How many carbs in a low carb diet for diabetics

When you receive a diagnosis like diabetes, the first thing your care team will probably want to talk about is your diet—and specifically, how many carbohydrates you're getting on a daily basis. That's because carbohydrates play an outsized role in the management of diabetes, as their breakdown in your digestive system causes your blood sugar to rise. And controlling diabetes is directly related to controlling blood sugar.

It's important to note that there is no one-size-fits-all diabetes plan. As you become more knowledgeable about carbohydrates and diabetes, it will help you—along with your diabetes care team—design a plan that fits you and your lifestyle.

Related: Can You Eat Carbs When You Have Diabetes? What Dietitians Have to Say

Nutrition Basics for Diabetes-Friendly Eating

Since carb counting goes hand-in-hand with calorie counting, let's do a quick refresher on what makes up a calorie. Calories come from three nutrients: carbohydrates, proteins and fats, which are also known as macronutrients. Alcohol also has calories but is not considered a macronutrient. In contrast, vitamins and minerals are micronutrients and don't have any calories.

The foods we eat are made up of varying amounts of carbohydrates, protein and fat. For example, a potato is mostly carbohydrate with a small amount of protein. Top it with sour cream and you've added calories from fat. A piece of skinless chicken breast—like the one in the recipe for Chicken Burrito Bowls above—contains mostly protein, a small amount of fat and no carbohydrate. How the chicken is prepared can add other nutrients and calories. For example, breading the chicken will add more carbohydrates; frying it will add more fat.

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What Foods Contain Carbs?

There are three types of carbohydrates: sugar, starch and fiber. If you're counting carbohydrates, you want to pay attention to the total carbohydrates listed on the nutrition label, which is the sum of all three types.

Here are some foods that mostly derive calories from carbohydrates (some also contain protein and fat).

• Grains: Bread, cereal, pasta, rice, tortillas, crackers, oats, whole grains
• Legumes: Lentils, beans, peas
• Starchy vegetables: Potatoes, corn
• Nonstarchy vegetables: All other vegetables (e.g., green beans, tomatoes, lettuce, carrots, asparagus, cauliflower, broccoli, spinach, kale, beets, etc.)
• Fruit and fruit juice: All kinds
• Dairy products: Milk, yogurt
• Sugar-added beverages: Regular soda, juice beverages, juice cocktails
• Sweets: Ice cream, candy, baked goods

What's the Connection between Carbs, Insulin and Blood Sugar?

When you eat foods with carbohydrates, the carbohydrate is broken down into glucose (sugar), which enters your bloodstream, raising the amount of sugar in your blood. This signals the pancreas to release insulin. Insulin then takes the sugar from your blood to your cells to be used for energy. Subsequently, the amount of sugar in your blood comes down. The next time you eat, this process happens again.

If you have diabetes, your body doesn't use insulin properly, making it hard for your body to regulate the amount of sugar in your bloodstream. Because carbohydrates cause your blood sugar to rise, controlling your intake of carbohydrates helps control your blood sugar as well.

But here's a little tip: While there are three types of carbohydrates—sugar, fiber and starch—they are not all digested the same.

Nonstarchy vegetables contain mostly fiber and little to no sugar, so they don't raise your blood sugar very high, and therefore, not as much insulin needs to be released. So pile those nonstarchy vegetables on your plate!

In contrast, fruit juice, soda and refined grains (e.g., white pasta, rice or bread), contain little to no fiber, so they spike your blood sugar and more insulin is released. According to the Academy of Nutrition and Dietetics, the glycemic index (GI) further explains the effect that different foods have on your blood sugar level. The Academy also states that the glycemic load, which takes into account the GI of a food, as well as the amount of it being eaten, might be a more accurate guide to consider when eating for diabetes.

Why Should You Eat Foods That Have Carbs?

Lemon-Herb Salmon with Caponata & Farro

strawberry spinach salad

Vegetable Weight-Loss Soup Recipe

Pictured Recipe: Vegetable Weight-Loss Soup

Research shows that losing weight can help you hit your blood glucose targets and control or slow the progression of your prediabetes or type 2 diabetes. Studies haven't shown a low-carb diet to be more effective than a low-fat diet for long-term weight loss and maintenance. But you do need to maintain a calorie deficit if you want to lose weight.

For example, two large, multi-year studies funded by the National Institutes of Health (NIH)—the Diabetes Prevention Program (DPP) for prediabetes and Look AHEAD (Action for Health in Diabetes) for type 2 diabetes—used a lower-calorie eating plan and encouraged people to be more aware of their fat consumption by counting fat grams and calories. They didn't focus on carbs. Both studies showed that people who lost weight—and kept it off—experienced numerous health benefits over the years. Both studies also encouraged physical activity almost every day.

In 2022 in the journal Medicine & Science in Sports & Exercise, the American College of Sports Medicine (ACSM) released updated guidelines for people with type 2 diabetes. For blood glucose management, ACSM recommends small doses of physical activity throughout the day, including after meals. They also recommend either moderate aerobic exercise for at least 150 minutes spread throughout the week or more vigorous aerobic exercise for at least 75 minutes spread throughout the week. In addition to aerobic exercise, ACSM also recommends muscle-strengthening activities at least twice a week, as well as balance exercises and stretching.

