What is the Primal Diabetes Diet?

Steve Cooksey before after
Steve Cooksey, before after he became the Diabetes Warrior

There is a relatively small group of very vocal, dieting extremists who advocate a high fat, high protein and very low carbohydrate diet to combat diabetes.

This is very different from the advice given by health professionals, who continue to say that eating mostly vegetables and lean proteins is the best way to manage diabetes. Does this method work? Is it safe? Let’s have a quick look.

Why extreme?

I refer to this type of diet as extreme because it pushes beyond the limits of what is considered a healthy diet; that is not to say that it is not effective.

The first extreme primal dieter that I became aware of is Steve Cooksey; he runs the website Diabetes Warrior where he tells his story of is battle with diabetes.

Steve Cooksey was diagnosed with type 2 diabetes In February 2009. At this time he weighed 235 pounds. had high blood glucose, was prescribed four insulin shots a day, took the diabetes drug Actos, had blood pressure of 150/90, high cholesterol, frequent bouts of asthma and bronchitis, suffered plantar fasciitis, lower back pain, acid reflux, indigestion and lethargy.

In February 2010 he blogged about his first year with diabetes. He says that he made most changes in the first eight months of his new lifestyle. He lost weight, got fit and eliminated all of his health problems. He explained: “I am still a Diabetic, but my blood sugar is NORMAL!!!”

He stopped all medication and later blog updates a year later confirmed that he was still living free of medication. So, how did he do it?

Twin Pillar Approach

Steve Cooksey’s attributes his success to a “Twin Pillar Approach” to Fitness/Wellness. This means diet and exercise.

Paleo Style Meal Plan

He follow’s Mark Sisson’s diet plan that is set out in “The Primal Blueprint“ (available in ebook and paper formats).

Steve Cooksey followed a very low carbohydrate version of the Primal Blueprint, meaning that he eliminated more carbohydrates than the average paleo dieter eliminated. Needless to say, anything derived from wheat or other hybrid, agricultural grass (rye, oats, barley, rice etc.) is off the menu.

Steve Cooksey’s Diabetic Nutrition Pyramid

Steve took the traditional diet pyramid and converted into one that represents a low-carb paleo style diet.

Stever Cooksey food-pyramid

The most fundamental change is eliminating refined sugar completely, so no soft drinks, fruit juices, cookies, cakes, cakes, cookies. Starchy carbs are also banned, so no potatoes or rice.

Successfully living with diabetes (especially type II) is all about “rationing”  carbs.” – Cooksey

Foods off the menu

No grains in any form, so no flour, pasta, breads, crackers, cakes. Includes all cereals.

He also stopped all transfats and hyrdogenated oils – including corn and vegetable oils.

Legumes (inc. peanuts) are also avoided / banned along with pasteurized milk, high carb fruits, all high carb vegetables and reduced fat foods (because sugar is always added to low fat foods).

Foods on the menu

The following foods are eaten, but only when hungry. Steve does not follow strict meal times because he believes that eating when not hungry is not only unnecessary but will also more likely increase blood glucose levels.

  • Meats – beef, pork, fish, poultry, eggs, etc. Organ Meats are particularly high in nutritional value (he loves liver).
  • Veggies – low carb veggies are best such as greens, cauliflower, broccoli, green peppers, celery, asparagus
  • Fat – Coconut Oil, Butter (with salt), Rendered Fat or Lard.
  • Drinks – water, tea and coffee unsweetened (coconut oil and butter can be used in coffee, occasionally cream)
  • Condiments/Spices – Louisiana Hot Sauce, Tabasco, Black and Red Pepper

Also allowed, but infrequently, are:

  • Wine – once a month, always red and usually a Merlot or Cabernet Sauvignion.
  • Vinegar – apple cider on salads or greens
  • Cheese – typically cheese added to LC Caulicrust pizza or LC Primal Chili
  • EVOO – Extra Virgin Olive Oil, on salads or slaw, also for low to medium temperature cooking.
  • Nuts – walnuts, pecans, cashews, etc. (not peanuts)
  • Fruits – Low Carb Fruits but not daily, blueberries, raspberries


In February 2009, Steve could only walk about half a mile; he was very unfit. This did not stop him from working on his fitness every day. His advice, much like our own, is simple: “Start moving… walking, jogging, tennis, etc etc. Today, I exercise most days a week.”

