When people first learn about diabetes, cutting out all carbohydrates can sound like the easy answer. But managing diabetes is more complex—there’s no quick fix (Evert et al., 2019). In fact, going totally carb-free can bring new risks, and most leading diabetes organizations do not recommend this approach for everyone (Evert et al., 2014). What matters most is understanding the types and amounts of carbs you eat, your medications, activity level, and your own health priorities (CDC, 2020).
You can’t cure diabetes by avoiding one food group.
Diabetes is a lifelong condition; it happens when the body either doesn’t make enough insulin or can’t use insulin properly (CDC, 2020). If you have Type 1 diabetes, your pancreas produces little or no insulin, so taking insulin is always necessary, regardless of what you eat. In type 2 diabetes, the body becomes less sensitive to insulin. Managing it often requires a combination of good nutrition, regular exercise, and sometimes medications (Evert et al., 2019). Some individuals with Type 2 diabetes can achieve remission, often by losing weight, but remission isn’t a cure—you still need to keep an eye on your blood sugar (Evert et al., 2014). No diet or single food group can “reverse” diabetes.
There are different types of carbs.
There are three main types of carbohydrates:
Sugars—These cause the sharpest spike in blood sugar. You’ll find them in sweets, sugary drinks, and, in smaller amounts, in foods like fruit and milk (CDC, 2020).
Refined grains – Such as white bread, white rice, and white pasta. They mostly contain starch and little fiber (Evert et al., 2019).
Whole grains, pulses, vegetables, and fruits – These foods come packed with fiber, vitamins, and essential minerals (Evert et al., 2019).
Fiber is passed through the body undigested. It makes you feel full, lowers blood sugar levels, and lowers your cholesterol (Evert et al., 2019).
If you cut out all carbs, you might also exclude foods that actually help keep your blood sugar steady.
Why cutting out carbohydrates completely can cause issues
Going extremely low carb can cause problems in some diabetes patients:
Hypoglycemia – Patients taking insulin or some diabetes tablets can become dangerously low in blood sugar.
Ketones—If you go extremely low carb, then your body will start using fat as its energy source, causing ketones to build up. This can increase your risk of a serious condition called diabetic ketoacidosis in type 1 diabetes or with some medications (Evert et al., 2019).
Lack of nutrients—Fruit, whole grains, and pulses contain fiber and micronutrients that can be harder to replace.
Hard to stick with—Extremely strict diets are tough for most people to maintain long-term. If you stop suddenly, you may see blood sugar swings and even gain back weight.
Before making any significant changes to your diet, speak to a healthcare professional to ensure your medication is adjusted safely (Evert et al., 2019).
Expert opinion
The American Diabetes Association brought together an expert panel. They reviewed over 600 nutrition studies. They concluded that no single dietary pattern suits all people with diabetes. Furthermore, they found no evidence of a perfect balance of calories from carbohydrates, protein, and fat. It should be personalized. Evidence supports low-fat and Mediterranean-style diets, as well as low-carbohydrate diets. They agreed we should reduce added sugars and refined grains and focus on eating plenty of non-starchy vegetables. They also agreed to eat whole foods rather than processed foods (Evert et al., 2019; Evert et al., 2014).
So, for some people, cutting back on carbs makes sense—but you don’t have to avoid them altogether.
How to make better carb choices
Try to eat high-fiber foods:
Make vegetables, beans, lentils, whole grains, and whole fruits the staples of your meals. Skip refined grains and fruit juices when you can.
Reduce added sugars – Sweets, sugary drinks, and desserts will cause a rapid increase in your blood sugar, with little nutritional value (Evert et al., 2019).
Plate method – Fill about half your plate with non-starchy vegetables. Split the remainder between lean protein and carbs (CDC, 2020).
Pair with protein or healthy fats – This can slow how quickly glucose enters the blood (Evert et al., 2019).
Eat regularly – Regular meals make your blood sugar levels easier to predict (Evert et al., 2019).
Ask for individualized advice—talk to a registered dietitian or diabetes educator to create a plan that fits your medication, culture, budget, and preferences (Evert et al., 2019).
Stay active—being active, sticking to your medication, and regularly checking your blood sugar levels is just as important (CDC, 2020).
Conclusion
While carbohydrates will affect your blood sugar levels, they aren’t the only cause of diabetes. Going completely carb-free won’t cure diabetes (Evert et al., 2019). Many people will find it safer and more sustainable to choose better carbs, control portion sizes, and have a plan created by their healthcare team. Your healthcare team can best manage diabetes by reviewing your diet, activity, medication, and monitoring (Evert et al., 2014).
Note: This article provides general information. Always check with a qualified healthcare professional before you change your diet or medication.
Evert, A. B., Dennison, M., Gardner, C. D., et al. (2019). Nutrition therapy for adults with diabetes or prediabetes: A consensus report. Diabetes Care, 42(5), 731–754.
Evert, A. B., Boucher, J. L., Cypress, M., et al. (2014). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care, 37(Supplement 1), S120–S143.
Centers for Disease Control and Prevention. (2020). National Diabetes Prevention Program: Participant guide. https://www.cdc.gov/diabetes/prevention/pdf/participant-portal/participant-guide.pdf
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