Diabetes and Carb Counting For Dummies. Shafer Sherri

1-1 Variables Affecting Blood-Glucose Regulation

      

Diabetes imposes the need to understand how to juggle carbs, exercise, and medications, but it can be done, as you find out in Chapters 6 and 14. No one has perfect blood-glucose control, so set realistic expectations. Use a blood-glucose monitor (see Chapter 23) and have A1C levels checked regularly. You and your healthcare team can use glucose data to make adjustments to your self-care regimen. If your medications put you at risk for low blood glucose, find out more about preventing, recognizing, and treating hypoglycemia in Chapter 15.

      Nutritional needs and diabetes management strategies change and evolve through all ages and stages of life. Chapter 17 provides specific tips for managing diabetes in childhood, during pregnancy, and into the golden years.

Getting Acquainted with Carbs

      Carbs have been getting a bad rap lately. Many people are swept up in the notion that carbs are fattening or carbs are bad. Perhaps the pendulum has swung too far, causing some diets to be too low in carbs and excessive in protein or fat. The human body has basic needs, and glucose is one of them. Carbohydrates provide glucose, which is the preferred fuel source for the brain, nervous system, and muscles. For the sake of your health, it’s important to find a happy medium … a little carb equilibrium.

      What all carbs have in common is their chemical make-up. Simple carbohydrates and complex carbohydrates are made out of the same basic building blocks: sugar molecules. Chapter 3 boils it down into super simple chemistry concepts; a preview is just ahead. In this section I also talk about the nutrients in carbs and other food groups.

      

Carbohydrate foods do more than just contribute simple or complex carbs; they provide vitamins, minerals, and good taste too!

       Introducing the so-called simple carbs

      Imagine a pile of Legos. Lego blocks can exist separately or be snapped together in pairs. Those would represent the “simple” carbohydrates, which are single or double sugar molecules. The sugars in fruit are single sugars, while lactose, the sugar in milk, is a double sugar molecule. White sugar, brown sugar, honey, and syrups are simple carbohydrates too, but they don’t offer the same health benefits as fruit, milk, and yogurt. Spoon for spoon, most sugars and syrups have similar amounts of carb. Agave nectar is a natural carb-containing sweetener that has less impact on blood-glucose levels if used in moderation.

      Desserts that contain sugar alcohol can claim to be “sugar free,” but they typically have as many carbs and calories as their sugar-containing counterparts. Chapter 12 sorts through the many sugars and alternative sweetening agents, and separates fact from fiction when it comes to carb-free sugar substitutes.

       Catching up on complex carbs

      Consider again the Lego analogy introduced in the preceding section. If you connect many Lego pieces together, you can build complicated structures. The same thing is true of starches; starches are complex carbs that are made out of many sugar molecules. Fiber is also considered a complex carb, but it doesn’t digest. Chapters 3 and 16 fill you in further on fiber facts.

       Noting the nutrition in carb food groups

      Carbohydrates are found in many healthy, nutrient-packed foods, including grains, legumes, whole-grain breads, starches, milk, yogurt, fruits, and vegetables. Beware of sweets and desserts, though. They are usually high in sugar (and oftentimes fat) and don’t offer much in terms of nutrition. Desserts and processed snack foods can contribute to weight gain and health problems if eaten in excess. Chapter 13 shows best-bet options in all food groups and even helps you figure out how to have a little dessert when you have diabetes; the key is moderation.

      

The term “carb” encompasses many foods, and not all carb foods are alike. Healthy carbs shouldn’t be condemned like junk-food carbs. Guilt by association isn’t fair. Give carbs a break and enjoy wholesome carb-containing foods in appropriate portions. Chapter 5 reviews carb-intake targets and reflects on established dietary guidelines.

      Fruit is packed with nutrition, but you can’t ignore that it’s a simple sugar and that too much of a good thing isn’t good anymore. Fruits should be enjoyed in smaller serving sizes and one portion at a time. Chapter 11 specifically addresses fruit juice and sugary soft drinks and makes a convincing case against consuming your carbs in liquid form.

      A balanced diet includes an appropriate amount of carbohydrate, protein, and fat and adequate intakes of all key vitamins and minerals. Some vitamins and minerals are found across a wide array of food choices, while other nutrients are unique to specific foods. Cutting out entire food groups cuts the nutrition in those groups. For example, vegetarians need to focus on getting adequate intakes of protein and iron. In addition, vegans must seek out vitamin B12 and calcium. When people try to avoid carbs, all kinds of nutrition red flags go up.

      

While focusing on carbohydrate is important, don’t lose track of the overall quality of your diet. Learn to make choices that are good for your heart, weight, and health. Check out Chapter 13 for more information about eating for health and happiness.

       Acknowledging that staying healthy isn’t just about carbs

      Diabetes requires that you control carbohydrates, but that isn’t the whole story. Keeping healthy means eating smart for your weight and heart (see Chapter 16); learning to identify the perfect proteins and the heart-healthiest fats and oils (see Chapter 13); and putting together balanced meals (see Chapter 8 and Part 5). A balanced diet not only assures nutritional needs are met, but blood glucose is also easier to control when meals have appropriate amounts of carbohydrate, protein, and fat.

      

Physical fitness plays an essential role in overall health. While exercise is encouraged for everyone, there are diabetes-related considerations and safety tips to be aware of (check out Chapter 14).

Making the Case for Carb Counting: To Count or Not to Count?

      Whether you loosely manage your carbs or strictly count them depends on your situation. Carb counting is the gold standard if you have type 1 diabetes, but people with type 2 diabetes also stand to benefit from knowing how to count carbs. Establishing carb budgets and adhering to those budgets is one method of managing blood-glucose levels while simultaneously controlling calories and managing weight.

       Counting carbs with type 1 diabetes: An essential tool

      When you count carbs accurately, you know exactly how much glucose is going to end up in your bloodstream. Insulin doses can be adjusted to cover that amount of carb. People with type 1 diabetes don’t make any of their own insulin. If insulin doses are based on carbohydrate intakes, counting carbs as precisely as possible is really important. It takes a little extra time initially, but with experience it gets easier and quicker. Label reading and carb-counting fundamentals are covered in