If you ask your doctor, a registered dietitian or your friends with diabetes what is the best diet, you are likely to get a different answer from each of them. Although most people would agree that diabetics should consume a lot of non-starchy vegetables, such as leafy greens, mushrooms and red bell peppers, and that their meals should include some protein from fish, poultry or meat and some fats from olive oil, avocado or nuts, opinions may differ when it comes to the optimal amount of carbohydrates to eat. Carbohydrate is the nutrient that has the largest influence over your blood sugar levels.
Typical Recommendations
The advice given by most diabetes educators is in line with the recommendations from the American Diabetes Association, which suggests aiming for 45 to 60 g of carbohydrates at each of your meals. Carbohydrates are found in grains, starchy vegetables, sugar, fruit, milk and yogurt, but not in non-starchy vegetables, protein and fat. Following the ADA advice, you could mix and match 1/4 of a large potato, 1/3 cup of cooked rice or pasta, 1/2 cup of oatmeal, 1/2 cup of legumes, 2/3 cup of plain yogurt, 1 small fruit, 1 tbsp. of jam or syrup or 2 small cookies, each of these servings being the equivalent of about 15 g of carbohydrates, to obtain your 45 to 60 g of carbohydrates per meal. For example, your breakfast could contain 1 cup of oatmeal with 2/3 cup of plain yogurt and a small apple, and your lunch or dinner could be 1 cup of pasta with tomato sauce and meatballs and 2 small cookies, for a total of 60 g of carbohydrates each.
Carbohydrate Intolerance
Diabetes is the result of having elevated blood sugar levels, either because of a deficiency in insulin in type 1 diabetes or because of a lack of sensitivity to the action of insulin, or insulin resistance, in type 2 diabetes. The Metabolism Society, a nonprofit health organization providing research, information and education in the application of fundamental science to nutrition, defines diabetes as a disease of carbohydrate intolerance. This definition makes it easy to understand that whether you have type 1 or type 2 diabetes or gestational diabetes, your body is not able to handle carbohydrates properly, which explains your high blood sugar levels.
Low-Carb Approach
The best way to treat an intolerance is to decrease your exposure or eliminate the substance you are intolerant to. Because diabetes actually is an intolerance to carbohydrates, it would make sense that lowering your carb intake could help you better manage your condition. In a study with a mild carbohydrate restriction, where carbs provided 30 percent of their calories or about 140 g a day, for six months, type 2 diabetics lowered their A1C, or average blood sugars, from 10.9 percent to 7.4 percent, without insulin, as reported in the May 2009 issue of "Nutrition & Metabolism."
Another study published in December 2008 in "Nutrition & Metabolism" compared a stricter carbohydrate restriction, limiting carbs to less than 20 g a day, against a low-glycemic index, calorie-restricted diet for a period of 24 weeks. The low-carb diet resulted in a greater decrease in their A1C levels and greater weight loss compared to the low-glycemic index diet. Moreover, diabetes medications were reduced or discontinued in 95.2 percent of the participants in the low-carb group, compared to 62 percent of the participants in the low-glycemic index group.
Finding the Best Diet for You
Not everybody agrees on what is the best diet to follow if you have diabetes. However, it is accepted that diabetics should include plenty of non-starchy vegetables, along with a source of protein and healthy fats at each meal. To determine what level of carbohydrates is best for you, start counting your carbohydrates. Use food labels or look up the carb content of the foods you eat on an online food composition table and log your carb intake every day. Besides your carb intake, write down your blood sugar levels. You can start with 45 to 60 g of carbohydrates per meal and see the influence over your blood sugar levels. The next week, experiment with 15 to 30 g of carbohydrates per meal and see if you get better results. Play with your carb intake until you find the amount that helps you better manage your blood sugar levels.
Special Considerations
If you take diabetes medications or insulin, drastically lowering your carb intake may result in hypoglycemia, or low blood sugar levels, because your medications should be adjusted to your carbohydrate intake. Consult your doctor before restricting your carb intake for advice on how to adjust your medications and prevent hypoglycemia. Although you may experience some blood sugar drop in the first two weeks of reducing your carb intake, Dr. Eric C. Westman, researcher and co-author of "The New Atkins for a New You," reports that hypoglycemia is rarely experienced on a low-carb diet after the first two weeks. You can also ask to have some blood work done as a comparison basis in three to six months to objectively evaluate how your diet impacts your health.
References
- Metabolism Society: Position Statement on Diabetes
- "Nutrition & Metabolism"; Effects of a Low-Carbohydrate Diet on Glycemic Control in Outpatients With Severe Type 2 Diabetes; Hajime Haimoto, et al.; May 2009
- "Nutrition & Metabolism"; The Effect of a Low-Carbohydrate, Ketogenic Diet Versus a Low-Glycemic Index Diet on Glycemic Control in Type 2 Diabetes Mellitus; Eric C. Westman, et al.; December 2008
- "Nutrition & Metabolism"; The Case for Low Carbohydrate Diets in Diabetes Management; Surender K. Arora, et al.; July 2005
- American Diabetes Association: Carbohydrate Counting
- "The New Atkins for a New You"; Eric C. Westman et al; 2010
