Diabetes Diet: High Carb? Low Carbs?

When it comes to Type 2 diabetes and obesity, what is the best diabetes diet to control blood sugar and lose weight? Is diabetes better controlled and weight loss achieved with a high carb, low fat diet or a low carb diet? A review of the medical evidence has caused a reversal of the current thinking and recommendations for the best diet for Type 2 diabetes together with obesity.

Diabetes Diet of the Past in the US

The typical diabetes diet recommended in the United States since the 1970’s has been the low fat, high carb diet. This recommendation sprang from the fact that diabetics are more prone to heart disease. The low fat portion of the diet is prescribed with the goal of offsetting this risk of cardiovascular disease.

The high carb portion of the current diabetes diet was prescribed for two reasons. First, insulin injections could supplement the amount of insulin produced by the body in response to eating foods containing carbohydrates. (In diabetes, the body stops producing the amount of the hormone insulin needed to digest and process carbohydrates.)

So, with insulin injections helping to control the blood sugar levels, the diet could now contain an increase amount of carbohydrates which were necessary to replace the calories lost by the restriction of fat. Increasing the calories from carbs to replace the lost calories from fat is the second reason the standard diabetes diet is high in carbs.

But, current evidence indicates that the high carb, low fat diabetes diet could make Type 2 diabetes and the problem of obesity worse!

While carbohydrates are necessary for the body because they easily convert to glucose and are a great source of energy, eating carbs constantly means that there is a continual demand for insulin. What happens then is that the cells become insulin-resistant and less sensitive to insulin, demanding more insulin to bring the blood sugar down to normal levels.

So, the body then needs to make more insulin, which then makes the cells even more resistant and the blood sugar levels stay high. The excess sugar being carried in the blood then gets stored as fat (triglycerides). This causes weight gain and, the weight gain along with the high blood sugars worsens diabetes. It can also cause diabetes.

Check the USDA My Plate for the current nutritional recommendations and notice how much of the plate is carbohydrates. And we wonder why there is an increase in obesity and diabetes in the US? And diabetes is predicted to increase by 165% in the next 50 years.

The UK Diabetes Diet Recommendations

A UK review of the medical evidence on the management of diabetes with diet indicates that the high-carbohydrate diet is not the best for Type 2 diabetes. In fact, diabetes can worsen with this diet. The current UK recommendation for the Type 2 diabetic who needs to lose weight is a low-carbohydrate diet with slightly higher amounts of protein.

Research backs this recommendation. In 2004, the journal Diabetes published a study done which resulted in Type @ diabetic men achieving lower blood sugar levels eating a low carb (less that 20% of calories from carbs) diet for five weeks than Type 2 diabetic men eating a higher-carb (55% of calories from carbs) diet.

And there may be even more health benefits with a low-carb diet. A 2004 study published in the Annals of Internal Medicine, found, compared to a conventional diet, following a low carb diet of fewer than 30 grams of carbs per day:

  • Improved blood sugar levels
  • Lowered triglycerides
  • Increased the level of good cholesterol

Long Term Recommendations and Caution

Medical professionals and researchers still advise caution when it comes to low carb diets. First, the low-carb diet does not apply to those with Type 1 diabetes.

The second caution is that carbohydrates do provide an essential fuel for the body, especially the brain. Plus, they contain valuable fiber.  Following a low-carb diet for a year to lose weight and control Type 2 diabetes may be ok. But, the recommendation is to consult your dietitian or doctor for the best long term Type 2 diabetes diet to follow.

Click here to return from Diabetes Diet: Low Fat or Low Carbs? to the home page for High Triglycerides.