Carbohydrate counting and Diabetes

Do you know why do we count carbohydrate in Diabetes? Carbohydrate counting is the amount of carbohydrate intake in our body in units which provides energy to the body and also increases the blood sugar levels. It is usually counted to monitor the diet, meal intake to regulate the sugar control.

If you take insulin, carbohydrates counting can help you know how much insulin is needed. Not all people suffering from diabetes need to count carbohydrates. Carbohydrate counting is usually counted in grams. Let us first understand which foods are rich in carbohydrates. Some of the carbohydrate rich foods include milk and milk products, rice, starchy substances, sugars, sweets, fruits, processed foods and juices, refined grains, carbonated aerated drinks. One must avoid such substances or keep control over eating habits of carbohydrates.

carbs counting

If you take insulin during your meal time then one needs to monitor the carbohydrate intake so that it doesn’t increase your sugar levels and also one can judge the amount of insulin required for the body.

Advantages of carbohydrates counting in Diabetes:

  • It helps in improving the lifestyle.
  • Improves your activity and prevents sluggishness.
  • It prevents or delays the complications of Diabetes like Diabetic Nephropathy, Neuropathy, retinopathy, obesity, cardiovascular diseases, hypertension etc.

One carb serving gives 15 grams of carbohydrates. Every body needs different amounts of carbohydrates. If you have 2 baked potatoes, it gives 2 carb servings with total of 30 grams of carbohydrates. Also the amount of carbohydrates needed by the body depends upon various factors like age, weight, activity of the individual etc. A person usually takes 1800 to 1900 calories/day , out of which 900 to 1000 calories consists of carbohydrates as indian’s eat more of carbs. If 4 calories/gram of carb then 225-250 grams of carbs per day. One needs to avoid fried oily fatty foods, starchy substances to control body weight and maintain blood sugar levels. Try to eat same amount of carbohydrates every day to maintain a stable blood sugar level.

Carbohydrate serving 15 grams meal plan:

Starch: 1 slice of bread, 1/4 cup of pasta, 3/4 cup cereals

Milk: one cup of skimmed milk or 3/4 cup curd

Fruit: One small piece of fruit or 1/2 cup of fruit juice

Desert: 2 small buiscuits or  1/2 cup ice cream.

Tools that can be useful to patients as they become familiar with carbohydrate counting include measuring cups and spoons, food package labels, food scales, carbohydrate counting books.

Advanced Carbohydrate Counting:

However the following skills are required for people who have understood basic carbohydrate counting and wish to learn more advanced carbohydrate counting level (e.g., if a patient is planning to use an insulin pump or a bolus insulin regimen).

  • Ability to count all aspects of basic carbohydrate counting.
  • Understanding the concept of target blood glucose levels.
  • Understanding the concept of action of insulin and the basal-bolus insulin.
  • Willingness and ability to keep complete proper records.
  • Willingness to do pattern management.

Additionally one needs to know how to calculate a bolus insulin dose using insulin-to-carbohydrate ratios, insulin sensitivity factor for correction or supplementation of insulin doses when glucose levels are either too high or too low before meals, and how to make corrections for such special situations.

There are various ways and methods for determining insulin-to-carbohydrate ratios. For patients with type 1 diabetes, the general rule is that most people need about half of their total daily dose of insulin for basal insulin and half for their bolus doses to cover their meals. In type 2 diabetes, the basal and bolus demands can vary from patient to patient. Bolus insulin doses is calculated from the insulin-to-carbohydrate ratio which is based on the total grams of carbohydrate or the total number of 15gm carbohydrate servings consumed.

How to determine insulin carbohydrate ratio:

  • First record the total amount of carbohydrate intake during meals and snacks for 3 days. It will vary as per the activity and demand of the person.
  • Note down the blood glucose levels for 3 days.
  • Calculate the average intake of carbohydrates of 3 days and average of blood glucose levels. Then one can determine the amount of insulin required for that average blood glucose levels.
  • Then one can calculate the ratio of insulin carbohydrate ratio by dividing the number of grams of carbohydrate in a meal by number of bolus insulin given in units.

Hope our readers understood the simple way of calculating carbohydrate in your meal and plan your meal accordingly. Also the importance of monitoring carbohydrates in regulating the blood glucose levels and also manage the intake of insulin injections accordingly. One also needs to consult your diabetologist for proper guidance for calculating carbohydrate intake and insulin dose regulation.

Role of Spices for Diabetes Control

Role of Spices for Diabetes Control :-

The use of spices and herbs should be a part of patient’s nutritional diet plan as they have demonstrated their effectiveness in
lowering blood glucose, boosting insulin sensitivity, reducing high blood pressure and cholesterol, etc.

