Very Low Carb Ketogenic Diets
Very low carb diets typically induce mild to moderate ketosis, a state in which your body uses ketones and fat, rather than sugar, as its main energy sources.
Ketosis usually occurs at a daily intake of fewer than 50 or 30 grams of total or digestible carbs , respectively. This equates to no more than 10% of calories on a 2,000-calorie diet.
Very low carb, ketogenic diets have been prescribed for people with diabetes even before insulin was discovered in 1921 .
Several studies indicate that restricting carb intake to 2050 grams of carbs per day can significantly reduce blood sugar levels, promote weight loss, and improve heart health in people with diabetes .
In addition, these improvements often occur very quickly.
For instance, in a study in people with obesity and diabetes, limiting carbs to 21 grams per day for 2 weeks led to a spontaneous decrease in calorie intake, lower blood sugar levels, and a 75% increase in insulin sensitivity .
In a small, 3-month study, people consumed a calorie-restricted, low fat diet or a low carb diet containing up to 50 grams of carbs per day.
The low carb group averaged a 0.6% decrease in HbA1c and lost over twice as much weight as the low fat group. Whats more, 44% of them discontinued at least one diabetes medication, compared with 11% of the low fat group .
In fact, in several studies, insulin and other diabetes medications have been reduced or discontinued due to improvements in blood sugar control (
What Counts As A Low Carb Diet
Theres no clear definition of exactly what constitutes a low carb diet, and whats low for one person may not be low for the next.
An individuals optimal carb intake depends on their age, gender, body composition, activity levels, personal preference, food culture, and current metabolic health.
People who are physically active and have more muscle mass can tolerate a lot more carbs than people who are sedentary. This particularly applies to those who do a lot of high intensity exercise, like lifting weights or sprinting.
Metabolic health is also a very important factor. When people develop metabolic syndrome, obesity, or type 2 diabetes, their carb needs change.
People who fall into these categories are less able to tolerate a lot of of carbs.
The optimal carb intake varies between individuals, depending on activity levels, current metabolic health, and many other factors.
How Many Carbs Can I Eat Per Day
As we said, it varies by person, but the average person with diabetes gets 40 to 45 percent of their daily calories from carbohydrates. Some very low-carbohydrate diet plans may contain half this amount per day.
Starting slowly and steadily lowering your carb intake will help you avoid feeling fatigued or overwhelmed by the lifestyle change.
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Carbohydrate Goal And Diabetic Diet For Older/elderly Diabetic Patients
On the other end of the spectrum, people who are like really frail, some already losing weight unintentionally at an already advanced age are a different class of diabetics. ;As we discussed in the previous articles, I m not super strict with their blood sugars in that class. I let them go to 150 mg/dl range in the morning up to 200 mg/dl after meals. Again,; that is for those older, frail individuals. I dont restrict them too much because they dont have a good appetite, to begin with, Some are cancer patients. ;We sometimes limit their carbohydrates because sugar really drives your cancer cells. But, if you are like youre really losing too much weight and you really are not looking to cure this cancer, really theres no point in torturing these people with low carbs. ;I just tell them, if your cancer doctor said that the chances of recovery from this cancer are nothing, then maybe just enjoy your life. Some are already on heavy chemo and dont even have an appetite. ;I am not going to give that person a diet.
Yet, the majority of the time most diabetics fall into the previous category who needs tight control. I hope it is now clear how many carbs should a diabetic patient eat. I hope this article was helpful. For individualized goals and treatment regimens please do not hesitate to contact our office at 561-462-5053.
Please feel free to contact us directly for any questions or concerns.
Ahmet Ergin, MD, FACE, CDCES, ECNU
Endocrinologist in West Palm Beach, FL and New York.
Are Women And Men Carbohydrate Goals Different
For a woman, my maximum carbohydrate recommendation is 45 grams per meal in a diabetic diet compared to men who can eat up to 75 gr of carbs provided that they are physically active. Again, the exact amount depends on you and your lifestyle. Most of the time women need fewer calories and fewer carbs than men.
In most cases, If youre looking from a carbohydrate eating standpoint youre looking for a percentage of total calorie intake. ;So, if you want to be on the low carb side you may go down to 30 percent of your total calories. If you want to be on the more on the generous side, because youre physically active, you may go up to 35 to 45 percent of your total calories as carbs. That is true for both men and women.
The basic thing here to understand if you want to keep your blood sugar under control while eating healthy carbs and being physically active. If youre not physically active then your goals are down to 15 to 20 grams for women and less than 45 grams for sure for men. On the other hand, this goal can be as high as 60 to 75 gr of carbs per meal for men who are very very active.
