The topic of carbs for diabetics has a long-standing history and will continue to be one of the main topics discussed at diabetes check-ups.
Carbs play a big role in the management of diabetes (which we’ll cover), and there are many ways of approaching carb intake for blood sugar control.
What are carbs, and how do they impact your blood sugar?
How many carbs should a diabetic have a day?
Should you count or restrict carbs to help reach your blood glucose targets?
We’ll answer those questions (and more) in this article!
What are carbs?
Carbohydrates (carbs) are one of three main nutrients (macronutrients) your body needs to provide energy. The other two macronutrients are protein and fat.
Carbs have the greatest impact on your blood sugar levels. When you eat carbs, they’re broken down into glucose (sugar) in your blood.
Protein and fat don’t raise blood sugar levels like carbs do, which is why there is so much emphasis on carb intake if you have diabetes.
There are three types of carbohydrates: starch, sugar, and fiber. Of these, fiber doesn’t impact your blood sugar because it isn’t absorbed by your body.
That’s one of the reasons eating fiber-rich carbs like whole grains, fruits, and vegetables is encouraged!
Starch is found in the walls of plant-based foods like grains and vegetables, while sugars occur naturally in foods like fruit.
You can also get sugar from added sources like table sugar, corn syrup, honey, etc.
Some examples of carbs include:
- Grains (bread, oatmeal, rice, crackers, tortillas, etc.)
- Certain dairy products (mainly milk and yogurt); cheese is low in carbs because it’s mostly protein and fat
- Legumes (dried peas, beans, lentils, etc.)
- Starchy vegetables like potatoes, corn, and peas
- Fruit (fresh, frozen, canned, dried)
- 100% fruit juice
- Sweeteners like honey, maple syrup, table sugar, etc.
- Anything with added sugar
How do carbs affect blood sugar?
Your body prefers carbs as its primary energy source, but it can also use protein and fat for energy.
When you eat carbs, they’re broken down into blood sugar (blood glucose). For the sugar to get into your cells, where it’s used as energy, you need the hormone insulin.
Insulin acts as a “key” to open the door to your cell to allow the sugar to get in.
Without enough insulin, the sugar remains in your bloodstream and isn’t able to enter your cells where it’s needed.
The root cause of type 1 diabetes is insulin deficiency from your pancreas not making enough insulin, while the main cause of type 2 diabetes is insulin resistance, which is when your body doesn’t respond to insulin the way it should.
This means that your body has a harder time getting the sugar into your cells than if you didn’t have diabetes.
If you eat a large number of carbohydrates at once, your blood sugar might increase to a level that is considered too high.
Eating moderate amounts of carbohydrates consistently throughout the day can help prevent your blood sugar levels from becoming too high and can help things like medications and exercise be more effective at managing your blood sugar.
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How many carbs should a diabetic have a day?
There isn’t a one-size-fits-all amount of carbs that you should have when you have diabetes.
The Recommended Dietary Allowance (RDA) for carbs is 130 grams per day. This is much lower than the average American’s intake of at least 250 grams of carbs per day.
A low-carb diet is generally considered to be fewer than 130 grams per day, while a very low-carb diet is less than 50 grams of carbs per day.
The number of carbs you need to eat in a day depends on many factors, such as your age, weight, height, and activity level.
As a starting guideline, many healthcare providers suggest diabetics eat between 45-60 grams of carbs per meal and 15-30 grams of carbs at snacks.
This would equate to around 165 grams per day on the low end for three meals and two snacks, and 240 grams per day for the higher end of the range for the same amount of meals and snacks per day.
The number of carbs you need to keep your blood sugar from going too low (especially if you take diabetes medications like insulin) or too high can most accurately be determined by keeping a food journal and monitoring your blood sugar at home.
If you’re unable to do that, then it can take some trial and error to determine how many carbs per day is your “sweet spot.”
Should diabetics count carbs?
Carb counting used to be very popular as a way to help people with diabetes manage their blood sugars.
Carb counting isn’t as popular today because it can be seen as tedious and not realistic for some people, such as those who eat outside of the home often and can’t accurately estimate the carbs in their food.
That doesn’t mean that carb counting isn’t an effective tool for managing diabetes.
Many people with type 1 diabetes count carbs to accurately dose their mealtime insulin amounts, and some people like to count carbs to help them become more familiar with foods that impact their blood sugar. Carb counting can also help with a better sense of portion control.
The bottom line is that carb counting isn’t necessary to manage your diabetes, but for some people, it can be a useful tool whether it’s used short-term or for the long haul.
Do low-carb diets work for diabetes?
The problem with many low-carb diets (or any diet in general) is that they don’t tend to work long-term.
You might stop following a diet if you get bored with the way you’re eating on the diet, don’t have time to count/measure your food, or can’t afford the diet (especially structured weight loss programs that charge a fee or require you to buy special food), or if you stray away from the diet.
Diets tend to be restrictive and can lead to disordered eating habits. However, studies have shown that lower-carb diets tend to be effective at reducing both body weight and blood sugar levels of people with diabetes.
