How many carbs should a person with diabetes type 2 consume daily. What are the recommended carbohydrate intake levels for effective blood sugar control. How can individualized approaches to carb consumption benefit diabetes management.

Understanding Carbohydrates and Their Impact on Blood Sugar

Carbohydrates play a crucial role in managing type 2 diabetes, as they significantly affect blood sugar levels. To effectively control diabetes, it’s essential to understand the different types of carbohydrates and their impact on the body.

Types of Carbohydrates

• Simple carbohydrates (sugars)
• Complex carbohydrates (starches and fiber)

Simple carbohydrates, or sugars, are found naturally in foods like fruits, milk, and honey, as well as in processed foods such as candy. Complex carbohydrates include starches and fiber, which are present in foods like potatoes, whole grains, legumes, and vegetables.

While all digestible carbohydrates are broken down into glucose and can raise blood sugar levels, fiber is an exception. Fiber doesn’t raise blood sugar and may even help slow its rise, making it an important component of a diabetes-friendly diet.

The Relationship Between Carbohydrate Intake and Blood Sugar Control

Of all macronutrients, carbohydrates have the most significant impact on blood sugar levels. When people with diabetes consume carb-rich foods, their blood sugar can surge, often requiring higher doses of insulin or diabetes medication to manage.

For individuals with type 1 diabetes, who cannot produce insulin, multiple daily insulin injections are necessary regardless of carbohydrate intake. However, reducing carb consumption can help lower mealtime insulin requirements.

Factors Affecting Blood Sugar Levels

• Carbohydrate intake
• Exercise
• Stress
• Illness

While carbohydrate intake is a major factor, it’s important to remember that other elements such as physical activity, stress levels, and overall health also play a role in blood sugar management.

Evolving Guidelines for Carbohydrate Intake in Diabetes Management

Recommendations for carbohydrate intake in diabetes management have evolved over time. Previously, the American Diabetes Association (ADA) suggested that people with diabetes obtain around 45% of their daily calories from carbs. However, current guidelines emphasize a more personalized approach.

The ADA now promotes an individualized strategy that takes into account dietary preferences and metabolic goals. This shift reflects the understanding that optimal carb intake can vary significantly from person to person.

Factors to Consider When Determining Carb Intake

• Individual metabolic response
• Personal dietary preferences
• Overall health goals
• Lifestyle factors

When determining the ideal carbohydrate intake for diabetes management, it’s crucial to consider these factors and work with healthcare professionals to develop a personalized plan.

Carbohydrate Intake Ranges for Effective Diabetes Management

While there is no one-size-fits-all approach to carbohydrate intake for people with type 2 diabetes, various ranges have shown effectiveness in blood sugar management.

Moderate Carbohydrate Intake

A moderate carbohydrate intake typically falls between 100-150 grams per day, which is lower than the average American diet but still provides a variety of food choices. This range may be suitable for individuals who prefer a balanced approach and can effectively manage their blood sugar with medication or lifestyle interventions.

Low Carbohydrate Intake

A low carbohydrate diet usually involves consuming 50-100 grams of carbs per day. This approach can lead to improved blood sugar control and may reduce the need for diabetes medications in some individuals.

Very Low Carbohydrate Intake

A very low carbohydrate or ketogenic diet typically restricts carb intake to less than 50 grams per day. Some studies have shown dramatic results with this approach, including potential reduction or elimination of insulin or diabetes medication needs. However, this restrictive diet may be challenging to maintain long-term and should be undertaken under medical supervision.

Is a very low carbohydrate diet suitable for everyone with type 2 diabetes? While some individuals may experience significant benefits from a very low carb approach, it’s not appropriate for all people with diabetes. Factors such as overall health, medication regimen, and personal preferences should be considered when choosing a dietary approach.

The Concept of Net Carbs in Diabetes Management

When tracking carbohydrate intake, some experts recommend focusing on net carbs rather than total carbs. Net carbs are calculated by subtracting the grams of fiber from the total grams of carbohydrates in a food.

The concept of net carbs is based on the idea that fiber doesn’t significantly impact blood sugar levels. By focusing on net carbs, individuals may be able to include more fiber-rich foods in their diet while still maintaining their carbohydrate goals.

Calculating Net Carbs

1. Identify the total grams of carbohydrates in a food
2. Subtract the grams of fiber
3. The result is the net carbs

For example, if a food contains 25 grams of total carbohydrates and 5 grams of fiber, the net carbs would be 20 grams.

Does focusing on net carbs improve blood sugar control for everyone with diabetes? While the concept of net carbs can be helpful for some individuals, it’s important to note that everyone’s body responds differently to carbohydrates. Some people may find that total carb counting works better for their blood sugar management.

Implementing a Carbohydrate-Conscious Approach to Diabetes Management

Adopting a carbohydrate-conscious approach to managing type 2 diabetes involves more than just counting grams. It’s about making informed food choices and understanding how different carbohydrates affect your body.

Strategies for Carbohydrate Management

• Choose complex carbohydrates over simple sugars
• Incorporate high-fiber foods
• Practice portion control
• Balance carbohydrates with protein and healthy fats
• Monitor blood sugar responses to different foods

By implementing these strategies, individuals with type 2 diabetes can better manage their carbohydrate intake and blood sugar levels.

