How many carbs should a person with diabetes consume daily. What factors influence the ideal carbohydrate intake for diabetics. Which types of carbohydrates are best for managing blood sugar levels.

Understanding Carbohydrates and Their Impact on Diabetes

Carbohydrates play a crucial role in managing diabetes, as they have the most significant effect on blood sugar levels among the three macronutrients. To effectively control diabetes, it’s essential to understand the different types of carbohydrates and their impact on the body.

The Three Main Types of Carbohydrates

• Sugars (simple carbohydrates)
• Starches (complex carbohydrates)
• Fiber (complex carbohydrates)

Sugars are simple carbohydrates consisting of one or two sugar molecules. They are found naturally in foods like fruits, milk products, and honey, as well as added to processed foods. Starches and fiber are complex carbohydrates with at least three sugar molecules. The body takes longer to break down starches compared to sugars, while fiber cannot be digested at all.

Do all carbohydrates affect blood sugar equally? No, they do not. While sugars and starches raise blood sugar levels, naturally occurring fiber does not and may even slow the rise in blood sugar. This distinction is crucial for diabetics when making food choices.

Carbohydrate Intake Recommendations for Diabetics

Traditionally, dietary guidelines from various health organizations recommended that people with diabetes obtain 45-65% of their daily calories from carbohydrates. However, recent research and expert opinions suggest that a lower carbohydrate intake may be more beneficial for managing diabetes.

Is there a one-size-fits-all approach to carbohydrate intake for diabetics? No, there isn’t. The American Diabetes Association (ADA) now promotes an individualized approach, taking into account personal dietary preferences and metabolic goals.

Factors Influencing Optimal Carbohydrate Intake

• Individual metabolic response
• Type of diabetes (Type 1 or Type 2)
• Medication regimen
• Physical activity level
• Overall health status
• Personal dietary preferences

Can a low-carb diet be beneficial for diabetics? Yes, studies have shown that reducing carbohydrate intake can lead to improved blood sugar control and may even reduce or eliminate the need for insulin or diabetes medication in some cases.

Low-Carb Approaches for Diabetes Management

While the typical American diet provides around 275 grams of carbs per day (50% of a 2,200-calorie diet), many experts now recommend lower carbohydrate intakes for people with diabetes.

Low-Carb Diet Options

1. Moderate low-carb: 100-150 grams per day
2. Low-carb: 50-100 grams per day
3. Very low-carb (ketogenic): Less than 50 grams per day

A severely restricted intake of less than 50 grams of carbs per day has shown dramatic results in some studies, potentially reducing or eliminating the need for insulin or diabetes medication. This represents about 9-10% of daily calories on a 2,000-2,200-calorie diet.

Should diabetics focus on total carbs or net carbs? Many experts recommend focusing on net carbs, which is the total amount of carbs minus fiber. This approach takes into account the beneficial effects of fiber on blood sugar management.

Tailoring Carbohydrate Intake to Individual Needs

The optimal carbohydrate intake for a person with diabetes can vary significantly based on individual factors. It’s crucial to work with a healthcare provider or registered dietitian to determine the most appropriate carbohydrate intake for your specific situation.

Steps to Determine Your Ideal Carb Intake

1. Consult with a healthcare professional
2. Monitor blood sugar levels regularly
3. Experiment with different carb intakes
4. Keep a food and blood sugar diary
5. Adjust medication as needed (under medical supervision)
6. Reassess and fine-tune your approach periodically

How can you determine if your carbohydrate intake is appropriate? Monitor your blood sugar levels before and after meals, as well as your overall energy levels, weight, and other health markers. This information will help you and your healthcare team make informed decisions about your diet.

Choosing the Right Types of Carbohydrates for Diabetes Management

While the quantity of carbohydrates is important, the quality of carbs consumed also plays a crucial role in managing diabetes. Focusing on nutrient-dense, high-fiber carbohydrate sources can help improve blood sugar control and overall health.

Beneficial Carbohydrate Sources for Diabetics

• Non-starchy vegetables (e.g., leafy greens, broccoli, cauliflower)
• Whole grains (e.g., quinoa, oats, brown rice)
• Legumes (e.g., lentils, chickpeas, black beans)
• Berries and other low-glycemic fruits
• Nuts and seeds

Are all fruits suitable for diabetics? While fruits contain natural sugars, they also provide essential nutrients and fiber. Choose lower-glycemic fruits like berries, apples, and pears, and consume them in moderation as part of a balanced meal plan.

The Role of Glycemic Index and Glycemic Load in Diabetes Management

Understanding the concepts of glycemic index (GI) and glycemic load (GL) can help diabetics make informed food choices that support better blood sugar control.

Glycemic Index (GI)

The glycemic index measures how quickly a carbohydrate-containing food raises blood sugar levels compared to pure glucose. Foods are ranked on a scale of 0 to 100, with higher values indicating a more rapid rise in blood sugar.

Glycemic Load (GL)

Glycemic load takes into account both the glycemic index of a food and the portion size. It provides a more accurate picture of how a specific serving of food will affect blood sugar levels.

Can focusing on low-GI and low-GL foods improve diabetes management? Yes, choosing foods with a lower glycemic index and glycemic load can help stabilize blood sugar levels and improve overall glycemic control.

