Carbohydrates, proteins, and fats are the most essential nutrients in every diet, with carbohydrates being the most important in terms of quantity because it is the primary source of energy in the body. Moreover, plasma glucose levels are determined by the levels of carbohydrates and insulin in the blood. Therefore, carbohydrate intake is very key in blood glucose regulation in diabetics. High carbohydrate diets if rich in refined sugars can be extremely harmful, on the contrary high carbohydrate diets rich in dietary fiber with low glycemic index have positive effects of blood glucose control. Carbohydrates are a heterogeneous class of nutrients
Monitoring the intake of these carbohydrates is one of the major ways people with diabetes can manage blood sugar levels. These carbohydrates can be obtained from foods such as fruits and vegetables, whole grains, sweetened drinks such as soda, and cereal. By eating safe amounts and quality of carbohydrates, diabetics can:
- reduce the risk of diabetes complications
- improve their quality of life
- maintain plasma glucose at target levels
The body’s main source of energy is carbohydrates that are consumed in the form of simple sugars such as glucose, sucrose, and fructose, or as complex sugars such as starch. They can be gotten from foods such as maize, rice, fruits, and dairy products. Carbohydrates raise blood sugars faster than other macronutrients like fats and proteins will. The quantity and quality of carbohydrates you eat will affect the process of diabetes management.
Counting carbs helps the patient to keep track of the carbohydrate intake. Dieticians will help you figure out how many grams of a particular carbohydrate you should eat, depending on the glycemic index and glycemic load of the food. This, together with insulin therapy will help keep blood glucose at target levels.
Dietary fibers in the control of type 1 DM
Dietary fiber, especially soluble fiber is useful in the management of type 1 diabetes. High fiber diets are said to reduce plasma glucose concentration in diabetic patients by slowing the process of glucose absorption. This is one of the reasons why most diabetes associations encourage high fiber diets for patients. Fibers also have the ability to reduce weight and disturb carbohydrates and fat metabolism. Intake of insoluble dietary fibers can be increased by replacing refined foods with whole grains and cereals. as found in whole-grain cereal products are considered to be especially effective in the prevention of type 2 diabetes mellitus. High consumption of fruits, vegetables, and pulses also shows these health-promoting properties. Type 1 diabetes patients are recommended to consume between 15 g to 35 g per day of fiber.
How many carbohydrates?
For females, they recommend 3–4 servings of carbohydrates, at 15 grams (g) per serving. For males, they recommend a slightly higher amount of 4–5 servings. This is equivalent to 45–75 g each meal.
However, various other factors can influence how many carbohydrates a person with diabetes needs per day at an individual level.
Factors to consider when counting carbohydrates
Other factors that influence how many carbohydrates diabetics require include:
- physical activity level
- diabetes medications
More physically active people need enough calories for energy. This can affect their blood glucose levels, as well as how many carbohydrates they will need on a given day.
Weight also affects carbohydrates intake. According to the Obesity Action Coalition, excessive body fat can cause a person at risk of developing type 2 diabetes to develop insulin resistance, which can raise blood sugar levels. As such obese people may require fewer carbohydrates
Lastly, the carbohydrate intake should be proportionate to the dose of insulin injectable to prevent hypoglycemia or hyperglycemia.
Effects of too many or too few carbs
1) According to the American Diabetes Association (ADA), eating too many carbohydrates causes hyperglycemia (high blood sugar) in diabetics. Its symptoms include:
- Polydipsia (excessive thirst)
- Polyuria (frequent urination)
- high plasma glucose levels
Persistent hyperglycemia can lead to ketoacidosis, a life-threatening condition with symptoms such as; breath with a fruity smell, dry mouth, nausea, and vomiting. See a doctor urgently if you notice signs of ketoacidosis.
A person should seek emergency help from a doctor if they notice signs of ketoacidosis.