How can one determine the best carbohydrate intake for their individual needs? The most effective way to determine your ideal carbohydrate intake is through a combination of self-monitoring, professional guidance, and gradual adjustments. Keep a food and blood sugar diary to track how different carb levels affect your glucose readings, energy levels, and overall well-being.

The Role of Glycemic Index and Glycemic Load in Carbohydrate Management

Understanding the glycemic index (GI) and glycemic load (GL) of foods can be valuable tools in managing carbohydrate intake for type 2 diabetes. These measures provide insight into how quickly and significantly a food may affect blood sugar levels.

Glycemic Index

The glycemic index ranks carbohydrate-containing foods on a scale from 0 to 100 based on how quickly they raise blood sugar levels. Foods with a high GI are rapidly digested and cause a quick spike in blood sugar, while low GI foods are digested more slowly, resulting in a more gradual rise.

Glycemic Load

Glycemic load takes into account both the glycemic index of a food and the portion size. It provides a more accurate picture of how a specific serving of food will impact blood sugar levels.

Can focusing on low GI and GL foods improve diabetes management? Many studies suggest that emphasizing low GI and GL foods can lead to better blood sugar control and improved insulin sensitivity. However, it’s important to consider these measures alongside total carbohydrate intake and overall nutrient quality.

Balancing Carbohydrate Intake with Other Nutritional Needs

While managing carbohydrate intake is crucial for type 2 diabetes control, it’s equally important to ensure that nutritional needs are met across all food groups. A well-balanced diet that includes appropriate amounts of protein, healthy fats, vitamins, and minerals is essential for overall health and diabetes management.

Key Nutrients to Consider

• Protein for muscle maintenance and satiety
• Healthy fats for hormone balance and nutrient absorption
• Fiber for digestive health and blood sugar stabilization
• Vitamins and minerals for various bodily functions

How can one balance carbohydrate restriction with overall nutritional adequacy? Focus on nutrient-dense, low-carb foods such as non-starchy vegetables, lean proteins, and healthy fats. If carbohydrate intake is significantly restricted, consider working with a registered dietitian to ensure all nutritional needs are met.

By taking a holistic approach to nutrition that considers both carbohydrate management and overall nutrient intake, individuals with type 2 diabetes can develop a sustainable and effective dietary strategy for long-term health.

How Many Carbs Should a Person with Diabetes Have?

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Healthline only shows you brands and products that we stand behind.

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• Fact-check all health claims: Do they align with the current body of scientific evidence?
• Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

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Was this helpful?

An individualized approach is often best when it comes to carb intake for diabetes management. These guidelines can help you get started on the right path.

Figuring out how many carbs to eat when you have diabetes can seem confusing.

Dietary guidelines from around the globe traditionally recommend that you get around 45–65% of your daily calories from carbs if you have diabetes (1, 2, 3).

However, a growing number of experts believe that people with diabetes should eat far fewer carbs. In fact, many recommend less than half this amount.

Counting your carbs will help ensure that you stay within the range that’s best for you.

This article tells you how many carbs to consider eating if you have diabetes.

There are three main types of carbs: sugars, starches, and fiber (4).

Sugar belongs to a category known as simple carbohydrates. Simple carbs have one sugar molecule (monosaccharides) or two sugar molecules (disaccharides).

Sugar is found naturally in foods and beverages like whole fruit, juice, milk products, and honey. It’s also added to processed foods such as candy.

Starches and fiber are both complex carbohydrates. Complex carbs have at least three sugar molecules. The body takes more time to digest, or break down, starches than sugar, and it can’t digest fiber at all.

Starches are found in foods like potatoes, corn, legumes, and whole grain breads and pastas.

Fiber is found in foods like fruits, vegetables, legumes, nuts, and whole grains. Unlike sugars and starches, naturally occurring fiber doesn’t raise your blood sugar level and may even slow its rise (5, 6).

Many foods and beverages, such as rice, contain more than one type of carbohydrate.

SUMMARY

The three main types of carbohydrates are sugars, starches, and fiber.

Many factors, including exercise, stress, and illness, affect your blood sugar levels. That said, one of the largest factors is what you eat.

Of the three macronutrients — carbs, protein, and fat — carbs have the greatest effect on blood sugar. That’s because your body breaks down carbs into sugar, which enters your bloodstream.

This occurs with all digestible carbs, including refined sources like chips and cookies as well as whole, unprocessed sources like fruits and vegetables.

When people with diabetes eat foods high in carbs, their blood sugar levels can surge. High carb intake typically requires high doses of insulin or diabetes medication to manage blood sugar.

Given that people with type 1 diabetes are unable to produce insulin, they need to inject insulin several times a day, regardless of what they eat. However, eating fewer carbs can significantly reduce their mealtime insulin dosage.

SUMMARY

Your body breaks down certain carbs into sugar, which enters your bloodstream. People with diabetes who eat a lot of carbs require insulin or diabetes medication to keep their blood sugar from rising too much.

Studies have shown that many different levels of carb intake may help manage blood sugar, and the optimal amount of carbs varies by individual.

The American Diabetes Association (ADA) used to recommend that people with diabetes get around 45% of their calories from carbs.

However, the ADA now promotes an individualized approach in which your ideal carb intake should take into account your dietary preferences and metabolic goals (7).

