Calories and carbohydrates are two words that get thrown around quite frequently when talking about nutrition and diabetes.
A question we often hear is: “What is more important to manage my diabetes: carbs or calories?”
Trying to navigate between counting calories and counting carbohydrates can feel cumbersome, and the good news is, you don’t have to.
Carbs Are More Important Than Calories
Quite simply, focusing on carbs is far more important than calories, period!
Why?
Because carbohydrates have the biggest influence on your blood sugar and A1c levels.
When you choose the right kind of carbohydrates in the right amounts, the calories work themselves out – they really do.
Even if you’re trying to lose weight, focusing on carbs is more important than calories as well. People often think it’s the opposite, that you need to cut calories to lose weight.
Not so.
The smarter weight loss strategy is to follow your body’s natural mechanisms and that makes weight loss effortless.
Carbs, especially certain types, spike blood sugar, spike insulin and that leads to more fat storage. That’s the body’s normal physiology!
In contrast, when we choose the right kind of carbohydrates in the right amounts, the opposite happens. Blood sugar comes down, insulin comes down, we burn fat easier.
Not to mention, blood sugar stabilizes, A1c normalizes, and so does cholesterol, blood pressure and other things, too.
The combination of high blood sugar and high insulin (a common situation for people with prediabetes and type 2 diabetes), pushes your whole metabolism out of whack.
Focus on the carbohydrates and bring everything back into balance.
But, there is of course more to the story when we talk about low calorie and low carb diets and you’re probably curious to learn more about that.
To clear up any confusions, let’s look closer at the difference between low calorie and low carb diet approaches. Then, we’ll turn to the research to find out what science tells us is most important for treating prediabetes and type 2 diabetes.
A Low Calorie Approach for Diabetes
A low calorie diet has long been the “traditional” recommendation for weight loss and overall health, including for people with diabetes.
The general idea is straightforward: consuming fewer calories than you burn will lead to weight loss, which can, in turn, help improve blood sugar control.
Given the carbohydrate-insulin model we just mentioned above, there’s a bit more to this and using a low calorie approach has many disadvantages.
Decreased Nutrition Quality: A low-calorie approach often prioritizes calorie counting over the nutritional quality of food, which can often lead to an increase of carbohydrates, particularly refined carbs and a reduction in healthy fats, which are necessary for health. This can lead to a diet that is low in essential nutrients, even if it’s low in calories.
Potential for Nutrient Deficiencies: When calorie intake is significantly reduced, there is a risk of not getting enough essential nutrients, such as vitamins, minerals, and healthy fats, which again, are necessary for health.
Fail To Address Underlying Metabolic Issues: While a low-calorie diet may lead to short-term weight loss and improvements in blood sugar levels, it does not address the underlying metabolic dysfunctions that are often present in people living with type 2 diabetes and prediabetes.
Unsustainable: Calorie restriction can lead to feelings of deprivation, hunger, and fatigue, making it challenging to maintain over time. This can result in yo-yo dieting, where weight lost is quickly regained once normal eating patterns resume. It is vey deflating when your weight and blood sugar goes up again!
Less Muscle Mass, Slower Metabolism: A significant concern with a low-calorie diet is its potential impact on muscle mass, particularly for those over 50. When calorie intake is reduced, the body may break down muscle tissue for energy, which can lead to a slower metabolism.
A slower metabolism can make weight management even more challenging and may counteract the benefits of calorie restriction, leading to a vicious cycle of weight regain and further muscle loss!
In our experience over more than a decade, most people find a low-calorie diet ineffective and its been keeping them in a repetitive cycle of “dieting” for years.
There is an easier, more effective approach.
A Low Carb Approach for Diabetes
A low carb approach has gained significant attention as an effective strategy for managing type 2 diabetes and prediabetes
And for good reason – it’s backed by a huge amount of science to be the most sustainable long term strategy to achieve results!
This approach focuses on reducing carbohydrate intake to minimize blood sugar spikes and improve overall metabolic health.
