# What is the best macronutrient diet for blood sugar control in diabetes **URL:** \ **Category:** Factual Questions\ **Created:** [August 27, 2012, 1:02am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774 "2012-08-27T01:02:55Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [August 27, 2012, 1:02am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/1 "2012-08-27T01:02:55Z")
If a person has type II diabetes which diet is best for bringing blood sugar under control? Or does it vary drastically person to person or does it really not matter much between them? Very low carb diet (20g a day of carbs) low carb diets (carbs restricted to 20% of calories) plant based diet high in fruits and vegetables (very high in carbs, very low fat) paleo diet mediterranean diet ---
**Author:** ![Harmonix](https://avatars.discourse-cdn.com/v4/letter/h/3ec8ea/32.png) [@Harmonix](https://boards.straightdope.com/u/Harmonix)\ **Post date:** [August 27, 2012, 1:32am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/2 "2012-08-27T01:32:52Z")
IANAD but the high carb diet sounds like bad news for a type II diabetes sufferer. Also, I believe timing is very important. ---
**Author:** ![Speaker\_for\_the\_Dead](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@Speaker\_for\_the\_Dead](https://boards.straightdope.com/u/Speaker_for_the_Dead)\ **Post date:** [August 27, 2012, 1:41am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/3 "2012-08-27T01:41:33Z")
IAAD, and coincidentally I was just reading an evidence summary on vegetarian diets and T2DM. Here’s the nutshell version: > [@Academy of Nutrition and Dietetics Guidelines](#): > > Treating Type 2 Diabetes with a Vegetarian Diet for Adults > > If consistent with patient or client preference, the RD (dietician) may recommend and educate on the benefits of the therapeutic use of a vegetarian diet for adults seeking treatment for type 2 diabetes. Research indicates that a **vegetarian diet may decrease or maintain blood glucose levels** ; a **vegan diet may decrease hemoglobin A1c (A1c) as well as, or better than, an omnivorous diet**. Additionally, a vegetarian diet may reduce diabetes-related co-morbidities (e.g., cardiovascular disease, obesity, and hypertension). The evidence isn’t bulletproof, but it’s not weak, either. Here’s the full link, if you’re curious to read more about vegetarianism: [| Agency for Healthcare Research and Quality](http://guidelines.gov/content.aspx?id=35174) (look out–it’s a boring technical article). ---
**Author:** ![Harmonix](https://avatars.discourse-cdn.com/v4/letter/h/3ec8ea/32.png) [@Harmonix](https://boards.straightdope.com/u/Harmonix)\ **Post date:** [August 27, 2012, 1:44am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/4 "2012-08-27T01:44:57Z")
> [@Speaker\_for\_the\_Dead](#): > > IAAD, and coincidentally I was just reading an evidence summary on vegetarian diets and T2DM. Here’s the nutshell version: > > The evidence isn’t bulletproof, but it’s not weak, either. > > Here’s the full link, if you’re curious to read more about vegetarianism: [| Agency for Healthcare Research and Quality](http://guidelines.gov/content.aspx?id=35174) (look out–it’s a boring technical article). Well. That’s not very helpful. There’s a huge difference in beans, nuts and eggs vegetarians vs fruit, rice and grains vegetarians. The latter sounds like it would be serious bad news for a diabetic. ---
**Author:** ![Speaker\_for\_the\_Dead](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@Speaker\_for\_the\_Dead](https://boards.straightdope.com/u/Speaker_for_the_Dead)\ **Post date:** [August 27, 2012, 1:45am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/5 "2012-08-27T01:45:12Z")
Two caveats: 1. An all-Cheetos™ diet is “vegetarian,” but not healthy. This assumes a well-researched and managed vegetarian diet, which can be tough. 2. Fruit/vegetable carbs are very different from simpler carbs like grains or sugars. The complex sugars found in most whole foods have a lower glycemic index. That is, they tend not to produce the big blood-glucose spikes that wreak havoc on one’s sugar-control. Instead, they have more gradual ups and downs. Simply saying “this is a carb and this isn’t” ignores this important distinction. ---
**Author:** ![Harmonix](https://avatars.discourse-cdn.com/v4/letter/h/3ec8ea/32.png) [@Harmonix](https://boards.straightdope.com/u/Harmonix)\ **Post date:** [August 27, 2012, 1:49am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/6 "2012-08-27T01:49:25Z")
> [@Speaker\_for\_the\_Dead](#): > > Two caveats: > 2) Fruit/vegetable carbs are very different from simpler carbs like grains or sugars. The complex sugars found in most whole foods have a lower glycemic index. That is, they tend not to produce the big blood-glucose spikes that wreak havoc on one’s sugar-control. Instead, they have more gradual ups and downs. Simply saying “this is a carb and this isn’t” ignores this important distinction. Very good point. This is due to the lag time required to change fructose into glucose correct? ---
