How many carbs should you consume daily with type 2 diabetes. What are the best strategies for carb counting. Which foods are recommended for a diabetes-friendly diet. How can you maintain healthy blood sugar levels through proper carb management.

Understanding Carbohydrates and Their Impact on Blood Sugar

Carbohydrates play a crucial role in managing type 2 diabetes. When consumed, they break down into glucose, directly affecting blood sugar levels. For individuals with type 2 diabetes, who may be insulin resistant or have insufficient insulin production, this process can lead to elevated blood glucose levels if not properly managed.

There are three main types of carbohydrates:

• Sugars: Including natural sugars in fruits and milk, as well as added sugars in processed foods
• Starches: Found in vegetables like potatoes and grains like wheat
• Fiber: A non-digestible carbohydrate with high nutritional value

Understanding these distinctions is crucial for effective diabetes management. Simple carbs, like table sugar, are rapidly broken down and can cause quick blood sugar spikes. Complex carbs, on the other hand, take longer to digest and provide a more sustained energy release.

The Glycemic Index: A Valuable Tool for Carb Management

The glycemic index (GI) is a scale that ranks carbohydrates based on how quickly they raise blood glucose levels. Foods with a high GI are rapidly digested and can cause sharp increases in blood sugar, while low GI foods are digested more slowly, resulting in a gradual rise in blood glucose.

For individuals with type 2 diabetes, focusing on low GI foods can help maintain more stable blood sugar levels throughout the day. Some examples of low GI foods include:

• Most vegetables (except potatoes)
• Whole grains like quinoa and barley
• Legumes such as lentils and chickpeas
• Most fruits, especially berries and citrus fruits

The Art of Carb Counting for Type 2 Diabetes

Carb counting is an essential skill for managing type 2 diabetes effectively. By tracking the number of carbohydrates consumed, individuals can better predict and control their blood sugar levels. Here’s how to get started:

1. Read nutrition labels carefully, paying attention to serving sizes and total carbohydrate content
2. Use a food diary or smartphone app to log carbohydrate intake
3. Learn to estimate carb content in foods without labels using reliable sources like the USDA’s FoodData Central database
4. Consider working with a registered dietitian to develop a personalized carb counting plan

Is carb counting always necessary? While it’s an effective tool, some individuals may find success with other methods, such as the plate method or simply choosing low GI foods. The key is to find an approach that works for your lifestyle and helps you maintain stable blood sugar levels.

Determining Your Optimal Daily Carb Intake

There’s no one-size-fits-all answer to how many carbs a person with type 2 diabetes should consume daily. The ideal amount varies based on factors such as age, weight, activity level, and individual insulin sensitivity. However, general guidelines can provide a starting point for meal planning.

The American Diabetes Association suggests that carbohydrates should make up about 45-60% of total daily calories for most people with diabetes. For a 2,000-calorie diet, this translates to 225-300 grams of carbohydrates per day. However, some individuals may benefit from a lower carb intake, especially if they’re trying to lose weight or have difficulty controlling their blood sugar levels.

Tailoring Your Carb Intake: A Personalized Approach

To find your optimal carb intake, consider the following steps:

1. Consult with your healthcare provider or a registered dietitian
2. Start with a baseline carb intake and monitor your blood glucose levels closely
3. Adjust your carb intake based on your blood sugar readings and how you feel
4. Consider factors like physical activity and medication when planning meals

Can you eat too few carbs with type 2 diabetes? While low-carb diets can be effective for some individuals, it’s important not to eliminate carbs entirely. Carbohydrates are an important source of energy and nutrients. Extremely low-carb diets may lead to nutrient deficiencies and can be difficult to maintain long-term.