Unlike traditional calorie-restriction diets, a low carb approach directly targets the root cause of blood sugar imbalances, treating insulin resistance to reset metabolism back to normal.
Better Blood Sugar Control: Carbohydrates have the most significant impact on blood sugar levels. By reducing carbohydrate intake, particularly refined carbs and sugars, a low carb diet can help stabalize blood sugar levels, leading to lower HbA1c levels and reducing the risk of diabetes complications.
Improved Insulin Sensitivity: A low carb diet can enhance insulin sensitivity, allowing the body to use insulin more effectively. As insulin sensitivity improves, the body can manage blood sugar levels more efficiently.
Facilitates Long-Term Weight Loss: Many people experience natural and sustained weight loss on a low carb diet without the need to count calories. By focusing on nutrient-dense, satiating foods like proteins and healthy fats, hunger and cravings often decrease, making it easier to adhere to a long-term nutrition plan.
Supports Metabolic Health: A low carb diet can help correct underlying metabolic imbalances by reducing high blood sugar and insulin levels. This, in turn, supports better cholesterol profiles, blood pressure, and other markers of metabolic health.
Preserves Muscle Mass: A low carb approach that includes adequate protein intake can help preserve muscle mass, supporting a healthy metabolism, physical function, and overall vitality.
What type of carbohydrate intake are we talking here?
- Low carbohydrate diet: Below 130 g per day. Below 26% total energy intake.
The sweet spot for most people is 50-100g a day for best results!
Research: Low Carb vs Low Fat Diets
When it comes to treating type 2 diabetes and prediabetes, overwhelming, research shows that unrestricted calorie low carb diets outperform calorie-restricted low-fat diets.
Optimal Blood Sugar Control: Low carb diets are more effective at lowering blood sugar and HbA1c levels compared to low-fat diets.
Significant Sustainable Weight Loss: Low carb diets often result in more significant sustainable weight loss than low-fat diets.
Improve Cholesterol: Low carb diets improve lipid profiles by increasing HDL cholesterol and lowering triglycerides.
Lower Blood Pressure: Low carb diets help reduce blood pressure by reducing circulating insulin, which decreases sodium retention in the kidneys.
Reduce Medication Dependency: Across all studies, a low carb diet is the only diet that always leads to reductions in medications. This highlights the superior effect it has on improving overall metabolism, from the root cause.
An interesting point about the mechanisms behind all of this, is that lower carbohydrate diets are thought to be so effective because of the higher fat content, which helps with satiety (feeling full).
This means on a low carb higher fat diet, your stomach (and brain) will remain satisfied longer, so you can go longer between meals or without snacking, which interestingly, ultimately helps to lower your calorie intake.
However, don’t totally dismiss calories, yet!
Please pin, tweet or share; then keep reading.
Research on VERY Low Calorie Diets
Research shows that caloric restriction (and we’re talking very low calorie diets varying between 600-800 calories per day) can help people with type 2 diabetes achieve non-diabetic glucose levels, and even diabetes remission.
The Soups & Shakes Diet is one such example. Derived from the 2017 DiRECT study clinical trials, where a large percentage of the calorie restricted group lost over 30 pounds/15 kg, and 46% achieved complete diabetes remission.
While the results for the DiRECT seemed very impressive, you must have clinical guidance to follow a diet so low in calories.
And in the real world, the story is quite different. The Soups & Shakes Diet didn’t achieve such good outcomes, with only a small percentage achieving remission.
The reality is most people failed to follow the diet successfully – it is VERY difficult to eat only 600-800 calories a day!
An important thing to note is that the low calorie diet was also a low carbohydrate diet, containing between 122 to 126 grams of carbs per day. Even the diet recommended to participants after the study, was… you guessed it – low carb!
The good news is that low carb diets are equally effective, if not more effective for achieving diabetes remission, without the need to restrict calories – hooray!
Calories vs Carbs: Which is Better?
