Just saw a dietician who encouraged me to eat more carbs!

I’m fairly new here and I’m sure this is a regular topic. But I want my $25 back from my consultation yesterday with a dietitian. I had almost canceled but I thought, be open minded and see what she has to say. Well all she did was tell me to eat more carbs! I do eat hardly any but I don’t understand why they keep telling diabetics to eat carbs. I realize that there are healthier carb choices but basically a carb is a carb. She even suggested I eat potatoes! And summer squash! And she talked about how good the carmelized squash is.

I could increase my carb intake some (I’m newly on a pump) but what is wrong with a low carb approach? Is it unhealthy? I feel worse when I eat carbs.


This article is of interest for how many carbs are necessary:

I was given the same advice by a diabetic educator because of the dosage I was suppose to take with the pens. She said based on my docs prescribed dosaged I was experiencing lows because I was not eating enough carbs. I explained that I do not want to eat more carbs, I feel I would have a better luck controlling my BG levels on a low carb diet. So she recommened that I speak with my endo about adjusting my dosage. I did and now I take my fast acting insulin based on what I eat and not a set number anymore.

You know what is best for your body. Everyone else is just telling you what they read. I hope at least she gave portion sizes with those carb recommendations or she truly sucks…lol

Been down this road with a dietician, several endos & a CDE. I eat low carb & was the best thing I ever did. They all receive the same food pyramid training so advise the same thing with nonsense cautions that your brain will starve,& you’ll have no energy. The facts that my lipid profile improved, my BG stablized & I felt great made no impression.

The worst advice there is eating for insulin.

Do what works for you. You’re the expert on you.

My CDE gave me the same advice, at least 4 carb servings ( 60 carbs) at each meal + a couple of 15 carb snacks. I had to pay $60 for that advice. That was the first and last visit. I do mine own thing now and have almost normal bg levels most of the day. I think a lot of doctors and CDE’s don’t think diabetics can have normal bgs so that is why they tell us it is ok to be at 180 after meals and still be healthy. Well, I value all my body parts and I am not going to take the chance. I like to be 110-120 after meals. Lots of times now, I am under 100.

to be fair, summer squash has 3 grams of net carbs per cup and is delicious. i don’t know why you couldn’t eat it.

Thanks for the link! It was fascinating! :slight_smile:

I believe that’s raw but yes, summer squash is not the worst that I could eat. It was just her general attitude; the appointment was all about increasing carbs…I’ve been on these forums for years and been indoctrinated into controlling carbs for better control.


I think there is something wrong if you can not eat potatoes at all. Really! You should be able to manage them with all the knowledge you should have from carb counting and I:C ratios. I do not say you need to eat lots of them but if you just do low carbing because you have experienced you can not handle them then there is a problem to address.

I personally eat half of the carbs recommended for my weight and age. Of course it is possible to replace carbs totally with other sources as the quoted article suggests but this comes with a price. The high protein alternate will put some pressure on the kidneys. Is it the same pressure as for example an elevated blood pressure of 140 would put on the kidneys? I am afraid nobody can answer that. How many carbs do you eat per day and how many protein?

Hi Orpy - just curious, did the dietitian give any reasons why she felt you had to eat more carbs?

For myself, there are certain foods I say I “cannot” eat. Potatoes aren’t on that list for me, but rice, cereal, and to a lesser extent pasta are. What I mean when I say “cannot” is that my normal I:C ratios don’t hold when I eat any reasonable size servings of those foods. So I am left uncertain how much to bolus. I can’t say as I’ve experimented in any kind of determined way but when I tried bolusing for these things I either came out too high or overshot and too low and no consistent numbers emerged. So for me, I made the determination that it just wasn’t worth it to try and dose for those foods. I don’t like the uncertainty, the inevitable highs and lows. I also don’t like eating more carbs, taking more insulin, possibly going low and needing to treat, etc. I’m a middle aged post-menopausal woman so have to be pretty vigilent to avoid gaining weight and the last thing I want is to get insulin resistant. We’re all different but for me the hassle of eating those foods is far outweighed by the pleasure! YMMV

I feel the same, Zoe. I have no desire to do endless calculations & experiments. The many discussions on how to cover pizza leave me baffled. Easier to simply not eat something that causes this issue. No food is worth it to me. It’s not a challenge, it’s a PIA.