Crafting a Diabetes-Friendly Diet: Foods to Embrace and Avoid

Managing type 2 diabetes through diet involves more than just counting carbs. It’s about making smart food choices that support overall health and help maintain stable blood sugar levels. Here’s a guide to foods that can be beneficial or detrimental to your diabetes management:

Foods to Embrace

• Non-starchy vegetables: Leafy greens, broccoli, cauliflower, peppers
• Whole grains: Quinoa, brown rice, whole wheat bread (in moderation)
• Lean proteins: Chicken, fish, tofu, eggs
• Healthy fats: Avocado, olive oil, nuts, seeds
• Low-fat dairy: Greek yogurt, cottage cheese
• Legumes: Lentils, chickpeas, black beans

Foods to Limit or Avoid

• Refined carbohydrates: White bread, pastries, sugary cereals
• Sugary drinks: Soda, fruit juices, sweetened tea
• Processed meats: Bacon, sausages, deli meats
• Trans fats: Found in some fried and packaged foods
• Alcohol: Can interfere with blood sugar management

How can you incorporate these guidelines into your daily meals? Start by planning your meals around non-starchy vegetables and lean proteins. Add small portions of whole grains or legumes for complex carbohydrates. Include healthy fats to help you feel satisfied and support overall health.

The Role of Fiber in Diabetes Management

Fiber is a type of carbohydrate that deserves special attention in a diabetes-friendly diet. Unlike other carbs, fiber isn’t digested by the body and doesn’t raise blood sugar levels. In fact, it can help slow the absorption of other carbohydrates, leading to more stable blood glucose levels.

There are two types of fiber:

• Soluble fiber: Dissolves in water and can help lower cholesterol and blood sugar levels
• Insoluble fiber: Adds bulk to stool and helps maintain digestive health

Both types of fiber are beneficial for individuals with type 2 diabetes. The American Diabetes Association recommends aiming for 25-30 grams of fiber per day from whole food sources.

High-Fiber Foods to Include in Your Diet

• Vegetables: Broccoli, Brussels sprouts, carrots
• Fruits: Apples, pears, berries (with skin)
• Legumes: Lentils, black beans, chickpeas
• Whole grains: Oats, quinoa, brown rice
• Nuts and seeds: Almonds, chia seeds, flaxseeds

How can you increase your fiber intake without overloading on carbs? Focus on non-starchy vegetables, which are high in fiber but low in digestible carbohydrates. When choosing grains and fruits, opt for whole, unprocessed versions that retain their natural fiber content.

The Impact of Physical Activity on Carb Management

Physical activity plays a crucial role in managing type 2 diabetes and can significantly influence how your body processes carbohydrates. Regular exercise can improve insulin sensitivity, allowing your cells to use glucose more effectively and potentially reducing the amount of insulin you need.

Benefits of exercise for individuals with type 2 diabetes include:

• Improved blood sugar control
• Enhanced cardiovascular health
• Weight management
• Reduced risk of diabetes-related complications

The American Diabetes Association recommends at least 150 minutes of moderate-intensity aerobic activity per week, spread over at least three days. This can include activities like brisk walking, swimming, or cycling.

Adjusting Carb Intake for Exercise

When incorporating regular exercise into your routine, you may need to adjust your carbohydrate intake. Physical activity can lower blood sugar levels, so you might need to consume additional carbs before, during, or after exercise to prevent hypoglycemia.

How should you manage carbs around exercise? Consider these tips:

1. Monitor your blood sugar before, during, and after exercise
2. Have a small snack containing 15-30 grams of carbs before exercise if your blood sugar is below 100 mg/dL
3. For longer or more intense workouts, you may need to consume carbs during the activity
4. Always carry a fast-acting carbohydrate source (like glucose tablets) in case of low blood sugar

Remember, everyone’s needs are different, so work with your healthcare team to develop an exercise plan that’s safe and effective for you.

Advanced Carb Management Techniques

As you become more comfortable with basic carb counting and management, you may want to explore more advanced techniques to fine-tune your diabetes control. These strategies can help you achieve even better blood sugar management and overall health outcomes.

Carb Cycling

Carb cycling involves alternating between higher and lower carb intake days. This approach can help improve insulin sensitivity and may be particularly beneficial for individuals who are also focusing on weight loss or athletic performance.

