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Slideshow: Counting Carbs When You Use Insulin

What Are Carbs?

Carbohydrates are found in lots of foods. Whether the carbs are starches, sugars, or fiber, they give your body energy to use right away or to store for later. But different types of carbs can affect your blood sugar differently, says registered dietitian Rachel Beller, president of Beller Nutritional Institute: "If you have diabetes, get familiar with the carbs in the everyday foods you eat, so you can choose wisely."

Simple Carbs

Simple carbs contain only one or two sugars, so the body processes simple carbs quickly. These carbs – such as table sugar, the added sugars in processed foods, and the sugars found in fruits and milk – make your blood sugar rise and fall rapidly.

Complex Carbs

Foods that are complex carbs contain three or more sugars. Your body has work harder to break down complex carbs because the sugars take longer to digest. Examples of complex carbs include the fiber in spinach, watercress, buckwheat, barley, wild or brown rice, beans, and some fruit. Complex carbs may contain soluble or insoluble fiber, but both are beneficial to your health, says Beller.

The Glycemic Index

The glycemic index ranks foods based on how much they raise blood sugar. Choosing low-GI carbs, which produce fewer changes in blood sugar, may help control your diabetes and manage your weight. What's on this low-GI list? Lentils, green beans, broccoli, spinach, plums, yogurt, and brown rice, for example. You can look up these and other foods at www.glycemicindex.com. But a low-GI diet may not automatically control your blood sugar: How much and what kind of carbohydrates you eat matter, too.

Choosing Better Carbs

"When it comes to carbs, be choosy," says Beller. Limit the amount of added sugars in your diet. Eat a variety of fruits and vegetables, especially non-starchy vegetables like leafy greens. Opt for whole grains instead of refined grains, which lose fiber, vitamins, and minerals in the refining process. Beller advises looking for whole grains as the first ingredient when you choose foods like bread and cereal.

How Carbs Raise Blood Sugar

Our bodies break carbohydrates down into glucose for energy. The presence of glucose causes blood sugar levels to rise and signals the pancreas to release insulin, which helps the body use or store the glucose. People with diabetes may not make enough insulin, or their insulin may not work well, so they need medications to disperse the glucose. When you live with diabetes, managing your diet and insulin use help keep blood sugar stable.

Counting Carbs

It's important for people with diabetes to keep their blood sugar levels under control. To do this, you'll need to watch serving sizes and read all food labels to learn how much carbohydrate is in your food. In some cases you may have to guess. Some people aim for 45-60 carb grams per meal. Suppose you eat a plain turkey sandwich with a half cup of fruit. Two slices of bread have 30 carb grams. The fruit contains 15 carb grams for a total of 45 grams.

What About Fruit?

Are you avoiding fruit because you have diabetes? Don't. Fruit is still a part of your healthy diet. Eat fresh or frozen fruit – a small peach or 1 cup of diced cantaloupe provides less than 15 grams of carbs. Dried fruit is acceptable, too, as long as you keep an eye on portion sizes. A portion of dried fruit, 2 tablespoons, provides 15 carb grams.

Finding Carbs on Nutrition Labels

Look for the amount of "total carbohydrate" grams on your food label. "Total carbohydrate" can also be broken down as "dietary fiber" and "sugars." But "sugars" won't tell the whole story. These include the natural sugars found in fruit and milk products as well as added sugars. A food label that lists a form of sugar as the first ingredient may be high in total sugars.

Added Sugars

Added sugars are carbohydrates, but they provide no nutrients. They sweeten and often preserve processed foods. Soft drinks, cookies, and cake have added sugars. But so can yogurt and cereal. Read ingredient labels and think twice about eating foods that list sugar as the first ingredient. Tip: Some added sugars end with "ose" – like dextrose, sucrose, maltose, or high fructose corn syrup.

A Balanced Diet

A balanced diet with at least 3-5 servings of vegetables a day can help you lose weight and control your blood sugar. And cooked, non-starchy vegetables like okra, beets, or eggplant have only 5 carb grams per half cup. Even though you might focus attention on counting carbs, you also need to eat enough protein and healthy fats. Don't skip meals, and eat healthy snacks to help keep blood sugar under control.

Happy Hour No More?

Is a glass of wine off-limits? It depends. Alcohol can cause hypoglycemia (low blood sugar), so ask your health care provider if drinking is safe for you, says Beller. Check your blood sugar levels before and after you drink, and only drink – in moderation, with food – when your blood sugar is under control. And check your blood sugar levels before you go to bed to make sure they're within a healthy range.

Diabetes Taking Control With Insulin

Reviewed by Laura J. Martin, MD on September 22, 2011

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