While both play a role in overall health, the evidence clearly favors focusing on carbohydrates, especially for blood sugar management and improving overall metabolic health.
Carbohydrates have the most direct impact on blood sugar levels. By reducing carb intake, especially refined carbs and sugars, you can significantly lower blood glucose levels and improve insulin sensitivity.
This approach directly addresses the underlying issues of prediabetes and type 2 diabetes—high blood sugar and insulin resistance—making it a more effective strategy than simply cutting calories.
Calories, on the other hand, do matter to some extent. However, cutting calories without considering the type of foods you eat can lead to nutrient deficiencies and metabolic imbalances.
In contrast, when you focus on the right types of carbohydrates, your body naturally regulates calorie intake, often leading to weight loss without the need for strict calorie counting.
Conclusion
For people with type 2 diabetes and prediabetes, focusing on carbs is more beneficial than simply cutting calories.
Taking a low carb approach not only helps control blood sugar but also supports weight loss and overall metabolic health.
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When you stick to eating blood sugar friendly foods, and delicious low carb meals, these help you achieve both calorie and carbohydrate goals, often without the need to count either, especially when you get your head around what’s what.
A lot of managing this process comes down to the quality of the food you are eating. When you’re primarily consuming whole foods and lots of vegetables, you don’t really need to count every single calorie or carb going into your mouth. That makes for a much easier life too, right!
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I have tried a low carb diet less that 20 carbs per day plus 800 cals still not losing weight been on it for 6 weeks why is this so.
Hi Jeniferahari, There is no need to go so low on carbs and calories. When calories and carbs are very low, your body can adapt by slowing down your metabolism to conserve energy. Many other factors can influence weight loss, but the carb/calorie thing is likely the issue here.
i am prediabetic 6.0 and high cholesterol i weigh 100 lbs and need to gain weight. i have lost 5 pounds from cutting back on bad carbs. how can i gain weight without carbs/ what was your program i saw a while ago for gaining weight yet improving the a1c? thank you
Hi Judie, we have a lot of people in the same situation, needing to gain some weight. Find our program information on that here.
What foods should I be focusing on and what are low carb options please.
When it says carbs on package s do I choose low sugar content ones? I’m confused 😕
Even if things are low sugar the carb content is still quite high?
Hi Stacey, I see you’re on our email list. Have you got a copy of our food list? If not, contact our helpdesk and Emma will send it to you. You need to look at the carb content on labels, not just the sugar. The carb content INCLUDES the sugar, and since all carbs are sugars that’s a more accurate way to know what you’re eating. So you will choose a product with the lowest amount of carbs.
I’m pre-diabetic, now restricting my carb intake to 40-50g per day. I also create resistant starch foods too. I have enjoyed reading your article. Thank you.
I am 42 years old eating 1000-1500 calories and less than 40 total carbs per day. I do light weight cardio three times a week. I am on 10 units of 70/30 insulin twice a day with a sliding scale of type R after every meal. Even when I do eat 3 even meals, I am always in the high 200’s. They claimed type 2 at first, but no pills ever worked. I ended up DKA on a keto diet. They are thinking I am type 1 now and have been since a teen according to many medical records (mild type 1 then over 150 after eating several hours post meal if sedentary) Only when I fast over 24 hours while taking all my insulin do my numbers go below 180. Any suggestions?
A few things some to consider – first, without knowing your full medical history, the level of calories you are eating sounds very low. Staying under 40g of carbs per day is fine, our recommendation is to stay under 80g – but anywhere in that range that works for you should be okay. To increase calories without adding carbs try eating an extra fat source with your meals. Keto diet can be a great approach to lowering blood sugar, but not necessary as long as you are still eating low carb.
Secondly, if you’re in the high 200s with your current medication regimen then you definitely need to speak with your doctor about making some adjustments. They can try a different type of insulin, change the dose, or change the frequency. You goal should be to stay under 140mg/dL post meals and fasting for 24 hours shouldn’t be necessary to achieve this goal. Good luck and keep advocating for yourself.