**Author:** ![Speaker\_for\_the\_Dead](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@Speaker\_for\_the\_Dead](https://boards.straightdope.com/u/Speaker_for_the_Dead)\ **Post date:** [August 27, 2012, 1:52am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/7 "2012-08-27T01:52:41Z")
> [@Harmonix](#): > > Very good point. > > This is due to the lag time required to change fructose into glucose correct? Partially, but not just that. After all, sucrose also needs to be converted (split into glucose and fructose, specifically). It has to do with the fact that fruits are much more complex and so take a lot longer to be broken down to the point that our intestines absorb the sugars, so the actual absorption (and therefore dumping-into-our-blood) of their sugars is slowed down. ---
**Author:** ![al27052](https://avatars.discourse-cdn.com/v4/letter/a/41988e/32.png) [@al27052](https://boards.straightdope.com/u/al27052)\ **Post date:** [August 27, 2012, 2:12am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/8 "2012-08-27T02:12:44Z")
A diet of about 20% protein and 75-80% fat will often work well for diabetes sufferers. I’ve seen it work very well, but some do need more carbs than that. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [August 27, 2012, 2:17am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/9 "2012-08-27T02:17:32Z")
Also because of _fiber effects_, which entails more than just slowing absorption. But that is perhaps even [more true for cereal fiber](http://care.diabetesjournals.org/content/29/4/775.full) (tends to insoluble fiber) than for fruits (tend to soluble fiber). It may be by way of the [short chain fatty acids](http://diabetes.diabetesjournals.org/content/58/7/1509.short)that the bacteria of the large intestine ferment fiber into; they seem to increase insulin sensitivity and decrease inflammation that is part of the disease process. So high fiber whole grains, many fruits, vegetables, beans, nuts, all good from the T2DM POV. Highly refined carbs not. Very low carb can work but does get the green light from the ADA. They are mainly concerned that such a diet is not maintainable long term for most. ---
**Author:** ![PlainJain](https://avatars.discourse-cdn.com/v4/letter/p/5daacb/32.png) [@PlainJain](https://boards.straightdope.com/u/PlainJain)\ **Post date:** [August 27, 2012, 2:19am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/10 "2012-08-27T02:19:16Z")
Timely. I just found I have it last week. Here’s some good info from the Mayo clinic: > **[Diabetes diet: Create your healthy-eating plan](https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-diet/art-20044295)** > > Learn more about a healthy-eating plan that can help control blood sugar. Check out meal-planning methods and what foods to choose. Includes a sample menu. ---
**Author:** ![al27052](https://avatars.discourse-cdn.com/v4/letter/a/41988e/32.png) [@al27052](https://boards.straightdope.com/u/al27052)\ **Post date:** [August 27, 2012, 2:31am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/11 "2012-08-27T02:31:09Z")
> [@DSeid](#): > > Very low carb can work but does get the green light from the ADA. They are mainly concerned that such a diet is not maintainable long term for most. I’ve seen some people adapt to it very well, and some just can’t do it. Most people do use it as a way to heal specific problems, though, not as a lifelong thing. Of course, Eskimos/Inuit eat this way their whole lives, in very remote areas, but they live in an extreme environment. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [August 27, 2012, 3:23am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/12 "2012-08-27T03:23:08Z")
> [@al27052](#): > > Most people do use it as a way to heal specific problems, though, not as a lifelong thing. And managing T2DM is not something you “heal” but a lifelong thing. Of course that does not mean that the plan is not a good fit for some people, and not only traditional Inuits. (And most Inuits today are [as bad off](http://www.cbc.ca/news/canada/north/story/2011/05/10/diabetes-inuit.html) as most others. Some detail on[T2DM among the Inuit](http://care.diabetesjournals.org/content/25/10/1766.full); interestingly more fruit consumption was found to be protective.) ---
**Author:** ![tracer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tracer/32/20578_2.png) [@tracer](https://boards.straightdope.com/u/tracer)\ **Post date:** [August 27, 2012, 4:05am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/13 "2012-08-27T04:05:39Z")
Cecil Adams’s take on the Glycemic Index and Glycemic Load: > **[Is the glycemic index the new key to healthy eating?](https://www.straightdope.com/21343471/is-the-glycemic-index-the-new-key-to-healthy-eating)** ---
**Author:** ![Seanette](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/seanette/32/9139_2.png) [@Seanette](https://boards.straightdope.com/u/Seanette)\ **Post date:** [August 27, 2012, 4:26am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/14 "2012-08-27T04:26:51Z")
One factor not mentioned in this thread is that exercise is VERY helpful, at least according to my husband (Type 2 diabetic). ---
