Options for the Management of Diabetes through Diet
The American Diabetes Association (ADA) stated in their 2015 Standards of Medical Care in Diabetes that research does not back up the concept of a one-size-fits-all diet for people with diabetes. Each diet should be tailored to the individual and designed by a registered dietitian nutritionist. Carbohydrate restriction is a common dietary treatment for diabetes but the question is how restrictive should these diets be?
Low Carbohydrate Diet
Very low carbohydrate diets like the popular Atkins Diet have shown promising results in recent research looking at individuals with diabetes (Feiman et al, 2015). A very low carbohydrate diet, or ketogenic diet as it is sometimes referred to as, limits carbohydrate intake to only 20 to 50 grams per day. This diet has been shown to improve hemoglobin A1C levels significantly compared to a standard low calorie, moderate carbohydrate diet. Lipid levels (blood cholesterol and triglycerides) are also significantly improved despite the increased consumption of dietary fat. Improving lipid values is important for people with diabetes since they are at greater risk of cardiovascular disease. It is important to note that this type of diet has been shown to decrease and sometimes eliminate the need for diabetes medications. To prevent episodes of hypoglycemia (low blood sugar), patients should have medical supervision when beginning a new diet.
Carbohydrate or Carb Counting is a strategy used to simplify keeping track of how many grams of carbohydrates a person consumes. Here are the basics to carb counting:
- 1 carb serving = 15 grams of carbohydrates
- Look at serving sizes and then grams of total carbohydrates on food labels
- Plan meals and snacks in advance to make sure you stay within your carb limit
Types of Carbohydrates:
- Grains like flour, pasta, bread, oatmeal, crackers, and rice
- Starchy vegetables like corn, peas, and potatoes
- Added sugars are found in processed foods like sweets, table sugar, syrup, and even a number of condiments
- NCHPAD Diabetes Nutrition Cooking Video. http://www.nchpad.org/Videos/PLwMObYmlSHaOf1nFVw2g3CD29pxkWBbOn
- American Diabetes Association. www.diabetes.org
- Academy of Nutrition and Dietetics. www.eatright.org
American Diabetes Association. Foundations of Care: Education, Nutrition, Physical Activity, Smoking Cessation, Psychosocial Care, and Immunization. Diabetes Care. 2015;38(1):S20-S30.
Feinman R, Pogozelski W, Astrup A, et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutr. 2015;31:1-13.