Diabetes is a chronic disease that has reached epidemic proportions. It currently affects more than 400 million people worldwide, and although diabetes is a complicated disease, maintaining good blood sugar control can greatly reduce the risk of complications. One of the ways to achieve better blood sugar levels is to follow a low carbohydrate diet. This article provides a detailed look at one of the most effective ancient ways to treat diabetes before insulin hit, and that is with low carb diets.
What is diabetes and what role does diet play?
If you have diabetes, your body cannot effectively process carbohydrates. Normally, when you eat carbohydrates, they are broken down into small units of glucose, which end up as blood sugar. When blood sugar levels rise, the pancreas responds by producing the hormone insulin. This hormone allows blood sugar to enter cells.
In healthy people, blood sugar levels stay within a narrow range throughout the day. In diabetes, however, this system does not work the way it is supposed to. This is a big problem, because having blood sugar levels that are too high and too low can cause serious harm.
There are several types of diabetes, but the two most common are type 1 diabetes and type 2 diabetes. Both conditions can be diagnosed at any age.
- In type 1 diabetes, an autoimmune process destroys the insulin-producing beta cells in the pancreas. To treat diabetes of this type, diabetics must inject insulin several times a day to ensure that glucose enters the cells and remains at a healthy level in the bloodstream.
- In type 2 diabetes, beta cells first produce enough insulin, but the body’s cells are resistant to its action, so blood sugar remains high. To compensate, the pancreas produces more insulin, trying to bring blood sugar down. Over time, beta cells lose their ability to make enough insulin.
Of the three nutrients – protein, carbohydrates, and fat – carbohydrates have the greatest impact on blood sugar control. This is because the body breaks them down into glucose. Therefore, diabetics when treating diabetes need to take large doses of insulin and diabetes medications when they eat a large amount of carbohydrates.
Bottom Line: Diabetics are insulin deficient, or resistant to its effects. When you eat carbohydrates, your blood sugar can rise to potentially dangerous levels if you don’t take medication.
Old way to treat diabetes before insulin.
Many studies support low-carbohydrate diets for treating diabetes. In fact, before the discovery of insulin in 1921, very low-carbohydrate diets were considered standard treatment for people with diabetes. What’s more, low-carb diets seem to work well in the long run, as long as patients stick to the diet.
In one study, type 2 diabetics followed a low-carbohydrate diet for 6 months. Their diabetes remained well controlled over 3 years later if they stuck to the diet. Similarly, when people with type 1 diabetes followed a carbohydrate-restricted diet, those who followed the diet saw a significant improvement in blood sugar levels over a 4-year period.
Bottom Line: Research has shown that people with diabetes experience long-term improvements in blood sugar control while on a low-carbohydrate diet.
What is the optimal carbohydrate intake for diabetics?
The ideal carbohydrate intake for diabetics is a somewhat controversial issue, even among those who support carbohydrate restriction. Many studies have found improvements in blood sugar levels, weight, and other carbohydrate markers when restricted to 20 grams per day.
Dr. Richard K. Bernstein, who has type 1 diabetes, eats 30 grams of carbohydrates per day and has documented excellent blood sugar control in his patients on the same regimen. However, other research shows that restricting more moderate carbohydrates, such as 70-90 grams of total carbohydrates, or 20% of calories from carbohydrates, is also effective.
The optimal amount of carbohydrates can also vary from person to person, as each has a unique response to carbohydrates. To calculate your ideal amount, you may want to test your blood glucose before a meal and again 1 to 2 hours after eating.
As long as your blood sugar stays below 140 mg/dl (8 mmol/L), which is where the point of nerve damage can occur, you can consume 6 grams, 10 grams, or 25 grams of carbohydrates per meal on a low-carbohydrate diet. It all depends on your personal tolerance. Just remember that the general rule of thumb is, the less carbohydrates you eat, the less blood sugar will rise.
