Is a no carb, low carb or moderate carb diet the best choice for someone living with diabetes? This is a question Iโm asked almost daily, and today I will try to answer it by sharing my experiences with all three diet types.
Before I jump into the different diets, letโs get the obvious answer out of the way which is โit dependsโ. The diet that is best for you will always depend on your goals and activity level โ the diet that works for you might not work for me, and vice versa. If you are trying to build strength and muscles, you shouldnโt follow the same diet as when you are trying to lose weight.
In the same way, someone who runs every day has different dietary requirements to someone who sits in an office all day and doesnโt exercise.
Now that we have that out of the way, letโs get into the details of the different diets!
The moderate carb diet
The general recommendation for a non-diabetic person is to get 40-60% of their daily calories from carbs. If you eat 2,000 calories a day, thatโs between 200 and 300 grams of carbs a day.
For people with diabetes, this is generally too many carbs, but I do get pretty close to this when I exercise a lot and am trying to build muscle mass. During my last building phase, I averaged about 200-250 grams of carbs a day, but I was also lifting heavy weights 5-6 days a week. As long as I stick to low glycemic carbs (except right after my workout), I can eat that many carbs and still have very good blood sugar control.
The great thing about the moderate carb diet (aside from eating lots of tasty carbs) was that I managed to lean out slightly while adding some nice muscle mass. However, I wouldnโt consider this a weight loss diet by any means. Most people, myself included, wonโt be able to โkeep it cleanโ all of the time, and thereโs really no room for error on this diet, as you can easily start putting on some fat as well.
My โstandardโ diet when I am not trying to gain muscle or lose weight is around 100-120 grams of carbs a day for a 2000-calorie diet. You can see exactly what my typical diet is like in this post.
The low carb diet
There is no clear definition of exactly what a โlow carb dietโ means, but when I talk about low carb diets, I refer to a diet consisting of approximately 50-75 grams of complex carbs a day (not including vegetables).
Iโve found this to be the sweet spot for most type 1 diabetic women (myself included) when dieting. I only go this low when I want to slim down, like when I want to drop the last few pounds for a photo shoot or fitness competition.
An added benefit of a low carb diet is that it makes good blood sugar control easier. I divide my daily carbs between several meals and combine them with lean protein and good fats, so I hardly see any blood sugar fluctuations after meals.
I know that this will be controversial to a lot of people in the diabetes community, but, in general, I donโt recommend a low carb diet as an optimal every-day maintenance diet. Itโs great for weight loss and can help with blood sugar control, but it also decreases your metabolism and energy levels.
If you live an active lifestyle (and especially if you do resistance training), the moderate carb diet provides you with the energy you need to fuel your workouts, while still allowing for great blood sugar control.
The no-carb (ketogenic) diet
The theory behind the ketogenic diet is that by consuming almost no carbs (less than 5% of your total calories), your body will start converting fat into fatty acids and ketones. Ketones can replace glucose as your bodyโs main energy source, meaning that your body mainly relies on fat for energy. In theory, this should make it very easy to lose excess body fat if you limit your calorie intake at the same time.
Because you eat almost no carbs, you also, in theory, need very little insulin, making blood sugar control easier.
I tried the ketogenic diet and it did not work for me AT ALL! I only had 20 grams of carbs a day and my insulin sensitivity went bonkers. Since fat is released more slowly into the bloodstream than complex or refined carbs, I didnโt see any crazy blood sugar fluctuations, but my insulin needs increased by 100% in comparison to when I was eating a low carb or moderate carb diet.
Needless to say, my experience with the ketogenic diet was that I gained weight FAST. Not really what I was going for. My blood sugars were nice and stable although often trending high but since gaining fat isnโt part of my goal, I can honestly say that I will most likely never try a ketogenic diet again.
I know that some people successfully follow a ketogenic diet for diabetes management, so my experience may not be typical, but I cannot recommend a ketogenic diet at this point. You donโt need it for good blood sugar control, and the downsides can be serious.
Conclusion
As I wrote in the beginning, what the optimal diet is for you depends on your goals. Personally, I find a low carb diet optimal for weight loss and a moderate carb diet optimal for maintaining and building muscle mass.
As a final note, some people with diabetes also follow an all-carb all-fruit diet in which they eat over 600 grams of carbs a day and get great results. This is not something I would ever try, but it clearly shows that there are many different diets that can work well for diabetes management. The best thing for you to do is to experiment, take notes, learn from your mistakes, and find the diet that works for you and your body!