Oh good for you still trying to get a grip on mine doctors are so contradictory in what they want versus what you need to do
Hello Jedha,
I miss talking to you guys. I have a dilemma. For over a year my fasting blood in the morning has been staying under 100. Around Easter ( like over night) it started going into the 100’s. I did not change anything. I thought I bought bad test strips. I was following your plan to the t. You guys were the ones to bring it down in the first place. I was a pre diabetic and just had my A1c taken last week and it’s still is 5.4. But for how long with my numbers in the 100’s , I don’t know. I did talk to my Dr and he lowered my calories by 200. He said to stay between 1200 a1400, I was eating around 1600. My carbs have been 20 g. It worked for two day my numbers went down under 100 but now for the last two days back up into the 100’s. What are your thoughts on this?
Hi Debbie. How high in the 100s are you typically seeing? If you’re still in the 100-120 range in the morning (under 140mg/dL after meals), then you need to cut yourself a little slack. Remember, stress in and of itself can be a culprit of high blood sugar. Also, have you tried any of these ideas to help lower morning sugar?
Two other potential causes could be an infection/sickness or a change in medications (any steroids will definitely elevate your blood sugar.) If either apply to you then you need to address with your doctor.
As you just read in the article, calories are not necessarily the deal breaker for diabetes control. I certainly would not advise you to reduce your calories any lower that what you are currently consuming. Continue to monitor your carb intake and consider keeping a log to see if there is any correlation between what you’re eating and when you’re experiencing the most rise.
Emily thank you for getting back with me.
My morning number is around 117. Which this is very high for me. I have never seen this in over a year. No I have not been sick or under anymore stress then normal. This is why I am so very confused why this is changing. I keep a log of everything I eat and have been since Jan 2017.
I am doing intermitting fasting from 7 pm -11 am . Been doing this for the past two weeks. Numbers still doing the crazy up and downs. So, I am missing something! Just when I think I’ve made it ……I go backwards. Very frustrating.
Since you haven’t changed anything else, you have just answered your own question Debbie – the intermittent fasting is causing your high morning levels. This is not uncommon. The added stress of fasting could raise cortisol. Cortisol stimulates blood sugar and other hormones. And the body can still produce glucose even when fasting, via a process called gluconeogenesis. Perhaps try to lower the amount of fasted hours and see if this lowers peak numbers. Otherwise I would suggest intermittent fasting does not work for you and that it is better to stick to a low carb regular eating routine.
Are carb ranges shown above TOTAL carbs or net? Thank you 😊
Sorry, some of us seniors are forgetful. Can you please repeat? Thank you
If you’re referring to the low carb definition ranges of carbs, that’s total carbs.
I thought this was a very informational article. I a Type 2 diabetic in my 60’s on medication. I have trouble with getting enough exercise. I am going to share this article with my other.
Yes, please feel free to share to help others! Walking is often the easiest exercise to fit into a busy schedule, but that also depends on the climate where you live as well. Something like squats, chair lifts, or bridges might be good indoor activities is that works better with your schedule.
Hi, I noticed in reading some of your emails that yall say its ok to eat cheese if you are Type ll diabetic. I love cheese and would love to be able to eat it, however, in another program for controlling diabetes I was in, they said to cut out ALL dairy products including cheese. I see yall have cheese snacks, cheese in recipes, etc. Which is correct? And if I can eat cheese, what kind?
Thanks!
Most foods have some sorts of controversy around them, dairy included. Here is an article we wrote that will help you understand some of the research between diabetes and dairy. According to our research, cheese is a great choice with a lot of nutritional benefits, and the best cheeses are cheddar and mozzarella.
I tried to open your article listed above ‘Dairy and Diabetes’. I’m a Type 2 diabetic so I would like to read this article.
Are you able to open it here? We also have a great search feature on our blog, so if you type it ‘dairy’ it should also direct you to this article. We also have articles on more specific types of dairy such as milk, yogurt and cheese.