It’s important to eat the number of carbs at which you feel best and that you can realistically maintain in the long term.

The typical American diet provides around 2,200 calories per day, with 50% of them coming from carbs. This is equivalent to 275 grams of carbs per day (8).

A severely restricted intake of less than 50 grams of carbs per day appears to produce the most dramatic results and may reduce or even eliminate the need for insulin or diabetes medication. This represents 9–10% of daily calories on a 2,000–2,200-calorie diet (9, 10, 11).

When tracking carb intake, experts sometimes recommend focusing on your net carbs instead of the total amount of carbs you eat. Net carbs is total grams of carbs minus grams of fiber (11).

People with diabetes can also benefit from diets that allow up to 26% of their daily calories to come from carbs. For people who eat 2,000–2,200 calories a day, this is equivalent to 130–143 grams of carbs (12).

Since carbs raise blood sugar, reducing them to any extent can help you manage your blood sugar levels. Therefore, figuring out how many carbs to eat requires some testing and evaluating to find out what works best for you.

For instance, if you’re currently consuming about 250 grams of carbs per day, reducing your intake to 150 grams should result in significantly lower blood sugar after meals.

SUMMARY

There’s no one-size-fits-all recommendation for how many carbs people with diabetes should eat. However, having carbs account for no more than 26% of your daily calories may help you manage your condition.

To determine your ideal carb intake, measure your blood sugar with a blood glucose meter before a meal and again 1–2 hours after eating.

To prevent damage to your blood vessels and nerves, the maximum level your blood sugar should reach is 180 milligrams per deciliter (mg/dL), or 10 millimoles per liter (mmol/L), 2 hours after eating. However, you may want to aim for an even lower ceiling (13).

To achieve your blood sugar goals, you may need to restrict your carb intake to less than 10, 15, or 25 grams per meal. Also, you may find that your blood sugar rises more at certain times of the day, so your upper carb limit may be lower for dinner than for breakfast or lunch.

In general, the fewer carbs you consume, the less your blood sugar will rise and the less insulin or diabetes medication you’ll require to stay within a healthy range.

If you take insulin or diabetes medication, it’s very important to speak with a healthcare professional to ensure the appropriate dosage before reducing your carb intake.

SUMMARY

Determining the optimal carb intake for diabetes management requires testing your blood sugar and making adjustments as needed based on your response, including how you feel.

Many studies support the use of carb restriction in people with diabetes. Research has confirmed that many levels of carb restriction can effectively lower blood sugar levels.

Very low carb ketogenic diets

Very low carb diets typically induce mild to moderate ketosis, a state in which your body uses ketones and fat, rather than sugar, as its main energy sources.

Ketosis usually occurs at a daily intake of fewer than 50 grams of total carbs (9).

Very low carb ketogenic diets were prescribed for people with diabetes even before insulin was discovered in 1921 (8).

Several studies indicate that restricting carb intake to 20–50 grams per day can significantly reduce blood sugar levels, promote weight loss, and improve cardiovascular health for people with diabetes (9, 10, 11, 14, 15, 16).

In addition, these improvements often occur very quickly.

For instance, in a small 3-month study, people consumed either a low carb diet containing up to 50 grams of carbs per day or a calorie-restricted low fat diet.

The low carb group averaged a 0.6% decrease in hemoglobin A1c (HbA1c) and lost more than twice as much weight as the low fat group. What’s more, 44% of them discontinued at least one diabetes medication compared with 11% of the low fat group (16).

In fact, in several studies, participants have reduced or discontinued use of insulin and other diabetes medications due to improvements in blood sugar control (9, 10, 11, 14, 15).

Diets containing 20–50 grams of carbs per day have also been shown to lower blood sugar levels and reduce the risk of disease in people with prediabetes (17).

Although concerns have been raised that higher protein intake on low carb diets may lead to kidney problems, a 12-month study found that a very low carb intake didn’t increase the risk of kidney disease (18).

Another study found that the diet might actually improve kidney function in people with type 2 diabetes and normal renal function or mild kidney disease (19).

Low carb diets

Many low carb diets restrict carbs to 50–100 grams, or about 10–20% of calories, per day.

Although there are very few studies on carb restriction in people with type 1 diabetes, those that exist have reported impressive results (20, 21, 22, 23).

One of the biggest concerns for people with type 1 diabetes is hypoglycemia, or blood sugar that drops to dangerously low levels.

In a small 12-month study from 2005, adults with type 1 diabetes who restricted their daily carb intake to fewer than 90 grams had 82% fewer episodes of low blood sugar than before they started the diet (20).

In a 2012 study in people with type 1 diabetes who restricted carbs to 70 grams per day, participants saw their HbA1c drop from 7.7% to 6.4%, on average. What’s more, their HbA1c levels remained the same 4 years later (21).

A 1.3% reduction in HbA1c is a significant change to maintain over several years, particularly in those with type 1 diabetes.

People with type 2 diabetes may also benefit from limiting their daily carb intake.

According to a research review, people who consumed no more than 26% of calories from carbs were 32% more likely to experience diabetes remission than people who mostly followed a low fat diet. A person was considered in remission if their HbA1c was under 6.5% (12).

Moderate carb diets

A more moderate carb diet may provide 130–220 grams of carbs per day, or 26–44% of calories in a 2,000-calorie diet (24).

