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Carbohydrates and Diabetes: Breaking it down

Anna Delany and Joan Bushman


 

If you have diabetes it's important to know how carbs can affect your blood glucose levels. If you eat too many carbohydrates, or the types of carbohydrates that process rapidly, then your blood glucose levels will fluctuate dramatically, increasing health risks. Even if you don't have diabetes, it's good to know the ins and outs of carbs and how they affect your body.

So how do you learn to moderate your carb intake effectively? You need to get a good understanding of two things: carbohydrate distribution and carbohydrate quality. Carbohydrate distribution refers to when you eat and the amount of carbohydrate you eat. Carbohydrate quality refers to the types of carbohydrates you eat and can be moderated using the glycemic index or load. If you familiarize yourself with both these aspects of carbohydrate intake, and make any necessary changes to your diet, you’ll be well on your way to effectively managing blood glucose levels.


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Carbohydrate distribution

Carbohydrate distribution refers to when you eat and the amount of carbohydrate you eat.

If you have diabetes, regular meals with an even distribution of carbohydrate over the day are important for good control of blood sugar levels. If you eat large quantities of carbohydrate foods at main meals and little or none between meals you risk excessive fluctuations in blood sugar levels. It's better to eat smaller amounts of food more frequently as this results in steadier, more even blood glucose levels. In general, the recommended daily eating pattern for good blood glucose control is:

  • Three meals and three snacks for people with Type 1 diabetes and normal blood glucose variations
  • Three meals (and 1-2 snacks as needed) for those with Type 2 diabetes

If you are diabetic, your doctor or dietitian can advise you on the level of calories and carbohydrate most appropriate to your weight, medication, and activity. You should also check your blood glucose regularly for feedback on how carbohydrate intake is affecting blood glucose levels.

Whether or not you have diabetes, a rough rule of thumb for carbohydrate intake is 13g of carbohydrate per 100 calories; this is equivalent to about 50% of total calories. Variations on this rule are shown in the table below.

 

Carbohydrate Intake

Daily Total Calories

Daily Total Carbohydrates

Percent of Carbohydrate Calories

Each main meal(3)

Between Meals(3)

1200 Cals

120g

40%

30g

10g

1500 Cals

170g

45%

40g

15g

2000 Cals

250g

50%

60g

25g

2500 Cals

345g

55%

70g

45g

3000 Cals

450g

60%

90g

60g

From The Doctor’s Pocket Calorie, Fat and Carbohydrate Counter, 2005 Edition, page 20.


Carbohydrate quality

Choose less processed carbohydrates, such as brown rice instead of white rice

Moderating your carbohydrate involves more than just eating the right amounts of carbohydrate at the right times. You also need to choose the right kinds of carbohydrate foods.

Various forms of carbohydrate affect blood glucose levels in different ways. The same amount of carbohydrate from different foods may affect blood glucose differently. For example white and brown rice have approximately the same amount of carbohydrate, but white rice will cause your blood glucose levels to rise faster than brown rice.

The aim is to choose carbohydrate foods that cause a slow, steady release of glucose into the blood stream. These tips can help you towards that goal:

  • Choose carbohydrates containing soluble fiber as these can help slow the release of glucose. The best sources of soluble fiber are fruits, vegetables, oat bran, barley, dried beans and peas.
  • The physical form of the carbohydrate food (whether it is solid, puree, or liquid), can influence the rate of glucose release. Choose solid forms of food, rather than liquid - for example, choose oranges instead of orange juice. In general, the more refined the food substance, the quicker the release of glucose into the blood stream.
  • Choose raw carbohydrate foods rather than cooked ones, and whole-foods rather than processed foods. These are generally more slowly absorbed, even though the carbohydrate content is often the same.
  • Avoid carbohydrate foods high in simple sugars, such as white bread, cookies and candies as these will speed up the release of glucose.

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Next: Using the glycemic index (GI) and the glycemic load (GL)

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