Carbohydrates and Diabetes

Carbohydrates and Blood Sugar

The two main forms of carbohydrates are sugars and starches. Types of sugars include fructose (sugar found in fruit and some baked goods), glucose (the main sugar in our bodies that's also found in foods like cake, cookies, and soft drinks), and lactose (sugar found in milk and yogurt). Types of starches include vegetables like potatoes, corn, and peas; grains, rice, and cereals; and breads.

The body breaks down or converts most carbs into glucose, which is absorbed into the bloodstream. As the glucose level rises in the blood, the pancreas releases the hormone insulin. Insulin is needed to move glucose from the blood into the cells, where it's used as an energy source.

In people with diabetes, the pancreas does not make enough insulin (type 1 diabetes) or the body can't respond normally to the insulin that is made (type 2 diabetes). In both types of diabetes, glucose can't get into the cells normally, so a person's blood sugar level gets too high. High blood sugar levels can make people sick if they don't receive treatment.

Carbs Can Be Part of a Healthy Diet

Eating carbohydrates makes blood sugar levels rise, but that doesn't mean that people with diabetes should avoid them. In fact, carbs are a healthy and important part of a nutritious diet.

For everyone — including people with diabetes — some carbohydrate-containing foods have more health benefits than others. Whole-grain foods, vegetables, candy, and soda all have carbohydrates. But fruits, vegetables, and whole-grain foods are generally healthier than sugary foods like candy and soda because they provide fiber, vitamins, and other nutrients.

On the other hand, some foods containing carbs — like sugary snacks — contain "empty calories." That means their calories lack nutritional value. Eating too many empty calories can contribute to being overweight or obese and can crowd out more nutritious foods from a daily diet. These foods can also cause tooth decay.

Fiber is the one type of carbohydrate that does not raise blood sugar. Everyone needs fiber — it helps you feel full and keeps the digestive system running smoothly. Most people don't get enough of it. Some experts think that people with diabetes should have more fiber than others to help control blood sugar levels.

Whichever type of carbohydrates your child eats, remember this: Generally, the amount of sugar that gets into the blood after eating depends on the amount of carbs eaten, not the type of carbs. So basically, as far as managing diabetes is concerned, a carb is a carb. Again, the one exception to this is fiber: It is the one type of carbohydrate that does not raise blood sugar because the body doesn't digest or absorb it.

Your goal is to help your child achieve the right balance between the insulin in the body and the carbs in food.

Balancing Carbohydrates

In addition to serving a balanced diet of carbs, proteins, and fats, you can also help keep your child's blood sugar at a healthy level by:

• making sure blood sugar is tested regularly
• encouraging plenty of exercise
• making sure your child gets insulin and other medications for diabetes according to schedule and in the right amounts

Following a meal plan helps kids with diabetes track their carbohydrate intake. You'll work with your child and the diabetes health care team to create a meal plan that will include general guidelines for carbohydrate intake. The team will consider your child's age, size, weight goal, exercise level, medications, and other medical issues, and will try to incorporate foods your child enjoys.

Usually, it's easier for most people with diabetes to control their blood sugar levels if they eat carbs in fairly consistent amounts and at regular times each day.

Three general types of meal plans can help achieve the proper balance:

An exchange meal plan lists items in six food groups and sets a serving size for each food. You can mix and match the foods while keeping track of what your child is eating, including how many carbohydrates.

With the constant carbohydrate meal plan, people eat about the same amount of carbs and other foods every day. This can be a good approach for those who take insulin only once or twice a day or who don't take insulin at all to control their diabetes.

The third type of plan, carbohydrate counting, matches a person's insulin dosage to the amount of carbs eaten. This plan offers more flexibility and can be a good fit for people who take insulin with each major meal and snack.

Keeping Carbs in Check

Kids may be tempted to sneak sugary snacks between meals without accounting for insulin coverage. You might discuss this with your child, even if it hasn't happened yet. It's healthier to create open communication about food instead of making kids feel like they need to hide dietary slip-ups.

Emphasize that most people eat unhealthy snack food occasionally, but eating lots of sugary junk foods can make it hard to keep a healthy blood sugar level, especially for kids who don't take insulin. And it can lead to weight gain and painful cavities!

If you're not sure how many carbohydrates a food contains, check the food label or ask someone — like a waiter or chef — about unlabeled foods like restaurant entrees.

Also, check the labels of diet foods. These foods may contain extra sugar as a substitute for fat calories. Try to include your child or teen as you evaluate and select healthy carbohydrate-containing foods. With your guidance and the meal plan, your child can begin to choose foods and learn how carbs affect blood sugar.

By taking a smart approach to balancing carbohydrates, medications, and activity, you can help your child enjoy food and stay healthy at the same time.

Reviewed by: Steven Dowshen, MD
Date reviewed: August 2010