Carbohydrates, or carbs for short, are sort of a dirty word these days thanks to the diet industry. Low-carb diets are all the rage.
But people with diabetes have worried about carbs long before Atkins and the Paleo diet were even glimmers in their creator’s eye. If you’re new to diabetes, carbs are about to become more important to you than ever before.
To help, here’s a primer on just what carbs are and why we need to care about them.
Why worry about carbs and blood sugar?
We’ve written about why high blood sugar is bad for you, and you’ve probably received an earful about it from your doctors. But basically, chronic high blood sugar causes long-term damage to the body, including nerve damage. That’s why it’s so important to measure your blood sugar often (those numbers are a measure of how much glucose is in your blood) and then take action to stay at a healthy level. Since carbs in your diet are the most direct source of sugar in your blood, it makes sense to learn more about them.
The humble carb
When we eat food, there are three main sources of fuel stored inside. These are protein, fat, and carbs (sometimes collectively called macronutrients). Your body has different ways to burn each of these, but people with diabetes have trouble processing carbs right. As such, carbs are what impacts blood sugar the most.
Carbohydrates are found mainly in foods from plants such as potatoes, rice, pasta, fruits, grains, and legumes. In smaller amounts, carbs are also found in animal/dairy products in the form of lactose. Think milk, yogurt, buttermilk, and even cream.
In simple terms, carbs are special chains of carbon and hydrogen atoms. Depending on how they’re linked, carbs come in three main types:
- Sugars
- Starches (simple and complex)
- Fiber
Sugars
Sugar (glucose) is the fastest to digest of these three. Our bodies easily absorb sugars. Great for fuel. Bad for our blood sugar levels. But sugars aren’t just about the cane sugar you put in your coffee or drink in your soda. Nearly all foods have some type of sugar in them, including natural ones. On processed food labels, any ingredient with the ending -ose is a sugar.
Fructose is a special type of simple “-ose” sugar (monosaccharide) because it doesn’t directly increase blood sugar. Fructose makes a detour via the liver where it’s transformed first. In larger quantities, such as in sweetened drinks, the liver turns the fructose into fat before storing it away and thus increasing insulin resistance. Fructose can be found in things like honey, sweets, agave syrup, juices.
Of course, fructose is also found in fruit. Fruits, however, are packed with fiber and therefore are usually less harmful in moderate amounts. High-fructose corn syrup is a topic worthy of an entire post of its own and we’ll dive into that another time.
For some people with diabetes, their treatment can cause blood sugars to dip too low sometimes. This condition, called hypoglycemia, is dangerous. Low blood sugar is urgent and potentially fatal if it dips too far. This is when those fast-acting sugary foods are your friend. There are even medicine-like glucose tabs available that are made exactly for raising blood sugar quickly. Typically, lows can be treated safely within about 10-15 minutes.
Starches
Starches are usually more complex combinations of sugars and have to be broken down and unlocked before they can be digested. You may also hear terms like disaccharides (double) or polysaccharides (multiple) here.
Disaccharides consist of two sugar molecules and polysaccharides are long chains of multiple sugar molecules. Both kinds take longer than sugar to process and raise blood sugar. We’ll dive into this more in just a moment. Disaccharides include things like lactose (found in dairy products) or table sugar and beet sugar. Sweets like cookies, chocolates or gummy bears often contain many disaccharides.
Starches are usually more complex combinations of sugars and have to be broken down and unlocked before they can be digested. You may also hear terms like disaccharides (double) or polysaccharides (multiple) here.
Disaccharides consist of two sugar molecules and polysaccharides are long chains of multiple sugar molecules. Both kinds take longer than sugar to process and raise blood sugar. We’ll dive into this more in just a moment. Disaccharides include things like lactose (found in dairy products) or table sugar and beet sugar. Sweets like cookies, chocolates or gummy bears often contain many disaccharides.
White processed flour products are also considered polysaccharides. But the molecules are so open that digestion happens quickly causing blood sugar to rise quickly (and drop again soon after).
Polysaccharides also include things like rice, oatmeal, and noodles. The whole grain varieties of these usually have higher fiber content and can be better for both your blood sugar and your intestines. You’ll also find some surprises in this category – like potatoes because of the starch molecule they contain. Unfortunately, there’s no whole-grain option for potatoes, but sweet potatoes (despite their name) can be a smarter option.
Fiber
Fiber, which we’ve mentioned a few times already, isn’t like the other carbohydrates. It isn’t digestible. Why would we eat it then? Besides keeping us regular, fiber can be a powerful tool in your dietary arsenal because it slows down the absorption of other carbohydrates. This is why eating an apple and drinking soda with the same amount of carbs will show different responses in blood sugar. The fiber in the apple slows the absorption of the fruit sugars in the apple.
The glycemic index
The glycemic index (also called GI) is a measure of how fast a particular food can raise your blood sugar. Pure glucose is the reference at 100 and raises blood sugar the fastest. The more complex the food makeup is, the lower the GI, and the slower it is to raise blood sugar levels.
Since life is not just made up of whole-grain, low GI products, it’s helpful to know that combining foods does make a difference. For example, a serving of rice with vegetables and fish or meat will raise blood sugar slower than if the rice is eaten alone. The mix does it! A fun rule-of-thumb: the less you have to chew, the faster the food raises your blood sugar.
It's personal
The exact amount (and type) of carbs you need depends on your body, your diabetes treatment plan, and how these foods make you feel. Some people with diabetes prefer a low-carb diet and others feel it’s too restrictive and can’t handle it. We believe the best indicator is your blood sugar levels. If your blood sugars (and other lab results from your doc) are where they should be, keep doing what you’re doing. You’re on the right track!
If you’re not where you want to be, working with a diabetes coach can be helpful. Your doctor may also have a dietician or nutritionist on staff to help develop a personalized plan for you. They’re worth their weight in gold!
Bonus fun fact
Did you know your brain consumes about 130 grams of carbs per day? During stress, the demand for carbohydrates can rise up to 180 grams! Next time you’re feeling hungry during an intense day of thinking or worry, it’s not just your imagination.
The mySugr website does not provide medical or legal advice. mySugr blog articles are not scientific articles, but intended for informational purposes only.
Medical or nutritional information on the mySugr website is not intended to replace professional medical advice, diagnosis or treatment. Always consult a physician or health care provider with any questions you may have regarding a medical condition.
