Since the publication of the Diabetes UK Guidelines in 2011, low carbohydrate diets have been seen as a safe and effective option for people with Type 2 diabetes.  Low carbohydrate diets can help with weight loss and glucose management, and reduce the risk of cardiovascular disease. However, if you have Type 2 diabetes and taking insulin or other blood glucose lowering medication, you should talk to your GP before starting a low carbohydrate diet.  Low carbohydrate diets have helped many people put their diabetes into remission and some have come off diabetes medication.

The role of carbohydrate in the diet

We know that most carbohydrate foods are broken down into glucose. Generally, the body aims to maintain tight control of glucose levels in the bloodstream, keeping a store of extra glucose in the liver and the muscles for times when fasting or when extra glucose is needed.

It is important to understand where carbohydrates are found in the diet:

• Starchy foods: these include bread, rice, pasta, potatoes, yams, breakfast cereals and couscous.
• Sugars: these can be subdivided into
• Naturally occurring sugars found in fruit (fructose), milk and milk products (lactose).
• Free sugars added to foods like sweets, chocolate, sugary drinks and desserts plus the sugar in fruit juices, syrups and honey.

Why follow a low-carb diet?

Carbohydrate is the nutrient which has the greatest effect in terms of raising blood glucose levels and requires the most insulin to be taken or produced by the body.

Lowering blood sugar levels is clearly a benefit for people with diabetes. Lowering the need for insulin is also particularly useful as lowering insulin in the body can reduce insulin resistance. Insulin is also a fat storage hormone in the body, so reducing insulin in the body with a low-carb diet can help with losing weight.

What counts as low-carb?

There is currently no agreed universal definition regarding the amount of carbohydrate in low-carb diets. One consistent definition has been ‘less than 130g’ of carbohydrate per day but other definitions also exist.  Reducing your carbohydrate portion to approximately one quarter of your meal is one way of reducing your carbohydrate intake.  You may need to increase your portions of vegetables or salad to fill your plate and make sure there is a source of protein at your meal as this will help to keep you fuller for longer.

Low-carb is a flexible way of eating that allows you to choose a level of carbohydrate that works well for your diabetes and lifestyle.

Low carb snack ideas

– small handful of nuts
– small bag of popcorn
– berry fruits
– one/two squares of dark chocolate
– a boiled egg
– vegetable crudite
– olives

Michelle Hooper
Diabetes Specialist Dietitian
Hounslow & Richmond Community Healthcare NHS Trust

You can find out lots of info about having a healthy balanced diet on our Eat Well page

References:

1. McArdle PD et al. Carbohydrate restriction for glycaemic control in Type 2 diabetes: a systematic review and meta-analysis. Diabetic Med 2019; 36:335-348
2. Type 2 Diabetes is Adults: management. NICE, London 2019. www.nice.org.uk/guideance/ng28
3. Evidence-based nutrition guidelines for the prevention and management of diabetes. Diabetes UK London 2018
4. Davies MJ et al. Management od Hyperglycaemia in Type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018; 41:2669 – 2701