A probably-very-obvious question about carbs?

zoeee said:

Hi everyone - this question has been on my mind all day so I thought I'd come to you! I've had type 1 for 10 years and have always been told to have some kind of "starchy carb" with every meal - so potato, pasta, bread etc. So I have always been very good and stuck to this rule - but what is the reason behind this? :shock: Please enlighten me!

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Not everyone will agree with me on this but i think the topic is covered very well by Gary Scheiner in his book "think like a Pancreas".

In essense it is because Carbohydrates are the fuel for your body. Without Carbohydrates your body will resort to fat, protein and ultimately muscle. He uses an example of a marathon runner where someone without diabetes would reach "the wall" i.e. the point at which their glucagon stores are depleted after about 4 hours of running whereas someone who has no or little carbs would reach this point after just 90mins.

So in short, carbs are needed to replensih glucagon stores and are essential for healthy function of your body. Without them you run a very real risk of depleting muscle for fuel, which is not a good thing.

A low carb person will probably come along and dispute this of course and they are entitled to but this is my opinion and is backed up by what i have researched including the aforementioned book.

I really think it depends what kind of carbs. Our bodies don't really need the junky carbs. If it's made in a factory it's not really good for you. E.g bread, pasta, sugar and pastries. Even rice is polished. I prefer to get my carbs from a natural source, well as natural as can be. I was once told 'there are no carbs in vegetables'. Hmmm wonder what kind of education they missed out on.
The problem is the carbs we in the West have access to are the yummy processed stuff, full of polystyrene plasticy stuff. See it coming out of a tube in a factory and then in a pot, yuk. Who knows what it does to us. Well I'm on this forum so I guess I know.

Hi Zoeee,

You'd think it was an obvious question with a simple and precise answer but strangely it is a huge issue of dissent here and elsewhere.

The facts though are relatively simple; the amount of carbohydrate you need to eat is none. Carbohydrate is not an essential nutrient. If you should so chose your body could get by quite happily eating just fat and protein. There is a small amount of glucose needed by the brain and (parts of) the heart (about 30 grams) but this can be provided by breaking down protein by means of a process called gluconeogenesis. The fact that our rather wonderful bodies can make glucose (which if you think about it is pretty astonishingly clever) means that we don't need to eat it.

So, why are we told to make starchy carbs the basis of our meals? Especially when elevated insulin levels are no good for anyone and eating carbohydrate is pretty difficult to manage as a Type 1 (and virtually impossible if you're Type 2) in terms of blood sugar swings?

That's the million dollar question; it really doesn't make any sense and in my view is solely based around the misplaced (read it up on here) view of fat as the key threat to (diabetic) life as a casual link in the elevated cholesterol/heart disease chain.

When you look at the actual evidence saturated fat for all the fear it engenders in the hearts of dietitians does not lead to increased cholesterol which in turn does not lead to increased heart disease (CVD in particular).

There are lots of threads on here dealing with these ideas; and some of this is very complex and fiercely disputed.

As a Type 1 I am convinced through reading up on this, talking to some very clever people here and seeing the results first hand (lipid profile and HbA1c in particular) that fat is fine and it's the carbs we should be avoiding like the plague.

I don't eat more than about 30 grams of carb a day (and that amount because it is pretty difficult to get rid of them altogether).

If you pursue these apparently sacrilegious ideas I'm sure you'll find the journey at the very least interesting and possibly life changing if you're like me.

The place to start is here, but also have a look at Dr Bernstein's Diabetes Solution (a very useful US book by a Type 1 doctor) and google Gary Taubes' NY Times Article 'What if it's all been a big fat lie?'.

Happy reading!

Best

Dillinger

I haven't heard that phrase for a long time where T1 is concerned not by a diabetic health care professional at least... Last time I was giving any advice on this score is when I moved onto basal/bolus regime upon I was told if I didn't eat any carbs, for goodness don't inject!

So nope you don't need starchy carbs with every meal, but if you eating a high protein based meal, you might find that you need a small amount of insulin... As a percentage of Protein does break down into the glucose, which normal ratio within a meal that contains carbs the impact of the protein is negligible, but in larger quantities it can have an impact, so this is a case of trial and error to find out what amount you need, and best time inject (before or after eating)

Yep, when I was first diabetic vegetable items such as peas, onions, and salad products such as lettuce, tomatoes etc were freebies... But this at the time was due to the 2 injections a day regime and prescribed amount of carbs... Because these are all have very low quantities of carbs per portion the impact effect on the blood glucose was pretty much negligible...

