The Low vs. High Carb Debate: What Works Best for People with Diabetes?
Managing diabetes isn’t just about taking insulin or medications; diet plays a huge role.
Many people with diabetes struggle with the question of whether a low-carb or high-carb diet is better for their health. This debate can be especially confusing for people with Type 1 diabetes (T1D) and Type 2 diabetes (T2D). A diabetes dietitian can help make sense of this topic, but with so many opinions and options, it’s hard to know where to start.
Type 1 Diabetes and Carbs: The Research
When it comes to Type 1 diabetes, which makes up only 5-10% of the total diabetes population, the answer isn't as straightforward. A Type 1 diabetes dietitian often works closely with clients to navigate these challenges. Some studies show that reducing carbs to fewer than 75 grams per day can lead to improvements in blood sugar control. One study followed people with Type 1 diabetes over four years, and those who stuck to a low-carb diet showed great results. However, sticking to a low-carb regimen is tough, especially for children, who may be surrounded by peers eating different foods. So, while low-carb can work for T1D, the key is adherence—it’s not a one-size-fits-all solution.
Another study found that people with Type 1 diabetes who cut their carbs from over 200 grams per day to less than 70 grams saw their A1C (a key indicator of blood sugar control) drop from 7.7% to 7.1% in just 12 weeks. That’s a pretty good improvement! But again, this was a small group, and sticking to such a strict diet long-term can be difficult.
Type 2 Diabetes: Finding Balance with Carbs
For those living with Type 2 diabetes, the conversation about carbs is just as complex. A Type 2 diabetes dietitian can help you balance your carb intake, but the focus should be on what works for you. One study showed that a low-carb diet helped improve A1C levels and led to weight loss for people with Type 2 diabetes. However, after almost four years, the average A1C went back up, showing that adherence can be a challenge here too.
Interestingly, other research shows that both low-carb and high-carb diets can work for people with Type 2 diabetes—what matters most is consistency. People who paid close attention to their diet, whether they chose low or high-carb, saw improved A1C levels. But once again, sticking with the diet for the long term is where many struggle.
What’s the Best Option? Low-Carb or High-Carb?
The short answer is: there’s no universal answer. A registered dietitian and certified diabetes educator knows first-hand that what works for one person might not work for another. Some people thrive on 400 grams of carbs per day, while others do well on just 40 grams. The key is personalization.
For example, the T1D dietitian has tried both ends of the carb spectrum. During periods of low-carb eating, blood sugar control wasn’t as ideal due to insulin resistance, despite the low-carb intake. But when the carb intake was increased—especially during times of intense physical activity—managing insulin doses became critical. It was about finding that “sweet spot” that worked best for their body.
The Bottom Line: Consult with a Diabetes Dietitian
Whether you have Type 1 or Type 2 diabetes, the most important thing is to find a way of eating that works for you. It’s not about following the latest trend or adopting a specific carb level that works for others. A diabetes dietitian, whether a T1D dietitian or a T2D dietitian, can help you figure out what’s best for your lifestyle and health goals.
