Carbohydrates and Diabetes
Carbohydrate is more immediately broken down into glucose
Carbohydrate is one of the body’s main sources of energy.
Carbohydrate is broken down into glucose relatively quickly and therefore has a more pronounced effect on blood sugar levels than either fat or protein.
This makes awareness of carbohydrate a particular important factor in management of diabetes.
Which foods contain carbohydrate?
Carbohydrate is found, to varying degrees in a wide variety of food, notably in starchy foods such as rice, pasta and flour (therefore including pastry, bread and other dough based foods).
Carbohydrate is generally found in all fruits and vegetables, however, the amounts of carbohydrate can vary substantially.
Fruit and vegetables with relatively high carbohydrate content include:
- Potatoes
- Root vegetables (such as parsnips and carrots)
- Mangoes
- Bananas
- Pears
How much carbohydrate is recommended for diabetics?
The optimum level of carbohydrate consumption for people with diabetes has been one of the hottest diabetic debates in the last few decades.
The recommendation, of the Food Standards Agency (FSA), for carbohydrate intake for people with diabetes is no different to people with diabetes.
The FSA recommend that 50% of our daily energy comes from carbohydrates. This amounts to about 225 to 300g of carbohydrates.
The recommendations are typically passed down to patients through the NHS.
The NHS carbohydrate advice has come under a lot of criticism from those who feel that for people with type 2 diabetes, in particular, the level of carbohydrate intake is far too high to maintain without the need for injecting insulin and the risks that come with the drug.
Carbohydrate and blood glucose levels
Because carbohydrate directly influences blood sugar levels, it is important to be aware of how much carbohydrate you are having at each meal. Ideally, the amount of insulin your body can produce, plus any insulin you may be injecting, should be in balance with the amount of carbohydrate you eat.
Carbohydrate and type 1 diabetes
In type 1 diabetes, the amount of insulin you will produce is likely to be either a small or negligible amount. As a result, people with type 1 diabetes will need to inject insulin and pay close attention to matching the dosage with the amount of carbohydrate eaten.
To match the insulin dosage with carbohydrate intake as closely as possible, people with type 1 diabetes will need to learn to estimate and count the amount of carbohydrates in each meal.
Correctly estimating carbohydrate content can be a difficult skill to pick up; as a result, a number of carbohydrate counting courses, such as the DAFNE course, have been developed to assist with carbohydrate counting as well as other key aspects of insulin dosing decisions.
Carbohydrate and type 2 diabetes
People with type 2 diabetes are able to produce their own insulin but are not able to respond to insulin as effectively as people without the condition.
This is called insulin resistance. The body’s natural response is to produce more insulin to help get glucose from the blood into the cells that need it.
Up to a point, the body can cope, but the higher the amount of carbohydrate eaten, the more the body will struggle, leading to high blood glucose levels.
There are two main ways to combat insulin resistance. One option is to reduce the dependency on insulin by lowering the amount of carbohydrate eaten and by exercising to improve the body’s own sensitivity to its insulin. The other approach is to use diabetes medication to help the body cope.
A number of different diabetes medications exist which act in differing ways.
As noted above, the NHS does not generally advise people with type 2 diabetes to go onto a low carb diet, however, many patients have opted to go for this approach of their own accord.
Carbohydrate and weight gain
When carbohydrates are broken down into glucose within the blood, the body will:
- Use insulin to help fuel the body’s cells
- Use insulin to turn any remaining excess of glucose in the blood into fat for storage
Carbohydrates provide energy.
If you are consuming more energy than your body needs, then carbohydrates, as part of your energy intake, will help to contribute to weight gain.
Carbohydrate and high cholesterol
Before glucose can be stored as fat, it is first turned into tryglycerides which can then be stored as body fat.
Whilst triglycerides and cholesterol are often mentioned together, there is a difference between them. In terms of the relevance to people with diabetes, high levels of triglycerides in the blood have been linked with declining health.
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