Diabetes: low carb, Mediterranean diet or reduced fat diet - what helps?

Diabetes: low carb, Mediterranean diet or reduced fat diet - what helps?

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Individual nutritional advice for diabetes is required

Diabetes is diagnosed in more and more people. After the diagnosis, those affected are often quickly given medical treatment. But a balanced diet is also an important cornerstone of the treatment of people with type 2 diabetes. Individual nutritional advice is a real help here.

"In addition to drug therapy and an intensive exercise program, sensible nutritional therapy plays a crucial role in diabetes mellitus," explains the Munich Diabetes Information Service of the Helmholtz Zentrum München on its website. According to the experts, it is particularly important to respond to the individual needs of those affected. The German Diabetes Society (DDG) also sees it that way. She recommends individual nutritional advice to adults with type 2 diabetes or prediabetes.

Diet with as little carbohydrates as possible

As the DDG writes in a recent announcement, it has almost become a fashion trend in recent years that people who want to lose weight or do something good for their metabolism should pay attention to "low carb" - that is, a diet with as little carbohydrates as possible . This form of nutrition is also generally suitable for weight loss in type 2 diabetes or prediabetes.

But a consensus statement from the American Diabetes Association ADA emphasizes that other diets can also be considered. Therefore, those affected should always receive individual nutritional advice, summarizes the Nutrition Committee of the German Diabetes Association, which analyzed the ADA report.

It is difficult to keep to strict dietary requirements in the long run

According to the ADA definition, a “low carb” diet is a diet with a carbohydrate content of less than 45 percent of the total energy intake. With “Very-Low Carb” even less than 26 percent of the energy consumed comes from carbohydrates. "In short-term studies lasting up to six months, a low-carbohydrate diet can lower the HbA1c value of the test subjects as well as the blood pressure, triglycerides and the amount of diabetes medication," explains Professor Dr. med. Diana Rubin, chief physician and head of the center for nutritional medicine at Vivantes Klinikum Spandau and Humboldt-Klinikum Berlin. However, these positive effects could not be maintained in longer-term studies - presumably because it is too difficult for those affected to adhere permanently to the strict dietary requirements.

The change in diet should always be accompanied by a doctor

A strict "low carb" diet is also not without problems for other reasons: On the one hand, hypoglycemia can quickly occur with diabetes medication, which is why the change in diet should always be accompanied by a doctor. On the other hand, there is a risk that the diet will be significantly higher in fat. “Dietary recommendations should therefore include a qualitative assessment of the macronutrients,” said Rubin, who chairs the DDG's Nutrition Committee. A moderate “low carb” diet can be recommended if it contains a high proportion of polyunsaturated fatty acids, as in Mediterranean diets.

A "high carb" diet could also be suitable with a high fiber content and low glycemic load. "From our point of view, it therefore makes no sense to limit only one macronutrient in the food," says Rubin - there are no generally applicable ideal values ​​for fat, protein and carbohydrate intake.

Individual and qualified nutritional advice

The importance of individual and qualified nutritional advice is all the greater. "In order for the patient to be able to implement nutritional recommendations, they must always be individually tailored and take into account different types of diabetes, forms of treatment, social aspects and personal preferences," explains Dr. Nikolaus Scheper, first chairman of the Federal Association of Resident Diabetologists.

The Techniker Krankenkasse (TK) explains on its website: “Diabetic patients receive competent advice in nutrition training, from the doctor and from the dietician. They learn which foods they prefer to eat and which foods and drinks they should eat rarely or only in small portions. ”They also receive information about suitable amounts and a convenient distribution of meals. In addition to the general information, individual advice is also offered in order to adapt the diet to the very personal situation. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • German Diabetes Society (DDG): Low Carb, Mediterranean, Reduced Fat or Other Diet? DDG recommends individual nutritional advice to adults with type 2 diabetes or prediabetes, (accessed: October 23, 2019), German Diabetes Association (DDG)
  • Diabetes information service Munich of the Helmholtz Zentrum München: Nutritional therapy for diabetes mellitus, (accessed: October 23, 2019), Diabetes information service
  • Techniker Krankenkasse (TK): Diet for diabetes mellitus, (accessed: October 23, 2019), Techniker Krankenkasse (TK)

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