One review of 37 trials involving over 3,000 participants concluded that low-carb diets “may produce small short-term improvements in HbA1c and weight, which are not maintained in the long term.”
Another study acknowledges that low-carb diets can enhance weight loss in the short term and can help improve blood sugar levels and insulin resistance.
However, the researchers note that very low-carb diets (fewer than 50 grams per day) have adverse side effects and that both very-low and very high-carb diets are associated with increased mortality (death).
So where does this leave us if eating too many carbs can be harmful, but eating too few can cause issues like electrolyte imbalances and fatigue?
Alternatives to counting carbs
Instead of restricting or counting carbs, you might consider a more moderate approach to carbs and your blood sugar by practicing habits like these:
Eat nutrient-rich carbs
Replace refined carbs (those made with added sugar, refined grains like white flour, etc.) with more nutrient-rich complex carbs like whole grains, vegetables, and legumes.
Complex carbs are those that haven’t been stripped of any of their nutrients during processing and contain more fiber than refined carbs.
Complex carbs break down into glucose more slowly because of the higher-fiber content, which means they promote a more steady rise in blood sugar.
Reduce added sugar
Reduce your intake of added sugar, which is prevalent in the majority of processed foods as well as drinks like soda, sweetened tea & coffee, fruit-flavored drinks, etc.
(The average American consumes 17 teaspoons’ worth of added sugar per day while the recommendation is no more than 6-9 teaspoons of added sugar per day for women and men (respectively)).
Practice portion control of carbs, such as using the diabetes plate method where half the plate is non-starchy vegetables, ¼ of the plate is protein, and ¼ of the plate is carbs/starch.
Other tips for diabetes diets and controlling blood sugar
Focus on small, realistic goals
One of the main problems with diets, including very low-carb diets, is that they’re difficult to follow long-term.
What happens when you go out to eat, and you don’t know how many carbs are in the meal?
Do you need to skip having cake at your kids’ birthday party or make yourself a separate meal for the holidays?
Lifestyle habits and goals should be realistic, sustainable, and forgiving. It’s okay to eat a slice of cake at a birthday party if you want to, and it won’t throw you off forever; your diet doesn’t have to be all or nothing.
You can work on making healthy choices for the majority of the time and also have treats for special occasions or “just because.”
Instead of swearing off carbs and sugar, what could a more realistic goal be?
Some ideas could include choosing to eat a protein-based breakfast like a veggie omelet instead of sugary cereal, having a green salad with your meal instead of fries, or cutting back from two sodas per day to one.
Lifestyle changes will only do you good as long as you can practice them, so try to choose goals that you can see yourself carrying out long-term.
Rethink your drinks
The majority of added sugar consumption in a typical Western diet comes from sugar-sweetened beverages.
Drinking sugary drinks can wreak even more havoc on your blood sugar levels than eating sugary foods because there is such a short digestion time.
Your body doesn’t have to break down any protein, fiber, or fat, so the glucose is immediately released into your bloodstream.
Even 100% fruit juice is still a source of sugar (though it is considered natural and not added sugar), so you might want to pay attention to your portion size of juice.
Choosing whole fruit instead of juice is easier on your blood sugar because it’s less concentrated in sugar and contains fiber to help slow the release of sugar into your blood.
Don’t forget about protein and healthy fat
So much emphasis is put on carbs for diabetes management that it can be easy to overlook the other macronutrients: protein and fat.
Eating a balanced meal containing (ideally complex) carbs, protein, and fat can help increase the time it takes you to digest your meal or snack, which slows down the release of glucose into your bloodstream.
Eating protein and fat with meals can also help you feel more satiated, which can reduce your hunger level and cravings and might help you better stick to your eating goals.
If you’re wondering what “healthy” fat means, it refers to fats that are primarily unsaturated in structure.
Unsaturated fats are linked with better heart health compared to saturated fat, which is primarily found in animal products like high-fat meat and full-fat dairy products but is also in coconut and palm oils.
It’s fine to eat some saturated fat – but if you can, try to make most of your fat come from unsaturated sources.
Some examples of unsaturated fats include:
- Fatty fish like salmon, mackerel, etc.
- Vegetable oils
Try to get moving!
While your diet is a very important part of your diabetes care plan, it’s easy to forget how much of an impact your activity level has on your blood sugar and health.
Being physically active helps your body be more sensitive to insulin, and it might even help you lose weight (which also tends to lower blood sugar levels).
Carbohydrates (carbs) are one of the main nutrients you get from food to provide your body with the energy it needs.
Carbs have the most impact on your blood sugar levels compared to the other main nutrients (protein and fat).
Counting carbs can be a useful tool for many, but it’s not the only strategy to help control blood sugar.
Other options besides carb counting can include reducing your intake of refined carbs and added sugars, choosing complex carbs, practicing portion control of carbs in general, and making realistic lifestyle goals in terms of your diet and activity level.