A few studies examining such diets have reported good results in people with diabetes (25, 26).

In a 2010 study of 259 people with type 2 diabetes, those who followed a Mediterranean diet providing 35% or fewer calories from carbs experienced a significant reduction in HbA1c. Over the course of 12 months, HbA1c dropped 2.0% on average (27).

SUMMARY

Studies demonstrate that restricting carbs may benefit people with diabetes. The lower your carb intake, the greater the effect on your blood sugar levels and other health markers.

Many tasty, nutritious, low carb foods raise blood sugar levels only minimally. You can enjoy these foods in moderate to liberal amounts on low carb diets.

However, you should avoid or limit the following high carb items:

• breads, muffins, rolls, and bagels
• pasta, rice, corn, and other grains
• potatoes, sweet potatoes, yams, and taro
• milk and sweetened yogurt
• most fruit, except berries
• cakes, cookies, pies, ice cream, and other sweets
• snack foods like pretzels, chips, and popcorn
• juice, soda, sweetened iced tea, and other sugar-sweetened drinks
• beer, wine, and spirits

Keep in mind that not all of these foods are unhealthy. For example, fruits are highly nutritious, but eating large amounts isn’t optimal for anyone trying to manage their blood sugar levels by eating fewer carbs.

SUMMARY

On a low carb diet, you should avoid or limit foods and beverages like beer, bread, potatoes, fruit, and sweets.

Low carb diets have consistently been shown to lower blood sugar and improve other health markers in people with diabetes.

At the same time, certain higher carb diets have been credited with similar effects.

For example, some studies suggest that low fat vegan or vegetarian diets may lead to better blood sugar control and overall health (28, 29, 30, 31).

In a 12-week Korean study, a brown-rice-based vegan diet containing 268.4 grams of carbs per day (about 72% of calories) lowered participants’ HbA1c levels more than a standard diabetes diet with 249.1 grams of total daily carbs (about 67% of calories) (30).

An analysis of four studies found that people with type 2 diabetes who followed a low fat macrobiotic diet consisting of 70% carbs achieved significant reductions in blood sugar and other health markers (32).

The Mediterranean diet likewise improves blood sugar control and provides other health benefits in individuals with diabetes (33).

However, it’s important to note that most of these diets weren’t directly compared with low carb diets, but rather with standard low fat diets often used for diabetes management. More research on these diets is needed.

SUMMARY

Studies suggest that certain higher carb diets may aid diabetes management. Still, additional research is needed.

If you have diabetes, reducing your carb intake may be beneficial.

Multiple studies have shown that a daily carb intake of up to 44% of calories not only leads to better blood sugar control but also may promote weight loss and other health improvements.

Here’s a sample menu, which would provide about 113 grams of total carbs for the day (34):

• Breakfast: 1 slice of whole wheat toast (about 14 grams of carbs) plus an omelet made with 2 large eggs (about 1 gram) and 1 cup of nonstarchy vegetables like broccoli and greens (about 10 grams)
• Lunch: 12 ounces of lentil soup (about 33 grams) and 1 apple (about 15 grams)
• Dinner: 4 ounces of grilled chicken breast (0 grams), 1. 5 cups of nonstarchy vegetables like zucchini and okra (about 15 grams), and 4 ounces of brown rice (about 25 grams)

However, some individuals can tolerate more carbs than others.

Testing your blood sugar and paying attention to how you feel at different carb intakes can help you find your ideal range for optimal diabetes management, energy levels, and quality of life.

It might also be helpful to reach out to others for support. Our free app, T2D Healthline, connects you with real people living with type 2 diabetes. Ask diet-related questions and seek advice from others who get it. Download the app for iPhone or Android.

How Many Carbs Should a Person with Diabetes Have?

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.

Healthline only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

• Evaluate ingredients and composition: Do they have the potential to cause harm?
• Fact-check all health claims: Do they align with the current body of scientific evidence?
• Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

Read more about our vetting process.

Was this helpful?

An individualized approach is often best when it comes to carb intake for diabetes management. These guidelines can help you get started on the right path.

Figuring out how many carbs to eat when you have diabetes can seem confusing.

Dietary guidelines from around the globe traditionally recommend that you get around 45–65% of your daily calories from carbs if you have diabetes (1, 2, 3).

However, a growing number of experts believe that people with diabetes should eat far fewer carbs. In fact, many recommend less than half this amount.

Counting your carbs will help ensure that you stay within the range that’s best for you.

This article tells you how many carbs to consider eating if you have diabetes.

There are three main types of carbs: sugars, starches, and fiber (4).

Sugar belongs to a category known as simple carbohydrates. Simple carbs have one sugar molecule (monosaccharides) or two sugar molecules (disaccharides).

Sugar is found naturally in foods and beverages like whole fruit, juice, milk products, and honey. It’s also added to processed foods such as candy.

Starches and fiber are both complex carbohydrates. Complex carbs have at least three sugar molecules. The body takes more time to digest, or break down, starches than sugar, and it can’t digest fiber at all.

Starches are found in foods like potatoes, corn, legumes, and whole grain breads and pastas.

Fiber is found in foods like fruits, vegetables, legumes, nuts, and whole grains. Unlike sugars and starches, naturally occurring fiber doesn’t raise your blood sugar level and may even slow its rise (5, 6).

