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October 3, 2003

Meal Planning, Food and Diet

Question from Seattle, Washington, USA:

My husband, who has type 2 diabetes treated with pills, is overweight, and his doctor told him he needs to bring his blood sugar levels down if he doesn't want to go on insulin.So, I put him on a "controlled" carb diet. He went from eating about 400 grams of of carb per day to an average of 75 grams per day. His protein has stayed about the same, and his calorie intake went from more than 3500 daily to an average of 1500 daily. His blood sugar has been running between 70 and 110 mg/dl [3.9-6.1 mmol/L] which I think is good, but others question whether a low-carb diet is healthy. I would like your opinion as to whether I'm doing the right thing.


You have not only restricted his carbs but also his calories. I would suggest that he would still lose weight, whether his carbs were as tightly restricted or not when you decrease his overall calorie intake by over 2000 calories. With his initial weight loss, you may have to change your strategy a bit to help him comply with a diet over the long haul.

The high fat, high protein content is not great for patients with diabetes as it may cause an increased protein load on the kidney and increase lipids. These parameters should be followed up by his physician.


[Editor’s comment: While your efforts are commendable, I suggest you and your husband ask for a referral to a registered dietitian. These days, meals plans are highly individualized and based on many factors, and a weight loss of one to two pounds per week is safe and appropriate. An RD can assist both of you in developing a meal plan that is consistent with food preferences and lifestyle and is designed to meet wight loss and blood glucose goals.

Two other quick points:

For maximum effectiveness, any weight loss program should include an exercise regimen. Exercise (such as rigorous walking) should be done in (at least) 30 minute intervals three times per week.
The nature of type 2 is progressive dysfunction of the beta cells, especially after 10 or more years. So it may be, despite your most concerted efforts, your husband will eventually wind up requiring insulin. Keep in mind that this will be through no fault of his (or yours) but rather the usual physiologic progression of type 2 diabetes.