Balancing Carbohydrates with Other Nutrients

While carbohydrate management is crucial for diabetes control, it’s essential to consider the overall balance of nutrients in your diet. Protein, healthy fats, and fiber all play important roles in managing blood sugar levels and promoting overall health.

Benefits of a Balanced Nutrient Approach

• Improved satiety and appetite control
• Better blood sugar stability
• Enhanced nutrient intake
• Reduced risk of cardiovascular complications
• Improved weight management

How can combining carbohydrates with protein and fat help manage blood sugar? Eating carbohydrates alongside protein and healthy fats can slow down the absorption of glucose, leading to a more gradual rise in blood sugar levels.

Carbohydrate Counting and Meal Planning for Diabetics

Carbohydrate counting is a valuable tool for many people with diabetes, particularly those using insulin. This method involves tracking the number of grams of carbohydrates consumed at each meal and snack to help determine insulin dosages and maintain stable blood sugar levels.

Steps for Effective Carbohydrate Counting

1. Learn to identify carbohydrate-containing foods
2. Read food labels carefully
3. Use measuring tools to ensure accurate portion sizes
4. Keep a food diary to track carb intake
5. Work with a registered dietitian to develop a personalized meal plan
6. Adjust insulin or medication dosages based on carb intake (under medical supervision)

Is carbohydrate counting necessary for all diabetics? While carb counting can be beneficial for many people with diabetes, it may not be essential for everyone. Some individuals may find success with other approaches, such as the plate method or simply focusing on low-carb food choices.

The Impact of Lifestyle Factors on Carbohydrate Tolerance

It’s important to recognize that carbohydrate tolerance can be influenced by various lifestyle factors. Understanding these factors can help diabetics optimize their carbohydrate intake and overall diabetes management.

Lifestyle Factors Affecting Carbohydrate Tolerance

• Physical activity level
• Stress management
• Sleep quality and duration
• Hydration status
• Medication timing and adherence
• Overall dietary pattern

Can regular exercise improve carbohydrate tolerance in diabetics? Yes, physical activity can enhance insulin sensitivity and glucose uptake by muscles, potentially allowing for greater carbohydrate tolerance. However, it’s essential to monitor blood sugar levels and adjust carb intake accordingly when incorporating exercise into your routine.

In conclusion, determining the optimal carbohydrate intake for diabetics requires a personalized approach that takes into account individual factors, preferences, and health goals. By working closely with healthcare professionals, monitoring blood sugar levels, and making informed food choices, people with diabetes can effectively manage their condition while enjoying a varied and nutritious diet.

How Many Carbs Should a Person with Diabetes Have?

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.

Healthline only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

• Evaluate ingredients and composition: Do they have the potential to cause harm?
• Fact-check all health claims: Do they align with the current body of scientific evidence?
• Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

Read more about our vetting process.

Was this helpful?

An individualized approach is often best when it comes to carb intake for diabetes management. These guidelines can help you get started on the right path.

Figuring out how many carbs to eat when you have diabetes can seem confusing.

Dietary guidelines from around the globe traditionally recommend that you get around 45–65% of your daily calories from carbs if you have diabetes (1, 2, 3).

However, a growing number of experts believe that people with diabetes should eat far fewer carbs. In fact, many recommend less than half this amount.

Counting your carbs will help ensure that you stay within the range that’s best for you.

This article tells you how many carbs to consider eating if you have diabetes.

There are three main types of carbs: sugars, starches, and fiber (4).

Sugar belongs to a category known as simple carbohydrates. Simple carbs have one sugar molecule (monosaccharides) or two sugar molecules (disaccharides).

Sugar is found naturally in foods and beverages like whole fruit, juice, milk products, and honey. It’s also added to processed foods such as candy.

Starches and fiber are both complex carbohydrates. Complex carbs have at least three sugar molecules. The body takes more time to digest, or break down, starches than sugar, and it can’t digest fiber at all.

Starches are found in foods like potatoes, corn, legumes, and whole grain breads and pastas.

Fiber is found in foods like fruits, vegetables, legumes, nuts, and whole grains. Unlike sugars and starches, naturally occurring fiber doesn’t raise your blood sugar level and may even slow its rise (5, 6).

Many foods and beverages, such as rice, contain more than one type of carbohydrate.

SUMMARY

The three main types of carbohydrates are sugars, starches, and fiber.

Many factors, including exercise, stress, and illness, affect your blood sugar levels. That said, one of the largest factors is what you eat.

Of the three macronutrients — carbs, protein, and fat — carbs have the greatest effect on blood sugar. That’s because your body breaks down carbs into sugar, which enters your bloodstream.

This occurs with all digestible carbs, including refined sources like chips and cookies as well as whole, unprocessed sources like fruits and vegetables.

When people with diabetes eat foods high in carbs, their blood sugar levels can surge. High carb intake typically requires high doses of insulin or diabetes medication to manage blood sugar.

Given that people with type 1 diabetes are unable to produce insulin, they need to inject insulin several times a day, regardless of what they eat. However, eating fewer carbs can significantly reduce their mealtime insulin dosage.

SUMMARY

Your body breaks down certain carbs into sugar, which enters your bloodstream. People with diabetes who eat a lot of carbs require insulin or diabetes medication to keep their blood sugar from rising too much.

