The Short Answer

The American Diabetes Association now officially recommends lower-carbohydrate diets as a viable option for managing blood sugar and diabetes — a significant shift from their previous stance. For people with autoimmune conditions affecting blood sugar regulation, including autoimmune diabetes and Hashimoto’s low thyroid, reducing processed carbohydrates can help stabilize glucose levels and reduce chronic inflammation.

Why the ADA Changed Its Stance on Low-Carb Diets

Although the American Diabetes Association (ADA) has historically lagged behind functional medicine practitioners, it has finally included lower-carbohydrate diets among its official recommendations for managing diabetes.

In functional medicine, we’ve known for decades that low-carb diets improve metabolic health and stabilize blood sugar. Typical Western diets high in sugars and processed carbohydrates promote chronic inflammation, weight gain, hormonal imbalance, and cognitive decline.

High blood sugar is linked not only to insulin resistance and diabetes, but also to heart disease, stroke, autoimmune disease, and Alzheimer’s. Researchers even refer to Alzheimer’s as “type 3 diabetes” because of how damaging elevated blood sugar is to brain health.

The ADA’s Updated Carbohydrate Guidelines

Previously, the ADA recommended that people consume at least 130 grams of carbohydrates daily, claiming that lower amounts would deprive the body of energy and essential nutrients.

However, numerous studies and clinical case reports have demonstrated the benefits of lower-carb eating for diabetes management, weight loss, heart health, and overall metabolic function. The ADA now officially includes lower-carb diets as an option in its recommendations.

This shift could finally influence government dietary guidelines, which have long promoted low-fat, high-carb diets based on corporate-influenced research. Current evidence shows that lower-carb approaches better manage chronic disease than traditional low-fat recommendations.

The ADA does exclude certain populations from low-carb diet recommendations: pregnant or breastfeeding women, people with active eating disorders or at risk of developing them, those with kidney disease, and individuals taking SGLT2 inhibitor medications.

A Critical Gap: Foods That Trigger Autoimmune Attacks

Despite these updates, the ADA overlooks important research showing that certain foods on its approved low-glycemic list trigger autoimmune responses targeting pancreatic cells.

The most common triggers of pancreatic autoimmunity are gluten and dairy, though other foods also cross-react with cells involved in glucose regulation. While not everyone develops an autoimmune response to these foods, studies demonstrate that specific dietary triggers increase the risk of developing or worsening autoimmune diabetes. Food sensitivity testing through labs like Cyrex Labs can help identify personal triggers.

Type 2 diabetes patients should also be aware that approximately 10–20 percent of people diagnosed with lifestyle-induced type 2 diabetes eventually develop autoimmune features, sometimes called type 1.5 diabetes.

Finding Your Optimal Carbohydrate Intake

Most Americans consume far more processed carbohydrates than the human body can tolerate without metabolic consequences. Inflammatory conditions driven by high blood sugar — including diabetes, obesity, heart disease, chronic pain, depression, and neurodegenerative disease — significantly burden the healthcare system.

The optimal carbohydrate intake varies by individual. A very low-carb ketogenic diet is highly therapeutic for some people, while for others, particularly those with compromised cognitive function, it may cause problems.

Finding your ideal carbohydrate range requires some experimentation. Continuous glucose monitors and regular HbA1c testing can guide this process. Regardless of your specific carb target, eliminate sugars, high-fructose corn syrup, processed carbohydrates, and industrial oils. Instead, build your diet around a rotating variety of colorful vegetables and fruits (moderate fruit intake), healthy fats, and quality proteins.

Daily physical activity, time in natural light, and meaningful social connections also play essential roles in metabolic health.