And instead of cutting out all carbohydrates, a healthy low-carb diet should include nutrient- dense, high-fiber carbohydrate sources like vegetables, berries, nuts, and seeds.
Bottom line: Intake of carbohydrates between 20-90 grams per day has been shown to be effective in improving blood sugar control and thus treating diabetes. However, it is best to test your blood sugar before and after eating to find your personal carbohydrate limit.
What Carbohydrates Raise Blood Sugar Levels?
The carbohydrates in plant foods are made up of a combination of starch, sugar, and fiber. Only starch and sugar raise blood sugar. Fiber found naturally in food, whether soluble or insoluble, does not break down into glucose in the body and does not raise blood sugar levels.
You can actually subtract the fiber from the total carbohydrate content, leaving the content of the “web” digestible carbohydrates. For example, a cup of cauliflower contains 5 grams of carbohydrates, 3 of which are fiber. Therefore, its net carbohydrate content is 2 grams.
Prebiotic fiber, such as inulin, has even been shown to improve fasting blood glucose and other health markers in type 2 diabetics.
Sugar alcohols such as maltitol, xylitol, erythritol, and sorbitol are often used to sweeten sugar-free candy and other diet products. Some of them, especially maltitol, can actually raise blood sugar levels in people with diabetes. For this reason, the net carbohydrate count on a product label cannot be accurate if all of the carbohydrates provided by maltitol are subtracted from the total.
Bottom Line: Starches and sugars raise blood sugar levels, but dietary fiber doesn’t. Maltitol, the sugar alcohol, can also increase blood sugar.
Foods to eat and foods to avoid.
It’s best to focus on eating low-carb, high-quality whole foods. It’s also important to pay attention to your body’s hunger and satiety signals, regardless of what you’re eating.
Foods to eat in the treatment of diabetes.
You can eat the following low carb foods until you are full, and you should make sure you get enough protein at each meal.
- Meat, poultry and seafood.
- Non-starchy vegetables (most vegetables except those listed below).
- Olive oil, coconut oil, butter, cream, sour cream, and cream cheese.
Foods to eat in moderation in the treatment of diabetes.
The following foods can be eaten in smaller amounts with meals, depending on your personal carbohydrate tolerance.
- Berries: 1 cup or less.
- Plain Greek yogurt: 1 cup or less.
- Cottage cheese: half a cup or less.
- Walnuts and peanuts: 1-2 oz or 30-60 grams.
- Chia seeds or flaxseed: 2 tablespoons.
- Dark chocolate (with at least 85% cocoa): 30 grams or less.
- Winter squash: 1 cup or less.
- Liquor: 1.5 oz or 50 grams.
- Dry red or white wine: 4 ounces or 120 grams.
Reducing carbohydrates generally lowers insulin levels, causing the kidneys to release sodium and water. Try eating broth, olives, or some other low-carb salty foods to make up for the lost sodium. Don’t be afraid to add a little salt to your meals. However, if you have congestive heart failure, kidney disease, or high blood pressure, talk to your doctor before increasing the amount of sodium in your diet.
Foods to Avoid When Treating Diabetes.
These foods are rich in carbohydrates and can significantly increase blood sugar levels in diabetics:
- Bread, pasta, cereals, corn, and other grains.
- Starchy vegetables like potatoes, sweet potatoes, yams, and taro.
- Legumes, such as peas, lentils, and beans (except green beans and snow peas).
- Fruits other than berries.
- Juice, soda, punch, sweetened tea, beer, etc.
- Desserts, baked goods, candy, ice cream, etc.
Bottom Line: Stick with low-carb foods like meat, fish, eggs, shellfish, non-starchy vegetables, and healthy fats. Avoid foods that are high in carbohydrates.
An example day of low carb meals for diabetics.
To treat diabetes with a good low carb diet, here is an example menu with 15 grams or less of digestible carbohydrates per meal. If your personal carbohydrate tolerance is higher or lower, you can adjust the portion sizes.