A typical carb cycling plan might look like this:

• Low-carb days: 50-100 grams of carbs
• Moderate-carb days: 100-150 grams of carbs
• High-carb days: 150-200 grams of carbs

Is carb cycling right for everyone with type 2 diabetes? Not necessarily. This approach requires careful planning and monitoring and should only be attempted under the guidance of a healthcare professional.

The Glycemic Load Approach

While the glycemic index (GI) is useful, it doesn’t take into account the quantity of carbs in a serving. The glycemic load (GL) combines both the quality and quantity of carbohydrates, providing a more comprehensive picture of a food’s impact on blood sugar.

To calculate the glycemic load:

1. Multiply the GI by the amount of carbohydrate in grams
2. Divide by 100

A GL of 10 or below is considered low, 11-19 is medium, and 20 or above is high. Focusing on low GL foods can help provide more stable blood sugar levels throughout the day.

Protein and Fat Pairing

Combining carbohydrates with proteins and healthy fats can slow down the absorption of glucose into the bloodstream, leading to more gradual rises in blood sugar. This strategy can be particularly helpful for managing post-meal blood sugar spikes.

Examples of balanced snacks or meals include:

• Apple slices with almond butter
• Whole grain crackers with cheese and vegetables
• Grilled chicken with quinoa and roasted vegetables

How can you implement this strategy? Try to include a source of lean protein and healthy fat with each meal or snack that contains carbohydrates.

Monitoring and Adjusting Your Carb Management Plan

Effective diabetes management is an ongoing process that requires regular monitoring and adjustment. As your body, lifestyle, and health status change over time, so too may your carbohydrate needs. Here are some strategies to help you stay on track:

Regular Blood Glucose Monitoring

Frequent blood glucose checks are essential for understanding how different foods and activities affect your blood sugar levels. Consider keeping a log that includes:

• Blood glucose readings
• Carbohydrate intake
• Physical activity
• Medication doses
• Stress levels

This information can help you and your healthcare team identify patterns and make necessary adjustments to your management plan.

A1C Testing

The A1C test provides a picture of your average blood sugar levels over the past 2-3 months. Regular A1C testing (typically every 3-6 months) can help assess the effectiveness of your current management strategy.

What’s a good A1C target for type 2 diabetes? The American Diabetes Association generally recommends an A1C below 7% for most adults with diabetes, but your personal target may differ based on individual factors.

Regular Check-ins with Your Healthcare Team

Schedule regular appointments with your diabetes care team, including your primary care physician, endocrinologist, and registered dietitian. These professionals can help you interpret your blood glucose data, adjust your management plan as needed, and address any concerns or questions you may have.

Continuous Glucose Monitoring (CGM)

For some individuals, continuous glucose monitoring devices can provide valuable insights into blood sugar patterns. These devices measure glucose levels in real-time throughout the day and night, allowing for more precise carb management and insulin dosing.

Is CGM right for everyone with type 2 diabetes? While not necessary for all individuals, CGM can be particularly helpful for those who have difficulty controlling their blood sugar or who are on intensive insulin therapy.

Remember, managing type 2 diabetes is a journey, not a destination. By staying informed, monitoring your progress, and working closely with your healthcare team, you can develop a carb management strategy that helps you maintain optimal health and well-being.

Carb Counting With Type 2 Diabetes

Content

• Overview
• Understanding how carbs affect type 2 diabetes
• How do I count carbs for type 2 diabetes?
• How many carbs should I eat in a day if I have type 2 diabetes?
• Foods to eat and avoid
• The lowdown

More than 9%¹ of people in the US have type 2 diabetes. The condition is characterized by high blood sugar caused when your body doesn’t produce or use insulin correctly.

If left untreated, type 2 diabetes can lead to serious health problems like kidney and heart disease, vision loss, and an increased risk of stroke. Most people can manage the harmful effects of type 2 diabetes through diet and exercise. In some cases, they may also need medication to help keep their blood sugar levels in a healthy range.

If you have type 2 diabetes, carb counting can help you maintain healthy blood sugar levels. Doing so can help prevent or delay the development of complications. Learn more about how carbs affect your blood sugar levels, how to count them, and the best foods to add to a diabetes-friendly diet.

