Seven Diabetes Challenges When You Low Carb

by David Mendosa Patient Advocate

Those of us who have diabetes have many good reasons to eat few carbohydrates. Two of the best reasons are better blood sugar control -- getting a very low A1C level -- and losing weight -- getting down to a low BMI.


But getting started has its challenges. Here are some tips to make it easier.

1. Decide why you want to follow a very low-carb lifestyle. It can be to reduce your blood sugar or your weight. It does both. It will also make you healthier and happier. Decide which of these aspects is important to you.

2. Set a goal.
Very low-carb means 50 to 60 grams of carbohydrate per day. But you may prefer to set an intermediate goal of 100 or 120 grams per day. Set the goal in terms of total carbohydrates, not net carbohydrates. Total carbohydrates are starches, sugars, and fibers, while net carbs exclude fiber. But fiber does affect our blood sugar. Starches and sugars have 4 calories per gram; fiber has 2. See "The Trouble with Fiber."

Whatever goal you set, you will need to measure the carb content of what you eat for a while until you know what your favorite foods contain. See "Nutrition Scales."

3. Expect to feel weak for a week or two. See "It's Low-Carb Weak."

4. Increase the amount of salt you consume. Our bodies function quite differently when we eat few carbohydrates. Our kidneys excrete rapidly when we eat low carb causing us to feel lightheaded when we stand up quickly or feeling fatigued when we exercise.

"The best solution is to include 1 or 2 cups of bouillon or broth in your daily schedule," write Jeff Volek and Stephen Phinney in The Art and Science of Low Carbohydrate Living (2011, p. 41). See my review of this book at "Low Carbohydrate Living."

5. Especially when you start low carbing, be sure to check your blood sugar level more often than usual. That's because quite soon after starting to low carb, you will need much less diabetes medication. See "Diabetes without Drugs."

6. Remember that you have to follow a high-fat diet when you go low-carb. If you thought that saturated fat is a bad fat, be sure to read this article: "The Bad Fats for Diabetes."

7. But at first avoid saturated fat for a week or two. See "Coconut Oil: A Different Kind of Saturated Fat."

Switch from burning carbohydrates to burning fats for your daily fuel takes a little time. But it's worth the effort. Hang in there!

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.