Carbohydrates — sugars, starches, and fiber — liberate single molecules of glucose during digestion, which are promptly absorbed directly into the bloodstream. When blood glucose levels begin to rise, insulin is released from special cells in the pancreas to assist in getting glucose out of circulation, stored away inside of certain cells, bringing blood glucose levels back to normal.
Carb loading is something athletes do before competition to make sure their body’s storage capacity for glucose, your body’s favorite and most efficient source of energy, is filled and ready for action. Diabetes, however, interferes with your body’s ability to store glucose quickly and efficiently, so glucose that’s loaded doesn’t necessarily get stored.
The glitch in this systemic imbalance is an inadequate amount of insulin, a diminished response to insulin by those cells that should be storing glucose for later, or both. Glucose that can’t be stored continues to circulate in the bloodstream, keeping blood glucose levels high. High blood glucose levels cause damage to cells over time, and lead to serious complications of diabetes like heart disease, vision loss, kidney damage, and more.
Carbohydrates are desirable and necessary in a healthy diet, however. The secret to eating healthy carbohydrates and keeping blood glucose levels in better balance is, in part, managing the amount, timing, and the quality of the carbohydrates you eat.
That means knowing how much carbohydrate is in the food you’re eating, spreading your carbohydrate consumption throughout the day, and choosing some of your carbohydrates from foods that don’t get digested and absorbed as quickly. Carb trickling, rather than carb loading.
Timing your carbohydrate consumption means don’t skip meals; eat meals around the same time each day; and eat an approximately equal proportion of your daily carbohydrate budget at each meal. Your meal plan may even set aside one or two carbohydrate choices for between-meal snacks. Giving your body a lighter load of glucose at any one time helps blood glucose levels come down more efficiently.
Carbohydrates that digest and absorb slowly are usually whole foods, like unrefined grains, beans, and whole fruit. These foods have a low glycemic index value, meaning their impact on blood glucose levels is slower, giving your body extra time to find vacant storage for the excess glucose.
Managing diabetes is partly about getting blood glucose levels to come down after eating carbohydrate foods. Carbohydrates make the blood glucose levels of people with normal glucose metabolism go higher, too, but a normal response between insulin and cells storing excess glucose brings blood glucose levels down significantly in a couple of hours.
Managing the amount, timing, and quality of carbohydrate intake works to get blood glucose levels decreasing more efficiently in people with diabetes.
Knowing the amount of carbohydrate you’re eating is a more complicated issue because the portion of a food that contains a set amount of carbohydrate — look for 15 grams, which is called one carb choice — is different for different carbohydrate containing foods. You can get one carb choice, 15 grams of carbohydrate, all of the following ways:
One tablespoon of sugar or concentrated syrup
Two tablespoons of raisins or dried cherries
One-quarter cup granola
One-third cup cooked rice, barley, pasta, or plantain
One-half cup beans, corn, cooked oatmeal, mashed potatoes, parsnips, or applesauce
Three-quarter cup blackberries or canned grapefruit
Two-thirds cup yogurt
One cup canned pumpkin, papaya, honeydew, or acorn squash
One-and-a-quarter cups strawberries or watermelon
One-and-a-half cups of cooked nonstarchy vegetables
Three cups raw, nonstarchy vegetables or popcorn
The difficulty many people with diabetes have with modifying their eating habits for better management is with the staple grains and starches — potatoes, rice, pasta, and corn. There are plenty of healthy carbohydrate foods with a generous portion size for one carb choice.
But one-third cup of rice or pasta, one corn tortilla, or the pointed end of a giant baked potato can seem drastically insignificant if you’re used to eating these grains and starches by the pile or by the pound.
That makes managing these foods all the more important. You likely have a meal plan recommendation of between 9 and 15 carb choices per day — three to five per meal. That definitely leaves room for your favorite staple foods if you manage portion sizes, and include other carbohydrate foods in your diet.
You might consider alternative recipes, like mashed potatoes and cauliflower, or a pasta that’s processed to make some of the carbohydrate indigestible. You might even splurge on rice as your only carbohydrate for a meal — choose whole-grain brown rice, keep the number of servings you eat consistent with your carbohydrate budget for that meal, and get your carbs from different foods groups most of the time.
Finally, how can sweets fit into a diabetes management plan? There are really two different considerations when it comes to sweets — empty calories and portion size. Empty calories are calories that don’t bring along any compensating nutritional value.
With diabetes and sweets, the concept can be extended to include both empty calories and carbohydrates — a cost to your weight and blood glucose without any redeeming benefit. A 20-ounce sugar-sweetened soft drink crosses off more than four of your daily carb choices; for example, 65 grams of carbohydrate for a negligible amount of phosphorous from phosphoric acid.
Getting your sweet calories and carbs from foods with real nutritional value, like fruits, is a better choice. And, non-nutritive sweeteners can eliminate both the calories and carbohydrates from sweets when appropriate for a recipe. But, in the big picture it’s not necessary to avoid sweets, or even sugar, like poison, as long as you fit them responsibly into your diabetes eating plan.