A Guide to Healthy Low Carb Eating with Diabetes

Diabetes is a state where the pancreas has stopped producing insulin or is not making enough.

If the body is still making insulin, it may not be using it well. When this happens, the body is unable to get sugar from the blood into the cells. That leads to high blood sugar levels.

Glucose is in the foods we eat that fuel our bodies cells. Insulin acts as a key to allow glucose into the cells.  Insulin resistance occurs when there is extensive visceral fat. This visceral adiposity causes a layer that makes it difficult for a hormonal response from insulin.

Over time as this layer of fat develops insulin sensitivity decreases. Overweight occurs in about 80% of those with type 2 diabetes or Syndrome X.

Carbohydrates are the primary energy source in the diet. Roughly on average, it will comprise 40-50% of total caloric intake.

While many people with diabetes may think that limiting carbohydrates in the diet is beneficial, it is, in fact, the type of carbohydrates that we include in the diet that can have the most positive impact on the body’s blood sugar levels.  

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Types of Carbohydrates

Refined grains are whole grains that have gone under a process of refinement. Refinement means that the outer hull and germ are stripped away from the grain. It is this part that contains fiber.

Refined foods are shelf-stable or in processed, refrigerated, packaged items. Refined carbohydrates like white bread, and crackers, do not offer nutritional benefits. Often these items come packed with loads of refined sugar, sodium, and saturated fat. These items can pack on pounds, raise blood pressure and clog arteries and lead to inflammation. 

Complex carbs have a more elaborate chemical structure. They also contain fiber, vitamins, and minerals. The high fiber content slows digestion down as it passes through the gastrointestinal tract. When digestion is slow, the food will not have an immediate impact on blood glucose levels.

A rise in blood sugar will be slower than the action of refined carbohydrates. These combined factors make Complex carbohydrates the optimal choice for a person with diabetes.

Glycemic Index

The Glycemic index measures the effect that carbohydrate foods have on blood sugar. The index is a ranking system based upon the glycemic load of the food. Food ranking depends on the number of dietary fibers it contains, the processing involved, and the food preparation.

The glycemic index measures the food as if it was eaten alone. If the food accompanies another food, this can equally affect the glycemic index. The glycemic index ranks carbohydrates on a scale from 0 to 100. This scale measures how quickly and how much they raise blood sugar levels after eating. The rating system classifies food like this:

  • 70-100 are high-glycemic foods

  • 56-69 are medium-level foods 

  • 55 or less are low-glycemic foods

Foods with a high glycemic index, like white bread, are rapidly digested and cause fluctuations in blood sugar. Like oats, food with a low glycemic index digests slower, prompting a more gradual rise in blood sugar. Eating many high glycemic index foods can lead to an increased risk for:

  • Prediabetes

  • Type 2 diabetes 2

  • Heart disease

  • Overweight 3

Vegetables are a part of a well-balanced diet, but people with diabetes need to care when selecting their choices. Starchy vegetables should be limited. When starchy vegetables are cooked, their GI index increases significantly. Starchy Vegetables include:

  • Cassava

  • White potato

  • Beets

  • Corn

  • Green peas

  • Pumpkin

  • Parsnips

  • Beans

  • Chickpeas

While carbohydrates affect blood sugar levels quicker, we must examine how fat combined in meals can affect the rise. Foods with high-fat content like birthday cake or ice cream will cause a spike in blood sugar much later in the day as the food digests.

Throughout a few hours, triglyceride levels in the bloodstream rise. Your liver becomes more resistant to insulin. The liver produces more glucose, and your blood glucose level continues to rise. You can avoid this by avoiding fat-laden foods like fried items and those containing saturated fat.

The higher amount of fat content, the longer it will take to digest. In place of these, include healthy fats in your diet. Healthy fats are in foods like avocado and walnuts.

Expanding your culinary adventures into coconut oil, ghee, cold-pressed olive oil, and algae oil can ensure you are getting the right amount of healthy fat. You may also add eggs and fish such as salmon, sardines, and tuna to help increase your diet’s healthy fats. 

Choosing the best type of grain for diabetes

You may be asking yourself, where is the best place to start? It’s not uncommon for one to walk down the aisle at the grocer and see and see items listed as “honey wheat” or “wheat” and assume that they are a health-conscious choice.

