Eating Carbs Last May Help With Diabetes, No Kidding!

What do a three-year-old and a good stand-up comedian have in common? They both mess up their ABCs. Many comedians (and people in other parts of live entertainment) follow the BCA method. The general idea is to start a set with your second-best (B-level) joke to get everyone laughing, then fill the middle with C-quality jokes, and close with the A-tier, best joke. Just like the order of jokes in a set matters, the order you eat your food matters too.

What do you get when you cross lots of sugar with long periods of time? Diabetes. It’s of course not that simple and genetics plays a large role, but excessive calories - especially from simple carbohydrates like sweetened beverages and french fries - are associated with an increased risk of developing type 2 diabetes.^[1] Eating refined carbohydrates increases blood sugar (glucose) levels, insulin levels, and - over time - hemoglobin levels, measured as HbA1c.^[2] When high levels of sugar are consumed for extended periods of time (say, all of childhood and into my thirties), the body stops being as sensitive to insulin, becomes less able to process glucose, and excess glucose binds to the hemoglobin in cells; all hallmarks of type 2 diabetes. Additionally, eating a whole bunch of extra calories in the form of sugar is a great way to gain an unhealthy amount of weight. Obesity, an extreme form of being overweight, is associated with a line up of serious health problems: type 2 diabetes, heart disease, high blood pressure, increased risk of stroke, and increased risk of cancer.^[3] 

What do you call a person who cuts their sugar content? Discontented. Cutting carbohydrate intake to recommended levels is ideal, but it might require longer cooking times, more money for groceries, or moving out of a food desert and into a neighborhood with a healthy grocery store within walking distance. These can be serious hurdles for people. Luckily, researchers have spent decades investigating a zero-cost, zero-time method to reduce some of the effects of eating carbohydrates. The trick is to act like a comedian and save the sweetest bit for the end, a method called Carbs Last. The idea is that by eating fiber, vegetables, and protein well in advance of carbohydrates, the body is “prepped” for an influx of energy, slows digestion, delays the absorption of sugary glucose, and helps keep the body’s reaction to glucose more stable and healthy.^[2,3]

How can you look for answers you swear you already looked for? Research. Many clinical trials have looked at eating carbs last, and they all more or less agree that it smooths out glucose levels and keeps spikes down.^[2,4,5] The general format of these studies is to bring people into a controlled setting and give them carbs first, carbs last, or all the food at once.^[2,4,5] These studies have found that the order you eat your food has a huge impact on how your body processes sugars.^[2,4,5] One study, published in 2025, found that when people with diabetes ate carbs last, they experienced a 44% drop in the maximum rise in blood sugar levels!^[2] Patients also experienced more blood sugar control in general and kept their blood sugar in the healthy range for longer when eating carbs last.^[2] Another 2025 study on pregnant women with gestational diabetes found that eating carbs last improved diabetes markers, and was also associated with better birth outcomes!^[5]

How is giving health advice similar to sailing in a hurricane? People tend to go overboard. Eating carbs last is not a fix-all or get-out-of-diabetes-free card to eat cookies all day every day. Practices such as eating carbohydrates last should be done in consultation with your doctor and paired with an overall healthy, balanced diet. Part of the benefit may actually come from eating more fiber‑rich foods, vegetables, and protein.^[3] Even the type of protein matters, with whole-food sources like meats and beans slowing digestion more effectively than powdered whey or soy.^[2,3] Studies also find that just by eating extra protein, people can lower the total amount of calories eaten, presumably by increasing our feelings of fullness.^[6] Regardless of the additional healthy steps available to you, however, eating carbs last is free, easy, and worth a shot. So next time you want to eat a cookie, act like a comedian and follow your BCA’s; they’re no joke!

Creative Director Benton Lowey-Ball, MWC, BS, BFA

References:

[1] Willett W, Manson J, Liu S. Glycemic index, glycemic load, and risk of type 2 diabetes. The American Journal of Clinical Nutrition. 2002 Jul 1;76(1):274S-80S. https://doi.org/10.1093/ajcn/76/1.274s

[2] Touhamy II S, Palepu K, Karan A, Hootman KC, Riad J, Sripadrao S, Zhao AS, Giannita A, D’Angelo D, Alonso LC, Aronne LJ. Carbohydrates-Last Food Order Improves Time in Range and Reduces Glycemic Variability. Diabetes Care. 2025 Feb 1;48(2):e15-6. https://doi.org/10.2337/dc24-1956

[3] Ferguson BK, Wilson PB. Ordered eating and its effects on various postprandial health markers: a systematic review. Journal of the American Nutrition Association. 2023 Nov 17;42(8):746-57. https://doi.org/10.1080/27697061.2022.2161664

[4] Shukla AP, Andono J, Touhamy SH, Casper A, Iliescu RG, Mauer E, Zhu YS, Ludwig DS, Aronne LJ. Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes. BMJ Open Diabetes Research & Care. 2017 Sep 14;5(1). https://doi.org/10.1136/bmjdrc-2017-000440

[5] Murugesan R, Thiruselvam S, Leela KV, Satheesan A, Geetha K, Ram M, Kumar J. Impact of a structured food sequence and mobile health monitoring on gestational diabetes outcomes: a clinical trial. Frontiers in Nutrition. 2025 Jul 28;12:1562240. https://doi.org/10.3389/fnut.2025.1562240

[6] Vozzo R, Wittert G, Cocchiaro C, Tan WC, Mudge J, Fraser R, Chapman I. Similar effects of foods high in protein, carbohydrate and fat on subsequent spontaneous food intake in healthy individuals. Appetite. 2003 Feb 1;40(2):101-7. https://doi.org/10.1016/S0195-6663(03)00003-5