Diabetes and Carbohydrates
Carbohydrates are found in foods such as bread, potatos and rice
One area of confusion for diabetics and their diets is carbohydrates. So, should you eat carbohydrates them or avoid them to lose weight?
Low-carb diets are very popular at the moment, and more than one person has made their fortune off the back of this. The Atkins Diet, for instance, promised significant weight loss through low-carb and high-protein dieting.
But a low-carb diet can have an impact on the health, even if the body seems to be getting slimmer. Low-carbohydrate, high-protein diets are nothing new. Even relatively recently, patients diagnosed with diabetes were recommended a low-carb diet.
The intake of carbohydrates was severely restricted to help in the control of blood sugar levels. However, a diet high in fats and proteins was eventually found to have a negative impact on overall health.
How do low carbohydrate diets work?
Cutting out carbohydrates from a diet in theory leads to reduced hunger and triggers a process known as ketosis. This occurs when the body begins to burn off its fat stores, and at an initial stage can lead to weight loss. This loss of weight occurs when stored glycogen deposits are taken up and converted into glucose. The resultant fluid is passed out in the urine and causes weight loss.
However, as soon as the stored energy is used up, the body will begin to break down vital muscle and bodily tissues to convert them into energy. Fat stores, as they are broken down and converted into glucose, release ketones into the blood (see Diabetes and Ketones).
I want to talk about carbohydrate counting and carbohydrates. In this demo I would like to talk about carbohydrates because without knowing what a carbohydrate is and how it works, you can't really get very far with counting them and making them a part of your daily knowledgebase living with diabetes.
There's 3 major food groups – carbohydrates, fats and proteins. Carbohydrates are the ones that when they break down, they become sugars; hence blood sugar, well blood glucose level is probably a more accurate way of talking about it – glucose gives you glycemia; hence hyper-glycemia and hypo-glycemia.
There are simple carbohydrates and there are complex carbohydrates – both of them occur in the natural world and both of them get used a lot in man made goods and it can make a difference to your body as to how these are processed, how these are put together, makes a difference as to how your body accesses the energy that's within them.
So, classic example of a complex carbohydrate would be a banana – people don't think of it as sugary but they do think of it as energy-giving and it gives you a long, slow release of energy. By comparison a simple sugar would be honey - completely natural but my goodness it is so blooming powerful. It will give you – I'll show you my little diagram in a minute, but it will literally give you a spike like that. It just releases all its sugars up immediately.
Now for somebody with diabetes, you're going to have to match that food and the nature of that food - the amount of it, with your insulin. So the more you can understand about how foods are absorbed in your body and get used by your body, and how insulin works, the better you're going to make the two of them balance so that you are nice and fit and healthy for the long term.
One of the things you might end up talking to your healthcare professional about is finding out your insulin to carbohydrate ratio. For example, if you have a digestive biscuit – worth 10 grams of carbohydrate or one exchange, you might need just one unit of insulin against that 10 grams of carbohydrate so you've got a 1-to-1 ratio.
Other people might need 2 units of insulin for that same 10 grams of carbohydrate. With time and with blood testing and just keeping a note on things, you get to know what your ratios are and they might change through the day. You might need 1-to-1 in the morning, 1-to-1.5 at lunchtime and maybe 2-to-1 in the evening. It's perfectly normal that in the day the body uses up energy on a different time scale than other point in the day.
It's probably likely that you might want to have carbohydrates with every meal but they don't have to be the fullest part of your meal. You should have some fat of some sort, protein, carbohydrates and each time you eat the 3 meals you have per day if you could have a little bit of all of them that's probably the healthiest thing to do.
You also need to understand the nature of the carbohydrate and how quick it's going to absorb, but there's another demo on counting carbohydrates – but just to know that the carbohydrate is basically the bit that's going to give you the energy, well, the sugar in your diet because the body digests carbohydrate down into the sugars that they're made of.
Losing weight can be an extremely important part of treating diabetes, yet the most feasible way of reaching and staying at your target weight is to establish a healthy diet. This should operate over a long period of time, and be able to be combined with regular physical activity. This should lead to lower blood fat, lower blood pressure and even a reduced risk of heart disease.
Losing small amounts of weight and keeping it off is more important than losing large amounts and putting it straight back on.
Are low-carb diets bad for diabetic people?
Low-calorie and low-carbohydrate diets are not necessarily a bad thing. A ‘quick fix’ diet has considerable application in the wider world.
However, because of the way in which the weight is shed, many of the fat stores within the body remain the same. For this reason, whilst a person may look slimmer, they are not necessarily healthier.
Low-carb diets also restrict the consumption of fruit and vegetables, and the antioxidants and fibre that is contained in these is therefore also reduced.
When it comes to diets high in protein, some negative affects include calcium excretion (which can lead to osteoporosis), and possibly impacts on the kidneys. This increases their unsuitability for diabetic people who are likely to be concerned about kidney disease as a complication anyway.
In some individual cases, a low-carb diet can have a use, even if the person is diabetic. However, they do not seem to comply with what common sense dictates is healthy or balanced eating.
What diet alternatives are there for diabetics?
Diabetic diets should be based on starchy carbohydrates, thereby helping to maintain blood glucose level control. It is advisable to seek a medium whereby you eat exactly how much your body needs, because any extra calories will cause excess weight gain.
Cutting down on carbohydrates can be a good idea, but only in some instances and never completely. Your carb intake should be tailored to your individual needs, and if necessary you should discuss this with a dietician.
