How to Stop Diabetes Hunger

Ask Theresa is a weekly advice column by Theresa Link. A Virta Health Coach since 2015 and a loyal follower of the ketogenic lifestyle, Theresa is a Registered Dietitian who is an expert in living a metabolically-healthy life. 

In this week's column, Theresa dives into the constant munchies that often come with type 2 diabetes. She gives a nod to all those diet attempts that just didn’t stick and reveals how insulin resistance keeps you feeling famished. Theresa also dishes out tips to tackle diabetes-related hunger, including cutting carbs and welcoming healthy fats into your diet to finally keep those hunger pangs at bay.

❓Question:

Theresa,

I have diabetes and got an email from my HR benefits department letting me know that Virta is a new diet program I can try, but I haven’t started yet. Lowering my blood sugar and getting off metformin sounds great, but every time I start a new diet I always fail because I’m starving. In fact, I feel like I’m always starving, even when I’m not on a diet. What’s going on? Is constant hunger a sign of diabetes? Does high blood sugar make you hungry?

Sincerely,
Flustered and Famished

👩🏻‍💻 Theresa:‍

Dear Famished,

You’re not imagining this. Constant hunger can indeed be a sign (or side effect) of diabetes. Before exploring this I’d like to first validate your past attempts to change your diet, even though they weren’t successful in creating lasting changes. The late Dr. Hallberg always said, “if you can’t stick with it now, you can’t stick with it later”. So if you go on an egg fast for 3 days and by day 4 you can’t even look at a chicken, I can assure you that this is not a long term solution.

Most weight loss approaches are (thankfully) more balanced than the egg fast. But even these will fail if you feel hungry, or worse – hangry – the dreadful combination of hungry and angry that transforms even the nicest person into a raging Hulk, smashing anything in their path until they get a snack.

Take Virta member Brian for example; he struggled with constant hunger because his dietary advice was all wrong. So Famished, you are not alone. Not only have you been given advice that doesn’t work for your metabolism, you are experiencing an unofficial term many refer to as  diabetes hunger. Let’s dive in.

Why does type 2 diabetes make you hungry?

Type 2 diabetes can make you hungry due to how it affects blood glucose regulation. It starts with insulin resistance, which can exist for decades before symptoms develop. Insulin-resistant cells don't effectively absorb glucose, leaving it in the bloodstream and causing high blood sugar levels while starving the cells of energy. No wonder you’re hungry – your cells aren’t getting enough fuel.

Type 2 diabetes also disrupts the normal functioning of hormones that regulate hunger and satiety (aka fullness), such as leptin and ghrelin. Leptin is responsible for signaling when you feel full and should stop eating, so when this process gets disrupted, hunger persists and your body wants to keep eating. It’s just not fair.

People with type 2 diabetes may take medications like insulin or sulfonylureas to regulate blood sugar. A common side effect is hypoglycemia (low blood sugar). When this happens, you may feel “hangry”, although racing to the snack cabinet is good in this case because eating helps your blood sugar return to normal. While eating can normalize blood sugar, frequent highs and lows disrupt hunger and satiety signals, making it difficult to know when you actually need to eat.

How to stop Diabetes-related hunger or Polyphagia

Polyphagia… what? It’s your fancy new word of the day, and after reading this article you can use it in a sentence and impress your friends. Polyphagia is a medical term used to describe abnormally increased appetite. It usually occurs in folks who have metabolic disease like insulin resistance and type 2 diabetes, and it’s largely due to your body’s inability to regulate glucose, as we discussed above. 

The best way to stop this is to address the root problem: insulin resistance, essentially a state of carbohydrate intolerance. For many, when you reduce your carbohydrate intake, your metabolism starts to heal. This means your body starts to regulate glucose normally and your cells are able to use it for fuel, effectively reducing your constant need to eat and improving your hunger and satiety signals. And if you work closely with a medical provider skilled in eliminating meds (ahem… Virta providers) you may be able to completely eliminate these medications, too. 

Another way to stop diabetes-related hunger is to confront your fear of fat and start adding more of it to your diet. I know, we’re all traumatized by the fat-phobic Food Pyramid, but it’s time to move on. Fats, especially natural fats and oils, are key to keeping our bellies full, at least in moderation. And a full belly kicks diabetes hunger right in the knees.