Low-Carb for Diabetes

Would you like a diet that lowered your blood sugar[1], prevented diabetes complications[2], gave you more energy and reduced hunger? Studies show that low-carbohydrate diets[3] have those benefits and also prevent hypoglycemia (low blood sugar)[4].

If you have diabetes, you probably already try to limit carbs, which are sugars and starches like breads and pasta. Carbs are one of the main food groups, along with protein and fats. They fuel human bodies, but because of lack of insulin and insulin resistance[5], people with diabetes can’t always handle them effectively.


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Low-carb diabetes: why eat low carb

According to the Low Carb Diabetes Association, “When someone[7] has diabetes, the person has lost the capacity to metabolize carbohydrates well. Their glucose levels go up when they eat carbs.” For people with type 1 diabetes[8], especially, higher carb intake can mean higher doses of insulin[9], which can potentially lead to frequent episodes of hypoglycemia and hyperglycemia (high blood sugar)[10].

Over decades, scores of studies have shown that diabetics do better when they eat fewer carbs. Books like Dr. Richard Bernstein’s Diabetes Solution[11] have reported how diabetes can be controlled and many complications reversed with a very-low-carb diet (VLCD). In the past year, a study in[12] the journal Pediatrics confirmed much lower A1c levels[13] (an average of 5.67% compared to 7.15% on a typical diabetes diet) in children on a VLCD, and a Canadian study[14] found that a low-carb breakfast stopped morning blood sugar spikes and kept blood sugar managed all day.

How much carbohydrate is low carb? Certified Diabetes Educator and Registered Dietitian Amy Campbell reports that[15] American men typically eat 200 to 330 grams of carbs a day, and women 180 to 230 grams. This intake represents about 40% to 50% of calories eaten.

Low carb, then, could mean anything less than 200 grams (about seven ounces) of carbs a day, but doctors like Bernstein and Dr. Mark Hyman, MD, author of The Blood Sugar Solution,[16] advocate much smaller amounts. Campbell says studies indicate “that some people have done well with averaging 36 grams of carb a day.” Bernstein says to eat 6 grams of carbs at breakfast, a maximum of 12 grams for snacks, and 12 grams each at lunch and dinner (so, 42 grams a day). Twelve grams is about the amount in one average slice of bread. You might want to aim for anywhere within these numbers.

Some keys to low-carb success

• Some people cut down carbs slowly, not all at once. Breakfast is a good place to start — excess carbs in the morning can throw blood sugar off for the whole day.

• At first, there might be some craving for sweets or bread when you’re feeling stressed, but those feelings normally resolve quickly.

• Cutting carbs while on insulin demands careful attention to insulin doses. Be sure to work with a doctor or certified diabetes educator[17] to avoid hypoglycemia. Other diabetes medicines may also need to be adjusted with the guidance of a health-care provider[18].

Science writer Kris Gunnars, BSc, gives additional strategies[19]:

• Avoid processed food[20] as much as possible — it tends to be high in refined carbs and other things that are better to avoid.

• Know which foods are low-carb. A good list is here[21]. In general, meats and seafood, nuts and seeds, and nonstarchy vegetables like leafy greens are extremely low in carbs, and fruits like berries are also very low.

• Make sure to always keep low-carb snack options close at hand.

• Do some research on low-carb recipes[22] you would like to try. Get some variety in your diet!

Eating low carb doesn’t mean eating all meat. You can get fat from eggs, oils, nuts, seeds, avocados and fish. You can get protein from beans, nuts, seeds, fish, dairy products and soy products such as tofu or tempeh. A good low-carb diet is balanced[23]. In a comment, Diabetes Self-Management reader Joe wrote, “I enjoy bacon and sausage once in a while. I eat green leafy vegetables, sprouts, broccoli, mushrooms, green peppers, blackberries, blueberries, walnuts and raw almonds.” Websites like Low-Carb Diabetes[24] will give you lots more ideas. Fibers (usually obtained in vegetables, beans or nonstarchy fruits) are a great form of carbohydrate[25] — they break down into fatty acids[26] in the large intestine, providing energy without creating glucose.

Low-carb eating: can you keep it up?

Like any diet change, a low-carb diet is easy to start, but it might be hard to maintain.That said, it’s not impossible. Although refined carbs can raise your mood temporarily, acting like an addictive drug[27], most advocates believe people easily learn to avoid them. Gunnars says “Sticking to low-carb is not so hard because this diet reduces hunger and stops cravings for sweets.”

The real barriers to low-carb eating are social. People are always offering sweets and breads. Sandwiches are convenient ways to eat lunch on the run. Restaurants serve delicious dishes of pasta. It’s easy to get tired of saying “no” and to not want to offend friends or coworkers, although having diabetes is a convenient excuse.

