Diabetes mellitus (more commonly referred to as diabetes) is a complex disease that affects insulin production, insulin metabolism or both. Insulin is the hormone responsible for carbohydrate metabolism. In an individual without diabetes, carbohydrate is converted to glucose (the body's useable form of carbohydrate) with the help of insulin. However, with diabetes, glucose is not used correctly and the result is hyperglycemia (high blood sugar). Chronic high blood sugar can cause damage to numerous organs, including the eyes, kidneys, nerves, heart and blood vessels. Insulin deficiency can also cause an individual to experience hypoglycemia (low blood sugar). Low blood sugars can cause a person to feel faint, dizzy, light headed, sweaty, hungry or weak.
Diabetes is best treated by a collaboration of health care professionals, including a physician, Registered Dietitian, Certified Diabetes Educator (CDE), nurse and pharmacist. Because each case of diabetes is different, a management plan should be tailored to each individual's needs. Treatment should focus on eating patterns, daily schedule, social activity, physical activity, other medical conditions and personal preferences.
Treatment goals for glucose control should include avoiding hyperglycemia, avoiding hypoglycemia, and reducing the risk of complications associated with diabetes. An individual who is not producing enough insulin will require an insulin regimen to replicate natural insulin. Make sure to work closely with your physician and Diabetes Educator to personalize your insulin regimen.
Nutrition therapy is essential for glycemic control and diabetes management. Although there is not one diet that first all individual's needs, monitoring carbohydrate intake can help maintain optimal glucose control.
Carb counting is tool you can use to count the grams of carbohydrates in foods and convert those into carb choices. Carbohydrates (carbs) are found in the starches and sugars in food. Carbs affect your blood sugar the most, but it is still important to include carbs in every meal for proper glucose control. First, you should identify foods that contain carbohydrates - grains, starchy vegetables, fruit, milk, yogurt, desserts and sweets. These foods are referred to as "carb choices" depending on serving size. You will need to become familiar with label reading in order to determine carb choices at each meal. It is important to keep carbohydrate intake consistent throughout the day in order to keep your blood sugar within an optimal range.
How can carb counting help manage my diabetes?
Carb counting allows you to have flexibility in your meal plan while keeping tight control over your blood sugar. Carb counting can be used for anyone with diabetes, not just those using insulin. Carb counting alone can help you control blood sugar, or it can help you adjust your insulin dosing.
In general, individuals need 3-4 carb choices (45-60 grams) per meal. However, consult with a Registered Dietitian to determine the amount that is right for you.
- Be familiar with food labels
- Always read the serving size and grams of total carbohydrates to determine carb choices
- Visualize portion sizes when a food label is not available:
- A fist = 1 cup of cooked pasta
- A handful = 1 or 2 oz of snack food
- A tennis ball = 1 fruit serving
- Check your blood sugar often to determine if your management regimen is working for you
- Stay in contact with your health care team
- Space carbohydrates evenly throughout the day - don't save your carb choices for "one big meal"
- Don't get frustrated! Becoming comfortable with carb counting takes time and practice
- Be aware of signs of hypoglycemia: shaking, fast heartbeat, sweating, dizziness, anxiety, hunger, impaired vision, weakness, fatigue, headache, irritability
- Be aware of the signs of hyperglycemia: extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness, decreased wound healing
- Always have a snack containing 1-2 carb choices available in case you experience a low blood sugar