Understanding Carbs

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Carbohydrate is a nutrient that is an important  source of energy in the diet. All the carbs that   you eat and drink are broken down in the body  into glucose and used by the body’s cells as fuel.   The type of carbohydrate and the amount that  you eat at any given time can make a difference   to your blood sugar level. If you are living  with diabetes you will need to take that into   account when eating carbs. By understanding  which foods contain carbs and learning how   to estimate the amount of carbs in your food  you can achieve better blood sugar control.   So where do we find carbs in the diet?   Foods that contain carbs can be grouped into  starchy foods and those that contain sugar.
Foods that contain starchy carbohydrate  include bread, rice, potato, pasta, cereals, oats   and other foods made from flour  such as pastry chapatis and pizza.
Carbohydrate foods also include foods that contain  sugar, whether that be added sugar or natural sugar.   These foods include sweet treats, cakes and  sugary drinks as well as fruit and some   dairy foods such as milk and yogurt. All of these  foods are broken down in the body into glucose   and will lead to a rise in your blood sugar.  Let’s look at the other food groups in our diet.   There are protein foods which include meat,  fish, seafood and eggs. Food which is mostly fat   such as butter, margarine, lard, ghee, oils and some  dairy foods like cheese and cream. And vegetables.   All of these foods have very little effect on our  blood sugar as they are broken down into other   nutrients which help to keep us strong and healthy.  This also includes most vegetables and salad.   Vegetables do contain some carbohydrate,  however it is trapped inside tough fibre,   which the body cannot break down  enough to release the carbohydrate.   Certain vegetables however contain  more starch than others and so these   can increase our blood sugar. These include  all kinds of potatoes, cassava and plantain.   Drinks such as lattes, full sugar pop and fruit  juice contain carbohydrate as do some alcoholic   drinks such as beer and sugary cocktails. These  drinks will cause a rise in your blood sugar.   Drinks that contain very little or no  carbohydrate include water, no added sugar   squash, diet soda and tea or coffee made without  sugar and little milk. Some alcoholic drinks also   have very little carbohydrate in and so have  a minimal effect on blood sugar. These include   wine and spirits. Alcoholic drinks may also  lead to a drop in your blood sugar later on.   If you have diabetes and would like to learn more  about this please speak with your diabetes team. Now let’s have a look at the different  nutrients and their effect on blood glucose.   As you can see carbohydrate is broken down  into glucose and absorbed into the bloodstream   soon after it is eaten. Protein foods are not  immediately broken down into glucose and so   have a minimal effect on our blood sugar. The same  can be said for foods which are mostly fat. Eating   carbohydrate foods in combination with protein and  fat can even slow down the absorption of glucose   into the bloodstream. When we look at how quickly  or slowly carbohydrates are broken down and   absorbed into the blood as glucose we are looking  at something called the glycaemic index or GI. GI measures how different  foods that contain carbohydrate   affect your blood sugar level after eating them.
Foods with a higher GI are broken down into  glucose quickly and so cause a rapid spike   in the blood sugar level. Foods with a lower  GI take longer to be broken down into glucose   and so get released into the bloodstream much more  slowly. This results in a more stable steady rise   in the blood sugar level. The lower the slower. The majority of carbs are considered to have a   medium GI either because they contain fibre  or because they also contain protein or fat,   which as mentioned earlier can slow down the  digestion of the carbohydrate in the food.   This results in a moderate rise in our blood  sugar. Insulin works well with medium GI foods. If you are living with diabetes it is useful to  understand which foods have a very high GI and   so cause a sharp rise in blood glucose. It is also  useful to understand which foods are broken down   so slowly that they have a minimal effect on blood  sugar. Foods and drinks with a very high GI contain   a large quantity of simple sugars and so they  are absorbed very quickly into the bloodstream.   This leads to a sharp rise in blood sugar. These  include sugary drinks such as cola, fruit juice   and Lucozade as well as sweets such as  jelly babies and glucose energy tablets.   Having lots of these foods and drinks in the  diet can lead to erratic variable blood sugars.   If you have diabetes it is useful to know which  foods and drinks cause a rapid rise in your   blood sugar in the event that it’s too low, also  referred to as hypoglycaemia or hypo for short.   Treatment for a low blood sugar is only necessary  if you take a sulfonylurea medication such   as glycoside or you inject insulin. Most other  oral diabetes medications will not cause your   blood glucose level to drop too low and so these  high sugary foods and drinks are not necessary   for you to manage your diabetes. If we  look at the other end of the GI scale,   there are certain foods that contain a large  amount of fibre. Fibre is broken down very   slowly and so the carbohydrate trapped  within it cannot be absorbed that well.   These foods have a minimal effect on your blood  sugar level unless eaten in large quantities.   If you have diabetes and you take insulin it is  useful to know which foods have a very low GI   as you may not need to match  these foods with any insulin.   These include the majority of vegetables,  nuts, beans, pulses and grapefruit.
If you have diabetes and take insulin you may be  aware of carbohydrate counting as a strategy   to manage your blood sugar levels. Carb counting  essentially means matching your quick acting   insulin to the carb portion in your food which  can result in predictable blood glucose control.   There are two ways to match your insulin to your  carbs. First we’ll be taking fixed doses of insulin,   if you are on this regime you cannot  adjust your insulin to your carb intake   but you can count your carbs so that you  eat a similar amount of carbs at each meal.   This will work better with your fixed insulin  doses. Let’s look at this in more detail.
A banana may contain 17 grams of carbohydrate a  naan bread may contain 43 grams of carbohydrate.  Both of these foods will enter the bloodstream as  glucose, however more insulin will be needed for   the naan bread as it contains more carbohydrate.  If the same insulin dose was given for both   the banana and the naan bread, the naan bread  would result in a much higher blood sugar level without being able to carb count and control your  carb portions. You may experience quite variable   blood sugars with fixed doses of insulin. Another  approach would be to vary your food choices as   you like, having different amounts of carbs in  your meals and instead learning to adjust your   insulin dose to what you’re eating, learning to  count the carbs in your foods and understand   how to adjust your insulin may help you to achieve  blood glucose levels as near to normal as possible.   If you would like to understand more about  this approach to managing your blood sugars   please speak to your diabetes team or  look out for the next video in this series.

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