Studies have shown that many different levels of carb intake may help manage blood sugar, and the optimal amount of carbs varies by individual.

The American Diabetes Association (ADA) used to recommend that people with diabetes get around 45% of their calories from carbs.

However, the ADA now promotes an individualized approach in which your ideal carb intake should take into account your dietary preferences and metabolic goals (7).

It’s important to eat the number of carbs at which you feel best and that you can realistically maintain in the long term.

The typical American diet provides around 2,200 calories per day, with 50% of them coming from carbs. This is equivalent to 275 grams of carbs per day (8).

A severely restricted intake of less than 50 grams of carbs per day appears to produce the most dramatic results and may reduce or even eliminate the need for insulin or diabetes medication. This represents 9–10% of daily calories on a 2,000–2,200-calorie diet (9, 10, 11).

When tracking carb intake, experts sometimes recommend focusing on your net carbs instead of the total amount of carbs you eat. Net carbs is total grams of carbs minus grams of fiber (11).

People with diabetes can also benefit from diets that allow up to 26% of their daily calories to come from carbs. For people who eat 2,000–2,200 calories a day, this is equivalent to 130–143 grams of carbs (12).

Since carbs raise blood sugar, reducing them to any extent can help you manage your blood sugar levels. Therefore, figuring out how many carbs to eat requires some testing and evaluating to find out what works best for you.

For instance, if you’re currently consuming about 250 grams of carbs per day, reducing your intake to 150 grams should result in significantly lower blood sugar after meals.

SUMMARY

There’s no one-size-fits-all recommendation for how many carbs people with diabetes should eat. However, having carbs account for no more than 26% of your daily calories may help you manage your condition.

To determine your ideal carb intake, measure your blood sugar with a blood glucose meter before a meal and again 1–2 hours after eating.

To prevent damage to your blood vessels and nerves, the maximum level your blood sugar should reach is 180 milligrams per deciliter (mg/dL), or 10 millimoles per liter (mmol/L), 2 hours after eating. However, you may want to aim for an even lower ceiling (13).

To achieve your blood sugar goals, you may need to restrict your carb intake to less than 10, 15, or 25 grams per meal. Also, you may find that your blood sugar rises more at certain times of the day, so your upper carb limit may be lower for dinner than for breakfast or lunch.

In general, the fewer carbs you consume, the less your blood sugar will rise and the less insulin or diabetes medication you’ll require to stay within a healthy range.

If you take insulin or diabetes medication, it’s very important to speak with a healthcare professional to ensure the appropriate dosage before reducing your carb intake.

SUMMARY

Determining the optimal carb intake for diabetes management requires testing your blood sugar and making adjustments as needed based on your response, including how you feel.

Many studies support the use of carb restriction in people with diabetes. Research has confirmed that many levels of carb restriction can effectively lower blood sugar levels.

Very low carb ketogenic diets

Very low carb diets typically induce mild to moderate ketosis, a state in which your body uses ketones and fat, rather than sugar, as its main energy sources.

Ketosis usually occurs at a daily intake of fewer than 50 grams of total carbs (9).

Very low carb ketogenic diets were prescribed for people with diabetes even before insulin was discovered in 1921 (8).

Several studies indicate that restricting carb intake to 20–50 grams per day can significantly reduce blood sugar levels, promote weight loss, and improve cardiovascular health for people with diabetes (9, 10, 11, 14, 15, 16).

In addition, these improvements often occur very quickly.

For instance, in a small 3-month study, people consumed either a low carb diet containing up to 50 grams of carbs per day or a calorie-restricted low fat diet.

The low carb group averaged a 0.6% decrease in hemoglobin A1c (HbA1c) and lost more than twice as much weight as the low fat group. What’s more, 44% of them discontinued at least one diabetes medication compared with 11% of the low fat group (16).

In fact, in several studies, participants have reduced or discontinued use of insulin and other diabetes medications due to improvements in blood sugar control (9, 10, 11, 14, 15).

Diets containing 20–50 grams of carbs per day have also been shown to lower blood sugar levels and reduce the risk of disease in people with prediabetes (17).

Although concerns have been raised that higher protein intake on low carb diets may lead to kidney problems, a 12-month study found that a very low carb intake didn’t increase the risk of kidney disease (18).

Another study found that the diet might actually improve kidney function in people with type 2 diabetes and normal renal function or mild kidney disease (19).

Low carb diets

Many low carb diets restrict carbs to 50–100 grams, or about 10–20% of calories, per day.

Although there are very few studies on carb restriction in people with type 1 diabetes, those that exist have reported impressive results (20, 21, 22, 23).

One of the biggest concerns for people with type 1 diabetes is hypoglycemia, or blood sugar that drops to dangerously low levels.

In a small 12-month study from 2005, adults with type 1 diabetes who restricted their daily carb intake to fewer than 90 grams had 82% fewer episodes of low blood sugar than before they started the diet (20).

In a 2012 study in people with type 1 diabetes who restricted carbs to 70 grams per day, participants saw their HbA1c drop from 7.7% to 6.4%, on average. What’s more, their HbA1c levels remained the same 4 years later (21).

A 1.3% reduction in HbA1c is a significant change to maintain over several years, particularly in those with type 1 diabetes.

People with type 2 diabetes may also benefit from limiting their daily carb intake.