Wheat is found high on the Glycemic Index List. Gluten is a grain protein that will reduce the risk of developing atherosclerosis (fat deposits in arteries). But, those with celiac disease need to avoid the wheat protein gluten. Exposure can cause bloating, gas, diarrhea.

Those with Celiac Disease need to be able to identify other whole grains that are tolerable. Further, research shows gluten, found in Wheat, Rye, and barley, affects the microbiota and increases intestinal permeability. Increased intestinal permeability intensifies the likelihood of a leaky gut and dysbiosis.

Studies have demonstrated that gluten peptides can cross the intestinal barrier, lead to a more inflammatory milieu. Diabetes is a disease of inflammation, pointing to gluten as a possible cause for increased inflammation. This may be reason enough to avoid wheat. (4)

There is a common misconception that “wheat” is “whole wheat.” To choose the healthiest grain for a person with diabetes, it should contain the word “whole.” Other markings, such as the whole grain stamp on food packages, make them easily identifiable.

Top choices of Grains for diabetics

Here we explore the top choices of Grains for diabetics. The key is to offer a variety from this list consistently.

Sourdough bread is made from a grain that is milled, then fermented. The process of fermentation creates probiotic bacteria. Probiotic bacteria help to feed the positive bacteria in our colon and help the GI tract flourish. A small study in Canada found interesting results when comparing the blood sugar levels of individuals with diabetes after eating various types of bread. “With the sourdough, the subjects’ blood sugar levels were lower for a similar rise in blood insulin.” (5)

There were indications that the effect lasted well into the next meal, Interestingly bread with wheat flour were found to spike blood sugar, even more so than white bread. Researchers were better able to understand the connection and difference between whole wheat and whole grain. 

Crushing plants like oats and millet comprise porridge.  Porridge has a significant amount of soluble fiber. Soluble fiber adds bulk to stool and helps it pass through the gastrointestinal tract. Like the other food items mentioned here, the fiber slows down digestion, and blood sugar levels do not spike rapidly. Also, the fiber helps you feel fuller longer.

While porridge doesn’t suit everyone’s palate. There are plenty of cold breakfast cereals that fit the bill. Understanding a food label is essential in selecting a cold cereal. Cereal grains that will give you the most bang for your buck include those that have:

  • No or little sugar added. 

  • 3 g or more of protein. Adding milk can also boost this.

  • Cereals that contain whole oats.

  • Carbohydrates: Contain no more than 30 g per serving.

Like grains, rice also goes through a refinement process; the result is white rice. Brown rice is essentially the unrefined rice product. As a result, it has a higher fiber content compared to its white counterpart. The fiber increases fullness and aids the health of the digestive tract. Brown rice is high in Flavonoid, a powerful antioxidant that reduces the risk of Alzheimer’s and some cancers.7

Rye bread hails from a cereal grain that is in the same family as barley and wheat. Rye has been cultivated and used in bread dating back to the ancient Romans. Traditionally it was produced similarly to the sourdough, using live active cultures.

While Pumpernickel Rye contains little fiber, Rye can have an average of 4 g. It is also low on the glycemic index, somewhere between 41-46, depending on the brand. A 2014 study found that Rye bread increased satiation, likely due to the fiber content. Increased satiation led to a decrease in overall food consumption, which could lead to weight loss.6

Quinoa has been newsworthy over the past few years. The ancient seed is relatively low on the glycemic index, gluten-free, and a complete protein. Being a complete protein source means that it contains all of the amino acids needed as the basic building blocks for cell function.

Quinoa is an excellent choice for diabetics and for vegetarians needing to fill this void. Quinoa also provides quercetin, a powerful antioxidant that fights off cancer and viruses. Quinoa packs 5g of fiber per serving, making this a high fiber food. It is Full of vitamins and minerals. 

Quinoa supplies a healthy dose of B vitamins and is rich in vitamin E. It also contains the minerals iron, calcium, and manganese. It has the highest potassium of any other grain. Potassium is essential for anyone that is trying to control their blood pressureCooked quinoa can be refrigerated to throw into a stir fry or even makes excellent breakfast cereal. 

Health benefits of adding whole grain to your diet 

Research on whole grains shows the numerous benefit for the cardiovascular system with consistent consumption. Studies also have concluded that consumption of whole-grain foods can help your waistline stay trim. While nutrition guidelines prompt people to consume at least 50% of their carbohydrate intake from whole grains, many health experts encourage 100%.

