My patient stopped carbs completely after his diabetes diagnosis: What happened next surprised him

Most people forget that carbohydrate is a macronutrient, as important as protein and fibre. The problem is not carbohydrates themselves but the type, quantity and way we eat them. They are the body’s main source of energy. Even your brain depends on glucose to function properly. If you remove carbohydrates completely, you will feel weak, irritable and tired. The key is smart selection and portion control.

Zero-carb diets can harm people with diabetes, especially those on insulin, by plunging their levels of blood sugar suddenly, what we call hypoglycaemia. They can lead to nutrient deficiencies due to the exclusion of many fruits, vegetables and wholegrains, which are rich sources of vitamins, minerals and fibres, too. Such diets lead to electrolyte imbalance and dehydration. This happens because in the absence of carbohydrates to draw calories from, the body uses up stored glycogen, which usually releases water.

Of course, the worst is ketoacidosis, when the blood becomes toxic. When the body burns fat for energy instead of glucose, it breaks fat into organic compounds called ketones, which in excess makes your blood acidic.

How to balance your carbohydrates?

First, eliminate refined carbs, including white rice in large portions, maida products, bakery items, sugary drinks and sweets. These raise blood sugar quickly. Then make your pick from complex carbs like brown rice, millets, whole wheat, oats, legumes and vegetables. Use high-fibre carbohydrate sources like leafy vegetables, nuts and seeds. Fibre slows down sugar absorption and keeps blood glucose stable.

Limit carbs to one-quarter of your plate. Fill the remaining half with non-starchy vegetables like beans, cabbage, carrot, or greens. Add a good source of protein like dal, curd, egg, or grilled chicken. When carbohydrates are combined with protein and fibre, blood sugar rises more slowly.

Avoid eating large amounts of carbohydrates in one meal. Spread them across the day. For example, one small serving of whole grains at breakfast, a controlled portion at lunch and a lighter dinner with more vegetables and protein.

What about fruits, my patient asked. Fruits contain natural sugars but also fibre and nutrients. Choose whole fruits, not juices. One small fruit at a time is enough. Avoid fruit immediately after a heavy carbohydrate meal.

People must learn practical rules: measure portions using your hand, choose whole grains, combine carbs with protein, which lend satiety, increase fibre intake, and avoid sugary beverages. Fear-based dieting does not work. Education does.

How should you complement your diet?

Back up your diet with muscle strengthening exercises. Do resistance training at least twice or thrice a week to work all muscles in the upper and lower parts of your body and prevent frailty. If you are undernourished, fatigue manifests easily, interrupting usual functionality of the body. As far as the brain is concerned, without proper nutrition, you will get brain fog.

(Dr Mohan is Chairman, Dr Mohan’s Diabetes Specialities Centre, Chennai)