Many foods and beverages, such as rice, contain more than one type of carbohydrate.

SUMMARY

The three main types of carbohydrates are sugars, starches, and fiber.

Many factors, including exercise, stress, and illness, affect your blood sugar levels. That said, one of the largest factors is what you eat.

Of the three macronutrients — carbs, protein, and fat — carbs have the greatest effect on blood sugar. That’s because your body breaks down carbs into sugar, which enters your bloodstream.

This occurs with all digestible carbs, including refined sources like chips and cookies as well as whole, unprocessed sources like fruits and vegetables.

When people with diabetes eat foods high in carbs, their blood sugar levels can surge. High carb intake typically requires high doses of insulin or diabetes medication to manage blood sugar.

Given that people with type 1 diabetes are unable to produce insulin, they need to inject insulin several times a day, regardless of what they eat. However, eating fewer carbs can significantly reduce their mealtime insulin dosage.

SUMMARY

Your body breaks down certain carbs into sugar, which enters your bloodstream. People with diabetes who eat a lot of carbs require insulin or diabetes medication to keep their blood sugar from rising too much.

Studies have shown that many different levels of carb intake may help manage blood sugar, and the optimal amount of carbs varies by individual.

The American Diabetes Association (ADA) used to recommend that people with diabetes get around 45% of their calories from carbs.

However, the ADA now promotes an individualized approach in which your ideal carb intake should take into account your dietary preferences and metabolic goals (7).

It’s important to eat the number of carbs at which you feel best and that you can realistically maintain in the long term.

The typical American diet provides around 2,200 calories per day, with 50% of them coming from carbs. This is equivalent to 275 grams of carbs per day (8).

A severely restricted intake of less than 50 grams of carbs per day appears to produce the most dramatic results and may reduce or even eliminate the need for insulin or diabetes medication. This represents 9–10% of daily calories on a 2,000–2,200-calorie diet (9, 10, 11).

When tracking carb intake, experts sometimes recommend focusing on your net carbs instead of the total amount of carbs you eat. Net carbs is total grams of carbs minus grams of fiber (11).

People with diabetes can also benefit from diets that allow up to 26% of their daily calories to come from carbs. For people who eat 2,000–2,200 calories a day, this is equivalent to 130–143 grams of carbs (12).

Since carbs raise blood sugar, reducing them to any extent can help you manage your blood sugar levels. Therefore, figuring out how many carbs to eat requires some testing and evaluating to find out what works best for you.

For instance, if you’re currently consuming about 250 grams of carbs per day, reducing your intake to 150 grams should result in significantly lower blood sugar after meals.

SUMMARY

There’s no one-size-fits-all recommendation for how many carbs people with diabetes should eat. However, having carbs account for no more than 26% of your daily calories may help you manage your condition.

To determine your ideal carb intake, measure your blood sugar with a blood glucose meter before a meal and again 1–2 hours after eating.

To prevent damage to your blood vessels and nerves, the maximum level your blood sugar should reach is 180 milligrams per deciliter (mg/dL), or 10 millimoles per liter (mmol/L), 2 hours after eating. However, you may want to aim for an even lower ceiling (13).

To achieve your blood sugar goals, you may need to restrict your carb intake to less than 10, 15, or 25 grams per meal. Also, you may find that your blood sugar rises more at certain times of the day, so your upper carb limit may be lower for dinner than for breakfast or lunch.

In general, the fewer carbs you consume, the less your blood sugar will rise and the less insulin or diabetes medication you’ll require to stay within a healthy range.

If you take insulin or diabetes medication, it’s very important to speak with a healthcare professional to ensure the appropriate dosage before reducing your carb intake.

SUMMARY

Determining the optimal carb intake for diabetes management requires testing your blood sugar and making adjustments as needed based on your response, including how you feel.

Many studies support the use of carb restriction in people with diabetes. Research has confirmed that many levels of carb restriction can effectively lower blood sugar levels.

Very low carb ketogenic diets

Very low carb diets typically induce mild to moderate ketosis, a state in which your body uses ketones and fat, rather than sugar, as its main energy sources.

Ketosis usually occurs at a daily intake of fewer than 50 grams of total carbs (9).

Very low carb ketogenic diets were prescribed for people with diabetes even before insulin was discovered in 1921 (8).

Several studies indicate that restricting carb intake to 20–50 grams per day can significantly reduce blood sugar levels, promote weight loss, and improve cardiovascular health for people with diabetes (9, 10, 11, 14, 15, 16).

In addition, these improvements often occur very quickly.

For instance, in a small 3-month study, people consumed either a low carb diet containing up to 50 grams of carbs per day or a calorie-restricted low fat diet.

The low carb group averaged a 0.6% decrease in hemoglobin A1c (HbA1c) and lost more than twice as much weight as the low fat group. What’s more, 44% of them discontinued at least one diabetes medication compared with 11% of the low fat group (16).

In fact, in several studies, participants have reduced or discontinued use of insulin and other diabetes medications due to improvements in blood sugar control (9, 10, 11, 14, 15).

Diets containing 20–50 grams of carbs per day have also been shown to lower blood sugar levels and reduce the risk of disease in people with prediabetes (17).