According to a research review, people who consumed no more than 26% of calories from carbs were 32% more likely to experience diabetes remission than people who mostly followed a low fat diet. A person was considered in remission if their HbA1c was under 6.5% (12).

Moderate carb diets

A more moderate carb diet may provide 130–220 grams of carbs per day, or 26–44% of calories in a 2,000-calorie diet (24).

A few studies examining such diets have reported good results in people with diabetes (25, 26).

In a 2010 study of 259 people with type 2 diabetes, those who followed a Mediterranean diet providing 35% or fewer calories from carbs experienced a significant reduction in HbA1c. Over the course of 12 months, HbA1c dropped 2.0% on average (27).

SUMMARY

Studies demonstrate that restricting carbs may benefit people with diabetes. The lower your carb intake, the greater the effect on your blood sugar levels and other health markers.

Many tasty, nutritious, low carb foods raise blood sugar levels only minimally. You can enjoy these foods in moderate to liberal amounts on low carb diets.

However, you should avoid or limit the following high carb items:

• breads, muffins, rolls, and bagels
• pasta, rice, corn, and other grains
• potatoes, sweet potatoes, yams, and taro
• milk and sweetened yogurt
• most fruit, except berries
• cakes, cookies, pies, ice cream, and other sweets
• snack foods like pretzels, chips, and popcorn
• juice, soda, sweetened iced tea, and other sugar-sweetened drinks
• beer, wine, and spirits

Keep in mind that not all of these foods are unhealthy. For example, fruits are highly nutritious, but eating large amounts isn’t optimal for anyone trying to manage their blood sugar levels by eating fewer carbs.

SUMMARY

On a low carb diet, you should avoid or limit foods and beverages like beer, bread, potatoes, fruit, and sweets.

Low carb diets have consistently been shown to lower blood sugar and improve other health markers in people with diabetes.

At the same time, certain higher carb diets have been credited with similar effects.

For example, some studies suggest that low fat vegan or vegetarian diets may lead to better blood sugar control and overall health (28, 29, 30, 31).

In a 12-week Korean study, a brown-rice-based vegan diet containing 268.4 grams of carbs per day (about 72% of calories) lowered participants’ HbA1c levels more than a standard diabetes diet with 249.1 grams of total daily carbs (about 67% of calories) (30).

An analysis of four studies found that people with type 2 diabetes who followed a low fat macrobiotic diet consisting of 70% carbs achieved significant reductions in blood sugar and other health markers (32).

The Mediterranean diet likewise improves blood sugar control and provides other health benefits in individuals with diabetes (33).

However, it’s important to note that most of these diets weren’t directly compared with low carb diets, but rather with standard low fat diets often used for diabetes management. More research on these diets is needed.

SUMMARY

Studies suggest that certain higher carb diets may aid diabetes management. Still, additional research is needed.

If you have diabetes, reducing your carb intake may be beneficial.

Multiple studies have shown that a daily carb intake of up to 44% of calories not only leads to better blood sugar control but also may promote weight loss and other health improvements.

Here’s a sample menu, which would provide about 113 grams of total carbs for the day (34):

• Breakfast: 1 slice of whole wheat toast (about 14 grams of carbs) plus an omelet made with 2 large eggs (about 1 gram) and 1 cup of nonstarchy vegetables like broccoli and greens (about 10 grams)
• Lunch: 12 ounces of lentil soup (about 33 grams) and 1 apple (about 15 grams)
• Dinner: 4 ounces of grilled chicken breast (0 grams), 1. 5 cups of nonstarchy vegetables like zucchini and okra (about 15 grams), and 4 ounces of brown rice (about 25 grams)

However, some individuals can tolerate more carbs than others.

Testing your blood sugar and paying attention to how you feel at different carb intakes can help you find your ideal range for optimal diabetes management, energy levels, and quality of life.

It might also be helpful to reach out to others for support. Our free app, T2D Healthline, connects you with real people living with type 2 diabetes. Ask diet-related questions and seek advice from others who get it. Download the app for iPhone or Android.

Carb Counting and Diabetes | ADA

Carbohydrates, or carbs, are naturally found in certain foods. For example, grains, sweets, starches, legumes and dairy all contain different amounts of carbs. Get up to speed on the three types of carbs, and what foods have them.

When foods and drinks with carbs are digested, the carbs break down into glucose to fuel our cells, and the body’s blood glucose, or blood sugar, level rises. In people without diabetes, blood sugar levels rise after eating but the body’s insulin response keeps levels from rising too high.

If you have diabetes, the process doesn’t work as designed. How carb counting can help your blood glucose control depends on your treatment regimen and whether or not your body makes insulin.

• Type 1: If you have type 1 diabetes, your pancreas no longer makes insulin, so you need to take background insulin as well as offset the carbs in your food with mealtime insulin doses. To do this, you have to know exactly how many carbohydrate grams are in your meal—cue carb counting!
   
• Type 2: Because people with type 2 diabetes are resistant to insulin and may not produce enough of it, it’s important that you be mindful of your carb intake. To avoid blood sugar spikes, it helps to eat a consistent amount of carbs at meals throughout the day, rather than all at once. People taking oral medications may use a more basic form of carb counting than those on insulin.

How do you count carbs?

Carb counting at its most basic level involves counting the number of grams of carbohydrate in a meal and matching that to your dose of insulin.

