Low Carbohydrate Diets and the Diabetic Patient: Things to Consider

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When it comes to low carbohydrate diets and the diabetic patient, is a low-carbohydrate eating plan safe? The following are the answers to that question as well as tips and other information geared towards making a successful low-carb eating plan.

What Is a Low-Carbohydrate Diet?

The basic premise of a low-carbohydrate diet is that by limiting carbohydrate consumption, levels of blood sugar in the bloodstream remain lower. When there are insufficient levels of blood sugar to fuel the body’s cells, fat stores are used to provide the body with energy.

There is plenty of debate within the medical community, diet specialists and nutritionists about what level of carbohydrate consumption constitutes a low-carbohydrate diet. The American Diabetes Association recommends a minimum of 45 to 60 grams of carbohydrates per meal, or roughly 300 grams per day. Many low carbohydrate diets limit carbohydrate consumption to between 50 and 150 grams of carbohydrates per day.

The Problems Associated with Low Carbohydrate Diets

A common problem diabetics that participate in low-carbohydrate diets is that they may not adjust their diabetes medications to compensate for the lack of carbohydrates, resulting in episodes of hypoglycemia.

According to the American Diabetes Association, one problem frequently found with low carbohydrate diets is that participants tend to consumer foods higher in protein, which frequently are higher in fats. This is problematic for those with diabetes since they are highly susceptible to heart disease.

The January, 2009 issue of the American Journal of Clinical Nutrition states that, “A long-term, multicenter study of people with type 1 diabetes found that diets lower in carbohydrates and higher in total, saturated and monounsaturated fat were associated with need for higher insulin doses and poorer control of blood sugar. Increased total and saturated fat was associated with particularly poor blood sugar control.”

Carbohydrates are not the Only Consideration

Diabetics cannot only consider carbohydrate counts when planning their meals. Other factors such as fat, cholesterol and calories all matter in the quest to manage blood sugar levels and maintain optimal health.

By considering all of these factors, the risk for certain diabetes-related diseases and complications can be reduced. These risks include stroke and heart disease. Another issue, particularly with type 2 diabetics, is weight management and weight loss.

Diabetics may follow low carbohydrate diets, but this should be only done with a doctor’s approval and monitoring, considering other factors along with carbohydrate counts.

Tips for Low-Carbohydrate Meal-Planning

When planning a low-carbohydrate meal or menu, some things to consider include:

  • Portion size
  • Total calories of each meal
  • Balance and variety (whole grains, fruits and vegetables)
  • Reduced fat and cholesterol
  • Reduced consumption of sweets
  • Reduced salt intake
  • Physical activity
  • Limited or no alcohol consumption

The Mayo Clinic illustrates the importance of looking beyond the carbohydrates by comparing two breakfasts that contained the same number of carbohydrates. In the first breakfast of fried eggs, sausage, toasted white bread and orange juice, the cholesterol content was 475mg, the fat was 60g and the caloric total was 830. The second breakfast of orange juice, corn flakes, a banana and wheat toast, came in at only 4mg of cholesterol, 5g of fat and 370 calories.

This example reveals that carbohydrate diets and the diabetic patient can co-exist with careful planning.


News & Research: Low-Carb Diet for People with Diabetes. American Diabetes Association. Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus. Y. Ma and Colleagues. Nutrition 22: 1129? 1136, 2006. https://www.diabetes.org/news-research/research/access-diabetes-research/Ma-low-carb-diet.html

Mayo Clinic Nutrition and Healthy Eating: For Those with Diabetes – There’s More to it than Carbs. Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D. January 28, 2009. https://www.mayoclinic.com/health/low-carb-diet-diabetes/MY00539

Mayo Clinic Diabetes: Question and Answer. Katherine Zeratsky, R.D., L.D. Mayo Clinic Nutritionist. https://www.mayoclinic.com/health/diabetes/HQ00384