**Author:** ![bardos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bardos/32/1069_2.png) [@bardos](https://boards.straightdope.com/u/bardos)\ **Post date:** [August 27, 2012, 9:16am UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/15 "2012-08-27T09:16:46Z")
> [@Wesley\_Clark](#): > > If a person has type II diabetes which diet is best for bringing blood sugar under control? Or does it vary drastically person to person or does it really not matter much between them? > Very low carb diet (20g a day of carbs) > low carb diets (carbs restricted to 20% of calories) > plant based diet high in fruits and vegetables (very high in carbs, very low fat) > paleo diet > mediterranean diet As a Type II myself: It does vary from person to person in that the state of the beta cells in the pancreas will vary, the amount of insulin resistance will vary, and the reaction to various foods will vary. Having said that, there are some general principles to follow. Eating cereals, whether whole grain or “white” is, in the end, the exact same thing as eating pure sugar. Maybe worse. The GI of table sugar is only about 60 whereas the GI of bread is in the 70’s. Carbohydrates produce glucose in the blood just like sugar, so even a type I will use much less insulin if he or she cuts back on carbohydrates. Having said that, if you cut down on carbs you must eat more fat. Your body either burns glucose or fat. Fat being the preferred fuel of the human metabolism, and you can trace this back to our evolutionary roots. Eating more fat (there are good fats and bad fats) and less carbs will drastically lower blood sugar and like myself, many type II’s who follow this type of diet, paleo perhaps, can avoid all those pharma products and maintain a fairly normal blood glucose level. ---
**Author:** ![al27052](https://avatars.discourse-cdn.com/v4/letter/a/41988e/32.png) [@al27052](https://boards.straightdope.com/u/al27052)\ **Post date:** [August 27, 2012, 1:11pm UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/16 "2012-08-27T13:11:53Z")
> [@DSeid](#): > > And managing T2DM is not something you “heal” but a lifelong thing. Of course that does not mean that the plan is not a good fit for some people, and not only traditional Inuits. (And most Inuits today are [as bad off](http://www.cbc.ca/news/canada/north/story/2011/05/10/diabetes-inuit.html) as most others. Some detail on[T2DM among the Inuit](http://care.diabetesjournals.org/content/25/10/1766.full); interestingly more fruit consumption was found to be protective.) Well, generally, people will do it when their chronic symptoms have gotten too bad, and start to increase carbs when their symptoms abate somewhat, or when they start having new problems that are being caused by the low-carb diet. IME, anyway. As far as the Inuit go, living in their traditional extremely cold environments, they are generally very healthy on their traditional diets. I would not recommend much fruit consumption to someone who has to deal with -30 F regularly. Fruit tends to lower body temperature. ---
**Author:** ![tracer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tracer/32/20578_2.png) [@tracer](https://boards.straightdope.com/u/tracer)\ **Post date:** [August 27, 2012, 3:18pm UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/17 "2012-08-27T15:18:16Z")
> [@bardos](#): > > Eating cereals, whether whole grain or “white” is, in the end, the exact same thing as eating pure sugar. Maybe worse. The GI of table sugar is only about 60 whereas the GI of bread is in the 70’s. Careful there. As Cecil explained in his article on the Glycemic Index, the GI is determined from an amount of food that totals 50 grams of carbohydrate. To get 50g of carbohydrate from table sugar, you need to consume 50g of it because it’s pure carbohydrate; but to get 50g of carbohydrate from bread you need to consume substantially more than 50g of it, because bread also contains a few fats and proteins. Cecil pointed out a different index, called the Glycemic **Load** , which is the Glycemic Index multiplied by the amount of food you actually eat. If you ate an ounce of bread, the Glycemic Load would be **less** than if you ate an ounce of table sugar, I believe. ---
**Author:** ![tracer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tracer/32/20578_2.png) [@tracer](https://boards.straightdope.com/u/tracer)\ **Post date:** [August 27, 2012, 3:19pm UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/18 "2012-08-27T15:19:22Z")
> [@bardos](#): > > Having said that, if you cut down on carbs you must eat more fat. Your body either burns glucose or fat. Or protein, right? ---
**Author:** ![al27052](https://avatars.discourse-cdn.com/v4/letter/a/41988e/32.png) [@al27052](https://boards.straightdope.com/u/al27052)\ **Post date:** [August 27, 2012, 3:35pm UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/19 "2012-08-27T15:35:39Z")
> [@tracer](#): > > Or protein, right? Well, your body has to break down protein into glucose before using it as fuel. ---
**Author:** ![bardos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bardos/32/1069_2.png) [@bardos](https://boards.straightdope.com/u/bardos)\ **Post date:** [August 27, 2012, 4:03pm UTC](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774/20 "2012-08-27T16:03:23Z")
> [@tracer](#): > > Or protein, right? As stated, not to overdo the protein as it gets converted into glucose at higher than the body can use levels. [Next page](https://boards.straightdope.com/t/what-is-the-best-macronutrient-diet-for-blood-sugar-control-in-diabetes/632774.md?page=2)