If you take mealtime insulin, that means first accounting for each carbohydrate gram you eat and dosing mealtime insulin based on that count. You will use what’s known as an insulin-to-carb ratio to calculate how much insulin you should take in order to manage your blood sugars after eating. This advanced form of carb counting is recommended for people on intensive insulin therapy by shots or pump, such as those with type 1 and some people with type 2.

While people with type 2 diabetes who don’t take mealtime insulin may not need detailed carb counting to keep their blood sugars in line, some prefer to do it. While some choose to stick with traditional carb counting, there are others who do a more basic version of carb counting based on “carbohydrate choices,” where one “choice” contains about 15 grams of carb. Still others use the Diabetes Plate Method to eat a reasonable portion of carb-containing foods at each meal by limiting whole grains, starchy vegetables, fruits or dairy to a quarter of the plate.

So, there are a few ways to go about it and it’s really about personal preference, but remember that the best carb counting method for you is the one that addresses your medication and lifestyle needs. A registered dietitian nutritionist (RDN/RD) or Certified Diabetes Care and Education Specialist (CDCES) can help you figure out what works best for you.

How many carbs should I eat?

As for the ideal number of carbs per meal, there’s no magic number. How much carbohydrate each person needs is in large part determined by your body size and activity level. Appetite and hunger also play a role.

In order to figure out how many carbs you should be eating, schedule an appointment with your RD/RDN or CDCES. They’ll work out an eating plan specifically for you. This service, when provided by a dietitian, is known as medical nutrition therapy.

Diabetes self-management education (DSME) sessions also may include creating an eating plan. During the sessions, you’ll determine your carb needs and how to divide your carbs among your meals and snacks. Everybody’s insulin response is going to be different, and we don’t want to make the diet more restrictive than it needs to be to manage blood sugars.

Find a diabetes education program

To get started, you’ll want to figure out how many carbs you are eating at your meals and snacks now. Tracking your food intake and your blood sugar before and about 2-3 hours after your meals for a few days can provide useful information for you and your diabetes care team to see how different meals impact your blood glucose so you can determine the right amount of carbs for you.

How many carbs are in my food?

You can find how many carbs foods have by reading food labels. If a product doesn’t have a food label, such as a whole piece of fruit or a vegetable, there are apps and other tools available to help you calculate. For example, the U.S. Department of Agriculture’s Food Composition Database has nutrition information for thousands of foods in a searchable format. The good news is, the longer you practice carb counting, the more you’ll remember the carb content of the foods you commonly eat.

There are two items on the nutrition facts label that you’ll want to pay attention to when carb counting:

• Serving size. The serving size refers to how much a person usually eats or drinks, and all the information on the label is about this specific amount of food. If you eat more, you will need to account for the additional nutrients. For example, eating two or three servings of something, means you will need to double or triple the amount of grams of carbs (and all other nutrients) on the label in your calculations.
   
• Grams of total carbohydrate. This number includes all carbs: sugar, starch and fiber. That’s right: You don’t have to worry about adding on grams of added sugars—they’re included in the number of total carbs! The added sugars and other bullets below the total carbs listing are included to provide more information about what’s in the food that you are eating. And while you don’t need to worry about adding added sugars when it comes to counting carbs, you should still aim to minimize the amount of added sugar in the foods you eat.

What about protein and fat?

Carb counting would be simple if we only ate carbohydrate foods, but meals are usually a mix of carbohydrate, protein and fat. A meal high in protein and fat can change how quickly the body absorbs carbs, which impacts blood sugar levels.

A great way to understand how food impacts your blood sugar is to keep track of your numbers and discuss them with your diabetes care team including a RD/RDN and/or CDCES. Continuous glucose monitoring (CGM) or self-monitoring of blood glucose can also help, especially for insulin dosing.

What should I eat?

Whether you count each carb gram or use one of the other meal planning methods, you’ll want to choose foods that are rich in nutrients. Opt for whole foods that are unprocessed and in their natural state, such as vegetables, fruits, whole grains and lean proteins. Processed foods, such as packaged cookies, crackers and other snack foods, usually contain added salt, sugar, carbohydrates, fat or preservatives.

While this sounds like a lot, don’t be overwhelmed—start by making small changes and sticking to them. Even small changes can have huge results!

Basic principles of nutrition in type 2 diabetes mellitus

The question of how to eat properly in diabetes worries most patients. What is a balanced diet?

Rational nutrition (from lat. Rationalis – reasonable) is a physiologically complete nutrition, taking into account the nature of work, physical activity, age, contributing to maintaining health, high physical and mental performance, as well as active longevity. Rational nutrition is one of the factors that strengthen the immune system.

At the same time, it is important to understand not following a “diet” for some time, but changing the diet and principles of nutrition on an ongoing basis, i. e. the patient must understand that the recommended principle of nutrition, in the presence of a number of restrictions, will allow him to lead an active life . For this, it is necessary to observe the principles of balance – the ratio of proteins, fats and carbohydrates. Approximately 55-60% of daily calories should be carbohydrates, 15-20% proteins and up to 20-5% fats.

The vast majority of overweight people with type 2 diabetes. Excess weight prevents its own insulin from acting effectively, which is why blood glucose levels remain high. Therefore, weight loss is an indispensable condition for rational treatment! Even moderate weight loss (by 5-10%) improves carbohydrate metabolism, especially in the early period of the disease. How to achieve weight loss?