When spices are consumed in moderation, health benefits can be derived, however, an overdose of any spice can lead to indigestion or even ulcers. Black pepper aids in digestion, congestion, an upset stomach and can also help stop the bleeding on a cut when applied topically. It also has all the essential nutrient contents. It promotes weight loss and relieves toothache.

Spices for diabetes control

So here is list of few spices and their benefits in combating diabetes and blood sugar levels :

  • Clove –

An equivalent of one or two cloves per day helps to improve cardiovascular anddiabetes risk factors in T2DM.

  • Cinnamon –

High levels of circulating insulin can lead to many of the secondary signs of diabetes such as nerve, kidney and eye problems as well as build-up of plaque in the arteries. Cinnamon increases insulin efficiency and hence is very helpful in diabetes.

  • Ginger –

Ginger is a very famous herb known for its intense flavor and warming aroma. A clinical study showed that ginger increases insulin sensitivity and affecting carbohydrates metabolism, thereby leading to greater glucose absorption in the muscles. Ginger also has the potential to help reduce the risk for diabetes complications due to its lipid-lowering effects.

  • Garlic –

Garlic has been recommended to help reduce high cholesterol levels and high blood pressure thereby reducing the incidence of heart disease. Raw garlic might be helping in diabetes control by reducing blood sugar levels as well as reduce the risk of atherosclerosis. This is particular interest as diabetes increases a person’s risk of atherosclerosis-related inflammation

  • Fenugreek Seeds –

The seeds contain fibre and other chemicals that may slow digestion and the body’s absorption of carbohydrates and sugar. A study showed that daily dose of 10 g of fenugreek seeds soaked in hot water may help control T2DM.Another study suggested that eating baked goods such as bread made with fenugreek flour may reduce insulin resistance in people with T2DM.

A quick guide to use spices :-

  • The recommended doses of turmeric by The University of Maryland’s Complementary and Alternative Medicine Guide are:
    – Cut root:1.5–3 g per day
    – Dried or powdered root:1–3 g per day
    – Fluid extract (1:1):30–90 drops per day
    – Tincture (1:2):15–30 drops, 4 times per day.
  • A pinch of turmeric on scrambled eggs, on top of roasted vegetables, rice, in soup or just to a plain glass of milk.
  • While preparing green tea, it is recommended to add ginger as it adds to the flavour as well
    as helps keep the upper respiratory tract clear.
    To prepare basil ginger tea: Take one cup of water, add 5 basil leaves, 3–4 ginger slices, 1 tsp tea leaves and 1/4 cup of milk. Boil for 5 minutes and remove from heat. Strain and 30 serve. Add honey (in moderation only) to replace sugar.
  • Soak a cinnamon stick in warm water and drink it with a drop of honey about two-three times a day,this helps soothe a scratchy throat
    Mix cloves, basil, cardamom and mint in tea and replace the sugar with honey. This drink will calm nerves and help de-stress.
  • Fenugreek seeds (methi dana): Soaked fenugreek seeds can be consumed on an empty stomach. This will help relieve acidity. Methi dana is excellent for regulating blood sugar. People with diabetes benefit a great deal from consuming fenugreek water. Sprouted
    fenugreek is even better as it has 30–40% more nutritive properties over soaked fenugreek seeds

Effectiveness of curcumin in diabetes :-

A study found that people with prediabetes who were given curcumin for a period of 9 months were less likely to develop the fullblown condition.

  • Controls blood sugar
  • Protects against diabetes
  • Improves function of β-cells that make insulin in the pancreas
  • May reduce diabetes-related complications: In a clinical study, researchers gave test subjects curcumin over a long period of time. As a result, these people appeared to have fewer symptoms of liver disorders. The compound curcumin was also reported to be active against diabetic vascular disease,and it seems to speed wound-healing

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Plate Diet For Diabetes

In today’s day and age, a healthy diet plays a pivotal role in maintaining not just the physical but also one’s professional and mental wellbeing. This paper delves into the role of diet and exercise in our lifestyle; correction in diet and proper exercise can save you from Diabetes and its complications like cardiovascular disorders, diabetic neuropathy, retinopathy, gangrene, keto-acidosis etc. This Plate Diet is useful in patients with borderline diabetes and also in severe cases of Diabetes Mellitus.

What is a Plate Diet? Don’t worry; your plate won’t be empty, it’s a full plate meal plan. First let us understand the basic definition of high blood sugar levels. Blood Sugar refers to presence of glucose molecules in your blood stream. When there is increase of glucose molecules in your blood stream beyond a particular limit then it’s called Diabetes mellitus.

