Wednesday, November 8, 2017

Diabetes Month Tip of the Day


Question
What are carbohydrate foods and why are people with diabetes told to limit them?


Answer
Simply put (in non-chemistry terms), a carbohydrate food is a food that contains mostly starch and/or mostly sugar.  From a practical sense carbohydrate foods include the “grain” group, starchy vegetables like potatoes and corn, fruits like apples and oranges, milk and yogurt, and all “sweets” and sweetened drinks.  Many of the people I have worked with do a pretty good job (or have very good intentions, rather) of cutting out the “added carbohydrate” or “concentrated carbohydrate” by avoiding sweets and “regular” soft drinks, but if they haven’t gone beyond the basics they are often surprised to find out that fruit, cereal, and milk could be affecting their blood sugar as well.


Now that you’ve finished that paragraph—go back and read it again and familiarize yourself with which foods groups contain carbohydrate.  Why? Because for many of us, once they have figured out the “sweets” part, our brains now only want to associate carbohydrate with grains and starches.  So if you have cut your bread but you are still consuming large amounts of fruit, you might still be having trouble with your blood glucose. Getting to know your carbohydrates will definitely take some getting used to and a lot of reading, but it does get a little easier with practice.  I also find that having a smart phone app, like this one done in conjunction with Joslin Diabetes center (https://itunes.apple.com/us/app/healthediabetes/id757759280?mt=8) is invaluable.
Learning about your carbohydrate intake, and how to adjust it if desired, with help with blood glucose control because carbohydrate foods change to blood glucose faster than protein foods, fats, and/or non-starchy vegetables do.  People with diabetes have to limit how much they eat of ANY carbohydrate foods (even the ones they thought were healthy) as a first line defense in controlling their blood glucose levels.  For many people this requires a pretty drastic reduction in amounts that they were eating, and some people wind up giving up certain foods because it’s hard for some of us to eat “just a bit” of certain foods.   For example, have you ever tried to eat “just a few” chips or “just one cookie” and succeeded? Okay, so my Type 1 Spouse can, but I don’t find that particularly easy.  And it is definitely not easy for most of the people I work with after having years of not paying attention to food content in general, let alone carbohydrate content.

Speaking of people with Type 1 diabetes, especially those who are not trying to lose weight and are trying to gain muscle mass, they will usually need to make sure they get a minimum amount of carbohydrate every day.  This is often difficult to understand in a world where most people with diabetes have Type 2 and are told to "avoid" carbohydrates (although, as stated above, it's not a matter of avoiding, it is a matter of counting).  If a person with Type 1 diabetes does not get a minimum amount of carbohydrate daily they can start breaking down fat for energy and then the body produces ketones.  If there are too many ketones in the blood stream, combined with less that optimal amounts of insulin (and higher than should-be blood glucose) this can cause a dangerous condition called ketoacidosis. If this condition is left untreated it can lead to severe dehydration and death.
We’ll talk more tomorrow about how much carbohydrate is recommended, but for now if you want to keep reading click on the link below:

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