This all comes from when the person was weighed and the formulas applied. If weighed in lbs, you got 1/4 of that in total daily dose (units). If weighed in kg, 0.3 x the kg was given to smaller people for their tdd.
1/2 of the tdd went to basal insulin; 1/2 to meals. For the meals they figured 3 with 2 snacks, and the dietitian was given the dose to be allotted to the 3 meals. Whatever carbs she gave, it was for a 175 lbs person and divided among 3 meals meant that 1/2 of the tdd was split 3 ways.
Back when all this was devised, the snacks were within the action time frame of Regular Insulin.
Unfortunately now they may need covering by another dose of Humalog. No changes were made for small people, so weight gains were inevitable. And dietitians knew nothing more than to tell people to eat to their dose. They were not schooled in how to reduce doses nor did they give protocols to determine how much a person needed.
There is nothing wrong with a low carb approach, and that means a low insulin approach, too! It also means being able to be in better control.

I really think it depends on your insulin sensitivity and carb tolerance. If I took enough insulin and timed it right, I COULD eat high carb foods, but it would require more insulin than I want to take. All insulin-using diabetics are already hyperinsulinemic in their peripheral tissues, because the pancreas would normally be secreting directly into the portal vein, which leads to the liver, and it would use most of that insulin to suppress liver dumps, and I don’t actually know whether that hyperinsulinemia contributes to complications, but don’t want to find out the hard way. So I keep my insulin dose as low as possible, which means limiting the carbs. I’m not as strict as some people, but I’m aiming for 50 - 65 a day.

Also, there is no evidence that protein harms normal kidneys. If you already have kidney disease, that is a different story. At that point, you have to alter your diet radically, and it can be extremely difficult for a diabetic!

I had the SAME experience when I was first diagnosed. The dietician told me to eat a minimum of 135 carbs per day and to eat 45 carbs per meal and 15 carb snacks but I was diet/exercise controlled LADA and if I ate what she told me to I would have been put on insulin right away! I got away with low carbing for almost a year before being put onto insulin and even now I still only eat about 40 carbs MAX per day. I am a firm believer in less carbs=less insulin=less mistakes.

That’s what we’re all told. It’s the ADA way.

You’ve hit on a very controversial subject. Some believe the low carb diet is best and others go for more carbohydrates, particularly complex carbs. I’m on the carb side of the discussion. I pump and just count the carbs an “pump up.” It works for me. My A1c ranges between 5.9 and 6.7 percent. I’ve been pumping for the last 12 years and am Type 1 for over 40 years. I enjoy my complex carbs including potatoes, carrots, etc. I might even slip in some pancakes. The hardest thing is eating out. It’s much more difficult to count the carbs in the restaurant so I test much more frequently after I eat out. Most low carb diets include more protein. I have some kidney damage so I stay low on protein. Your way works too. You get to choose.

I would rathernnot have the carbs than deal with the spikes. I was having crazy BG spikes before I started low carb. I was able to realize that all grains and starches were not working for me. (may be different for others, but I couldn’t keep control while eatting them) I had been reading Bernstein’s books and decided to give it a try.

I feel better than I have in years. I do not get hungry for snacks anymore and I don’t feel like my food choices are too restricted. I did have some issues with my BG dropping too low. My Dr. suggested I wait until 2 hrs after my meal to check BG and do bolus injection as needed on a sliding scale. In the past 14 days I have only had to use my fast acting insulin twice, for a total of 3 units. I have been able to maintain my BG levels nicely with low carbs and my Lantus dose.

Maybe some of these dieticians are just looking for job security. I mean, if we all get it under control, who will need them?

So far Ive seen two way to go for BG control. Exercise with meds or low carb with meds. Im sure there are some in the middle that can pull off moderation (moderate carbs, moderate exercise, etc), but they are the minority, IMHO.

The exercise route means when you eat, you exercise. if your a bit high, you walk the dog. You can pretty much eat away so long as you compensate with exercise. I know of a few PWD on this forum that control their D this way and it works wonderfully.

The other route is low carb. Pretty simple, your essentially allergic to carbs, so cut them out. You replace your carbs with fat and keep your protein intake around the same as it would be on a “normal” diet. I personally use this method and have seen amazing results with it. I exercise a few times a week, if that ( i try to more and am hoping chasing a 3 year old counts).

What the ADA seems to push is moderation all around. They tell you eat whatever (including candy) you want in moderation and just cover with insulin. You need to exercise (in moderation), you really need the “nutrients” in carbs (in moderation), and the only thing it seems you dont need in moderation is medication. That you can have tons of without fear of side effect (strong hint of sarcasm here). I dont mean to be offensive and frankly am jealous of those that can pull of minimum deviation and a low A1C with just moderation. They are amazing. I just dont see the masses (myself included) being able to survive on this regiment. Its far easier to open or close the door than to control things trickling through.

Thanks for the smiles. Enjoyed “the only thing it seems you dont need in moderation is medication.”