Carbohydrates: they’re in everything from lollies and bread to pasta and even soft drinks. Carbohydrates are starches and sugars found in foods, including the added sugars and naturally occurring sugars in fruit and dairy foods. When you have diabetes, keeping track of your carb intake is especially important. Once eaten, carbs break down to form glucose, which is absorbed into your bloodstream. You then need insulin to move that glucose into your muscles and cells. In someone without diabetes, the body produces just the right amount of insulin to deal with the carbs they eat. If you have type 1, your body doesn’t produce this insulin, and if you have type 2, the insulin your body makes doesn’t work as effectively as you need it to. If you have type 1, you have to take on the role of your pancreas and try to match the amount of carbs you eat with the amount of insulin you take to keep blood glucose levels within the desired range. Depending on the type of insulin you’re taking, you might also need to do this if you have insulin-treated type 2. If you have type 2 and are not taking insulin, you don’t have to be as strict about carb counting. However, it’s important to be mindful of your carb intake across the day. Spreading your carb intake evenly over the day and avoiding large amounts at one time helps keep blood glucose stable. And if you’re taking medication that can cause hypos, such as insulin or sulphonylureas, then matching your medication and carbs is important to prevent your blood glucose levels dropping too low.
HOW TO COUNT CARBS
Understanding how to work out the carbs in your meals and snacks is a key part of keeping your blood glucose levels on track. If you have type 2 it helps you to space your carb intake more evenly over the day, and if you have type 1 or insulin-treated type 2, it’s essential if you want to match your insulin to your carb intake. To match insulin to carbs, you can either add up the total grams of carbs in the food you eat, or count the number of ‘portions’ or ‘exchanges’ of carbs that are in your meals and snacks. A ‘portion’ or ‘exchange’ is the amount of food that contains 15g carbs (some people use 10g). For example, 1 average slice of bread, 1 medium orange and ¼ cup of rolled oats each contain about 15g carbs, or 1 carb exchange. This means the rise in your blood glucose, and the amount of insulin you may need, should be about the same if you were to consume any of these foods.
HELPFUL COUNTING TOOLS
To work out the carbohydrates in the foods you eat:
● Read the nutrition label on packaged foods.
● Consult carb-counting books such as The Traffic Light Guide to Food.
● Visit websites and download phone apps which let you look up the carb content of common foods. Try The Traffic Light Guide to Food app or the CalorieKing website.
● Use your kitchen scales and measuring cups/spoons when at home to help you accurately work out how much you’re eating, especially for foods that don’t come in packages. Spend time measuring and weighing and you’ll soon get better at making a reasonable guesstimate at how many grams of carbs are in your meals. This is especially useful when eating out.
● Visit your local diabetes centre. Some hold education sessions, such as DAFNE that teach people to count carbs. Ask your dietitian if there’s one running in your area.
MATCHING INSULIN TO CARBS
If you have type 1 or insulin-treated type 2, you may be taught to adjust your insulin dose to the amount of carbs you eat, or you may be recommended a set dose of insulin as well as an amount of carbs to aim for at each meal. Either way you’ll need to work out the grams of carbs you consume. To match your insulin to carbs, decide upon an Insulin-to-Carbohydrate Ratio (ICR) with your diabetes team – this is the insulin you’ll be required to take for a particular amount of carbs. For example, an ICR of 1:15g means that for every 15g of carbs you eat, you need to take one unit of insulin. This method gives you the flexibility to eat the carbs you desire at each meal and adjust the insulin accordingly
WHICH CARBS ARE BEST?
Stick to nutrient-dense lower GI carbs, particularly whole grains and legumes as well as most fruits and vegetables, including these:
● Wholemeal or wholegrain pasta or noodles
● Unsweetened dairy foods like milk and natural yoghurt and unsweetened soy milk
● Legumes including lentils, chickpeas and dried or canned beans
●Whole grains: rolled oats, barley, quinoa, cracked wheat (burghul), buckwheat, lower GI brown rice
●Fruits and vegetables (but go easy on the potatoes)
●Dense wholegrain breads
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