7 Challenges When You Start Eating Low-Carb

Patient Expert
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If you have diabetes, you have good reasons to cut back the amount of carbs you eat. The best reason is that a low-carb diet is the only proven way to have a normal blood glucose level without taking diabetes drugs. A low-carb diet is also the best way to get down to a normal weight. But first, you face several challenges. Here’s what you can do.


Set your goals

Eating low-carb can mean eating as few as 30 grams of carbs per day, as Richard K. Bernstein, M.D., recommends. At the other extreme, up to 130 grams per day is the generally accepted cut-off. Set your own goal, and depending on your personality, you may want to set intermediate goals or go cold turkey.


Count total carbs

Set your goals in terms of total carbohydrates, not net carbohydrates. Total carbohydrates are starches, sugars, and fiber, while net carbs exclude fiber. But fiber does affect our blood glucose. Starches and sugars have four calories per gram; fiber has about two calories per gram.


Helpful guides

No matter what goals you set, you need to count the carbs you eat. This can be as hard as giving up bread and other carbs because it means weighing and counting what you eat. Three sources of data give you the help you need: the Nutrition Facts on packaged food, the NutritionData site for all else, and your own nutrition scale to weigh your food.


Be patient

Expect to feel weak for a week or two. Our bodies need about 130 grams of glucose per day, either from carbs or from the synthesis of glucose from protein or fat. Our bodies can convert protein into glucose, but slowly and inefficiently. Fat converts to glucose works better. Still, when we cut back on carbs, our bodies don’t immediately switch.


Use more salt

Increase your salt. Stephen Phinney, M.D., Ph.D., and Jeff Volek, Ph.D., make this recommendation in their book “The Art and Science of Low Carbohydrate Living,” which I reviewed here. When you eat low carb, your kidneys excrete salt rapidly. This can cause you to feel lightheaded when you stand up quickly or to feel fatigued when you exercise.


Watch your blood glucose level

When you go low carb, you may well be surprised at how fast your blood glucose level drops. This means that if you had been taking a diabetes drug, especially insulin or a sulfonylurea, your level can get too low unless you cut back on how much you take. So talk with your doctor and check your level much more often.


You will need more fats

Remember that when you go low carb, you have to get more fats in your diet to give you the energy you need. Many people are still afraid of saturated fat, but recent studies show that only one fat  — trans fat  — is bad for diabetes.


The coconut oil exception

But first, you will need to get most of your saturated fat from coconut oil, which our bodies burn more easily than other saturated fat. Switching from burning carbohydrates to burning fats other than those that are saturated takes a little time. This can take a week or so and perhaps even longer for some people. But it’s worth the effort.