Although concerns have been raised that higher protein intake on low carb diets may lead to kidney problems, a 12-month study found that a very low carb intake didn’t increase the risk of kidney disease (18).

Another study found that the diet might actually improve kidney function in people with type 2 diabetes and normal renal function or mild kidney disease (19).

Low carb diets

Many low carb diets restrict carbs to 50–100 grams, or about 10–20% of calories, per day.

Although there are very few studies on carb restriction in people with type 1 diabetes, those that exist have reported impressive results (20, 21, 22, 23).

One of the biggest concerns for people with type 1 diabetes is hypoglycemia, or blood sugar that drops to dangerously low levels.

In a small 12-month study from 2005, adults with type 1 diabetes who restricted their daily carb intake to fewer than 90 grams had 82% fewer episodes of low blood sugar than before they started the diet (20).

In a 2012 study in people with type 1 diabetes who restricted carbs to 70 grams per day, participants saw their HbA1c drop from 7.7% to 6.4%, on average. What’s more, their HbA1c levels remained the same 4 years later (21).

A 1.3% reduction in HbA1c is a significant change to maintain over several years, particularly in those with type 1 diabetes.

People with type 2 diabetes may also benefit from limiting their daily carb intake.

According to a research review, people who consumed no more than 26% of calories from carbs were 32% more likely to experience diabetes remission than people who mostly followed a low fat diet. A person was considered in remission if their HbA1c was under 6.5% (12).

Moderate carb diets

A more moderate carb diet may provide 130–220 grams of carbs per day, or 26–44% of calories in a 2,000-calorie diet (24).

A few studies examining such diets have reported good results in people with diabetes (25, 26).

In a 2010 study of 259 people with type 2 diabetes, those who followed a Mediterranean diet providing 35% or fewer calories from carbs experienced a significant reduction in HbA1c. Over the course of 12 months, HbA1c dropped 2.0% on average (27).

SUMMARY

Studies demonstrate that restricting carbs may benefit people with diabetes. The lower your carb intake, the greater the effect on your blood sugar levels and other health markers.

Many tasty, nutritious, low carb foods raise blood sugar levels only minimally. You can enjoy these foods in moderate to liberal amounts on low carb diets.

However, you should avoid or limit the following high carb items:

• breads, muffins, rolls, and bagels
• pasta, rice, corn, and other grains
• potatoes, sweet potatoes, yams, and taro
• milk and sweetened yogurt
• most fruit, except berries
• cakes, cookies, pies, ice cream, and other sweets
• snack foods like pretzels, chips, and popcorn
• juice, soda, sweetened iced tea, and other sugar-sweetened drinks
• beer, wine, and spirits

Keep in mind that not all of these foods are unhealthy. For example, fruits are highly nutritious, but eating large amounts isn’t optimal for anyone trying to manage their blood sugar levels by eating fewer carbs.

SUMMARY

On a low carb diet, you should avoid or limit foods and beverages like beer, bread, potatoes, fruit, and sweets.

Low carb diets have consistently been shown to lower blood sugar and improve other health markers in people with diabetes.

At the same time, certain higher carb diets have been credited with similar effects.

For example, some studies suggest that low fat vegan or vegetarian diets may lead to better blood sugar control and overall health (28, 29, 30, 31).

In a 12-week Korean study, a brown-rice-based vegan diet containing 268.4 grams of carbs per day (about 72% of calories) lowered participants’ HbA1c levels more than a standard diabetes diet with 249.1 grams of total daily carbs (about 67% of calories) (30).

An analysis of four studies found that people with type 2 diabetes who followed a low fat macrobiotic diet consisting of 70% carbs achieved significant reductions in blood sugar and other health markers (32).

The Mediterranean diet likewise improves blood sugar control and provides other health benefits in individuals with diabetes (33).

However, it’s important to note that most of these diets weren’t directly compared with low carb diets, but rather with standard low fat diets often used for diabetes management. More research on these diets is needed.

SUMMARY

Studies suggest that certain higher carb diets may aid diabetes management. Still, additional research is needed.

If you have diabetes, reducing your carb intake may be beneficial.

Multiple studies have shown that a daily carb intake of up to 44% of calories not only leads to better blood sugar control but also may promote weight loss and other health improvements.

Here’s a sample menu, which would provide about 113 grams of total carbs for the day (34):

• Breakfast: 1 slice of whole wheat toast (about 14 grams of carbs) plus an omelet made with 2 large eggs (about 1 gram) and 1 cup of nonstarchy vegetables like broccoli and greens (about 10 grams)
• Lunch: 12 ounces of lentil soup (about 33 grams) and 1 apple (about 15 grams)
• Dinner: 4 ounces of grilled chicken breast (0 grams), 1. 5 cups of nonstarchy vegetables like zucchini and okra (about 15 grams), and 4 ounces of brown rice (about 25 grams)

However, some individuals can tolerate more carbs than others.

Testing your blood sugar and paying attention to how you feel at different carb intakes can help you find your ideal range for optimal diabetes management, energy levels, and quality of life.

It might also be helpful to reach out to others for support. Our free app, T2D Healthline, connects you with real people living with type 2 diabetes. Ask diet-related questions and seek advice from others who get it. Download the app for iPhone or Android.