Daily consistent action = SUCCESS!

Steve says, “I try to lift heavy three days a week. Other days I ride my bicycle, run sprints at the park or perform various bodyweight and intense exercises like push ups, squats or burpees.”

Weight training is a fantastic way to stay in shape and get fitter because it is low impact. Weight training can be done at any age and not only will it improve health it also improves stability later in life – you are less likely to stumble and fall if you maintain good muscle mass and good balance.

Our weekly fitness plan also suggests daily exercise (as does our article How Much Exercise Is Needed to Get Fit and Lose Weight?)

Steve Cooksey’s approach seems radical and extreme at first glance; his doctors and other health advisers warned him against his lifestyle changes, telling him that he would not get adequate nutrition from his low carb diet.

But, he appears to be doing OK and continues to share his healthy medical results. His final piece of advice is: “IF YOUR DOCTOR does NOT support a low carb paleo meal plan, FIND ONE WHO DOES.”

The limitations

The very low carbohydrate style diet does indeed appear to work for some people, especially Steve Cooksey. However, everybody is different and how far your diabetes has progressed will largely determine if it is possible live drug free by following a new lifestyle.

For anybody who is suffering more advanced stages of diabetes, where there is already vascular damage, walking and more gentle resistance training is often the only option.

The most important habit to get into is regular monitoring of blood sugar and blood pressure levels. Managing diabetes can be a complex and difficult task and not everybody has the skills to self-manage their diabetes; generally the older a person is the less likely they will successfully manage it well, especially if they do not receive support from family.

Steve Cooksey is not alone, many other diabetics have managed to turn their lives around by taking a more radical and extreme approach to their diet and lifestyle.

The reality is that it is a radical and extreme lifestyle that makes a person obese in the first place – we are not evolved to consume vast quantities of food and by doing so we are breaking our bodies. Diabetes is just one problem, overeating and sedentary lifestyles also causes increase risk of heart disease, stroke, cancer, dementia and depression.

Steve Cooksey has received complaints in the past about his website and his approach to managing diabetes. He makes it clear that he is not a medical professional and what he writes is only his own opinion based on what he is doing. The greatest challenge for many people is finding the right solution for them.

We have seen many medical professionals advocate similar, radical changes to diet and lifestyle, such has Dr. Atkins and more recently Dr. Peter Attia. While more research is probably needed to better understand the long-term impact, if people are becoming fitter and healthier without having to take medication or receive bariatric (weight loss) surgery we should certainly take notice.

The big question is, if this type of eating is considered more natural than eating refined sugar and improves one health condition, could it also be an affective way to live for everybody? The answer is very possibly yes.

Can we reduce the prevalence of health conditions such as diabetes, heart disease, cancer and stroke by encouraging everybody to stop eating bread, cereals, pasta and rice and instead eat more fruits, vegetables and lean meats? When said like this, it suddenly does not seem all that radical or extreme at all.

3 Comments on “What is the Primal Diabetes Diet?”

  1. Thanks for sharing my story and website.

    While I love to ‘push the envelope’ with fats (butter and coconut oil), I would submit that there is nothing extreme about a diet of mostly meat, veggies and in season… nuts and berries. :)


  2. Hi Steve, I agree. When I first came across your site about a couple of years ago I admit I was a little skeptical. I had recently studied some human nutrition and mentioned it to my tutor and they pretty much said what you had experienced, i.e. that it was unhealthy, all the saturated fat is going to make things worse. But I am coming round to the idea more now.

    Sugar really is the worst, at least, refined sugar. Totally not required in our modern world. Wheat and all its cousins may have helped us develop and flourish by providing our brains with the energy they need over the harsh winter months, but now we live in a world of relative abundance.

  3. While I love to ‘push the envelope’ with fats (butter and coconut oil), I would submit that there is nothing extreme about a diet of mostly meat, veggies and in season… nuts and berries. :)

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