It should be noted right away that there are no specific products or medicinal plants for weight loss. Currently, there are no medications that by themselves, without dieting, could provide highly effective and completely safe weight loss.
The only reliable way is to limit the intake of energy into the body, i.e. compliance with regulations low-calorie nutrition . The resulting energy deficit leads to the fact that the energy reserves “conserved” in adipose tissue will be spent on various needs of the body, and the weight will definitely decrease.

Principles of rational nutrition in type 2 diabetes:

1) Reducing the amount of carbohydrates in the diet

Carbohydrates increase blood sugar, but they must be consumed because the body needs them (they are the main source of energy).

Carbohydrates are divided into simple and complex.

It is clear that with type 2 diabetes, it is necessary to exclude or limit as much as possible the use of simple or easily digestible carbohydrates (sugar, honey, preserves and jams, sweets, muffins, sweet fruits and berries: grapes, bananas, raisins, dates). The diet should contain mainly products containing complex carbohydrates (cereals, bread, vegetables)

Carbohydrates are found in the following products:

• Bread and all flour products (dryers, crackers, pasta, etc. )
• Potato. Less than potatoes, but still quite a lot of carbohydrates contain corn, beans, ripe (yellow) peas, lentils.
• Cereals, including buckwheat.
• Fruit, even sour. However, the more ripe the fruit, the more sugar it contains. Dried fruits have a very high concentration of sugar in a small volume, because. they are deprived of water.
• Liquid dairy products (milk, kefir, yogurt, fermented baked milk). There are no carbohydrates in cottage cheese and cheese, they consist of protein and fat.
• Sugar, honey and any sugar-based confectionery (not recommended!).

How can the sugar-increasing effect of carbohydrates be reduced?

To achieve this, the products should be processed as little as possible both mechanically and thermally.

Sweeteners:

Caloric: fructose, xylitol, sorbitol.

These substitutes have a similar calorie content to regular sugar and are therefore not suitable for overweight individuals.

Non-caloric : aspartame, saccharin, acesulfame K.

Suitable for all persons with diabetes.

2) Limitation of fat intake0037 . Therefore, limiting the intake of fatty foods in diabetes is no less important than limiting carbohydrates.

It is also necessary to significantly limit, and it is better not to use fried, spicy, salty, spicy and smoked dishes, canned food, hot peppers, mustard, alcoholic beverages at all. Foods that contain a lot of fats and carbohydrates at the same time are completely unacceptable for people with diabetes: chocolate, ice cream, cream cakes and cakes.

Foods that can be consumed without restriction:

• cabbage (all kinds)
• cucumbers
• leaf lettuce
• greenery
• tomatoes
• bell pepper
• zucchini
• eggplant
• beets
• carrots
• green beans
• radish, radish, turnip
• green peas (young)
• spinach, sorrel
• mushrooms
• tea, coffee without sugar and cream
• mineral water
• sweetener drinks

Note:

• Vegetables can be consumed raw, boiled, baked.
• The use of fats (butter, mayonnaise, sour cream) in the preparation of vegetable dishes should be minimal.

Foods to be eaten in moderation

• lean meats
• lean fish
• milk and dairy products (nonfat)
• cheeses (less than 30% fat)
• cottage cheese (less than 5% fat)
• potatoes
• corn
• mature legumes (peas, beans, lentils)
• cereals
• pasta
• Bread and bakery products (not fancy)
• fruit
• eggs

Note:

• Moderate means half your usual serving.

Foods to be avoided or limited as much as possible

• butter
• vegetable oil*
• fat
• sour cream, cream
• cheeses (more than 30% fat)
• cottage cheese (more than 5% fat)
• mayonnaise
• fatty meat, smoked products
• sausages
• oily fish
• bird skin
• meat, fish and vegetable preserves in oil
• nuts, seeds
• sugar, honey
• jams, jams
• candy, chocolate
• pastries, cakes and other confectionery
• biscuits, pastry products
• ice cream
• sweet drinks (Coca-Cola, Fanta)
• alcoholic beverages

* vegetable oil is a necessary part of the daily diet, but not more than 1-2 tbsp. spoons per day

Note:

• Frying should be avoided if possible.
• Try to use cookware that allows you to cook food without adding fat.

3) Proper diet:

Eating up to 5-6 times a day – eating less often can lead to the inclusion of the so-called. a “saving mode” in which the body is deficient in essential nutrients and tries to reserve free calories, so all the free (extra) calories received from a heavy meal inevitably turn into fat. And also rare food, as a rule, leads to night overeating, which negatively affects body weight.

4) Eat slowly, chewing food thoroughly

5) Most of the food should be consumed before dinner.

Do not overeat at night.

The last meal should be taken no later than 1.5-2 hours before bedtime. Moreover, it should be 5-10% of the daily calorie intake.

4) Eat enough fiber (20-30 g/day).

It is necessary to include foods containing a large amount of it in the diet. The first place is occupied by bran and powdered fiber, which can be added to cereals, soups, salads. It is also important to use whole grain bread, vegetables, nuts, berries, a large amount of fiber is found in the peel and seeds of plant foods.