Money might also pose a barrier. Some good low-carb foods like nuts, berries, avocados and high-quality meats are expensive. But there are cost-saving ways to go low carb. These include using discount groceries and buying in large quantities to have leftovers. Lower-priced meats can be as healthy as pricier cuts.

Despite a few difficulties, millions of people are controlling their diabetes and living well with low-carbohydrate diets. They have more energy. They are reducing their A1C, their insulin use, and their number of  low blood sugar episodes. You can do this, too.

Want to learn more about low-carb diets for diabetes? Read “Low-Carb Myths and Facts”[28] and “Carbohydrate Restriction: An Option for Diabetes Management.”[29]

David Spero, BSN, RN[30]

A nurse for 25 years at University of California San Francisco and Kaiser hospitals, and one of the first professional health coaches. Nurse Spero is author of Diabetes: Sugar-Coated Crisis and The Art of Getting Well: Maximizing Health When You Have a Chronic Illness, as well as co-author of Diabetes Heroes and the diabetes chapter in Where There is No Doctor. He writes for Diabetes Self-Management, Pain-Free Living, and Everyday Health.

Learn more about David Spero:

Professional website[31] • LinkedIn[32]

(Image by Sewcream[33]/Shutterstock)

  1. blood sugar: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/blood-sugar-chart/
  2. diabetes complications: https://www.diabetesselfmanagement.com/education/diabetes-complications/
  3. low-carbohydrate diets: https://www.diabetesselfmanagement.com/blog/low-carb-myths-and-facts/
  4. hypoglycemia (low blood sugar): https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/what-is-hypoglycemia-symptoms-treatments/
  5. insulin resistance: https://www.diabetesselfmanagement.com/blog/insulin-resistance-need-know/
  6. sign up for our free newsletter: https://www.diabetesselfmanagement.com/newsletter/
  7. When someone: https://lowcarbdiabetes.org
  8. type 1 diabetes: https://www.diabetesselfmanagement.com/diabetes-resources/definitions/type-1-diabetes/
  9. insulin: https://www.diabetesselfmanagement.com/blog/what-does-insulin-do/
  10. hyperglycemia (high blood sugar): https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/managing-hyperglycemia/
  11. Diabetes Solution: http://target=
  12. study in: https://www.diabetesselfmanagement.com/practical-diabetology/news-tools/type-1-diabetes-and-the-very-low-carbohydrate-diet-vlcd-what-you-need-to-know/
  13. A1c levels: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/h-b-a-1-c/
  14. Canadian study: https://www.diabetesselfmanagement.com/blog/low-carb-breakfast-diabetes-control/
  15. reports that: https://www.diabetesselfmanagement.com/blog/can-very-low-carb-diet-help-people-type-1-diabetes/
  16. The Blood Sugar Solution,: https://drhyman.com/blog/2012/02/26/the-blood-sugar-solution/
  17. certified diabetes educator: https://www.diabetesselfmanagement.com/about-diabetes/diabetes-basics/certified-diabetes-educator/
  18. be adjusted with the guidance of a health-care provider: https://www.medscape.com/viewarticle/915595
  19. additional strategies: https://www.healthline.com/nutrition/low-carb-diets-healthy-but-hard
  20. processed food: https://www.diabetesselfmanagement.com/news-research/2020/01/14/study-links-type-2-diabetes-to-ultra-processed-foods/
  21. is here: https://www.healthline.com/nutrition/44-healthy-low-carb-foods
  22. low-carb recipes: https://www.diabetesselfmanagement.com/blog/our-top-7-low-carb-recipes-for-diabetes/
  23. is balanced:
  24. Low-Carb Diabetes: https://lowcarbdiabetes.org/low-carb-diet/
  25. a great form of carbohydrate: https://www.diabetesselfmanagement.com/blog/treating-diabetes-with-fiber/
  26. break down into fatty acids: https://www.diabetesselfmanagement.com/blog/how-fiber-helps-with-diabetes/
  27. addictive drug: https://www.theguardian.com/society/2017/jan/05/is-sugar-worlds-most-popular-drug
  28. “Low-Carb Myths and Facts”: https://www.diabetesselfmanagement.com/blog/low-carb-myths-and-facts/
  29. “Carbohydrate Restriction: An Option for Diabetes Management.”: https://www.diabetesselfmanagement.com/nutrition-exercise/meal-planning/carbohydrate-restriction/
  30. David Spero, BSN, RN: http://www.davidsperorn.com/
  31. Professional website: http://www.davidsperorn.com
  32. LinkedIn: https://www.linkedin.com/in/david-spero-3278b914/
  33. Sewcream: https://www.shutterstock.com/g/ThitareeS

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