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The carbs you eat significantly impact your blood sugar levels. When you ingest carbohydrates, your body breaks them down into glucose (sugar). Glucose then enters your bloodstream, which raises your blood glucose levels.

In a non-diabetic person, insulin helps move glucose out of the bloodstream into the cells, where it’s used for energy.

When you have type 2 diabetes, you may be insulin resistant or unable to produce it sufficiently to remove glucose from your bloodstream. This keeps your blood sugar levels elevated, which can lead to serious health complications.

Limiting your carb intake can be helpful. By monitoring how many carbs you consume, you can avoid blood sugar spikes which put extra demand on your insulin supply. You may also be able to control your blood sugar levels and keep them in a healthy range more effectively.

Tracking carbs can also help you monitor how your diet impacts the effect of oral diabetes medications or insulin injections.

Carbohydrates can be simple or complex. Your body breaks down simple carbs like table sugar and baked goods quickly, which leads to blood sugar spikes.

Complex carbs take longer for your body to break down and help you feel fuller for longer. You should stick to complex carbs as much as possible.

There are three types of carbohydrates:

Sugar

These include natural sugars found in foods like milk and fruit, and added sugars found in processed foods and baked goods. Sugars can quickly raise blood glucose levels, and processed sugar should be consumed in strict moderation.

Starches

There are two types of starch carbohydrates based on their structure: amylose and amylopectin.

You’ll find starches in certain vegetables, such as potatoes, corn, and peas. You’ll also find starches in grains like wheat.

While you should eat plenty of vegetables and whole grains as part of a well-balanced diet, foods high in starches can also cause spikes in blood sugar, especially amylopectin. You should only eat these foods in moderation.

Fiber

Fiber is a type of carbohydrate your body doesn’t digest, but it still has high nutritional value. Fiber helps you feel full for longer, which may help you make healthier food choices and avoid too much snacking.

Foods high in fiber include beans, broccoli, avocados, and apples. Like starch, it can also be classified into two types: soluble and insoluble.

To count carbs, you should track how many grams of carbohydrates are in the foods you eat. You can do this for most foods by reading the product’s nutrition facts label. The label will list the total number of carbohydrate grams per serving, including all three carb types.

You should pay attention to your serving size when calculating how many grams of carbs you consume. For example, you will need to make an adjustment if the serving size for your favorite cereal is one cup on the nutrition label, but you eat a cup and a half.

If you are eating something that doesn’t have a nutrition label, such as an apple or whole grains, you can use the USDA’s FoodData Central database to look up the nutritional information.

The easiest way to track your carbs is to keep a food diary. You can do this in a notebook or by using an app on your smartphone.

There is no fixed formula to determine how many carbs you should eat each day with type 2 diabetes. The amount differs from person to person and depends on several factors, including your activity level, your weight, and how your body responds to insulin.

Finding the right balance is important. Eating too many carbs can cause a blood sugar spike, while eating too few could cause your blood sugar to drop — a condition called hypoglycemia.

Tracking your blood sugar levels before and after meals can help your doctor determine the amount of carbs you should eat.

Some common recommendations include: 

• Moderate carb diets, where 26–44% of your daily calorie intake comes from carbs

• Low-carb diets, where less than 26% of your daily calorie intake come from carbs

• Very low-carb or ketogenic diet, where less than 10% of your daily calorie intake comes from carbs

Health professionals usually recommend a low-carb diet to help manage type 2 diabetes. Low-carb diets have been shown to improve blood sugar control and decrease the need for medication. Some people who stick to a low-carb diet experience diabetes remission.

Depending on your doctor’s advice, you can determine the amount of carbs to eat each day based on how many calories you typically consume.

For example, if you usually eat around 2,000 calories a day and your doctor recommends sticking to a low-carb diet, fewer than 520 calories a day should come from carbs. One gram of carbs contains four calories, so you can consume 130 grams of carbs per day.

You should consume a healthy, well-balanced diet focused on whole foods.

