Following a low-carb diet is the only reliable path for people with diabetes who want to live a long life and avoid disability. It is the only approach that allows you to reach critical health goals, including:
- Maintaining blood sugar levels that are consistently normal, the same as your healthy peers have.
- Stopping blood glucose levels swings and improving your daily well-being.
- Managing your diabetes with small doses of insulin that don’t cause weight gain. Some patients can even avoid daily insulin injections altogether.
- Quitting expensive, risky, and harmful blood glucose-lowering pills.
- Eliminating the risk of severe hypoglycemia.
- Halting the progression of chronic diabetic complications and, in many cases, even reversing them.
These goals are achievable even for people with severe type 1 diabetes, in which the pancreas produces no insulin at all. They are even more attainable for people with type 2 diabetes or latent autoimmune diabetes in adults (LADA), both of which tend to be milder forms. A low-carb diet is both helpful and safe not only for adults, but also for children with diabetes.
Stable Blood Sugar Prevents Diabetes Complications
Only keeping your blood sugar consistently normal offers genuine protection against the chronic complications of diabetes. If you can maintain stable, healthy blood glucose levels, like those of people without diabetes, issues with your legs, eyes, kidneys, and other systems will stop getting worse. Many existing complications may even begin to reverse.
No pills or injections—no matter how advanced—can replace the benefits of normalizing blood sugar in diabetes. Simply put, nothing can offset the damage caused by high blood glucose. This fact won’t change anytime soon. Eye-catching headlines may suggest that a miracle cure is just around the corner. But that impression is misleading.
Dr. Bernstein and His Legacy
Dr. Bernstein, after living with type 1 diabetes since 1946, for about 20 years, was able to reverse serious complications, including advanced kidney disease, in the 1960s. He achieved it by normalizing his blood sugar. At that time, he had high levels of protein in his urine, and doctors predicted he would die soon. But that prediction proved wrong.
Dr. Bernstein lived for 55 to 60 years longer than expected by consistently keeping his blood sugar levels in the normal range. As a result, the protein in his urine disappeared, and he avoided both dialysis and the need for a kidney transplant. His kidneys recovered, many symptoms of diabetic neuropathy went away, and he was also able to prevent atherosclerosis and calcium buildup in his arteries. Read more about his journey here.
Dr. Bernstein became the founder of the low-carb religion for people with diabetes who want to live long and avoid disability. The first commandment of this religion is strict adherence to a low-carb diet, because it is the only diet that allows one to keep blood sugar consistently normal.
The Harmful Effects of Carbohydrates on Diabetes
Official medicine claims that people with diabetes can eat whatever they want as long as they cover the carbohydrates with enough insulin or blood sugar-lowering pills. However, in practice, it is impossible to maintain normal blood glucose levels when consuming forbidden foods high in carbohydrates. You can quickly verify this claim. To do it, analyze your continuous glucose monitoring results or check your blood sugar levels with a glucometer often enough.
The problem with dietary carbohydrates is not just that they raise blood sugar, but that they do so very quickly. Neither insulin injections nor diabetes medications can effectively manage this rapid rise. Consuming forbidden foods packed with carbohydrates inevitably results in blood sugar staying elevated for a long time or fluctuating like a roller coaster. It leads to poor health and, over time, contributes to the development of chronic diabetes complications.
Exploring Diabetes Pills as an Alternative to Low-Carb Diet
Potent diabetes medications might give the impression that your blood sugar is under control, even if you eat a lot of carbohydrates. However, this impression is misleading for two key reasons:
- Your blood sugar will likely remain elevated. It is unlikely that drugs will allow you to achieve the normal levels seen in healthy individuals.
- All potent diabetes medications come with serious side effects, and the harm they cause almost always outweighs the benefits.
I plan to cover diabetes medications in more detail later. For now, I’ll provide a brief overview below.
Metformin is a great drug, but it doesn’t eliminate the need for a proper diet. You’ll likely still need to follow a dietary plan alongside taking it.
Alpha-glucosidase inhibitors (acarbose and miglitol) lower blood sugar, but they do so weakly and cause awful digestive issues. The low-carb diet is easier to tolerate than these medications. It gives people with diabetes health and satiety instead of upsetting their digestion.
Sulfonylureas and Thiazolidinediones
Sulfonylureas and thiazolidinediones are popular diabetes medications that effectively lower blood sugar. However, there is no clear evidence that they increase life expectancy for patients. Despite my thorough research, I haven’t found any information suggesting it. Additionally, these drugs come with significant side effects, which I will discuss in detail someday.
If sulfonylureas or thiazolidinediones had been proven to increase life expectancy, their manufacturers would be eager to highlight this in their marketing. It would also be prominently featured in medical guidelines and professional recommendations. However, the silence from the medical community on this matter speaks volumes. Doctors quietly ignore the fact that these drugs do not increase life expectancy. Given the serious risks and side effects associated with these medications, I strongly advise you to avoid them.
If you’re not ready to commit to a low-carb diet, there are two groups of diabetes medications that you can consider as alternatives:
- SGLT2 inhibitors – These drugs help lower blood sugar by causing the kidneys to excrete excess glucose through urine.
- GLP-1 receptor agonists – These medications are powerful appetite suppressants.
Below is a brief explanation of how each group works.
SGLT2 Inhibitors Versus Low-Carb Diet
SGLT2 inhibitors may be a reasonable option for people with diabetes who aren’t willing to follow a strict low-carb diet. This group includes popular drugs Farxiga, Jardiance, Invokana, and others. While these medications are not as effective as dietary changes, they offer noteworthy benefits that outweigh their side effects and justify their cost. They work by helping the kidneys excrete some of the excess glucose through the urine. This mechanism can help keep blood sugar levels in a moderately elevated range, typically around 140–160 mg/dL. It’s not ideal, but it’s better than uncontrolled high blood sugar.