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How Many Carbs Do Physically Active Diabetic Men Can Eat
Physically active men can have 30 to 75 gr of carbohydrates in their diabetic diet.
In this example, the patient has a very active, physical job. He is 35 and has type 1.5 diabetes . He is on one long-acting insulin and two oral agents. This individual is doing well with his lifestyle and also goes to the gym five times a week and works out one hour on those five days. I would tell this individual that my conservative goal for him could be as low as 30 grams of;carbs;per meal if he wants to go really low carb. This approach also will help reduce the number of diabetic medications. So, If youre very active and youre working out you must have some carbohydrates. Glucose is what your muscles are burning. If you do not eat any carbs youre going to have significant fatigue with exercise.
Best Apps For Carb Counting
While the fully automatic carb analyzer app is yet to be invented , there are a growing number of apps that can help you better gather, crunch, and manage the data surrounding carb counting.
Some are databases, some are tracking systems, most are a mix of both. The following get top marks from users:
- Foodvisor, that uses your smartphones camera to help you estimate portion size
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How Many Carbs And Sugars Should A Diabetic Have Per Meal
According to the CDC, people living with diabetes should get about 45% of their total calories each day from carbohydrates. For females, they recommend 34 servings of carbohydrates, at 15 grams per serving. For males, they recommend a slightly higher amount of 45 servings. This is equivalent to 4575 g each meal.
What Is A Very Low Carb Diabetic Diet
Avoid processed food and bakery for your diet for type 2 diabetes
A very low carbohydrate diet is not the same thing as keto diet. In a very low carbohydrate diet a diabetic individual can have 15-30 gr of carbs.
Now, when I say very little what I mean by that? ;I mean like 20 to 30 grams of carbs per meal.; And thats very generous.; And the reason I say its very generous is that youre really not burning any calories. Yes, I know. you may want to eat more. Thats the only thing you enjoy nowadays.; And I understand that but if you want to eat more carbs youre going to need more medications. Sometimes more medications may mean more side effects. ;Yet, we have a lot of ways, especially at SugarMDs. We have a variety of ways to help our patients.
Even if you want to use medications in addition to what youre already on, then I would suggest you can go up to a maximum of 45 grams of carbs for a woman at that stage. ;You may end up needing insulin as well of course.
The good news this, we have a lot of non-insulin medications we can use depending on your activity level and diet. Basically, even for very inactive people or people with disabilities or joint problems we have ways to get them to exercise one way or another.; If youre really not exercising, ;youre really looking for 20 to 30 grams of carbs and if you want to force it 45 grams.
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Choosing What Carbs To Eat
When choosing what carbohydrates to eat when you have diabetes, it’s important that you choose those that offer vitamins, minerals, and other elements of nutritional valuenot just empty calories.
Skip or limit refined carbohydrates in favor of complex carbohydrates, which are slower-burning starches like whole grains such as brown rice or oats, or veggies like squash or potatoes, in portion-controlled amounts.
The carbohydrate count of all packaged foods can be found by reading the Nutrition Facts label. For foods without a label, a food journal app in which you input specific foods and portion size can determine the approximate number of carbs you’re consuming.
Carbs To Lower Blood Sugar In Prediabetes
Regardless of the total number of prediabetes carbs per day that you have, you will get better results if you choose healthier sources and stay aware of portion sizes. Look for high-fiber, high-nutrient sources, and know that a serving size may be smaller than you think!;
Healthy Carbs for Prediabetes
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How To Count Carbs For Better Blood Sugar Control
Counting carbs is one of the most important ways people with type 2 diabetes manage blood-sugar levels.
Your doctor may have told you to count carbs or use something called the glycemic index to plan your meals. A healthy diet consists of a balance of carbohydrates, proteins, and fats. However, people with type 2 diabetes need to watch carbohydrates carefully. Why? Because when any food that contains carbohydrates is digested, it turns into sugar, which increases your blood-glucose level. Its pretty basic: Eating too many carbs can raise the amount of sugar in your bloodstream and lead to complications. The key for people like you with type 2 diabetes is to eat carbs in limited amounts at each meal and when you snack. Total carbs should make up about 45 to 60 percent of your daily diet if you have type 2 diabetes.
Theres no one diet that works for everyone with type 2 diabetes there are just too many variables: Age, weight, level of physical activity, medications, as well as daily routine and personal preference need to be taken into account. So heres where your diabetes care team comes in: Talk to your dietitian or diabetes educator to determine the right carb-counting number for you so youll be able to provide your body with a steady flow of energy throughout the day, maintain a healthy weight, and manage your blood sugar.
