Keto, low-carb or plant-based? Know the truth about the best diet for Type 2 diabetes

At the centre of dietary planning is energy balance. For individuals who are overweight, reducing calorie intake helps improve blood glucose control and overall metabolic health. However, calorie restriction should be achieved without compromising nutritional quality. Meals need to provide adequate protein, controlled amounts of carbohydrates and appropriate fats.

How to have carbs

Carbohydrates are often viewed with concern but they do not need to be eliminated. The focus should be on quality and portion size. Whole grains, pulses and minimally processed foods are preferable as they are absorbed more slowly and lead to a gradual rise in blood glucose. Refined carbohydrates and sugary drinks should be limited as they cause rapid glucose spikes.

Focus on nutrient-dense options like non-starchy vegetables, berries and nuts. Avoid refined sugars, sugary drinks and refined grains. A low-carb diet generally means consuming less than 130 g of carbs per day, though some with Type 2 diabetes go lower. Reducing carbs improves HbA1c levels, aids weight loss, and can reduce the need for diabetes medication. Reduce portion sizes of starchy foods like rice, potatoes, and pasta by about 10% initially to see how your blood sugar reacts. Then work with your doctor

What about protein?

Protein intake deserves greater attention. Including a source of protein in each meal helps improve satiety, supports preservation of lean body mass and reduces post-meal glucose fluctuations. Common sources include lentils, dairy products, eggs, fish and lean meats. In many individuals, increasing protein within recommended limits can improve overall dietary balance.

A common, safe recommendation is 1 to 1.5 grams of protein per kilogram of body weight. If you have chronic kidney disease (CKD), your protein needs are lower, generally 0.8 g per kg body weight.

And fat?

Fat intake should be moderated, with attention to both quantity and type. Saturated fats, commonly found in fried foods, processed snacks, butter, and fatty cuts of meat should be limited due to their association with cardiovascular risk. Preference should be given to unsaturated fats from nuts, seeds and plant oils, used in controlled amounts.

Salt intake is another often overlooked aspect. Excess dietary salt contributes to hypertension, which frequently coexists with diabetes and increases cardiovascular risk. Reducing added salt, avoiding packaged and processed foods, and being mindful of hidden sodium sources can support better overall outcomes.

What about fruits?

Fruits are frequently misunderstood. Whole fruits can be included in moderation and provide fibre, vitamins, and antioxidants. The concern lies more with fruit juices and large portions, which can raise blood glucose levels quickly.

Popular dietary approaches such as ketogenic diets, intermittent fasting, or plant-based eating may benefit selected individuals. However, none is essential. Their effectiveness depends largely on whether they help maintain calorie control and nutritional balance. Highly restrictive diets may be difficult to sustain and may not align with individual preferences or cultural practices.

What matters most is a structured, practical approach. Regular meal timing, portion control, adequate protein intake, reduced saturated fat, moderation of carbohydrates and restriction of excess salt form the foundation of effective dietary management.

Equally important is individualisation. Dietary advice should reflect personal preferences, daily routine and medical context. A plan that fits into one’s life is more likely to be followed consistently. With appropriate guidance and consistency, the initial confusion gradually gives way to clarity and confidence.

(Dr Saptarshi Bhattacharya is senior consultant, Endocrinology, Indraprastha Apollo Hospitals, New Delhi)