Proper Nutrition for Diabetes – Actions

How Food Affects Blood Glucose Levels

Carbohydrates

Carbohydrates are the only nutrients that directly increase blood sugar, but this is not a reason for their sharp restriction. Knowing which foods contain carbs, as well as the amount of carbs per serving, will make it easier to control your blood glucose levels.

Carbohydrates in the diet of any person, including those with diabetes, should be sufficient (at least 50% of total calories), as they are a source of energy for the body. But different carbohydrates have different effects on blood sugar.

There are carbohydrates that are very easy to digest (they are called easily digestible) because they consist of small molecules and are quickly absorbed in the digestive tract. They immediately and very strongly raise the level of sugar in the blood. It is from these carbohydrates that sugar, honey are composed, a lot of them are found in fruit juices, beer (it is rich in malt sugar or maltose).
Another type of carbohydrates (called hard-to-digest or starches) has a less sugar-increasing effect. Representatives of such products: bread, cereals, pasta, potatoes, corn.

Severe increases in blood sugar when starches are consumed can be prevented by certain food processing and preparation practices. Enrichment of food with plant fibers prevents an increase in blood sugar.

Proteins

Proteins are an essential part of a balanced diet. They relieve the feeling of hunger and, unlike carbohydrates, do not increase blood glucose levels. However, to prevent weight gain, control the amount of food containing proteins. In people with type 2 diabetes, protein makes insulin work faster, so don’t try to manage low blood glucose levels with protein shakes and formulas.

Fats

Fats are also an important part of a balanced diet, especially those that are most beneficial to the body, such as olive oil (however, the amount should still be moderate, because its calorie content is even slightly higher than that of butter, and gain weight it is forbidden!). According to the principles of a healthy diet, fatty foods should not exceed 30% of total calories.

Five food groups

There is an opinion that with a diagnosis of diabetes, you have to say goodbye to delicious food. This is wrong. Just because a person has been diagnosed with diabetes does not mean that he will no longer be able to enjoy delicious food and indulge in his favorite dishes. Living with diabetes means eating right and healthy foods that fall into one of five groups:

1. Grains and carbohydrates
2. Vegetables
3. Fruits
4. Milk and dairy products
5. Meat and meat substitutes

Healthy eating transition

9 0002 A dietitian or endocrinologist can help you develop a meal plan that fits your lifestyle.

Here are some tips for healthy eating:

• Healthy eating for a person with diabetes is healthy eating for the whole family.
• Eat regularly: do not skip breakfast, lunch and dinner. Let the interval between the main meals be no more than 6 hours. It is advisable to observe the principle of fractional nutrition, i.e. distribute carbohydrates in 5-6 doses per day in small portions.
• Strive to include healthy fats, lean meats or proteins, whole grains, and low-fat dairy products in your diet.
• Eat as many fiber-rich foods as possible, such as fruits, vegetables, and whole grains (dark bread, bran, wholemeal pasta, and brown rice).
• Try replacing meat with lentils, beans or tofu.
• Drink low-calorie drinks such as tea, unsweetened coffee, and water.
• Add sweeteners to your diet.

Serving size

Choose your food and quantity based on your blood glucose levels. If you eat more than your body needs, your blood glucose levels will rise. To control diabetes, you need to track what and how much you eat. It is important to be able to correctly determine the portion size. Fortunately, the tool for this is always at hand – these are the palms.

The Canadian Diabetes Association recommends the following serving size:

Measure your blood glucose before and two hours after a meal to see how meal choice and serving size affected glucose levels.

What is unacceptable in nutrition

STRONGLY NOT RECOMMENDED

• Skipping meals.
• Eat foods that are difficult to digest.
• Limit saturated fats, such as butter, coconut oil, and palm oil, as much as possible.
• Eat salty foods.
• Limit sugary foods as much as possible, such as cakes, pies, donuts, sweetened cereals, honey, jams, jellies, ice cream, and candy.
• Limit sugary drinks such as soda and fruit juices as much as possible.
• Add sugar to your food.

How to choose healthy foods

Before you go to the store:

• Make a meal plan for a certain period of time (for example, from a couple of days to a week) and include foods from the above five groups in it.
• Write a list of foods according to your meal schedule.

At the grocery store:

• Take a list with you and stick to it.
• Never go shopping when you’re hungry, as this can make you impulsively buy unhealthy foods.
• Do not buy sugary soda, candy, and chips.
• Read labels for natural ingredients.

Healthy restaurant food

Diabetes is not a reason not to go to a restaurant with family or friends. After all, even there you can control diabetes and order healthy meals.

Here are some tips to help you when you go out to a restaurant:

1. Don’t eat bread while waiting to order. Instead, have a light snack before you go to the restaurant, such as crunchy fresh vegetables, fruits or nuts.
2. Choose green foods. If the restaurant has a buffet, then take a light salad and, for example, lean meat and do not mix many different dishes in one plate.
3. Dress the salad the right way. Place the salad dressing on the edge of your plate so you can eat just the right amount. Opt for a low-fat dressing with vinegar.
4. Ask for food substitutions if they don’t suit you. Choose steamed, boiled, or baked foods over sautéed or fried ingredients, and steamed salads or vegetables over heavy side dishes like french fries.
5. Watch your portion sizes. Order an appetizer-sized dish or have your portion cut in half. If the portion is too large, you can ask to wrap half with you.
6. Choose fruit. If possible, have fruit for dessert and avoid heavy, high-calorie, sugar-rich desserts.
7. Eat before 8 pm and leave yourself some time to walk before bed.