Recommended next post: How to Lose Weight When You Live with Diabetes
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Hi Christel!
I just started resistance training 6 days a week and your website has been the biggest help!
I was hoping you could say more about the low carb diet. Iโm planning on eating 1,380 calories a day but I was wondering what the macros would look like in a low carb diet.
Thank you so much!
So glad the website is a good resource for you!
As I mention in the article the “low carb” definition is fluid but I see it as 50-75 g carbs per day excluding veggie carbs. So that’s 200-300 calories from carbs a day (50-75 x 4), plus ~200 calories from veggies, meaning you have 980-880 calories left for fats and protein. Since I don’t know your details lets me give you an example of what that could look like.
Let’s say you weigh 140 lbs and decide on 0.8 g of protein per lbs. That would be 140 g of protein (x4) = 560 calories. You’d then have 420-320 calories left for fat. Where carbs and protein have 4 calories per gram fat has 9 calories meaning you’d eat (420-320 divided by 9) 46.7-35.6 g fat per day.
Hi Christel,
I have type 1 diabetes and I’m on day 9 of the Keto diet. I’m about to give up because I feel terrible. My blood sugars have been perfect, but I think I’ve had the Keto flu for the past seven days. So, I’m curious, what percentage of macros work best for you? I’m interested in losing a little fat, but gaining muscle.
Thank you!
Natalie
If your goal is weight loss you have to be in a calorie deficit, just doing keto will not do it. You can lose weight on any diet as long as you can stick with it.
The right calorie level will depend on the individual (age, sex, activity level, fitness level, genetics, etc.) so you’ll have to determine that for you. You can start by using the calorie calculator (HERE) or even better, track what you eat and drink for a week in MyFitnessPal and then reduce that amount by 200-500 calories per day
Hi I’ve just discovered your website while looking for an explanation for high insulin resistance while on keto diet.
I’ve tried keto diet twice now and my experience both times was that for a first month or so, my BG levels would go down and stabilize between 4-7 mmol/l and my daily insulin needs would go down 30-50%. So far so good.
But after a month, my BG would start to rise and most of the time it would stay between 7-10 mmol/l. It was very difficult for me to get my BG levels to drop below 7 mmol/l. I started to pump more insulin into my body, but it seemed that to have little effect. Keto diet might not be for me, so I think I will rather stick to low-moderate carb intake.
Is there any explanation yet for this “problem”?
Thank and keep up the good work :).
I don’t have a scientific explanation, unfortunately. All I can say is that I had the same experience and did not enjoy it. One theory could be that the body becomes so used to / depended on using fat for fuel that it becomes inefficient at using glucose. But again, that’s just a theory
I am a type 1 LADA. Low carb has always worked for me. Because of my insulin to carb ratio, I would need too much insulin for 200-300 carbs. Keto did not work at all for me. I did not tolerate all the fat. My BS would spike overnight. So am tooling along at less than 70 carbs daily. Am active. I do weights and cardio. And still work as a nurse 2 days a week. Feel great for an old lady.
Dear Christel,
Thank you for this article. Cleared lot of my confusion on carb diets.
One question; I am looking to start low carb diet recipes can you help…
Hi Rob, glad you found it helpful. For low carb recipes you can filter for “Low carb recipes” in the recipe library here on the site:
Hi Christel
Thank you for this great article.
Many people don’t have enough money to discuss everything with dr.
For those, your article is like a DR.
Thank you
Dear Christal,
Really big thanks to you for this article. Save me from the confusion.
Now I have confidence to go moderate carb without feeling “wrong”.
One question:
Is moderate carb compatible with moderate/high fat diet?
I am 32 y o, 152cm and 44kg (BMI: 19). I have a high body fat ratio though, so I want to lower that.
As I am tiny, I think 100g carb daily is good for me (30% of daily caloric intake). 100g of proteins seem to be the upper limit too (30% also, plus I don’t exercise much). In this case, how much fat is a sensible proportion? Another 30%? Will that be too high?
I know low carb and high fat work together. High carb and high fat are plain old bad diet. How about moderate carb and (???) fat……?
Hi Yilam,
I’m glad you found this post useful. My goal is to convey that ultimately the right diet will depend on you and your goals. There is not a one-fits-all.
I suggest you start by calculating your daily calorie need: https://diabetesstrong.com/how-to-find-your-daily-calorie-need/
That will help you find your macros. If you decide on 100 g carb, that equates ~400 calories, 100 g protein will be ~400 calories as well.
