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Making Sense of Carbs

Carbohydrates — along with fats and proteins, make up the three macronutrients. For people with type 2 diabetes, carbohydrates have the biggest impact on elevating blood sugar.
For this reason, it is important that people with diabetes find a balance with carbs. Without balance, blood sugars can be elevated and unstable, which can  make it more challenging to fend off infections such as COVID-19. If blood sugars stay too high over time, it can lead to serious complications, including diabetic ketoacidosis (DKA) which requires emergency treatment, something we want to avoid as it provides opportunity for potential exposure.

How Many Carbs Should I Eat?

The answer will vary based on the person, but the CDC recommends that about 45% of a person’s total calories come from carbs, and a serving is defined as 15 grams of carbs. This means the average woman should be consuming 45-60 grams per meal, and the average man about 60-75 grams per meal. Age, weight, activity level and medications will all influence this number and it is important to discuss your own situation with your own doctor or dietician.

Carbs primarily fall into one of three categories: starch, sugar and fiber.

Types of Carbs:

Starchy carbs, use sparingly (will affect blood sugar):

  • Include things like peas, potatoes and corn
  • Dried lentils
  • Pastas
  • Breads
  • Grains—oats, rice, barley and others

Sugar, use with caution (can dramatically affect blood sugar)

  • Naturally occurring like lactose in milk, or fructose in fruit
  • Sugars added during processing

Fiber, use liberally

Fiber doesn’t affect blood sugar like the other two and is critical for the health of your gut. Fiber also plays a prominent role in stabilizing blood sugar and reducing cardiovascular risk. For these reasons, people with diabetes should be looking for fiber rich foods. Good sources include vegetables, fruits, beans and whole grains. Most Americans do not get nearly enough fiber so any increase in fiber is likely to be helpful.
If we were to make a list of “good” and “bad” carbs as it relates to type 2 diabetes and pulling from all three sources, it would look something like this: 

Eat plenty of:

  • Vegetables: All are fantastic, and variety is key.
  • Whole fruits*
  • Legumes
  • Nuts
  • Seeds: chia, pumpkin, flax, etc.
  • Whole grains: Oats, quinoa, rice*
  • Tubers: potatoes, sweet potatoes*

*Fruits, grains and tubers while healthy, it’s worth pointing out they are likely to have more of an effect on blood sugar than the others listed here.

Limit and/or avoid:

  • Sugary drinks: Soda, sports drinks, etc
  • Fruit juice: While masquerading around as healthy, most have a similar effect to soda.
  • White bread: Refined carbs in general are low in nutrients and high in their ability to disrupt blood sugar
  • Pastries, cookies and cakes
  • Ice cream
  • Candies and chocolates: If you need chocolate, 70% dark or more is best
  • French fries and potato chips: Whole potatoes are healthy, but fried foods come with added calories, unwanted fat and often sodium

Carbs are still an important macronutrient. It’s just important to focus on consuming healthy carbs that can help you keep blood sugar in range. By monitoring the amount and kind you consume — you’ll be in position to set yourself up for success!

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