Other benefits of whole grains include reducing blood pressure, increased insulin sensitivity, prevention of weight gain, and improved endothelial function (blood flow).2 Studies have shown including grain foods2-4 servings daily can :

  • Reduce the risk of heart disease by as much as 40%. This percentage is equivalent to the effect of statin drugs. 

  • Reduction in Stroke risk. Women eating 2.7 serves of whole-grain food per day were found to be 31% less likely to suffer a stroke compared to women consuming less than half a serving of whole-grain food. 2

  • Improve Hypertension: Individuals who eat 48 grams or 2 – 4 servings of whole grains or more have a 19 – 23% reduced risk of developing hypertension

  • Benefit Blood Lipids: Oats, barley, and psyllium reduce blood lipids. The reduction is significant, making these items essential to include in your diet daily. 

While soluble fiber is an important nutrient, it is not the only oneWhole grains contain other Nutrients and Phytochemicals: Other vital components of whole grains include magnesium, folate, alpha-tocotrienol. The various phytochemicals may directly inhibit oxidative stress and inflammation.

Some grains contain Polyphenols. They are a naturally occurring organic compound in plants that are phytoactive. These are potent phytochemicals that have anti-atherogenic activity. They work intently to protect the body from free radicals and any damage they can cause. Examples of the other polyphenols in grains:

  • Oryzanol in rice

  • Avenanthramides in oats

  • Ferulic acid in corn and wheat

Certain other compounds found in grains like vitamin E, selenium, and polyphenols may also bestow cardio-protective benefits.

Some tips to increase the whole grains in your diet:

  • Enjoy breakfasts that include whole-grain cereals, such as whole-wheat bran flakes, shredded wheat.

  • For a hot breakfast, try porridge or oatmeal.

  • Substitute low-fat, sugar-free muffins made with whole-grain grains, such as oatmeal or others, for pastries.

  • Make sandwiches using sourdough and rye bread. 

  • Replace white rice with quinoa, brown rice, wild rice, barley, or bulgur.

  • Use rolled oats or crushed whole-wheat bran cereal in recipes instead of dry bread crumbs.

  • Make home-made soups, wild rice, or barley in soups, stews.

  • Add whole grains, such as cooked brown rice or whole-grain bread crumbs, to casseroles.


One with diabetes understands the conditions that can accompany it with uncontrolled blood sugar levels. Type 2 diabetes’s chronic conditions can cause neuropathy, heart disease, and vision loss. Understanding the basics of blood sugar control can ensure that these do not progress. Stress reduction and sufficient sleep are essential in prolonging disease progression.

A diabetes diet encompasses an overall healthy eating plan and lifestyle. We know that insulin sensitivity can be increased and improved by changing your lifestyle. A diabetics meal plan should include a variety of whole grains, lean protein, low-fat dairy, healthy fats, and various fruits and vegetables with a low GI index.

Performing physical activity, losing excess body weight will help improve overall health. We know Eating whole-grain food significantly lowers the risk of cardiovascular disease. Choosing foods with higher dietary fiber and a low gi index will enhance insulin sensitivity and overall blood sugar levels. 

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  1. Barclay et al. . (2008). Glycemic index, glycemic load, and chronic disease risk–a meta-analysis of observational studies. AJCN. 87 (1), 627-37.
  2. Flight I and Clifton P. (2006). Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. European Journal of Clinical Nutrition. 10) (60), 1145-59
  3. Pereira MA, et al. . (2002). Effect of whole grains on insulin sensitivity in overweight hyperinsulinemic adults. American Journal of Clinical Nutrition.. 75 ((5)), 848-855.
  4. Martin Haupt-Jorgensen,. (2018). Possible Prevention of Diabetes with a Gluten-Free Diet. Nutrients. 10 (1746), 11
  5. News release. (2008). Sourdough Bread Has Most Health Benefits, Prof Finds. Available: http://www.uoguelph.ca/news/2008/07/sourdough_bread.html. Last accessed 2/9/21.
  6. Tina Forsberg, Per Åman, Rikard Landberg. (2014). Effects of whole-grain rye crispbread for breakfast on appetite and energy intake in a subsequent meal: two randomized controlled trials Nutrition Journal. Mar 25 (13), 26
  7. David R Jacob. ( June 2007). Whole-grain consumption is associated with a reduced risk of noncardiovascular, noncancer death attributed to inflammatory diseases in the Iowa Women’s Health Study. The American Journal of Clinical Nutrition. Volume 85 (Issue 6), 1606–1614

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