg (0.6-1.0g per lb) of protein for the majority of people reading this.

In other words, if you weigh 67kg (147lb) you would consume 90-150g of protein per day. Split equally over 3-5 servings of 20-40g each day.

How much fat do I need?

Generally speaking, consuming 20-30% of your calories from fat is a great place to start. You might consume different amounts each day. However, over a period of weeks/months – they should average out.

In respect to your overall fat intake, certain types of dietary fat are essential, others not.

Omega-3s are essential long-chain polyunsaturated fatty acids that need to be supplied through the diet

There are three types of omega-3s involved in human physiology: ALA, EPA & DHA. Predominantly of marine origin, EPA and DHA are better than ALA found in plant oils, due to their greater bioavailability ^2,3.

Consuming fatty fish and fish oil supplements has been shown to improve dozens of aspects of health and disease, including insulin sensitivity, blood lipids, depression, inflammation and blood pressure, to name a few ^2,3,4,5,6.

Taking the different government and health organisations’ recommendations into account, 1-3 g of combined EPA-DHA per day suffices. The upper dose of 3g would be more suitable for people with diabetes due to the predisposition of a high triglyceride level and elevated blood pressure.

1 gram of fish oil is the equivalent to around 3 fish oil capsules per day or three to four 112g portions per week of oily fish like salmon, mackerel or sardines.

You’ll want to check how much Omega 3 you can take with your health care professional if you’re taking blood thinning medication.

How many carbs do I need?

Carbohydrate should make up the remainder of your calorie intake once you have calculated your calorie intake for protein and fat. The more carbs you eat, the less fat you’ll eat, and vice versa. The more dietary fat you eat, the fewer carbs you’ll consume.

Think of carbohydrate as a performance fuel, not a recovery fuel. The more training you do, the more you’ll need.

Do I need to go low carb if I live with diabetes?

Not necessarily.

If you are highly active and strength train 3-6 times per week, carbohydrates will help fuel your exercise performance and provide your body with a better training stimulus.

The fibre aspect of carbohydrates has also been shown to play a key role in the health of our microbiome, which has now been repeatedly shown to play a key role in body weight management ^7,8.

Carbs provide a range of different vitamins and minerals. They also taste great and help with dietary adherence.

Provided you manage your blood glucose levels and account for the calories you consume from carbohydrate, there is no reason to exclude them. On a side note, you must account for the carbohydrate calories you use to treat hypoglycaemia. This may vary from day to day.

If you”re like most women with diabetes, trying to figure all this out can get pretty overwhelming. One of the easiest ways to overcome this is to follow simple recipe plans. That’s why I created the Ultra Lean Diabetic Cookbook – it’s jam packed with 100 delicious diabetic friendly recipes. All the calories and macronutrients are outlined for you – they even come with a Myfitness pal barcode for easy food tracking.

6. NUTRIENT TIMING

Nutrient timing is more important for people with diabetes, especially when it comes to preventing/treating hypoglycaemia or preventing hyperglycaemia.

Refer to the infographic below and review when nutrient timing is Very Important, Worth Considering and Not Important. It’s the perfect size for Instagram, so please do feel free to share on social media (remember to tag us)

Getting your nutrition timed right has favourable effects on body composition, mood, and diabetes management. However, it should never be prioritised over the more important levels of the pyramid such as energy balance and macro nutrients.

A prime example of this would be the ‘no carbs after 6 dogma.’

In terms of meal frequency, 2-4 meals for fat loss and 3-5 if developing shape.

7. MICRONUTRIENTS/FIBER/WATER.

The topic of micro-nutrition may sound mind-numbing but you can’t overlook it.

Long-term micronutrient deficiencies will have a detrimental impact on your health and ability to perform/recover optimally from your training efforts.

Micronutrient deficiencies can result from prolonged period of low-calorie dieting and poorly controlled diabetes. A varied diet is a great way to get a range of micronutrients in

If you have any problems with energy levels, hunger, skin, or problems sleeping, you might be short of a few vitamins or minerals. Rather than assuming, the best way to check for micronutrient deficiencies is by getting a blood test done.

Fiber Intake

First of all, it is worth noting fiber is not an essential nutrient.

1. It makes you feel fuller (helps with fat loss)
2. Slows gastric emptying and nutrient absorption (can help with blood glucose management)
3. Decreases blood cholesterol
4. Decreases mineral absorption
5. Provides food for the bacteria in our guts which are shown to play a massive role in health and obesity prevention.
6. Helps you go to the toilet.