The Basics of Counting Carbs
Carbohydrate Guidelines For Type 2 Diabetes
Carbohydrates are an essential part of a healthy diet. But carbs also raise your blood sugar. When you have , its important to aim for a balanced carb intake. It can seem confusing and a little overwhelming at first, but dont be discouraged. Your doctor, diabetes educator, or can help you find a meal plan that works for you.
Foods that contain carbohydrates include:
Grains, such as breads, cereals, pasta, and rice
Fruits and fruit juices
Starchy vegetables, such as potatoes and
Dried beans and peas
Dairy foods, such as milk and yogurt
Sweets, such as cookies, pastries, cakes and candy
Snack foods, such as potato chips
To find the carb content of a food, check the amount of total carbohydrate on the food label. Be sure to look at the serving amount as well. If youre eating twice as much as the listed serving, youll need to double the total carbs. If a food doesnt have a label, there are many apps and books available to help you track carbs. One great free tool is MyFoodAdvisor from the American Association. At first, you may need to look up almost everything. But with time, youll start to learn how many carbs are in your favorite foods and dishes.
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Why Every Carb Counts
Carbs are one of the 3 main nutrients found in food, along with proteins and fats. Inside the body, carbs turn into blood sugar. So, carb-rich foods affect your blood sugar levels more than other foods do. Foods and beverages that contain carbs include:
Grains and grain-based foods, such as bread, pasta, and rice
Starchy vegetables, such as potatoes, corn, and peas
Fruit juices and fruits, such as apples, oranges, and bananas
Legumes, such as dried beans and lentils
Dairy products, such as milk and yogurt
Sweets, such as cakes, cookies, and candy
Sugary drinks, such as sodas, fruit drinks, and sports drinks
The amount of carbs you need depends on your weight, activity level, and diabetes medicines. Work with a registered dietitian or diabetes professional to set a carb goal that is right for you. As a general rule, most women with diabetes should get about 45 to 60 grams of carbs per meal. Most men with diabetes should get about 60 to 75 grams per meal.
How Many Carbs Are Right For You
To determine the right amount of carb grams to aim for in your eating plan, choose one of the categories below that best matches your stature, weight status, weight goals and activity level.
Consider the targets a starting point. Get a referral from your primary care provider or endocrinologist to meet with a dietitian and diabetes educator, and/or to attend a diabetes self-management education and support program to determine the best goals for your health.
Category 1: A Woman of Small Stature Who Wants to Lose Weight
You’re a woman who wants to lose weight, is small in stature and/or gets limited exercise. Consider the following:
Height: 4’10” to 5’2″
Daily calorie range: 2,300â2,800
Carb grams/day range*: 259â455 grams
Carb grams/meal range : 86â151 grams
*Based on 45â65% of calories from carbohydrate.
Note: Men who are under 65 years of age, moderate to large in stature, at a healthy weight and get a lot of exercise may need more calories and grams of carbohydrate.
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Personalize Your Carb Intake For Diabetes
If youd like to learn more about how you can reverse diabetes, lower high blood sugar, and get the health benefits of simply eating a more healthy diet, you can reach out to our coaches through our coaching program.
Our diabetes educators are experts with years of experience and the latest research and can work with you, your healthcare professional, and your registered dietitian to develop a healthy diet that works for you.
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Mastering Diabetes has strict guidelines for scientific references in our articles. We rely on peer-reviewed studies, academic research institutions, governmental organizations, and reputable medical organizations. We do our best to avoid using non evidence-based references in all articles. The references in this article are listed below.
5. Lifestyle Management: Standards of Medical Care in Diabetes2019 | Diabetes Care. .
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No Cost Health Kit To Lower Your Risk Of Diabetes
Keeping your prediabetic carbs per day in check can lower your risk for diabetes by helping you lose weight and by preventing wild blood sugar swings. Its not so difficult to be sensible about healthy carbs. Choose 1 to 3 small servings of healthy carbs per meal or snack, and you will be well on your way!
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What Are The Different Types Of Carbs
There are 3 types of carbs:
Sugars and starches raise your blood sugar, but fiber doesnt.
What About Sugar Substitutes
A sugar substitute is a sweetener that is used in place of sugar. The sugar substitutes approved by the Food and Drug Administration are aspartame, saccharin, acesulfame potassium, sucralose, and neotame. All can be safely consumed in moderation. Sugar substitutes do not need to be counted in your meal plan. If they are used as a sweetener in food that contains few calories and no other carbohydrate , that food is considered to be a “free food.” If, on the other hand, the sugar substitute is used in a food that contains other carbohydrate sources , the total carbohydrate content must be counted. That food is not considered a “free food.”
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