Key points:
- While the food you eat has a big impact on diabetes control, there's no such thing as a special diet for people with diabetes!
- When it comes to a healthy eating plan, Canada's Food Guide is your best bet for making wise food choices.
- Since carbohydrates really affect blood glucose levels, one key to managing diabetes is to think about the type of carbs you eat, how much and when you eat them. This article explains how to measure the impact of the carbohydrate in the foods and drinks you choose.
Many questions come along with a diagnosis of diabetes. Chances are that some of them are about nutrition.
Do you have to eat a 'diabetic diet' or give up sugar forever? The truth is that there is no special diet for diabetes.
If you are living with diabetes, you should follow the same recommendations from Canada’s Food Guide that everyone should use.
Just because you received a diagnosis of diabetes doesn’t mean you need to completely give up sugar. Diabetes Canada guidelines recommend people with diabetes get 45 to 60 per cent of their daily calories from carbohydrates. This can include up to 10 per cent from sucrose (also known as table sugar).
Understanding carbohydrates
Macronutrients are your body’s main sources of energy. Carbohydrates (or carbs) are one of three types of macronutrients. Carbohydrates include simple carbohydrates (like glucose, sucrose, and fructose) and more complex carbohydrates (like starches and fibre). The other two macronutrients are proteins and fats.
When choosing carbs, consider the type, how much you’re eating, and when. Some foods have a greater effect on blood glucose than others. The glycemic index (GI) ranks how much and how fast a food or drink that contains carbohydrate will increase your blood glucose.
The glycemic index assigns a number from one to 100 to food products. Foods with a high GI number will raise your blood glucose higher and faster than foods with a lower GI number. To better control blood glucose, select low GI foods and include them in meals with fats and proteins. For example, consider having sourdough bread (low GI) instead of white bread (high GI), or baked sweet potatoes (low GI) instead of French fries (high GI).
Not all foods raise blood glucose
Proteins aren’t changed into glucose right away, so they won’t raise your blood glucose after eating them. Fats also don’t raise blood glucose.
Diabetes Canada guidelines recommend getting 15 to 20 per cent of your daily calories from protein, and 20 to 35 per cent from fat. To lower your risk of heart disease, choose lean meats (like chicken without the skin), fish, nuts, beans and lentils, low-fat dairy products, and mono- or poly-unsaturated fats (like canola and olive oil) more often. Avoid trans fat, and try to limit saturated fats.
Since fibre isn’t absorbed, it doesn’t raise blood glucose either. Some foods don’t have enough carbs in them to raise your blood glucose. Examples include non-starchy veggies such as peppers and broccoli, which are high in fibre and low in carbohydrates.
Counting carbs
Carb counting is important for people with diabetes who use insulin. By tracking carbs, and eating the same amount of carbs at regular times of the day, they can match the right dose of insulin to the amount of carbs in their food.
What if you don’t use insulin? Will counting carbs and sticking to a regular eating schedule benefit you? Yes, it can.
In type 2 diabetes, the body can’t make enough insulin on demand to bring down high blood glucose. For example, imagine that you eat most of your day’s carbs at breakfast. Your body will have a hard time dealing with the extra glucose in your blood and bringing your blood glucose back down to target levels. If you don’t eat many carbs for the rest of the day, you may be at risk of having your glucose drop too low. If so, you could end up with hypoglycemia. Depending on the type of medication you use to manage your blood glucose, you might be at higher risk of having this happen.
What is carbohydrate consistency?
Carbohydrate consistency means eating the same amount of carbs with each meal at regular times of the day. Being consistent can lower the risk of having your blood glucose going too high or too low, and helps to improve glucose control. By knowing how many carbs to eat at meals, you can add variety, swapping foods with the same amount of carbs in them while maintaining better glucose control.
For the purposes of carbohydrate consistency, we assume that all carbs affect blood glucose levels in a similar way when they have the same amount of available carb.
How many carb servings / grams of carbohydrate are in this lunch?
You are eating a sandwich with chicken, lettuce, and mustard between two slices of bread.
- Chicken is a protein that doesn’t contain available carbs.
- Lettuce is a non-starchy veggie.
- Mustard doesn’t contain enough carbs to need to be counted.
- The available carbs in the sandwich are in the bread.
When you look at the Nutrition Fact Table on the bread package, you see that a serving is one slice of bread. It contains 15 grams of available carbs. Since you are eating two pieces of bread, you double the carbs. Your sandwich contains two carb servings / 30 grams of available carbs.
You are aiming for four carb servings / 60 grams of available carbs in each meal. You add an apple and yogurt (two more carb servings) to meet your goal.
Steps to Be Carb Consistent
Step 1
First, know how many carbs you’re aiming for at each meal. There are two ways to think about the amount of carbs in your food. You can count either carbohydrate servings or grams. Choose the method that makes the most sense to you.
One carb serving has 15 grams of available carbohydrate. (In general, if a food has eight to 22 grams of carbs, it’s considered one carbohydrate serving.)
Step 2
Next, count the carbs in your meals. You can use nutrition information or food labels to find out how many available carbs are in what you’re eating. You may need measuring cups or a food scale to figure out portion sizes. Pay attention to the serving size of the nutritional information you are using. If the amount you eat doesn’t match the serving size, you’ll need to adjust the number of carbs to match the amount you’re actually eating.
When looking at food labels, keep in mind that fibre and sugar alcohols don’t raise blood glucose after a meal enough to matter. They are subtracted from the total amount of carbs per serving.
Step 3
Remember to check your blood glucose level two hours after a meal to see how the food has affected your blood glucose. Keep in mind that the levels will always rise after you eat. This is normal and expected.
By following these steps, you can create meal plans that include a variety of nutritious foods. Just look for meals that have similar amounts of carbs in them. Combining carb consistency, a regular meal and snack schedule, and eating healthy fats and proteins with your carbs will help improve your blood glucose control.
Where to find nutrition information
- Food Labels
See the Nutrition Facts Table and the ingredient list.
- Recipes
Some include a nutritional breakdown.
- Websites
Health Canada- Nutrition Value of Some Common Foods
Food Composition Database - U.S. Department of Agriculture
Want to learn more?
Diabetes Canada is a great resource for helpful information on carb counting and meal planning. For more details, you could talk with a registered dietitian or a Certified Diabetes Educator.
Carbohydrate guidelines for people with Type 2 Diabetes
- Men – four to five carb servings / 60 to 75 grams of available carbs per meal
- Women – three to four carb servings / 45 to 60 grams of available carbs per meal
- Snacks – one to two carb servings / 15 to 30 grams of available carbs
For most people, recommended glucose targets are:
- 4.0 to 7.0 mmol/L fasting or before meals
- 5.0 to 10.0 mmol/L two hours after eating.
WRITTEN BY: This 2024 Managing Diabetes article was written by Karen Flemming, BSc Pharm, CDE, a pharmacist and Certified Diabetes Educator (CDE) practising at Sobeys Pharmacy in Dartmouth, Nova Scotia..
