Why should you count carbs?
What are the different types of carbs?
There are three main types of carbs: sugars, starches, and fibre. Sugar belongs to a category known as simple carbohydrates. Sugar is found naturally in foods and beverages like whole fruit, juice, milk products, and honey. It’s also added to processed foods such as sweets and pastries. Starches and fibre are both complex carbohydrates. The body takes more time to digest, or break down, starches than sugar, and it can’t digest fibre at all.
Starches are found in foods like potatoes, rice, legumes, and whole grain breads and pastas. Fibre is found in foods like fruits, vegetables, legumes, nuts, and whole grains. Unlike sugars and starches, naturally occurring fibre doesn’t raise your blood sugar level and may even slow its rise.
How does food affect blood sugar levels?
Many factors, including exercise, stress, and illness, affect your blood sugar levels. That said, one of the largest factors is what you eat. Of the three macronutrients — carbs, protein, and fat — carbs have the greatest effect on blood sugar. That’s because your body breaks down carbs into sugar, which enters your bloodstream. This occurs with all digestible carbs, including refined sources like crisps and cookies as well as whole, unprocessed sources like fruits and vegetables.
When people with diabetes eat foods high in carbs, their blood sugar levels can surge. High carb intake typically requires high doses of insulin or diabetes medication to manage blood sugar. Given that people with type 1 diabetes are unable to produce insulin, they need to inject insulin several times a day, regardless of what they eat. However, eating fewer carbs can significantly reduce their mealtime insulin dosage.
How many carbs should a person with diabetes have in a day?
Studies have shown that many different levels of carb intake may help manage blood sugar, and the optimal amount of carbs varies by individual.
Thanks to the advent of more in-depth research around themes such as gut health, there is an appreciation that all people can’t be banded under the overly simplistic term of “average.” More recently, there is a movement towards an individualised approach in which your ideal carb intake should take into account your dietary preferences and metabolic goals.
It’s important to eat the number of carbs at which you feel best and that you can realistically maintain in the long term.Since carbs raise blood sugar, reducing them to any extent can help you manage your blood sugar levels. Therefore, figuring out how many carbs to eat requires some testing and evaluating to find out what works best for you.
For instance, if you’re currently consuming about 250g of carbs per day, reducing your intake to 150g should result in significantly lower blood sugar after meals.
How do you determine your optimal carb intake?
To determine your ideal carb intake, measure your blood sugar with a blood glucose meter before a meal and again 2 hours after eating. Suggested goals and levels should be managed in line with your GP or health practitioner’s advice and guidance.
To achieve your blood sugar goals, you may need to restrict your carb intake to less than 10, 15, or 25g per meal. Also, you may find that your blood sugar rises more at certain times of the day, so your upper carb limit may be lower for dinner than for breakfast or lunch.
In general, the fewer carbs you consume, the less your blood sugar will rise and the less insulin or diabetes medication you’ll require to stay within a healthy range. If you take insulin or diabetes medication, it’s very important to speak with a healthcare professional to ensure the appropriate dosage before reducing your carb intake.
Does carb restriction work for diabetes?
It should be noted that carbohydrates are an important macronutrient and thus, an important source of energy for the body. However, as detailed earlier, some carbs are better than others. Furthermore, when specifically considering effective diabetes control and management, carbs can act as a red flag food component. With that in mind, many studies support the use of carb restriction in people with diabetes. Research has confirmed that many levels of carb restriction can effectively lower blood sugar level.
Very low carb ketogenic diets
Very low carb diets typically induce mild to moderate ketosis, a state in which your body uses ketones and fat, rather than sugar, as its main energy sources. Very low carb ketogenic diets were prescribed for people with diabetes even before insulin was discovered in 1921.
Several studies indicate that restricting carb intake to 20–50 grams per day can significantly reduce blood sugar levels, promote weight loss, and improve cardiovascular health for people with diabetes. In addition, these improvements often occur very quickly.*
Diets containing 20–50 grams of carbs per day have also been shown to lower blood sugar levels and reduce the risk of disease in people with prediabetes.
*A note of caution when any diet claims to deliver “quick” results. These are in the long-term unsustainable and not a realistic diet plan. The body will covertly strive to return to its original weight and condition when the person returns to a normal eating pattern. Quick fixes offer quick results that aren’t normally sustaining in the long-term.
Low carb diets
Many low carb diets restrict carbs to 50–100g, or about 10–20% of calories, per day. Although there are very few studies on carb restriction in people with type 1 diabetes, those that exist have reported impressive results. One of the biggest concerns for people with type 1 diabetes is hypoglycaemia (Hypo), or blood sugar that drops to dangerously low levels.
In a small 12-month study from 2005, adults with type 1 diabetes who restricted their daily carb intake to fewer than 90 grams had 82% fewer episodes of low blood sugar than before they started the diet.
In a 2012 study in people with type 1 diabetes who restricted carbs to 70g per day, participants saw their HbA1c drop from 7.7% to 6.4%, on average. What’s more, their HbA1c levels remained the same 4 years later.
A 1.3% reduction in HbA1c is a significant change to maintain over several years, particularly in those with type 1 diabetes. People with type 2 diabetes may also benefit from limiting their daily carb intake. According to a research review, people who consumed no more than 26% of calories from carbs were 32% more likely to experience diabetes remission than people who mostly followed a low-fat diet.* (A person was considered in remission if their HbA1c was under 6.5%)
*It’s worth noting that many people will turn to ultra-processed low-fat or 0% fat products. In removing fat content, food manufacturers are removing taste and texture. As a result, food manufacturers will merely replace fat with some source of carbs (to restore taste and texture) which will ultimately break down into simple sugars during digestion.
Moderate carb diets
A more moderate carb diet may provide 130–220g of carbs per day, or 26–44% of calories in a 2,000-calorie diet. A few studies examining such diets have reported good results in people with diabetes.
In a 2010 study of 259 people with type 2 diabetes, those who followed a Mediterranean diet providing 35% or fewer calories from carbs experienced a significant reduction in HbA1c. Over the course of 12 months, HbA1c dropped 2.0% on average.
What are some high carb foods to avoid?
Many tasty, nutritious, low carb foods raise blood sugar levels only minimally. You can enjoy these foods in moderate to liberal amounts on low carb diets. However, you should avoid or limit the following high carb items:
breads, muffins, rolls, and bagels
pasta, rice, corn, and other grains
potatoes, sweet potatoes, yams, and taro
milk and sweetened yogurt
most fruit, except berries
cakes, cookies, pies, ice cream, and other sweets
snack foods like pretzels, chips, and popcorn
juice, soda, sweetened iced tea, and other sugar-sweetened drinks
beer, cider, sweet wines, and spirits with sugary mixers
Keep in mind that not all of these foods are unhealthy. For example, fruits are highly nutritious, but eating large amounts isn’t optimal for anyone trying to manage their blood sugar levels by eating fewer carbs.
Extracts taken from Jerlyn Jones, MS MPA RDN LD CLT, & Franziska Spritzler from https://www.healthline.com