The information is advisory in nature and should not be taken as advice from a healthcare professional or replace it. Before you follow this or that recommendation, it is necessary to consult your doctor.

Fundamentals of rational nutrition for type 2 diabetes and overweight

Unfortunately, there is no “golden pill” for type 2 diabetes that can fully compensate for the effects of poor diet on blood glucose levels. Proper nutrition is an essential part of effective type 2 diabetes management to help you reach your blood glucose targets.
The vast majority of overweight patients with type 2 diabetes. Being overweight prevents your own insulin from working effectively, causing blood glucose levels to remain high. Therefore, weight loss is an indispensable condition for rational treatment. Even moderate weight loss (by 5-10%) improves carbohydrate metabolism, especially in the early period of the disease.

How to achieve weight loss?

The only effective way to lose weight is to limit energy intake (low-calorie diet) and/or increase its expenditure (exercise). The resulting energy deficit leads to the fact that the energy reserves, “canned” in adipose tissue, will be spent on various needs of the body, and weight will decrease.

Proteins, fats and carbohydrates foods are direct energy carriers. The most high-calorie of them are fats, they contain 9kcal in 1 gram; in proteins and carbohydrates – 4 kcal per 1 gram.

The most effective way to reduce the calorie content of a diet is to reduce the content of fats and easily digestible carbohydrates in it. At the same time, you can expand your diet at the expense of protein, dairy products, foods rich in fiber.

There are three groups of products that need to be consumed in different ways in order to reduce weight. Looking at these groups, you will definitely have an association with a traffic light.

Limit as much as possible

Large amounts of butter, lard, bacon, fatty meats, fatty dairy products, cheeses over 30% fat, poultry skin, mayonnaise; oily fish, sausages, canned food in oil, offal, white flour products, chocolate, sugar and sweets, honey, jam, soda, fruit juices.

Moderately limit (eat half your usual portion)

Pasta, cereals, potatoes, legumes, bread, low-fat meats and fish, dairy products less than 4% fat, low-fat cheeses, fruits (except grapes, dates, persimmons, bananas), berries, dried fruits.

Use without restriction

Mushrooms, turnips, radishes, beets, carrots, mushrooms, cucumbers, tomatoes, peppers, marrows, eggplants, green beans and peas, lettuce, greens, spinach, sorrel, cabbage; tea, coffee without sugar and cream, mineral water.

How do different carbohydrates affect blood glucose levels?

There are simple or fast digesting carbohydrates which are very easy to digest because they are small molecules and are quickly absorbed in the digestive tract. They immediately and very strongly increase the level of glucose in the blood (sugar, honey, fruit juices, etc.).

Another type of carbohydrates – slowly digestible (starches), they also increase blood glucose levels, but not as quickly and not as much as simple carbohydrates (bread, cereals, pasta, potatoes, etc.).

There are “indigestible” carbohydrates – a group of dietary fibers, the main representative of which is fiber. After their use, the level of glucose in the blood does not rise or rises slightly. These products include almost all types of vegetables (except potatoes). For example: cabbage, lettuce, parsley, dill, radish, turnip, zucchini, eggplant, pepper, etc.

Any grinding, prolonged thermal exposure to starchy foods (slowly digestible carbohydrates) contributes to a rise in blood glucose levels. This means that a strong increase in blood glucose when eating starches can be prevented by using certain methods of processing and cooking. For example, it is more correct to cook potatoes not in the form of mashed potatoes, but to boil them whole in their skins, so that they remain dense. It is also better not to cook porridge for too long.

Enrichment of food with plant fibers prevents an increase in blood glucose levels. Therefore, it is better to use fruits and berries in their natural form, and not in the form of juices and compotes.

Do I need to count carbohydrates?

A patient with type 2 diabetes who is on oral antidiabetic drugs or is on a diet alone does not need to accurately calculate the amount of carbohydrates in food. Many people with diabetes have heard of the so-called bread units. A system of such calculation exists for those who receive insulin. It allows you to correlate the amount of carbohydrates consumed with the doses of short-acting insulin that these people with diabetes inject before meals.

Special “diabetic” foods

Sweeteners can make food taste sweeter without raising blood glucose or gaining weight. But in this case we are talking only about non-caloric sugar substitutes. These include aspartame, saccharin, cyclamate, acesulfame potassium, sucralose, stevioside. They do not affect blood glucose levels and weight at all. However, most “diabetic” foods (cookies, chocolate, waffles) instead of sugar contain sorbitol, xylitol or fructose, which are almost as high in calories as sugar. Therefore, when overweight, they must be limited as much as possible, like regular sweets.

Fractional diet

For overweight people with diabetes, the choice of diet will be in favor of three meals a day. “Food” are any snacks. Everything that is not water is food. But the selection of a diet is always individual, taking into account the nutritional characteristics of a person and concomitant diseases.

Alcohol

Due to its high calorie content (7 kcal per 1 g), alcohol can contribute to weight gain. The only way to reduce the risk of the negative effects of alcohol on the body is to completely stop drinking it.