Carbohydrates have become one of the most misunderstood nutrients in modern diets. Many people newly diagnosed with diabetes or prediabetes are advised, often informally, to "cut out carbs completely." The idea sounds logical. Since carbohydrates influence blood sugar, removing them must help. Yet, in practice, this approach often backfires more often than you know.
According to the Apollo Health of the Nation Report 2024, India continues to face a surge in metabolic disorders. Among more than 2.5 million people screened, 23 percent were diabetic and 26 percent hypertensive, many of them unaware of their condition. Extreme carbohydrate restriction, without medical guidance, can create further instability in blood sugar, disrupt metabolism, and make long-term management harder.
Healthy blood sugar control is not about removing carbohydrates altogether, but about choosing, combining, and timing them better. On World Diabetes Day, the focus should be on understanding - because informed choices, not fear, define effective diabetes care.
1. Understanding what happens when carbs disappear
Carbohydrates are the body's main energy source. When intake drops drastically, the liver converts fat and protein into glucose through a process called gluconeogenesis. This shift may initially lower sugar levels but increases strain on the liver and kidneys over time.
Studies from the Indian Journal of Endocrinology and Metabolism show that very-low-carbohydrate diets raise LDL cholesterol and fatigue levels in Indian adults with diabetes within six weeks of adoption. The body begins to break down muscle tissue for energy, slowing metabolism and reducing insulin sensitivity.
Carbohydrates also carry fibre, B vitamins, and trace minerals essential for nerve and gut health. Their complete removal affects digestion, mood, and concentration - issues often mistaken for stress or overwork.
2. Fibre is the forgotten ally
The problem lies less in carbohydrate quantity and more in quality. Refined grains and sugary snacks spike glucose quickly, whereas complex carbohydrates release energy gradually and help maintain satiety. Fibre slows digestion and supports gut bacteria that influence glucose control.
The Indian Council of Medical Research (ICMR) recommends 25-40 grams of dietary fiber daily, yet the average intake in urban India is less than 15 grams. People who regularly include fibre-rich foods such as millets, pulses, oats, vegetables, and fruit show improved post-meal glucose levels and lower long-term HbA1c. Smart eating means replacing refined carbs with high-fibre ones, not removing them.
3. Timing matters as much as type
Even nutritious carbohydrates can raise blood sugar if eaten irregularly or late at night. The body's insulin sensitivity follows a circadian rhythm, peaking earlier in the day and falling toward evening. Late dinners, a common urban habit, delay glucose clearance and increase morning fasting sugar.
Research from the National Institute of Nutrition (NIN), Hyderabad highlights that consistent meal timing - three structured meals spaced through the day - helps maintain stable insulin response. The findings show that those who followed this pattern had lower postprandial glucose peaks and required fewer medication adjustments over six months.
4. Protein and good fats keep blood sugar steady
Balanced macronutrients protect against glucose spikes. Protein slows carbohydrate absorption, and healthy fats stabilise energy release. Indian diets often emphasise carbohydrates but underdeliver on these components.
Clinical dietitians at AIIMS Delhi note that diabetic patients who include moderate protein portions (from lentils, eggs, paneer, or fish) and unsaturated fats (from nuts or seeds) achieve steadier glucose readings and less mid-day fatigue. The goal is proportion, not exclusion - a balanced plate improves satiety and reduces cravings for quick sugars.
5. Restrictive eating can harm long-term metabolism
No-carb or severely low-carb diets often produce short-term weight loss but may lead to nutritional deficiencies, muscle loss, and hormonal imbalance. The Diabetes Foundation of India warns that such plans can worsen insulin resistance when normal eating resumes.
Women with diabetes or PCOS are particularly vulnerable to fatigue and cycle irregularity under prolonged carb restriction. Over time, the absence of resistant starch, a carbohydrate type found in cooled rice, potatoes, and lentils, may reduce beneficial gut bacteria that help regulate blood sugar.
6. Smarter carb choices for the Indian plate
A practical approach includes replacing polished rice with brown rice, millets, or hand-pounded varieties, and choosing chapatis made with whole wheat, jowar, or bajra instead of refined flour.
Combining carbohydrates with vegetables, pulses, or proteins helps slow digestion, while including whole fruits instead of fruit juices provides natural fibre and a lower glycaemic load. It's also beneficial to eat most carbohydrates earlier in the day to align with higher insulin efficiency. These small, sustainable swaps promote flexibility without leading to dietary fatigue.
7. Consult before changing your diet
Dietary trends spread quickly, but individual metabolism varies widely. Medical nutrition therapy works best when it is personalized, based on blood sugar profile, body composition, medication, and lifestyle. Sudden restriction can interact with medications, increasing the risk of hypoglycaemia.
A registered dietitian or diabetologist can help design meal plans that sustain energy while keeping glucose under control. Regular monitoring ensures adjustments are made as metabolism changes.
A note for World Diabetes Day
The theme of diabetes awareness is not deprivation but balance. Carbohydrates are not enemies of blood sugar; poorly chosen and poorly timed carbohydrates are. Nutrition that nourishes rather than restricts allows the body to sustain its energy and healing rhythm.
Healthy eating is less about saying "no" and more about knowing "how."
(By Dr Ramya Varada, MD, DM - Consultant Endocrinologist, Apollo Hospitals, Visakhapatnam)
Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.
Track Latest News Live on NDTV.com and get news updates from India and around the world
