Diabetes Management and The Role of Carbohydrates

Diabetes Care|July 27, 2018

BY DR TRUSHNA BHATT

What's the first thing that comes to your mind when you hear the word "diabetes"? Most people immediately think it's time to say goodbye to sweets and other carbs. Well, that is only partly true.

If you or someone you know has diabetes, you're likely quite familiar with the dietary and lifestyle advice that the doctor and nutritionist give to help with diabetes management. While maintaining a healthy blood sugar level is important for anyone, it's more difficult for those with diabetes because their body doesn't regulate itself.

Broadly speaking, diabetes means you have trouble regulating your blood sugar levels. This will probably bring on the question: Where does this sugar enter the blood from? Well, the answer is in your dinner plate! Let's start at the beginning to understand the processes that influence diabetes and the role carbohydrates play in it all.

The Normal Function of Insulin

The foods that we eat give us the energy we need for nearly all activities in our daily life. This energy mainly comes from the carbohydrates we eat.

In people without diabetes, carbohydrates — from sugar, fruits, cereals, milk and milk products, for example — enter the body and are digested into glucose (sugar) that enters the bloodstream. Once this happens, the body detects the rise in the glucose level of the blood, which is then passed on to a hormone called insulin, released by the pancreas, a small organ between the stomach and the liver.

This insulin picks up the glucose from the blood and takes it into the cells, where it is used for routine body processes — think of insulin as the ferry that transports goods across a river to the bank. Because of insulin, cells get their energy source and the sugar level of the blood is maintained. This is what normally happens.

Carbs, Insulin and Diabetes

Diabetes is a condition caused by a dysfunction in this process of making and using insulin. When your pancreas isn't able to make insulin after you eat carbs, the glucose isn't transported to your cells to give them energy. This results in the glucose staying in your blood and leaves little available to fuel you, which can lead to fatigue and other symptoms of diabetes. And this is not all; consistent, uncontrolled high blood glucose levels are capable of damaging the blood vessels that carry blood to and from the different organs of our body, ultimately damaging these organs. Some examples of such diabetic complications are vision problems, heart issues, kidney disease and nerve dysfunction.

While insulin shots can give your body enough insulin to manage the glucose you do eat, is effective diabetes management also means watching your diet to avoid sudden rises in blood sugar level. It's important to watch your sugar levels closely and to limit your intake of sugary and carbohydrate-rich foods, which are converted to glucose, to ensure that your blood sugar level doesn't spike.

Balance is Key

Carbs are not completely off-limits, however. Because the body isn't very good at using and storing consumed sugars, fasting or long gaps between meals are also dangerous for people with diabetes. If you don't eat frequently enough, your blood sugar levels can dip too much and lead to other negative effects, such as dizziness.

It's crucial to maintain a healthy blood sugar level because the body works properly only when your blood sugar is within a certain range. When your fasting blood sugar level exceeds 125 mg/dL, it may indicate diabetes. Your doctor and nutritionist will be able to guide you on how to make sure your sugar levels remain well within the normal range.

Conquer the Pentad

Diabetes is becoming increasingly common, but it can be well controlled with the right prescription and a diabetic diet plan. Research has shown that a more complete and inclusive approach to diabetes management is necessary for best patient outcome and quality of life. The "glycaemic pentad" is now emerging as a new standard for comprehensive diabetes management. This theory proposes a delicate balance among the following five core parameters:

  1. Fasting plasma glucose level: Maintain normal levels of fasting blood sugar to ensure optimal health.
  2. Postprandial plasma glucose level: Make sure your post-lunch blood sugar levels are in check.
  3. HbA1c level: Ensure consistent, good glycaemic control.
  4. Glycaemic variability: Pick a therapy with the least inter-individual variability — that is, a treatment regimen that's worked well in most people.
  5. Quality of life: Blood sugar control therapy should be tailored to your response to treatment.

Eat Your Way to Better Health

Talking about the most important factor that helps regulate your blood sugar level, food, the key to eating right for diabetes lies in understanding the concept of glycaemic index (GI) of foods. The GI index is a scoring system for foods that tells you how much a food will spike your sugar level. So, the lower the GI index, the healthier the food.

Examples of foods with a high GI index that you should eat occasionally and in moderation are simple carbs like ice creams, chocolates, refined flours and sweets. These major sources of glucose can do the most harm to your sugar balance.

Those with a low GI index that should be included in plenty are high-fibre atta (bajra, jowar and raagi), whole-wheat bread, fruits, vegetables and whole legumes (daals). These are must-haves for diabetics, as they balance out your simple carbohydrate intake and help you maintain a normal blood sugar level.

While diabetes management does require you to be more conscious of your diet and lifestyle patterns, it doesn't have to stop you from enjoying a healthy, active, routine lifestyle. With a better understanding of how foods work in your body, you can manage your diabetes better and spend more time concentrating on what you love.

 

Disclaimer: This publication/editorial/article is meant for awareness/educational purposes and does not constitute or imply an endorsement, sponsorship or recommendation of any Products. Please consult your doctor/healthcare practitioner before starting any diet, medication or exercise.