2) Low intake of carbohydrates can lead to a fall in blood sugar levels also known as hypoglycemia. Hypoglycemia can result from
- Excessive use of diabetes medication or insulin
- Inadequate intake of carbohydrates
- Skipped or delayed meals
- Increased physical activity
- Consuming alcohol on an empty stomach
The symptoms of hypoglycemia are usually mild and include:
- Profuse sweating
- Seizures or convulsions
- Loss of consciousness
Hypoglycemia requires quick treatment. Matching carbohydrate intake with insulin or diabetes medication intake can prevent hypoglycemia. Patients should also endeavor not to skip meals, drink alcohol on doctor’s recommendations, and exercise regularly but not excessively.
Best carbohydrates for diabetics
Dairy products contain nutrients such as proteins, and calcium. They also contain carbohydrates in the form of lactose. However, it is important to include dairy because of the proteins and calcium essentially. Proteins slow the process of digestion and absorption. They are also key in tissue and muscle growth, and other metabolic processes. Calcium is needed for strong bones and teeth, cell transport, and an essential mineral for muscle and heart health function.
Full dairy products contain higher levels of saturated fats, which can increase heart disease and insulin resistance. Thus low-fat diary with 1 or 2 percent fats is recommended
For reference, a cup of full-fat milk contains 4.55 grams (g) of saturated fat, 149 calories, and 12 g of carbohydrates, according to the U.S. Department of Agriculture (USDA). Compare that with a cup of 1 percent milk, which has 1.54 g of saturated fat, 102 calories, and 12 g carbohydrates, per the USDA.
Eat more beans and lentils:
Beans are largely packed with fiber, compared with other carbohydrates sources. Include kidney beans, butter beans, chickpeas, or red and green lentils in the diet. These have little effect on blood glucose levels and may help with the control of blood fats too. They can be added to stews, soups, and salad.
Fruits contain carbohydrates in the form of sugars such as fructose and sucrose, which may lead to sugar spikes when consumed excessively or as fruit juices.
Regardless, these fruits are also high in fibers. High fiber diets are said to reduce plasma glucose concentration in diabetic patients by slowing the process of glucose absorption. Generally, complex carbohydrates (more fiber) like most fruits have a less negative impact on blood sugar spikes than simple carbohydrates like soda.
Thus fruits can be appropriate for diabetics. On the contrary, fruits juices and canned fruits with added sugar should be avoided. Plain fruit juices contain as much sugar as soda, and crushing the fruits reduces the fiber content.
Also, choose fresh fruits over dried fruits, drying fruits leads to loss of water and an increase in the concentration of nutrients in the fruits, including the sugar concentration. Snacking on dried fruits will soar blood sugar levels, as opposed to eating fresh fruits with fiber. Low glycemic index fruits are more ideal for diabetics and include:
- kiwi fruit
Eat more vegetables.
Diabetics should increase the consumption of vegetables. They moderate carbohydrates in a diet by giving the feeling of being full. Dieticians recommend that half of your plate be filled with vegetables. Asides from adding bulk(fiber) to the diet, vegetables also contain health-promoting nutrients like minerals and vitamins. Be sure to include vegetables such as lettuce and cabbages, broccoli and cauliflower to your diet.
Eat starchy vegetables like corn, green peas, and sweet potatoes in moderation
Whole grains, pasta, bread, and rice are better sources of carbohydrates
Whole grains provide more fiber than refined grains. During the process of refining, nutrients, especially protein and fiber from the bran and gem are removed. Thus when making a grain-based selection, pick whole grains over refined grains. Nutritious whole grains and their products like barley, brown rice, whole-wheat pasta, whole wheat bread, whole grain couscous should be largely consumed. Avoid white rice, white bread, and white flour.
Being diabetic doesn’t imply complete avoidance of carbohydrates. However, the quality and quantity of carbohydrates are important in blood glucose control and the prevention of other cardiovascular risk factors. Chose carbohydrate foods rich in fiber and with a low GI; these include legumes, whole grain cereals, vegetables, low-GI fruit.
Angela A. Rivellese, Rosalba Giacco ,and Giuseppina Costabile.,(2014) Dietary Carbohydrates for Diabetics. Curr Atheroscler Rep DOI 10.1007/s11883-012-0278-4