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Question:
We recently received two similar questions:
- From Oklahoma, USA:
My son has been diabetic since he was 9 months old. He is now nine years old. We had just started counting carbs and I'm a bit confused. When it comes to meats, how do I figure the carbs, since meats don't really have any? I feel really stupid. I have always counted calories and now having some problems figuring this out. Any help would be great.
- From America OnLine:
My 12 year old daughter was diagnosed with Juvenile Diabetes two months ago. This is very new to us still. I have been frequenting the diabetes chats on the Internet and am a little confused. Almost everyone in the chats tell me that they follow the counting carbs methods in their child's diet and that they don't even count the sugars. I have heard about this method, however, I was under the impression that you still have to consider the sugar grams in a particular food when thinking of eating it. I know that carbohydrates turn to glucose. Everyone is saying that they don't look at the sugars in food because those sugars have already been converted into the total number of carbs listed for that food item. Am I wrong in thinking that a food that lists 25 carbs with 5 grams sugar is a better choice than a food that also contains 25 carbs but also lists 21 grams of sugar? Example: "Lite" pancake syrup has 25 carbs and 21 sugars; won't that elevate your blood glucose level more than an item that had the same number of carbs but less sugar?
I understand that I really need to consult with my daughter's physician and nutritionist, but I would also appreciate some feedback from you. I just want to make sure that I'm doing the right thing for my daughter while she is young. I want to start her off with the right diet so she'll feel accustomed to it when she's on her own.
Answer:
The basis behind "carbohydrate counting" is that not all calories raise the blood sugar the same amount (or, in other words, require the same amount of insulin to keep the blood sugar normal). There are 3 basic kinds of calories: carbohydrates, proteins, and fat.
- Carbohydrates raise the blood sugar the most and the fastest.
- Fat calories can make you fat, but do not need insulin to be used by the body.
- Some protein calories are changed to sugar by the body, but many protein calories are used for energy by the body without first being changed to sugar and therefore do not affect the blood sugar as dramatically or quickly as carbohydrate calories.
Meat is a protein.
100 calories of pure carbohydrate will raise the blood sugar more quickly and higher than 100 calories of protein. 100 calories of fat won't raise the blood sugar at all.
The older traditional meal plan was based on the exchange system to provide a well balanced diet made up of carbohydrate, protein, and fat. Since the proteins and fat don't affect the blood sugar as much as the carbohydrates, a simpler system of just "counting" carbohydrates has been recommended. In this system one attempts to eat approximately the same number of carbohydrates at the same time every day and try to match the insulin to the carbohydrates eaten. One doesn't worry so much whether the carbohydrates are starches, fruits, vegetables, or mixed with protein and fat as in milk.
In my experience, you can't completely ignore the type of carbohydrate or what it is eaten with. Some carbohydrates work faster than others. If you mix carbohydrate with protein and/or fat, the same amount of carbohydrate will be absorbed more slowly, raise the blood sugar more slowly, and last longer.
Whether the carbohydrate is "sugar" or a starch probably doesn't affect the blood sugar as much as with what the carbohydrate is mixed. A carbohydrate in liquid or gel form will almost always raise the blood sugar faster than a non-liquid.
I encourage you to ask your diabetes team any questions you may have. You shouldn't "feel stupid." This is the way you become even smarter!
Original posting 6 May 97
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Last Updated: Sun Jan 15 12:01:31 2006
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