Here's the bottom line on weight loss and diabetes: You can lose weight by eating low-carb or low-fat, as long as you're eating fewer calories. But the hard part is keeping it off. So work toward creating a healthy lifestyle that you can maintain for the long term. This usually involves being physically active most days, eating more fiber by prioritizing vegetables and whole grains, eating less sugar, swapping out saturated fats for mono- and polyunsaturated fats, consuming adequate protein and self-monitoring your progress. Managing your stress and clocking in plenty of quality sleep are also important lifestyle areas that contribute to your health and blood sugar and weight management.

How Many Carbs Are Right for You?

To determine the right amount of carb grams to aim for in your eating plan, choose one of the categories below that best matches your stature, weight status, weight goals and activity level.

Consider the targets a starting point. Get a referral from your primary care provider or endocrinologist to meet with a dietitian and diabetes educator, and/or to attend a diabetes self-management education and support (DSMES) program to determine the best goals for your health.

Category 1: A Woman of Small Stature Who Wants to Lose Weight

You're a woman who wants to lose weight, is small in stature and/or gets limited exercise. Consider the following:

Height: 4'10" to 5'2"

Daily calorie range: 1,200–1,400

Carb grams/day range*: 135–228 grams

Carb grams/meal range (3 meals per day): 45–76 grams

*Based on 45–65% of calories from carbohydrate

Category 2: A 65-Year-Old Female Who Wants to Lose Weight

You're a woman who is 65 years of age or older, wants to lose weight, has an average to large stature and/or gets limited exercise. Here are some basic calorie and carb recommendations:

Height: 5'3" to 5'8"

Daily calorie range: 1,400–1,600

Carb grams/day range*: 158–260 grams

Carb grams/meal range (3 meals per day): 53–87 grams

*Based on 45–65% of calories from carbohydrate

Category 3: A Female Who Wants to Maintain Weight

You're a woman who is under 65 years of age, is of moderate to large stature and is at a healthy weight. Consider the following:

Height: 5'8" to 6'

Daily calorie range: 1,600–1,900

Carb grams/day range*: 180–308 grams

Carb grams/meal range (3 meals per day): 60–103 grams

*Based on 45–65% of calories from carbohydrate.

Note: Women who are under 65 years of age, moderate to large in stature, at a healthy weight and get a lot of exercise may need more calories and grams of carbohydrate.

Category 4: A Male of Small Stature Who Wants to Lose Weight

You are a man who is 65 years of age or older, are smaller in stature, want to lose weight, and/or get limited exercise. Here are your recommendations:

Height: 5'4" to 5'8"

Daily calorie range: 1,600–1,900

Carb grams/day range*: 180–308 grams

Carb grams/meal range (3 meals per day): 60–103 grams

*Based on 45–­65% of calories from carbohydrate.

Note: These recommendations are the same for a woman of small stature who wants to maintain weight.

Category 5: A Male Who Wants to Maintain Weight

You're a man who is 65 years of age or younger, is moderate to large in stature, at a healthy weight and gets limited exercise. Here are some basic calorie and carb recommendations:

Height: 5'8" or taller

Daily calorie range: 2,300–2,800

Carb grams/day range*: 259–455 grams

Carb grams/meal range (3 meals per day): 86–151 grams

*Based on 45–65% of calories from carbohydrate.

Note: Men who are under 65 years of age, moderate to large in stature, at a healthy weight and get a lot of exercise may need more calories and grams of carbohydrate.

Are You Making Healthy Choices but Still Have High Blood Sugar?

According to American Diabetes Association guidelines, many people with type 2 diabetes should start taking a blood glucose-lowering medication, typically metformin (a generic medication that helps the body better use the insulin you still make), as soon as they are diagnosed.

Most people diagnosed with type 2 diabetes have had blood sugar levels in the diabetes range for months if not years before diagnosis. Don't think of taking blood glucose-lowering medication as failing. Type 2 diabetes, with prediabetes as its starting point, is a progressive disease during which people slowly lose their insulin-making capabilities over time.

It's of no health value to severely restrict the number of carbs you eat to manage your blood sugar levels and/or to delay medication. The recommended course of action to stay healthy with type 2 diabetes is to get blood glucose, cholesterol and blood pressure numbers under control soon after the time of diagnosis—and maintain target goals-adjusting diet and medication as needed. With lifestyle changes, it might be possible to reduce or stop your medication over time and this is something to discuss with your healthcare provider.

The Bottom Line

The amount of carbs you should eat per day depends on a variety of factors, such as your gender, weight and height. But, getting closer to 40-45% (or less) of your calories from carbohydrates may better improve blood sugar control and aid weight loss. It's most important to choose quality carbs—that is, carbs that are high in fiber and low in sugar—and limit refined and added sugars. Space carbs evenly throughout the day, and stick to a low-to-moderate carb count that you can keep up with long-term. Losing weight will improve diabetes control, but more research is needed to determine if a low-carb or low-fat diet is most effective long-term. There is no "one-size-fits-all" recommendation. Talk to your healthcare provider, dietitian and/or diabetes educator to learn more about what works best for you in order to create your individual care plan.

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