Your diet should include:

• Lean meats (including fish, chicken, turkey, and some pork cuts)

• Complex carbohydrates (vegetables and beans)

• Whole grains (found in brown rice, oatmeal, and popcorn)

Try to avoid processed foods like baked goods, crackers, pasta, chips, soda, and alcoholic beverages, as these often contain added sugar. Use the nutrition label to find out if there is added sugar.

If you are struggling to control your blood sugar levels by making changes to your diet, or if you feel you need additional support in managing your type 2 diabetes, ask your doctor to refer you to a dietician.

Type 2 diabetes is a health condition characterized by high blood sugar levels. It can lead to serious complications if left untreated.

One of the best ways to manage type 2 diabetes is by making dietary changes, including limiting the amount of carbohydrates you consume each day. Your body breaks down carbs and turns them into glucose which raises your blood sugar levels.

Following a low-carb diet is usually recommended to people with type 2 diabetes, where carb consumption is limited to 26% of your daily calorie intake. This means consuming less than 130 grams of carbs per day if you typically eat 2,000 calories. 

Try to eat complex carbs which take longer to break down, versus simple carbs like those found in table sugar and baked goods. Eating a well-balanced, nutritious diet rich in lean meats, whole grains, fruits, and vegetables is a good place to start.

If you are struggling to manage your blood sugar through dietary changes or want additional support, working with a registered dietician may help.

How Many Carbs Should a Person with Diabetes Have?

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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.

Basic principles of nutrition in type 2 diabetes mellitus

The question of how to eat properly in diabetes worries most patients. What is a balanced diet?

Rational nutrition (from lat. Rationalis – reasonable) is a physiologically complete nutrition, taking into account the nature of work, physical activity, age, contributing to maintaining health, high physical and mental performance, as well as active longevity. Rational nutrition is one of the factors that strengthen the immune system.

At the same time, it is important to understand not following a “diet” for some time, but changing the diet and principles of nutrition on an ongoing basis, i.e. the patient must understand that the recommended principle of nutrition, in the presence of a number of restrictions, will allow him to lead an active life . For this, it is necessary to observe the principles of balance – the ratio of proteins, fats and carbohydrates. Approximately 55-60% of daily calories should be carbohydrates, 15-20% proteins and up to 20-5% fats.

The vast majority of overweight people with type 2 diabetes. Excess weight prevents its own insulin from acting effectively, which is why blood glucose levels 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?

It should be noted right away that there are no specific products or medicinal plants for weight loss. Currently, there are no medications that by themselves, without dieting, could provide highly effective and completely safe weight loss.
The only reliable way is to limit the intake of energy into the body, i.e. compliance with regulations low-calorie nutrition . The resulting energy deficit leads to the fact that the energy reserves “conserved” in adipose tissue will be spent on various needs of the body, and the weight will definitely decrease.

Principles of rational nutrition in type 2 diabetes:

1) Reducing the amount of carbohydrates in the diet

Carbohydrates increase blood sugar, but they must be consumed because the body needs them (they are the main source of energy).

Carbohydrates are divided into simple and complex.

It is clear that with type 2 diabetes, it is necessary to exclude or limit as much as possible the use of simple or easily digestible carbohydrates (sugar, honey, preserves and jams, sweets, muffins, sweet fruits and berries: grapes, bananas, raisins, dates). The diet should contain mainly products containing complex carbohydrates (cereals, bread, vegetables)

Carbohydrates are found in the following products:

• Bread and all flour products (dryers, crackers, pasta, etc.)
• Potato. Less than potatoes, but still quite a lot of carbohydrates contain corn, beans, ripe (yellow) peas, lentils.
• Cereals, including buckwheat.
• Fruit, even sour. However, the more ripe the fruit, the more sugar it contains. Dried fruits have a very high concentration of sugar in a small volume, because. they are deprived of water.
• Liquid dairy products (milk, kefir, yogurt, fermented baked milk). There are no carbohydrates in cottage cheese and cheese, they consist of protein and fat.
• Sugar, honey and any sugar-based confectionery (not recommended!).

How can the sugar-increasing effect of carbohydrates be reduced?

To achieve this, the products should be processed as little as possible both mechanically and thermally.