Let’s say your calorie need is 1800 (again, you’d have to calculate that) and you decide on a 500 calorie deficit. Then you’d want to eat 1300 calories a day. 800 of that would be from carbs and protein so you’d have 500 calories left, which equates 55 g fat/day since fat has approximately 9 calories per gram.
As with all meal plans / macro splits this would be a start and you’d evaluate progress after (optimally) 4 weeks and consider making changes
Dear Christel,
Thank you for such a quick reply!!
And thanks for the link for calculating caloric need! Very useful!
I have done that and my daily caloric need is 1160 (43.5*0.9*24*0.95*1.3).
I am not planning to lose weight (just want to adjust the body composition), so I will keep my intake at 1160kcal.
In this case, 30% (348kcal) carb is 87g and 30% (348kcal) protein is also 87g. The 464kcal remaining would be equivalent to 51g fat.
My concern is…… would 87g carb + 87 g protein + 51g fat very imbalanced? As many of my friends tell me that, if I am not on a low carb diet, high fat will lead to all sort of problems……
Yes I am very willing to try first and evaluate. Just want to make sure it is not faulty in the first place to start ๐
Thanks a lot!!!
Sure,
I generally don’t recommend going below 1200 calories/day. And you might benefit from going a little higher some days.
Why not stick with the 100 g carbs, 100 g protein and then do 44 g fat? I would consider that a good starting point. But again, I don’t know you, your goals or activity level well enough to give a straight up recommendation. If you ever need more in debt guidance I can offer that as 1:1 coaching
https://diabetesstrong.com/online-personal-training/
Oh thanks so much Christal!! I thought my reply failed because it didn’t show. How glad to find it actually didn’t disappear and with your reply!! Thanksssss ๐
You are right I don’t want to go under 1200 either. I will try 100g carb (33%) + 100g protein (33%) + 44g fat (33%).
Planning to start, I realise it needs vast research on nutrition data and enormous time to learn about each food item. I will try to get familiar and adjust my current diet to the planned diet gradually.
Will definitely tell you how it goes…… if I manage to go that far. ๐ but really thank you for helping me start!!
You got it!
I know this is an older blog but, I have to say I’m having the same experience with keto. I’ve been keto (and yes…blood testing over .5 mmol most of the time, I stopped cause it’s expensive) for over a year and my belly fat is increasing! I’ve been so sold on the science behind it, I’m in denial. It was refreshing to see someone else with the same issues. Why is that and what is going on!?!? I’m switching back to your moderate carb idea.
Thanks!
Joel
You and I are not alone in having a bad experience with keto, not that many talks about it though. I believe it’s fantastic for some, but we are not all the same.
I don’t know the exact science, I’ve been told it can mess with your hormones and others told me that if it’s not done “right” (for example too much protein) it can have a negative effect on your metabolism. All in all, I haven’t seen any science on it, so it’s anecdotal. My advice is to do what feels right, and you can afford and don’t buy into the “one fits all” paradigm
Hi I am a mom to a newly diagnosed Type 1 three year old girl. I have started researching carb approaches, and any kind of “plan” in general is hard with a toddler…but wondering what approach you recommend for kids? Or any references to plans for them? Wanting the best blood sugars for my baby and am so overwhelmed! Thanks so happy to have found your blog!
Hi Brooke,
Unfortunately, I don’t really have any experience with kids that age. I would love to help you, but I don’t want to give any advice when I’m not sure what the right approach is. Do you have a local JDRF chapter you can contact? They have great support and events for parents and children in most cities.
Please tell your daughter from me that there is nothing she can’t do with diabetes and that I wish her (and you) all the best.
– Christel
This was a great blog! Defiantely gave insight into each diabetic diet type.
I always have great ideas to start the low carb diet but when it comes down to it I really dont know where to start, substitutions etc. A ‘sample’ menu, I think, would be very beneficial. Do you know where I could find one OR if you would like to write one?! ๐
Love the blog!
Hi Ashley, thanks for the positive feedback! We will be starting a new challenge on TheFitBlog in January (be on the look out for the sign up form) and that will actually have weekly meal plan suggestions. So you’ll actually get 4 ‘sample’ menus in the next month. I hope you like them.
Christel
Fantastic blog! Im interested to see how a low carb diet affects my diabetes, but was never really sure where to start. This has provided an awesome insight and i will be sure to experiment and find out what works best for me.
Thanks heaps.
Hi Ruby – thanks you ๐
You have the right approach, it’s all about testing things out and find what works for you. Be on the lookout for sample menus in the new year.
Christel