5) At least 1.5 liters of fluid per day (unless contraindicated)

6) Salt restriction (The World Health Organization recommends reducing your salt intake to 5 grams per day (one teaspoon)!

7) Reducing alcohol consumption .

Due to its high calorie content (7 kcal per 1 g), alcohol can contribute to weight gain. In addition, it directly worsens the indicators of fat metabolism and blood pressure. So limit your alcohol intake as much as possible.
Alcohol is known to have adverse effects on the liver. It can cause hypoglycemia if a person with diabetes is on glucose-lowering drugs and insulin. Never drink alcohol on an empty stomach!

The use of any drug in type 2 diabetes still cannot fully compensate for the impact of malnutrition on blood glucose levels. Thus, a balanced diet is an essential component of effective type 2 diabetes management, which will help to achieve blood glucose targets.

Endocrinologist of ME “Brest City Hospital No. 2”

Arabey Olga Vladimirovna.

Nutrition in diabetes: how to make a diet?

1. General dietary guidelines for diabetes
2. How to control glucose levels?
3. What does “diabetic product” mean?
4. Calculation of bread (carbohydrate) units
5. How many bread units can you eat per day?
6. What is the glycemic index of foods?
7. What you need to know about the glycemic index?
8. What sugar substitutes can be used in diabetes?
9. Is it possible to drink alcohol with diabetes?

Image by jcomp on Freepik

Competent diet is an essential condition for controlling the development of the disease in diabetes mellitus. This disease is directly related to the violation of carbohydrate metabolism due to insufficient production of insulin or its improper interaction with cells. Non-compliance with dietary recommendations for diabetics leads to sharp jumps in blood glucose levels and worsening of the diabetic condition.

If a patient is diagnosed with diabetes, special attention should be paid to the composition of products, menu planning in advance, avoiding overeating and skipping meals. Experts recommend purchasing a kitchen scale to monitor portion sizes.

The main tasks of a proper diet for diabetes are:

• normalization of body weight and maintenance of stable weight;
• cholesterol control;
• maintenance of normal blood glucose levels;
• providing the body with essential nutrients.

It is worth noting that it is necessary to monitor cholesterol and weight not only for diabetics, but also for all other people, regardless of their state of health. To maintain normal glucose levels in diabetes, you need to know the glycemic index of foods and their composition, which determines the ability to increase blood glucose.

General dietary guidelines for diabetes

These recommendations are suitable not only for diabetics, but also for healthy people:

• regularly eat foods with fiber: whole grain bread, cereals, wholemeal pastries, bran. These products contain dietary fiber, which is necessary for the normal functioning of the digestive tract;
• fresh fruits and vegetables should be included in the daily diet;
• Limit your intake of foods and drinks that are high in refined sugar, the so-called “fast carbs”. The same applies to trans fats, which are processed vegetable fats. They are present in large quantities in confectionery, mayonnaise and sauces, semi-finished products.
• with diabetes, it is worth limiting the consumption of fatty meat and meat products with a high content of fats, smoked meats, frozen convenience foods, butter, lard. It has been proven that an excess of fatty foods contributes to the progression of the disease;
• salt in the daily diet should be no more than 2.4 grams;
• fish and seafood are a source of omega-3 polyunsaturated fatty acids. The most useful for diabetics is fatty sea fish in boiled or baked form;
• unrefined vegetable oil must be present in the diet. The optimal amount of such a product is 1-2 tablespoons per day. To preserve useful components, unrefined oils should be added to ready-made dishes without heating.

Optimal for diabetics is 5-6 meals a day. Food is taken in small portions.

How do I control my glucose levels?

When diabetic is diagnosed, the patient regularly checks the glucose level with a glucometer. Carbohydrates cause an increase in blood sugar. Their percentage in the diet of any person is 55–60%, which is the recommended norm.

Carbohydrates are found not only in sweets, but also in dairy products, cereals, vegetables and fruits. They are an integral part of a healthy diet, so completely eliminating carbohydrates from the diet is impossible, and there is no need for this. At the same time, in diabetes, it is important to control how much carbohydrates enter the body. To do this, be sure to read the composition of the products before eating them. The nutritional value of a product is indicated on the packaging: the content of proteins, fats and carbohydrates. The more carbohydrates in the composition, the more glucose will increase.

What does “diabetic product” mean?

In stores, you can see products labeled “sugar-free”, “diet” or “diabetic”. They are in different categories of food products: sweets, pastries, yoghurts, drinks. You need to understand that the absence of sugar does not mean the absence of carbohydrates in the composition.

Manufacturers may use fructose or other sweeteners to add flavor. If there are carbohydrates in the composition of the product, they will raise the level of glucose in the blood, despite the absence of sugar. It is important to remember this when including diabetic cookies or chocolate in your diet.

Calculation of bread (carbohydrate) units

The most accurate way to calculate carbohydrates in diabetes is by weighing foods. Knowing how many carbohydrates are contained in 100 g, you can calculate their intake into the body, taking into account the serving size. In type 1 diabetes, counting carbohydrates in food is mandatory for the correct choice of insulin dose.

A kitchen scale is required to weigh portions, but is not available if the person is eating outside the home. For the convenience of patients, the concept of “bread unit” (XE) was introduced. With the help of bread units, you can determine the approximate content of carbohydrates in food without weights. 1 XE is equivalent to 10-12 grams of carbohydrates. With their use, glucose increases by 2–2.8 mmol / liter.

