Lindsay Nelson, RD, LD
I'm a Diabetic. How Many Carbs Should I Eat?
Updated: Dec 8, 2018
This is a question I get every day as I work with diabetic clients. Unfortunately, many diabetics are being told to eat way too many carbs. My goal with my diabetic patients is to lower blood sugars as naturally as possible without having to rely on diabetic medications or insulin. If someone is already on insulin, my first goal is to get them off insulin by changing their lifestyle. Insulin is only feeding the disease. Insulin is a fat-storing hormone and, therefore, only causes weight gain and further progression of diabetes.
Many diabetes centers and medical professionals are telling diabetic patients to eat upwards to 75 grams of carbs PER MEAL. The American Diabetes Association recommends 45% of calories coming from carb which would be anywhere from 135-230 grams of carbs per day based on total energy needs. This amount of carbs will likely require the person to stay on medication, and eventually need more medication and insulin. However, if a person was previously eating more than this recommendation, then they would see an improvement in blood sugars.
If you have type 2 diabetes that means your body doesn’t process carbs well. Your pancreas has stopped producing insulin or your body has become resistant to insulin’s glucose-lowering effect. You have excess blood sugar floating around that isn’t being used for energy in your cells. The first step approach should be cutting down on carbs. In general, the lower your carbs, the lower your blood sugar will be.
I’ve found that most of my pre-diabetic or diabetic patients best manage their blood sugars by staying below 30 g carbs/meal for women and 45 g carbs/meal for men. This is very individualized. I’ve had some patients completely reverse diabetes, meaning they got off of all medications and insulin and their A1c is below 5.7. To do this, some of them have had to go on a very low carb diet called the ketogenic diet, which requires fewer than 50 grams of carbs/day. Studies have shown that a daily carb limit of 20-130 g/day, or, 5-35% of calories is very effective at managing and possibly even reversing diabetes. The quality and type of carbs also makes a big difference. Choosing fiber-rich carbs, like those found in foods that come from the earth (fruits, veggies, beans, unrefined grains), will not raise your blood sugar nearly as much as choosing pure sugar-rich carbs like sugar-sweetened beverages, desserts and refined grains.
If you want to start better managing your blood sugars with your diet, start by tracking your carbs on an app like My Fitness Pal to see how many you’re currently eating. Gradually start decreasing carbs while checking your blood sugars daily and paying attention to how you feel. Once your blood sugars start to normalize, you have found the amount of carbs your body is comfortable with! Carbs are the main reason for blood sugars to spike, but other non-food reasons your blood sugar may raise include stress and lack of sleep (another type of stress). Exercise helps to decrease and you may be able to tolerate more carbs if you are regularly exercising.
Diabetes is a progressive disease when it’s not well managed and puts you at higher risk for other chronic diseases like heart disease and kidney disease. However, it can be very well managed with diet and lifestyle. Start by finding what carb amount works best for your body and lifestyle and watch your health transform! For more info, check out this Ted Talk on diabetes and diet.