I would also ask your DSN if there is a Carb Counting course you can attend, such as DAFNE (it might have a slightly different name in your area) this will give you a wealth of information concerning carb counting, and how to adjust your insulin etc... So are more than able to adjust your insulin to the amount of carbs or not you chose to eat

Yes, the 'low carb' label is deceptive and should perhaps read 'low simple carbs'. I agree with Dawn in that we can happily live without bread, rice, pasta, cakes, biscuits, sugar etc and other processed fast acting carbs which give us a quick rise in sugar levels, which the diabetic can't always handle as well as a non diabetic. I'm a T2 by the way.

I eat my carbs in the form of veggies and fruit and the sauces I might put on my food and the very low carb crackers I eat instead of bread. There are hidden carbs in foods that we forget are there, so even so called 'low carbers' like myself are getting some carbs somehow.

As for energy and muscle tone etc, I'm feeling more energetic and strong than I have in decades. When I was eating simple carbs with my meals I had no energy or muscle strength whatsoever, including heart strength which is why I was getting so breathless despite using inhalers for asthma. Best of all, I'm never hungry and don't crave sweet stuff any more which was an unexpected benefit of carb cutting.

I feel the need to add that I'm not preaching the low carb diet as the only way to eat. Each of us must find our own way through the diet maze, I just happened to hit on the right one for me first time.

zoeee said:

Hi everyone - this question has been on my mind all day so I thought I'd come to you! I've had type 1 for 10 years and have always been told to have some kind of "starchy carb" with every meal - so potato, pasta, bread etc. So I have always been very good and stuck to this rule - but what is the reason behind this? :shock: Please enlighten me!

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Hi there zoeee pleased to meet you :wave: I am type 1 as well. The funny thnig is I was at my diabetic clinic this morning and I did ask about carbs, because I asked if my intake of carbs was causing higher BS after some meals, the answer was no, as long as I injected the correct amount of insulin with the carbs( this was from the doctor). I talked about my 1 carb free breakfast and it went up alot afterwards, egg and bacon with a microwaved tomato with the dietian afterwards an she said that it may give me a little spike afterwards, but I told her it was a BIG spike afterwards.She then suggessted it could be an ongoing problem that I have :? Carbs come in all shapes and sizes :wink: I love things like yogurt which has carbs. I see nothing wrong in eating carbs with every meal, but it doesn't have to be a huge amount. 2 slices of a small wholemeal 400gm loaf could be about 20 crabs, so I would just inject 2 units of insulin whether it was as toast or with some cheese, ham and salad at lunchtime.( but I have different dietry needs now) Carbs are fuel as was mentioned in another post before mine.

The best thing for me is to have a well balanced diet with carbs,protein and a few fats. Find out what is best for you and your diabetes control, as everyone is so different.

With best wishes RRB

If you are using a mixed insulin then you would have to eat a certain amount of carbs as you can't easily adjust the dose,
Similarly if you use a relatively fixed bolus dose then you will need to match your carbs to the insulin.
As Jopar says if you are on a basal bolus regime and learn to dose adjust then you can choose to eat meals with little or no carbohydrate.

The people at my hospital still advocate some starchy carbs at each meal. (a quarter of a plate/ with half the plate veggies plus some dairy and fruit) Here's some of the reasons, as you will realise they are controversial on this forum,
because there is a concern that diets without will be either too high in protein or lacking in nutrients (unfortunately a lot of 1s do have reduced kidney function)
because they are concerned that a diet higher in sat fat may be deleterious to blood vessels and CVD is probably the complication that we are at biggest risk of developing
because diets high in fibre/veggies/fruit/wholegrains are thought to be protective against CVD.
The carbs they push are definitely of the less refined sort (ie not pastries, white bread and desserts)

Personally, I occasionally eat meals without any carbs but I do find them more difficult to dose for. I find that a regular distribution of carbs enables me to be very active, and have good glucose control so it works for me,

Carbohydrates provide the body with the energy it needs, if your on a flexible insulin regime you can adjust your insulin to suit the carbs on your plate which gives you a greater flexibility.

And how about stopping this thread right there? Both sides' argumenst have been succinctly articulated, there have been no personal exchanges, the OP can now decide for themselves. No moderator intervention needed. Please?????

Starchy carbs take longer to break down? So won't make your bg jump instantly, AFAIK!