If the product contains few carbohydrates in the composition, then a sufficiently large amount of it is needed to obtain one bread unit. For example, a glass of milk or a fermented milk drink without sugar contains only one XE. Chicken eggs, cheese, cottage cheese, fish, meat have practically no effect on blood glucose levels, since these products contain almost no carbohydrates.

As for high-carb foods, even a small amount of it leads to a significant increase in glucose. For example, one bread unit is contained in only 15 grams of dryers, crackers or crackers, 20 grams of chocolate or white bread, half a banana or persimmon, two tablespoons of mashed potatoes or boiled pasta, one orange or half a grapefruit. Including these foods in your diet, a diabetic should strictly control the portion size. Safer in this regard are beets, raw carrots. One serving of the product weighing 150-200 grams contains only one carbohydrate unit.

How many bread units can you eat per day?

According to the recommendations, the optimal daily diet of a healthy person should contain 18–24 bread units. At the same time, no more than 7 XE should be consumed at one meal. If a person adheres to five meals a day, then the main meals may include 3-5 XE, additional (snacks) – 1-2 XE, taking into account all products. The bulk of carbohydrate foods should be eaten in the morning.

Experts emphasize that the calculation of bread units is a conditional way to control the intake of carbohydrates into the body. More accurate advice is given by the doctor, taking into account the type of disease (diabetes of the first or second type), the severity of the pathology, the age of the patient, body weight, physical activity and other factors. For example, if overweight patients are recommended a low-calorie diet aimed at normalizing weight. In type 2 diabetes, this approach reduces the need for medication, which usually consists of taking blood sugar-lowering drugs.

What is the glycemic index of foods?

Glycemic index (GI) is an indicator that reflects the degree of increase in blood glucose when eating a product. GI is closely related to such concepts as “fast” and “slow” carbohydrates. “Fast” or “simple” carbohydrates are carbohydrates that are digested in a short time and lead to a rapid increase in blood sugar. Foods high in simple carbohydrates are:

• refined sugar and honey;
• sweet fruits and their juices, raisins, dates;
• white rice, semolina and corn grits, potatoes, pasta and other flour products;
• pastry, chocolate, sweets, ice cream, preserves and jams, halva.

In the diet of a diabetic, foods with a high glycemic index are undesirable. They can be no more than 10% of the total calorie intake. On the other hand, in some cases, sweets may be necessary. For example, if a patient has taken too much insulin, resulting in hypoglycemia, drinking sugar or a sweet drink can quickly raise glucose and normalize well-being.

Slow carbohydrates are otherwise called “complex”. They are found in cereals, durum wheat pasta, whole grain bread. When using such products, glucose rises more smoothly, without a sharp jump. This helps keep you feeling full for longer.

What you need to know about the glycemic index?

The glycemic index (GI) can be low (up to 55), medium (56-69) and high (70 to 100).

The same food can have a different GI depending on how it’s prepared. For example, for mashed potatoes, this figure is 85–95, which is a very high value. For fried potatoes, the GI drops to 60-75, and for boiled potatoes that have stood in the refrigerator, the GI is 50. The difference is quite significant. Cooked pasta, cereals, or flakes have a higher GI than whole-grain cereals or pastas that are eaten semi-solid.

To lower the GI, freshly cooked food can be refrigerated and then reheated. Also, the addition of bran to the dish helps to reduce the glycemic index.

What sugar substitutes are available for diabetics?

Artificial and natural sweeteners are used in cooking. Synthetic sweeteners are:

• aspartame;
• saccharin;
• sucralose;
• cyclamate;
• acesulfame;
• neotam.

These substances do not increase glucose levels and do not contain calories, but sweeteners are ten times sweeter than sugar. Artificial sweeteners are used in the preparation of drinks and pastries, desserts. Each substitute has its own restrictions and consumption norms. For example, aspartame is not recommended for patients with phenylketonuria, and cyclamate should be abandoned for kidney disease. Doctors do not recommend the use of synthetic sweeteners for pregnant women and children under three years of age.

Natural sugar substitutes include:

• sugar alcohols: xylitol, sorbitol, isomalt;
• leaves and extract of stevia, a sweet herb;
• fructose.

Each natural sugar substitute has its own characteristics. For example, fructose contains calories and increases blood glucose, but fructose is absorbed more slowly than sucrose. Stevia does not contain calories and does not increase glucose, but this plant has a characteristic aftertaste that changes the taste of the finished dish or drink. Stevioside, an extract of stevia leaves, will help to avoid such a situation. It has no aftertaste.

Xylitol, sorbitol and isomalt contain calories, but do not increase glucose. For some people, products with such sweeteners cause nausea, flatulence, and upset stools.

In stores, you can find single-component and multi-component sugar substitutes. To improve the taste properties, the mixture includes a combination of two or three different substitutes.

Can I drink alcohol if I have diabetes?

It is undesirable to include alcohol in the diet of a diabetic, since when drinking strong drinks, the level of glucose in the blood drops. Alcohol interferes with the release of glucose by the liver, which can lead to severe hypoglycemia. The exceptions are liquor and sweet wine, which contain a lot of sugar and increase glucose.