High-fiber foods like fruits and vegetables contain lots of other nutrients (vitamins and minerals) that are important to health.

If your fiber intake is low, don’t start ploughing it down. The body, particularly the bacteria within your gut need a little time to adapt. Otherwise, you’ll be pretty bloated and be blowing a lot of gas.

Provided you don’t suffer from IBS or any other serious bowel condition, 30-40g of fiber is a great target to shoot for daily.

Water Intake

Water is important for all things health, muscle building and exercise performance. There isn’t really a fixed water goal you should work to, per say, as hydration needs vary widely with body weight, sweat rates and frequency of hyperglycaemia.

Generally speaking,

• Aim for at least 5 clear urinations a day.
• Make sure you’re not dehydrated before training.
• Hydrate yourself well both during and after hyperglycaemia.
• Your hydration needs will increase if you are using the likes of creatine.

  8. SUPPLEMENTS.

When it comes to supplements, let’s get five things straight.

1. Supplements are the least important part of the nutrition pyramid.
2. Supplements can be a great nutritional insurance to someone living with diabetes. However, they will not mop up the damage caused by poorly controlled diabetes.
3. Supplements are a healthy addition to a good diet plan, but they will not make up for a poor one.
4. Generally speaking, supplements are not needed. Unless you don’t eat oily fish or natural sources of omega 3.
5. Supplements are never to be seen as shortcuts.

What supplements do I need?

Generally speaking, protein powder is a convenient easily digested source of high-quality protein, creatine along with caffeine are useful for boosting strength and cognition, Vitamin D is good for health if you live in a dull climate, fish oil seems to improve many elements of health – which makes all of these a worthwhile investment.

Since I consider the subject of supplements such a non-important topic, I’ll cover them in greater detail in a separate article, as I don’t want them distracting from the more important parts of this article.

In fact, I guarantee some people will have skipped everything I’ve said up until now. If you have – go back and start afresh.

If you’ve read the whole way up until here. Great!

Respect the hierarchy of importance for each element outlined in the Diabetic Muscle and Fitness nutrition pyramid, get focused on creating healthy habits over the long term, assessing your progress and just eat real food.

TAKE HOME

Before you pay for another month of gym membership ladies please consider these key principles for losing fat with diabetes.

• Proper female fat loss nutrition is about understanding how to eat healthily and sustainably towards your goals. All diet plans work (for a while), use them as a template from which you can adjust according to your results and personal circumstances.

• Never hop from diet to diet. It’s best to measure progress after about 2 to 4 weeks and then continually adjust.

• The ultimate nutritional approach to sculpt a great body will always be calorie controlled and nutrient dense, along with a diet that supports exercise performance and recovery.

• To get the best possible results your diabetes must be extremely well-managed through regular blood glucose testing and appropriate amounts of medication. This is essential for the proper absorption and metabolism of nutrients from food.

Since you have made it to the end of this blog, you are obviously serious about losing fat and building a new wardrobe (ha).

I hope you take action on what you’ve learnt!

If the idea of building your own diet and training seems too daunting for you,

here’s an 85% off coupon for what many diabetic women have coined the world’s Best Female Diabetic Body Transformation Diet and Training Plan.

Everything is done for you!

Join over 3500+ women who are currently following the plan and creating a better body and life for themselves.

The best thing about it?

It only costs a fraction of a typical 1-hour personal training session. You get 112 days’ worth of first class diet and training content that isn’t available anywhere else in the world, bar here!

IF YOUR GOAL IS FAT LOSS GET DIABETIC SHRED

REFERENCES

1. The poor, misunderstood calorie: calories proper: Volume 1 Lagakos Ph.D., Dr. William
2. https://www.ncbi.nlm.nih.gov/pubmed/28289069
3. https://www.ncbi.nlm.nih.gov/pubmed/23794360
4. https://www.ncbi.nlm.nih.gov/pubmed/25278765
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013121/
6. https://www.ncbi.nlm.nih.gov/pubmed/24117792
7. Le Chatelier, T. Nielsen, J. Qin, E. Prifti, F. Hildebrand, G. Falony, et al. Richness of human gut microbiome correlates with metabolic markers Nature, 500 (2013), pp. 541-546.
8. -P. Furet, L.-C. Kong, J. Tap, C. Poitou, A. Basdevant, J.-L. Bouillot, et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with
9. Pagoto, Sherry L, Appelhans, Bradley M. A. Call for an End to the Diet Debates