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Short Summary
Main recommendation: Do not treat a modestly elevated blood glucose or HbA1C on a carnivore diet as diabetes by itself; Dr. Eric Westman argues that diabetes should be defined by elevated blood glucose or A1C together with elevated insulin, and that low-carb eaters with low insulin do not experience the same intracellular glycation damage. He concludes that Coach Carnivore Cam's readings do not indicate prediabetes, while Carnivore Ray's normal fasting glucose and A1C of 5.5 are also not prediabetic.
Key Points
- Westman defines type 2 diabetes as prolonged elevated blood sugar, but argues the meaningful definition for carb eaters also requires high insulin at the same time.
- Glycation, where sugar attaches to proteins and lipids, is the mechanism he says causes diabetes damage, mainly inside cells rather than in the blood alone.
- Carnivore Ray had fasting glucose of 96 mg/dL and A1C of 5.5%, both outside the prediabetic range.
- Coach Carnivore Cam had fasting glucose of 93.6 mg/dL, normal, and an A1C of 5.7%, which Westman notes falls in the range labeled prediabetic by A1C alone, though he disputes this label applies to him.
- Westman argues the body makes glucose through gluconeogenesis from protein, fat, and lactate, so carbohydrates are not required for glucose supply.
Details Worth Noting
- Concrete instructions: If your HbA1C is 6% or above, do not ignore it, since that indicates considerable glycation. If your HbA1C is higher than you would like on a carnivore or low-carb diet, Westman recommends wearing a continuous glucose monitor and tracking blood sugar for a full week straight. If you develop neuropathy, take it seriously regardless of glucose or diet. Ask a doctor to check your insulin level, since low insulin is what he says changes the meaning of glucose and A1C readings. Discuss with a doctor if you see unexpected elevated glucose, since medications and even caffeine can raise blood sugar in some people.
- Westman says red blood cells may live longer on a carnivore diet, which could raise HbA1C without raising average blood sugar, but he acknowledges there is no data yet on red blood cell lifespan in carnivore eaters.
- He notes that normal reference ranges are based on carb-eating populations, many of whom are already unhealthy, so normal ranges may not reflect optimal health for low-carb eaters.
- He reports that type 2 diabetics on carnivore often see their diabetes reverse, which he attributes to stopping sugar intake.
- He speculates, based on limited historical evidence like Egyptian mummies with atherosclerosis, that diabetes and heart disease became common mainly after large carbohydrate consumption, presenting this explicitly as his own interpretation rather than established history.
- Westman's remarks are his own commentary and not professional medical advice to the viewer.
Bottom Line
Westman's view is that an isolated HbA1C or glucose reading on a low-carb or carnivore diet needs context, especially insulin levels and actual sustained blood sugar patterns, before it is labeled diabetes.