Sweeteners:

Caloric: fructose, xylitol, sorbitol.

These substitutes have a similar calorie content to regular sugar and are therefore not suitable for overweight individuals.

Non-caloric : aspartame, saccharin, acesulfame K.

Suitable for all persons with diabetes.

2) Limitation of fat intake0037 . Therefore, limiting the intake of fatty foods in diabetes is no less important than limiting carbohydrates.

It is also necessary to significantly limit, and it is better not to use fried, spicy, salty, spicy and smoked dishes, canned food, hot peppers, mustard, alcoholic beverages at all. Foods that contain a lot of fats and carbohydrates at the same time are completely unacceptable for people with diabetes: chocolate, ice cream, cream cakes and cakes.

Foods that can be consumed without restriction:

• cabbage (all types)
• cucumbers
• leaf lettuce
• greenery
• tomatoes
• bell pepper
• zucchini
• eggplant
• beets
• carrots
• green beans
• radish, radish, turnip
• green peas (young)
• spinach, sorrel
• mushrooms
• tea, coffee without sugar and cream
• mineral water
• sweetener drinks

Note:

• Vegetables can be consumed raw, boiled, baked.
• The use of fats (butter, mayonnaise, sour cream) in the preparation of vegetable dishes should be minimal.

Foods to be eaten in moderation

• lean meats
• lean fish
• milk and dairy products (nonfat)
• cheeses (less than 30% fat)
• cottage cheese (less than 5% fat)
• potatoes
• corn
• mature legumes (peas, beans, lentils)
• cereals
• pasta
• Bread and bakery products (not rich)
• fruit
• eggs

Note:

• Moderate means half your usual serving.

Foods to be avoided or limited as much as possible

• butter
• vegetable oil*
• fat
• sour cream, cream
• cheeses (more than 30% fat)
• cottage cheese (more than 5% fat)
• mayonnaise
• fatty meat, smoked products
• sausages
• oily fish
• bird skin
• meat, fish and vegetable preserves in oil
• nuts, seeds
• sugar, honey
• jams, jams
• candy, chocolate
• pastries, cakes and other confectionery
• biscuits, pastry products
• ice cream
• sweet drinks (Coca-Cola, Fanta)
• alcoholic beverages

* vegetable oil is a necessary part of the daily diet, but not more than 1-2 tbsp. spoons per day

Note:

• Frying should be avoided if possible.
• Try to use cookware that allows you to cook food without adding fat.

3) Proper diet:

Eating up to 5-6 times a day – eating less often can lead to the inclusion of the so-called. a “saving mode” in which the body is deficient in essential nutrients and tries to reserve free calories, so all the free (extra) calories received from a heavy meal inevitably turn into fat. And also rare food, as a rule, leads to night overeating, which negatively affects body weight.

4) Eat slowly, chewing food thoroughly

5) Most of the food should be consumed before dinner.

Do not overeat at night.

The last meal should be taken no later than 1.5-2 hours before bedtime. Moreover, it should be 5-10% of the daily calorie intake.

4) Eat enough fiber (20-30 g/day).

It is necessary to include foods containing a large amount of it in the diet. The first place is occupied by bran and powdered fiber, which can be added to cereals, soups, salads. It is also important to use whole grain bread, vegetables, nuts, berries, a large amount of fiber is found in the peel and seeds of plant foods.

5) At least 1.5 liters of fluid per day (unless contraindicated)

6) Salt restriction (The World Health Organization recommends reducing your salt intake to 5 grams per day (one teaspoon)!

7) Reducing alcohol consumption .

Due to its high calorie content (7 kcal per 1 g), alcohol can contribute to weight gain. In addition, it directly worsens the indicators of fat metabolism and blood pressure. So limit your alcohol intake as much as possible.
Alcohol is known to have adverse effects on the liver. It can cause hypoglycemia if a person with diabetes is on glucose-lowering drugs and insulin. Never drink alcohol on an empty stomach!

The use of any drug in type 2 diabetes still cannot fully compensate for the impact of malnutrition on blood glucose levels. Thus, a balanced diet is an essential component of effective type 2 diabetes management, which will help to achieve blood glucose targets.