Why SGLT2 inhibitors have not replaced the low-carb diet in diabetes:
- They do not lower blood sugar to normal levels like those in healthy individuals.
- They have serious side effects, including dizziness and an increased risk of urinary tract infections, including pyelonephritis.
- For people with type 1 diabetes, these drugs can be dangerous.
Taking SGLT2 inhibitors while following a low-carb diet is a bad idea. A better approach is to bring your blood sugar into the normal range using exercise, metformin, and maybe even some insulin. The low-carb religion for people with diabetes does not condone needlessly exposing yourself to the SGLT2 inhibitors’ side effects.
GLP-1 Receptor Agonists
GLP-1 receptor agonists are injectable drugs. Like insulin, they are available in injection pens. This group includes popular medications like Ozempic, Wegovy, Victoza, Mounjaro, Zepbound, and Trulicity. So far, they don’t exist in tablet form, though tablet versions are in development. These drugs work mainly by strongly suppressing appetite. They often cause nausea when a patient tries to eat a large amount of food.
These drugs essentially mimic the effects of fasting or severe calorie restriction. Most people who take them report feeling weak, losing muscle mass, and experiencing a significant decline in mood, sometimes even depression. In rare cases, they can cause pancreatitis requiring hospitalization. However, it is unlikely that taking these medications will cause any more serious side effects than those listed above.
In my view, following a low-carb diet is a much wiser and simpler choice than relying on GLP-1 receptor agonists. These drugs work by forcing patients to sharply reduce their calorie intake, which leads to weight loss and improved blood sugar levels. Hunger often disappears, but not naturally. The fear of triggering a severe wave of nausea replaces the feeling of hunger. A well-formulated low-carb diet can offer the same freedom from constant, painful hunger without the side effects. You can lose excess fat without depleting your body, sacrificing muscle mass, or suffering from weakness and depression.
Why Covering Carbs with Insulin Often Fails
The easily digestible carbohydrates cause a steep and rapid rise in blood glucose levels. The insulin doses that people with diabetes inject cannot effectively counteract it. This statement is true even for Fiasp, the fastest-acting insulin currently available, let alone for older insulin types, which act even more slowly.
Trying to compensate for eating a large amount of carbohydrates with high insulin doses causes blood sugar levels to swing like a roller coaster. It has grave consequences:
- You feel chronically unwell.
- There is a constant risk of dangerous severe hypoglycemia.
The reason is that insulin injections perform inconsistently and unpredictably. Official medicine does its best to avoid drawing attention to this issue. But ignoring it does not make the problem disappear. An insulin dose that works well for you today might cause hypoglycemia tomorrow or fail to lower blood sugar enough.
Don’t believe the claim that you can solve this problem with an insulin pump. Read more about it here. The only effective way to reduce the harmful impact of insulin’s unpredictable action is to switch to a low-carbohydrate diet. This diet sharply reduces the amount of insulin you need. And low doses of insulin work more consistently than high ones.
The main advantage is this: when your insulin doses are low, even if you miscalculate, the consequences are minor. In other words, the risk of severe hypoglycemia disappears completely. Also, when diabetics eat excess carbohydrates, insulin converts them into fat. Accumulation of fat reserves in the body worsens the disease. By switching to a low-carb diet, you avoid it.
Scientific Consensus on Low-Carb Diet for Diabetes
Until recently, doctors and scientists strongly opposed the idea of people with diabetes switching to a low-carb diet. This change deprives organized medicine of several massive revenue sources. Every leg amputation or kidney transplant that does not happen means surgeons, anesthesiologists, and hospital administrators lose a significant payday. A low-carb diet also reduces the need for fancy, expensive, patented diabetes medications.
Thousands of people with type 1 and type 2 diabetes have shared enthusiastic reviews online about the effectiveness of the low-carb diet. Faced with this overwhelming grassroots support, organized medicine and science have recently been forced to acknowledge the diet as an acceptable option for managing diabetes, not just for adults, but for children as well.
A landmark event occurred in June 2018, when a journal published by the American Academy of Pediatrics featured an article praising the low-carb diet for diabetes. Dr. Bernstein was one of its co-authors.
Here is the conclusion of that article:
Exceptional glycemic control of [type 1 diabetes] with low rates of adverse events was reported by a community of children and adults who consume a [very low-carbohydrate diet].
Official medicine still does not recognize the low-carb diet as the best option for diabetes. However, doctors and health authorities have at least stopped opposing it. They no longer try to scare patients with imaginary side effects.
Harrison’s Principles of Internal Medicine belongs to the most respected reference books for practicing American physicians. Its 18th edition, published in 2012, included the following statement:
Hypocaloric diets and modest weight loss (5-7%) often result in rapid and dramatic glucose lowering in individuals with new-onset type 2 [diabetes mellitus].
The 21st edition, published in 2022, says the following:
Very-low-carbohydrate diets that induce weight loss may result in rapid and dramatic glucose lowering in individuals with new-onset type 2 [diabetes mellitus].
The new edition also emphasizes that science does not know the optimal ratio of carbohydrates to protein in a diabetes diet. The authors of the diabetes chapter strongly encourage doctors to personalize dietary recommendations for each patient. In plain language, it means doctors are advised not to argue with diabetic patients who choose to follow a low-carb diet.
Conclusion
If you have diabetes, eating foods high in easily digestible carbohydrates is dangerous. Trying to offset the harmful effects of carbs with high doses of insulin or strong diabetes pills usually fails. You can easily verify this claim using a glucometer or continuous glucose monitor. Trying different diets and tracking the results is a great educational experience. Only those not motivated to live a long, healthy life can afford to ignore a low-carb diet.