There has been a lot of discussion over the last week on social media about whether low-carbohydrate diets are good or bad for people with type 1 diabetes Diabetogenic.
Some people say a low-carb diet is great for optimal HbA1c, while others say it’s dangerous, particularly for children who need more energy for growth and development.
So which is it?
Opinions have flourished off the back off new research published in the News York Times, How a Low-carb diet might aid people with type 1 diabetes. It relates to a study published in the Journal of Paediatrics Management of type 1 diabetes with a very low-carb diet.
“It found that children and adults with Type 1 diabetes who followed a very low-carb, high-protein diet for an average of just over two years — combined with the diabetes drug insulin at smaller doses than typically required on a normal diet — had “exceptional” blood sugar control,” (New York Times).
The average daily intake of carbs across the group was 36g (or just under 2.5 portions). This to me seems quite low for anyone.
On the other hand, a study out of Western Australia, found that low-carb diets resulted in more hypos.
A diet of less that 55g of daily carbohydrate achieved significantly better HbA1c results, but also resulted in ‘almost one’ hypoglycaemic event per day (6.3 per week).
Researchers particularly warned against low-carb diets in children, saying they were unsafe, “because they don’t provide enough energy for growth.”
Another study out of the United Kingdom, showed that a low-carb diet (30-50g per day), resulted in significant reduction in HbA1c and “was not associated with any adverse effects.”
So the take-home message is, don’t base your medication or dietary changes on one piece of information alone.
Do your own due diligence; analyse what you are reading, look at what else is being said, speak to others, consult with your doctor, and at the end of the day listen to your own body and do what is right for you.
So how many carbs should be we eating? The GI Foundation explains low carbohydrate diets like this:
- Low-carbohydrate diet – in which less than 26% of total energy comes from carbohydrates or 130g/day from a 2000 Calorie (8,400kJ) /day diet).
- Moderate carbohydrate diet – in which 130-230g/day or 26-45% of energy comes from carbohydrates
- High carbohydrate diet – where carbohydrates provide more than 230g/d or more than 45% of energy from a 2000 Calorie (8400kJ) diet.
Australian Dietary Guidelines say that carbohydrates should make up 45-65% of our total energy intake (230g-310g/day), Healthy Food Guide. With American guidelines recommending that healthy people get 50–65% of their calories from carbohydrates Diabetes Self-Management.
Diabetes Australia says, “Everyone’s carbohydrate needs are different depending on your gender, how active you are, your age and your body weight.”
“For some people, a lower carbohydrate diet may help with diabetes management.” However it is made clear that people who wish to consumer a lower carbohydrate diet should seek the advice of their healthcare team.
I personally eat about 6-7 portions (exchanges) of carbohydrate per day (90g-105g). This is less than the recommended dietary guidelines.
I have achieved a regular HbA1c of around 5% with this amount of carbs. I don’t feel hungry and I have plenty of energy to run around after my young two kids! This amount of carbs is the perfect fit for my lifestyle, and that, is key.
Diabetes isn’t a one-size fits all disease. So our carb intake shouldn’t be a one-size-fits all amount either.
There is no mathematical formula for insulin versus carbohydrate intake. There are many other factors that come into play including hormones, stress, illness, physical activity, or inactivity.
The bottom line is one’s diet should take a common-sense approach and fit your circumstance.
It really doesn’t matter what you call it.
If you are an active person and do a lot of training, you will naturally require more energy that someone who leads a very sedentary lifestyle.
There is no point eating a lot of carbs if you are just going to sit around all day.
And let’s face it, a person’s carbohydrate requirements may change from day-to-day as you don’t always eat the same thing every day, and activity levels change as well.
My job is quite sedentary, so I naturally eat less carbs on the day’s I’m in the office. It’s common sense.
I avoid force-feeding myself a whole lot of carbs to then just have to turn around and give myself a whole lot of insulin to counteract it. Eating less carbs on days when I’m not overly active means stable bloods, less insulin which means less chance of highs and lows and a more productive day as I’m not tired or in a bad mood from fighting the BGL round-about! Carb guidelines may be outdated in my view, particularly in today’s more sedentary society. Here is a great post from Diabetogenic
Everyone is different and what works for one person may not work for another. So at the end of the day, guidelines or no guidelines, whether you’re a low carb, medium carb, or high carb fan, your carb intake should suit your circumstances and your lifestyle.