Breakfast: Eggs and spinach.
- 3 eggs cooked in butter (1.5 grams of carbohydrates).
- 1 cup of sautéed spinach (3 grams of carbohydrates).
- 1 cup of blackberries (6 grams of carbohydrates).
- 1 cup of coffee with cream and -optional- sweetener without sugar.
Total digestible carbohydrates: 10.5 grams.
Lunch: Cobb Salad.
- 3 oz (90 g) of cooked chicken.
- 1 oz (30 g) of Roquefort cheese (1/2 gram of carbohydrates).
- 1 slice of bacon.
- 1/2 medium avocado (2 grams of carbohydrates).
- 1 cup of chopped tomatoes (5 grams of carbohydrates).
- 1 cup of chopped lettuce (1 gram of carbohydrates).
- Olive oil and vinegar.
- 20 grams (2 small squares) of dark chocolate -85% cocoa- (4 grams of carbohydrates).
- 1 glass of iced tea with a choice of unsweetened sweetener.
Total digestible carbohydrates: 12.5 grams.
Dinner: Salmon with vegetables.
- 4 oz grilled salmon.
- 1/2 cup zucchini sautéed (3 grams of carbs).
- 1 cup of sautéed mushrooms (2 grams of carbohydrates).
- 1/2 cup of sliced strawberries with whipped cream.
- 1 ounce of chopped walnuts (6 grams of carbohydrates).
- 4 oz (120 g) of red wine (3 grams of carbohydrates).
Total digestible carbohydrates: 14 grams. Total digestible carbohydrates for the day: 37 grams.
Bottom Line: An eating plan to manage and treat diabetes should evenly space carbohydrates between the three meals. Each meal should contain a balance of protein, healthy fats, and a small amount of carbohydrates, especially vegetables.
Talk to your doctor before changing your diet in the treatment of diabetes.
When carbohydrates are limited, there is often a dramatic reduction in blood sugar. For this reason, it is often necessary to reduce insulin and other drug doses. In some cases, they may need to be removed entirely. One study reported that 17 of 21 patients with type 2 diabetes were able to stop or reduce diabetes medications when carbohydrates were limited to 20 grams per day.
In another study, type 1 diabetics ate less than 90 grams of carbohydrates per day. Their blood glucose control improved, and there were fewer incidences of low blood sugar because their insulin doses were significantly reduced.
If insulin and other medications are not adjusted for a low-carbohydrate diet, there is a high risk of dangerously low blood glucose levels, also known as hypoglycemia. Therefore, it is important for people taking insulin or diabetes medications to speak with their doctor before starting a low-carbohydrate diet.
Bottom Line: Most people will need to reduce their dose of diabetes medicine or insulin when following a low-carb diet. Failure to do so can lead to dangerously low blood sugar levels.
Other ways to lower blood sugar levels.
In addition to following a low-carbohydrate diet, physical activity can also help control diabetes by improving insulin sensitivity. A combination of resistance training and aerobic exercise is especially beneficial. Quality sleep is also crucial. Research has consistently shown that people who sleep little are at increased risk of developing diabetes.
A recent observational study found that diabetics who slept 6.5 to 7.5 hours per night had better blood glucose control, compared to those who slept less or longer. Another key to good blood sugar control is stress management. Yoga, Qigong, and meditation have been shown to lower blood sugar and insulin levels.
Bottom Line: In addition to following a low-carbohydrate diet, physical activity, quality of sleep, and stress management can further improve diabetes control.
Low-carbohydrate diets are effective against diabetes.
Studies show that low-carbohydrate diets can effectively manage type 1 and type 2 diabetes. Low-carbohydrate diets can improve blood sugar control, reduce the need for medications, and reduce the risk of diabetes complications. Treating diabetes with this type of diet is a good option if you are at risk or already have diabetes.
Just remember that talking to your doctor before making dietary changes is important, as medication dosages may need to be adjusted, should you be on them.