The appropriate type 2 diabetes diet has traditionally been one of the most contentious issues in the diabetic community. On the one side, there is the Americans with Diabetes Association (ADA) advocating a traditional food pyramid approach that emphasizes a well rounded diet. On the other side, there are a wave of low carbohydrate alternatives, such as the Atkins and South Beach Diets. In between these two, there are many other choices ranging from the Mediterranean diet to Dr. Bernstein’s Diabetic Diet. What’s the difference? Generally they all have one thing in common: Carbohydrates.

Let’s start with the ADA. Up until recently, the ADA has been very critical of low carbohydrate diets. While they stress that each individual needs to consult a dietician to formulate a custom eating plan, they generally follow the Recommended Daily Allowance (RDA) of carbohydrates, which is approximately 130 grams. Up to six helpings of grains, beans and starchy vegetables are advocated. While whole grains are encouraged, they are not overly stressed.

The low carbohydrate folks over at the Atkins Diet and the South Beach Diet are a bit mortified by this recommendation. Not so much with the total amount of carbohydrates recommended, but where the carbohydrates come from. For example, once the Atkins diet initial weight loss phases are over, they allow for a daily intake of 120 grams of carbohydrates (may vary per individual). The difference between the two eating philosophies has to do with the source of carbohydrates, rather than the amount. Thus, the “low carbohydrate” name for diets such as Atkins and South Beach is a bit of a misnomer.

Let’s take a look at how certain carbohydrates, especially processed grains and sugars affect our body. As the Atkins and South Beach advocates are fond of pointing out, a high carbohydrate diet is one of the leading causes of overeating and leads to obesity. Eating a diet rich in grains, starchy vegetables and sugars, causes a person’s blood sugar, also called glucose, to spike, then fall almost as rapidly. Glucose is the substance our cells use for energy.

Curiously, this fall in glucose then causes the urge to eat more food, ultimately leading to over eating and weight gain. It also causes insulin spikes. Insulin is needed to process all of the excess glucose in our blood. As the body stresses to produce more insulin to process the extra glucose, our cells can either become resistant to the insulin or our body can stop producing it. When either of these two situations occurs, diabetes is the result. Spikes in glucose levels are also attributed to many health conditions including cardiovascular disease and kidney disease.

Instead of higher carbohydrate diets, like the ADA advocates, low carbohydrate folks, such as Atkins and South Beach Diets believe our energy should primarily come from protein and fats. They do allow for carbohydrates from grains. However, the grains must be whole grain and the vast majority of allotted carbohydrate intake should come from non-starchy vegetables and fruits. As noted above, this shift regarding the source of carbohydrates is the huge difference between the two eating philosophies.

Traditionally, the ADA has been very reluctant to acknowledge, let alone endorse, a low carbohydrate diet. However, recently, the ADA published, in its Standards of Medical Care in Diabetes, recommendations that low carbohydrate diets can be useful for losing weight in the short term. The association did stop short of providing a long term recommendation, however.

So, where do you go from here? Deciding which diet to follow is highly individualized, depending on age, weight, medical condition, etc. The purpose of this article was to provide a starting point for further research. All three of the diets discussed above, the ADA, South Beach and Atkins, have comprehensive books describing the benefits of their particular approach. Do some further research then discuss with your doctor or dietitian. Work towards a diet that you like, you believe is healthy and that you think you can follow.

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• How Do People Get Diabetes? - What Causes Diabetes
• Diabetes Risk Factors
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