Endocrinologist of ME “Brest City Hospital No. 2”

Arabey Olga Vladimirovna.

About the link between carbohydrates and diabetes

Carbohydrates have a difficult reputation. They are called the culprits of extra pounds, the enemies of a healthy diet, and even advised to cross them out of the diet once and for all. But is everything clear? And how do carbohydrates affect blood sugar? Today we dot all the “i”.

How carbohydrates are related to sugars

When you eat carbohydrates, your body breaks them down into glucose units, which are absorbed into the bloodstream. When blood sugar levels rise, the pancreas releases the hormone insulin. It helps glucose get into your body cells.

In people without diabetes, sugar levels remain within the normal range throughout the day. It is much more difficult for people with diabetes to keep it normal. And this is necessary to do, because too high or low levels of glucose can greatly harm the body. ¹

Of all macronutrients: proteins, fats, and carbohydrates, the latter have the greatest impact on sugar levels. This is why people with diabetes may need large doses of insulin or medication if they eat a lot of carbohydrates. ¹

If I eat little carbohydrates, will my sugars be normal?

Scientists say yes. Research shows that a low-carb diet reduces or even eliminates the need for medication and significantly lowers sugar levels. In addition, the researchers insist that, unlike drugs, such a diet does not have side effects. ²

^{A carbohydrate-restricted diet works well in the long run. In one study, people with type 2 diabetes followed a low-carbohydrate diet for six months. During this period, they both lost weight and reached stable sugar levels. 3 Moreover, two subjects who followed this diet for three and two years, respectively, lost 20 kg and got rid of all signs of diabetes. 3}

People with type 1 diabetes also benefit from reducing carbohydrate intake. For one study, people with type 1 diabetes followed a low-carbohydrate diet for four years. During this time, every second participant achieved a significant long-term decrease in HbA1c levels. ³

Prior to the invention of insulin in 1921, a very low carbohydrate diet was the primary treatment for diabetes. ⁴

Part of the carbohydrates was removed. How are the rest?

If you have type 1 diabetes, it depends on how you use your insulin.

If you are using a fixed amount twice a day, it is best to eat the same portion of each carbohydrate at the same time. It is important to determine the right amount of carbohydrates for you and follow these norms. Too many carbohydrates can cause high blood sugar levels, and not enough can cause hypoglycemia.

If you’re on a basal bolus, your carbohydrate regimen will be a little more flexible. Most people on this therapy count the amount of carbohydrates they will eat or drink and then calculate how much insulin they need to inject. Also, when calculating, other factors should be taken into account: physical activity, previous episodes of hypoglycemia, any infections. ⁵

How to determine the correct dose of insulin in correlation with your diet – in the article “Bread units”

For people with diabetes, restricting carbohydrates will reduce the number of calories they consume. And calorie restriction will help you lose weight.

Remember that a low-carbohydrate diet stabilizes HbA1c, cholesterol, and blood pressure levels and reduces your need for medication. ⁵

How do I know how much carbohydrate I can eat?

The American Diabetes Association (ADA) says there is no one diet that works for everyone. The ADA recommends that you consult with your nutritionist and develop a personalized menu.

To determine the ideal amount of carbohydrates for your body, you can measure your blood sugar levels before meals and 1-2 hours after meals. As long as your glucose stays below 140 mg/dL (or 8 mmol/L), you can eat 6, 10, or 25 grams of carbs at a time. ¹

Foods to Avoid

Be careful with foods that increase blood sugar levels.

Read more about “dangerous foods” in the resource Type 1 Diabetes Diet.

What Foods to Eat

Those who are low in carbohydrates. Eat, but consider calories and fat:

• meat, poultry, seafood;
• eggs;
• cheese;
• most vegetables;
• avocado;
• olives;
• olive, linseed and coconut oil;
• butter, cream, sour cream, cream cheese ¹

Which foods should be limited

(Of course, we are not talking about fast food, cakes and croissants here!)

• Berries – no more than one cup.