Are you in this situation? You, a loved one or good friend, has prediabetes or type 2 diabetes. You’re constantly searching for answers to the all-important question: what and how much to eat. But you’re left scratching your head about whether following a low carb diet is a must. Let’s sort it out with science and current recommendations from the American Diabetes Association (ADA).
Low Carb Diet Logic
Once you learn about how foods or beverages that contain carbohydrate raise blood glucose levels, it likely seems very logical to strictly limit the amount of carbohydrate you eat. However, and this is very important, resulting blood glucose levels do not solely depend on or can be controlled by the amount of carbohydrate you eat. To control glucose levels you must have a sufficient supply of available insulin (whether made by your pancreas or taken as the medication insulin) at the ready to help control your blood glucose levels after you eat.1
No One Amount of Carbohydrate Is Right For Everyone…Individualize
While there’s lots of noise touting low carb diets for people with prediabetes or type 2 diabetes, the research evidence doesn’t make this a slam, dunk conclusion. In fact, according to the ADA “studies examining the ideal amount of carbohydrate for people with diabetes are inconclusive.”1,2 The amount of carbohydrate one eats should be individualized based on a person’s current eating pattern, food preferences and metabolic goals – or the blood glucose, lipid and blood pressure targets that you and your healthcare provider agree upon for you.2 The total amount of carbohydrate you consume should also help you get to a healthy weight. To stay at a healthy weight, lose weight, or keep lost pounds off a person can’t regularly exceed his or her total daily calorie tally. If you are overweight, losing even 5-10% of your weight can help you more easily meet your blood glucose, lipid and blood pressure goals and decrease some of the health risks associated with diabetes.
Prioritize Carbohydrate Quality over Quantity
People can achieve diabetes control and weight loss (if needed) when consuming a wide range of carbohydrate within their daily calorie tally. Focus on quality first, quantity second. According to the ADA, people with diabetes, “should be encouraged to replace refined carbohydrates and added sugars with whole grains, legumes, vegetables, and fruits. The consumption of sugar-sweetened beverages and processed ‘low-fat’ or ‘nonfat’ food products with high amounts of refined grains and added sugars should be strongly discouraged.”2 This guidance aligns with the guidance for all Americans. When it comes to carbohydrate-containing foods, to get the fibers, vitamins, and minerals you need for good health, you need a sufficient amount of carbohydrate from healthy sources – in the range of 45 to 65 percent of total calories.3
Curious about how these numbers translate into grams of carbohydrate to eat per day? Check out this table. Based on three different calorie levels, it gives you a sense of the grams of carbohydrate that add up to 45, 55 or 65 percent of calories as carbohydrate. If you’re not sure about what calorie level is right for you, check with one of your diabetes healthcare providers.
Conversion Chart -- Percent of Calories as Carbohydrates per Day:
|Percent of Calories as Carbohydrate||1200 calories/day||1500 calories/day||2000 calories/day|
|45%||135 grams||170 grams||225 grams|
|55%||165 grams||205 grams||275 grams|
|65%||195 grams||245 grams||325 grams|
A person who eats about 45 percent of calories as carbohydrate would, depending on the number of calories they eat, likely need to limit the amount of fruit, bread, pasta, rice, potatoes and other starchy or high-sugar (high-carbohydrate) foods and/or beverages, and likely eat more foods lower in total carbohydrate such as cheese, non-starchy vegetables, and high-protein foods like meat or nuts, to get enough calories. A person who eats about 65 percent of calories as carbohydrate would, depending on the number of calories they eat, eat mainly vegetables, and other carbohydrate-containing foods (see below) and small amounts of protein foods.
Monitor Your Glucose, Manage Your Carb Count
On an ongoing basis, ADA recommends that people monitor the amount of carbohydrate they eat and consider how their blood glucose responds to that amount of carbohydrate, particularly an hour or two after eating.2 Ask your diabetes healthcare providers what your blood glucose, A1c, lipid and blood pressure goals should be. Use these as your bull’s eye. Then focus on healthy eating and glucose control jointly. It’s important to not over-restrict the amount of carbohydrate you eat as a means to stay off of glucose lowering medications.
Reality is, according to ADA, most people with type 2 diabetes at the point of diagnosis will need to start to take a blood glucose lowering medication.4 For many people, this can be a type of medication that can increase your body’s sensitivity to the insulin your body makes and help you control your blood glucose levels. It’s now well known that prediabetes and type 2 diabetes are progressive and advance, for most people, over the years along a continuum that includes a dwindling supply of the hormone insulin.4 To get and stay healthy with diabetes over the years and prevent or delay diabetes complications, what’s most important is to keep blood glucose, blood pressure and blood lipids under control.
The Bottom Line on Your Carb Count
What’s most critical over the years is that people with prediabetes and type 2 diabetes find a healthy eating plan and amount of carbohydrate, whether lower or higher, that they can adhere to day in, day out and over the years. In the end this isn’t just about being able to survive a low carb diet for a month or two. Having and managing diabetes is for the rest of one’s life.
For more reading on the topics of carbohydrates and low carb diets for diabetes, read:
- Should Everyone with Diabetes Follow a Low Carb Diet?
- Good Carbs vs. Bad Carbs (Are There Really “Bad” Carbs?)
- Diabetes: Healthy Eating Plans & Tips
I have been compensated for my time by Heartland Food Products Group, the maker of SPLENDA® Sweetener Products. All statements and opinions are my own. I have pledged to Blog with Integrity, asserting that the trust of my readers and the blogging community is vitally important to me.
For more information about planning a healthy diet, visit the Diabetes Management section of this blog.
Hope Warshaw, MMSc, RD, CDE, BC-ADM, is a nationally recognized dietitian and diabetes educator who applies more than 35 years of expertise as an author, freelance writer, media spokesperson, consultant and diabetes educator. Hope notes: “Healthy eating today is one tough job! The good news is that simple tweaks in your food choices and how you prepare foods can often set you on a path to healthier eating. Each positive step is a step in the right direction along the path to a long and healthy life.”
- American Diabetes Association Standards of Medical Care in Diabetes. Lifestyle Management. Diabetes Care 2017; 40 (Suppl. 1): S33-43.
- Evert A, Boucher J, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care: 2013;36(11):3821-3842.
- Institute of Medicine; Food and Nutrition Board; Planning Committee on Dietary Reference Intakes Research Synthesis; Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids http://www.nationalacademies.org/hmd/Reports/2002/Dietary-Reference-Intakes-for-Energy-Carbohydrate-Fiber-Fat-Fatty-Acids-Cholesterol-Protein-and-Amino-Acids.aspx. (Accessed May 16, 2017.)
- American Diabetes Association Standards of Medical Care in Diabetes. Pharmacologic approaches to glycemic treatment. Diabetes Care 2017; 40 (Suppl. 1): S33-43.