Many people with diabetes are following a low-carb diet because of its benefits in terms of improving diabetes control, weight loss and being a diet that is satisfying and easy to stick to.
Low-carb diets are flexible and can be followed by people with different types of diabetes.
The diet has allowed many people with type 2 diabetes to resolve their diabetes, that is to get their blood sugar levels into a non-diabetic range without the help of medication.
People with type 1 diabetes have also reported much more stable blood sugar levels, making the condition easier to predict and manage.
The diet is a healthy way of eating as vegetables and natural, real foods are integral to the diet.
Low-carb guidance and support
In 2015, Diabetes.co.uk launched the Low Carb Program which has helped thousands of people with type 2 diabetes to improve their diabetes control and reduce their dependency on diabetes medication.
Why follow a low-carb diet?
Carbohydrate is the nutrient which has the greatest effect in terms of raising blood sugar levels and requires the most insulin to be taken or be produced by the body.
Lowering sugar levels is clearly a benefit for people with diabetes. Lower need for insulin is also particularly useful as lowering insulin in the body can reduce insulin resistance which can help towards reversing type 2 diabetes.
Insulin is also the fat storage hormone in the body, so reducing insulin in the body with a low-carb diet can help with losing weight.
Benefits of low-carb diets
The benefits of a low-carb diet typically include:
- Lower HbA1c
- Improved weight loss
- Less chance of high sugar levels occurring
- Lower risk of severe hypos
- More energy through the day
- Less cravings for sugary and snack foods
- Clearer thinking
- Clearer thinking
- Lower risk of developing long-term health complications
What counts as low-carb?
Low-carb is a flexible way of eating that allows you as an individual to choose a level of carbohydrate that works well for your diabetes and lifestyle.
A research study in 2008  used the following brackets to categorise daily carbohydrate intake:
- Moderate carbohydrate: 130 to 225g of carbs
- Low carbohydrate: under 130g of carbs
- Very-low carbohydrate: under 30g of carbs
Generally speaking, the lower your carbohydrate intake, the more likely you are to lose weight and the lower sugar levels you are likely to have.
It’s important you choose a level of carbohydrate that works well for you.
For example, people with type 1 diabetes that do not need to low weight may wish to aim for a low or moderate carbohydrate intake.
Someone with type 2 diabetes, or needs to lose weight, may wish to aim for a very-low carbohydrate (ketogenic) intake.
It is important that you speak to your doctor before significantly lowering your carbohydrate intake. This is especially important if you are on medication that can cause hypoglycemia (low blood sugar), such as insulin, sulphonylureas or glinides.
How carbohydrates affect the body?
Carbohydrates, as do proteins and fats, provide energy so they help to fuel the body.
Carbohydrate is broken down into glucose so when carbohydrates are consumed, an increase in blood sugar levels occurs to a greater or lesser extent according to the amount of carbohydrate.
By reducing carbohydrate intake, you can help to reduce the rise in blood glucose levels after meals.
How will low-carbing affect my weight?
Low carbohydrate diets have been found to be successful in aiding weight loss.
The reduction in carbohydrates means that people need not produce, or inject, so much insulin. As insulin helps to store fat, less circulating insulin could help to prevent, reduce or reverse weight gain.
Also, by restricting the amount of carbohydrates, people often lower their calorie intake at the same time as the focus on eating real foods and the satiating effect of fat means people are less likely to snack and overeat in general.
Low carb diets have been amongst people with diabetes because they are blood sugar friendly. A low carb diet has less carbohydrate than the average diet.
There is no formal definition, but a diet of less than 130g of carbohydrate a day is regarded as low carb. It not uncommon for people with diabetes to have less than 100g of carbohydrate a day.
Low carb diets have become particularly popular with people who have type 2 diabetes. The diet’s also had appeal for people with type 1 diabetes who have either struggled with control on a ‘normal diet’ or who want to tighten their control.
People on insulin, or other blood glucose lowering medication, should take care if reducing their carbohydrate intake as hypoglycemia can occur. We would advise speaking with your doctor first, before making significant changes to your diet.
Some of the benefits of a low carb diet can include:
- Lower average blood glucose levels - particularly in the period after meals
- Reduction in ‘brain fog’ that tends to result from higher sugar levels
- Helping with weight loss
People have also found that low carb diets can improve cholesterol and triglyceride levels.
To reduce your carb intake you will likely cut down on or cut out food such as bread, pasta, rice, potatoes and of course sweeter foods.
Vegetables should be the foundation of a low carb diet –as they should for any diet. You may need to up your intake of protein or fat to compensate for the reduction in carbohydrate. If increasing the amount of fat, ensure you’re getting a good supply of unsaturated fats which are found in nuts, avocados and oily fish.
With any significant change in diet, you may experience a few effects in the first 2 weeks as the body gets use to the change.
This can include:
- Constipation or loose stools
If these effects don’t subside after a couple of weeks, you may need to make some changes. You may wish to consult a dietitian for advice.
A low carb diet is sometimes viewed as a restrictive diet.
However, many people on the diet find inventive ways to replace starchy foods - such as using swede or celeriac instead of potato, and using cauliflower instead of rice and making dough out of almond meal. You may well find that a low carb diet is more nutritious than your previous diet.
How to follow a low carb diet
A healthy low carb diet should have the following features:
- Strong vegetable intake
- Modest increase in fat intake from natural sources
- Moderate protein intake
- Low reliance upon processed food, sugar and grains
Read more on following a healthy low-carb diet.
Fats and protein
If you are significantly reducing the amount of carbohydrate in your diet, you may need to make up some of the reduced calories with either protein or fat.
It is advisable to ensure the fat content of your diet comes from natural sources, such as:
- Olive oil
Natural sources of fat, such as the above, will provide a balance of monounsaturated, polyunsaturated and saturated fat.
Try to avoid processed foods and takeaways as the fat in these are generally either man made or highly processed.
When choosing protein, aim to have unprocessed cuts of meat as processed meats have been consistently linked with higher rates of heart disease and even insulin resistance.
What is the counter-argument against low-carb diets for people with diabetes?
If low-carb diets can help to reduce blood glucose levels and aid weight loss, then why are low-carbohydrate diets not advocated by the NHS?
The reason that is commonly cited is that there is not enough evidence to support the effectiveness and safety of low-carbohydrate diets. The question is a hotly debated one which has seen disagreement from both sides as to which diet is more safe and effective.
However, more research in favour of low-carb diets is appearing on a monthly basis and the research is consistently showing low-carb diets to be superior to the low-fat diet advised by the NHS.
What side effects exist on a low carb diet?
Side effects that can be commonly experienced on a low carb diet include:
Hypoglycemia (low blood sugar) may occur if you take insulin or tablets that can cause low blood sugar. If you take medications that can cause hypos, it’s particularly important to discuss precautions to prevent hypos before starting a low carb diet.
- Read more on Low Carb Diet Side Effects
Is a low-carb diet suitable for everyone?
Low-carb diets are suitable for most people. As noted above, if you’re thinking of reducing your carbohydrate intake by a large amount, it’s best to check with your doctor if any precautions need to be made.
If you are pregnant, or planning pregnancy, a very-low carb diet may not be appropriate as the safety of very-low carbohydrate diets in pregnancy is not currently known.