Type 2 Diabetes is usually associated with hereditary, sedentary lifestyle and wrong diet. Diet plan in Diabetes doesn’t mean that one needs to avoid sweets completely. The American Diabetes Association (ADA) offers a simple Plate Diet Plan for Diabetes. In this plate method there is more focus on vegetables and the portion in which one should eat irrespective of calorie intake. This plate method should be followed for both lunch and dinner. Regular balanced diet helps to keep Diabetes under control. Also eating in small portions in regular intervals helps in proper check and control of Diabetes. This is usually checked by Glycemic index which is rated from 1 to 100. High GI foods are digested and absorbed more quickly. They have a bigger impact on your blood sugar, and you’ll get hungry sooner. Here are some examples:

  • High GI: Bread (white and wheat), mashed potatoes, watermelon, fruit juice
  • Low GI: Beans, brown rice, tomatoes, yogurt, apples, milk

Our body needs a balanced proportion of carbohydrates, proteins, fats, and fibre. The Plate method introduced by ADA helps in guiding the proper ratio in which food should be consumed. Also, daily brisk walk or exercise for half an hour is beneficial in improving the metabolism of the body. So basically, our motto is to reduce body weight, which in turn controls blood pressure, diabetes, hypercholestremia. Our diet must consist of balanced nutrients which has more of proteins and less of fats and carbohydrates.

The Plate Method Diet is as follows:

  • Fill one half of the plate with non-starchy vegetables, such as salad, green beans, broccoli, cauliflower, cabbage, carrots, asparagus, greens (lettuce, spinach, kale, arugula), mushrooms, peppers, snap peas, snow peas, squash (spaghetti squash, zucchini), tomatoes or turnips.
  • Fill one quarter with a lean protein, such as chicken, turkey, beans, tofu, or eggs.
  • Fill the last quarter with a grain like brown rice, barley, oatmeal, corn or starchy food such as potatoes or pasta (or skip the starch altogether and increase the non-starchy veggies).
  • Add a serving of a fruit or unsweetened tea or coffee or dairy. Fruits beneficial in controlling Diabetes: Grapefruit, Java Plum (Jamun). Also avoid canned processed food and beverages/aerated drinks.

One should have 3 meals a day, if intervals are longer than 4 to 5 hours then include snacks in small portions in between.

The_healthy_diabetic_plate

Eat more fiber:

  • Increase the intake of fiber – aim for 21 to 38 grams per day.
  • Fiber is found in whole grain breads and cereals, fruits and vegetables, and dried beans and peas
  • Increase fiber intake gradually and drink plenty of fluids

 

Be more active:

  • Increase lifestyle activity – use stairs, park further away
  • Aim for an hour per day of some or the other kind of regular activity e.g., brisk walking, swimming, skipping, cycling, dancing
  • It’s ideal to use a digital device to measure your daily walking activity and the target should be to clock at least 11,000 steps a day

Maintain a healthy body weight:

  • If overweight, aim for a moderate weight loss of 5 – 10 % of current weight with gradual reduction to reach ideal BMI
  • Choose healthy foods; watch portion sizes and limit sugary drinks

Control your carbohydrate intake:

  • Control total carbohydrate intake, not just sugar
  • Carbohydrate includes starches and sugars and both make your sugar levels go up.

 

Plate_diet_for_diabetes

Pathophysiology:

After you eat, your pancreas releases insulin, a hormone that transports the glucose molecules from your blood into your cells (like those in nerves or muscles) to fuel them. Ideally, you want to keep blood sugar from spiking or plunging to maintain steady energy throughout the day. Your blood sugar naturally rises in response to the food you eat. But it may spike if you eat something highly refined or really sugary. Let’s say you sit at your desk and munch on some candy. Typically, your pancreas will release the necessary amount of insulin, which will push that sugar into cells and bring your blood sugar back down. However, a glucose spike and resulting crash can make you feel sluggish and irritable, giving you brain fog and driving cravings.

Be choosy of Fat Intake:

Avoid saturated fatty foods which cause more harm to your body. Choose foods that are low in saturated fat, trans fat, and cholesterol.

Watch the amount of fat you add to foods such as margarine, mayonnaise, salad dressing or gravy. Use low fat cooking methods such as broiling, baking, steaming or grilling. Avoid deep frying methods.

Omega 3 fatty acids are good source of fats which prevent heart diseases. It increases the HDL levels in blood and decreases the LDL and VLDL levels of cholesterol which are not good for the body. These are present in salmon, flaxseeds. Also avoid eating nuts in any form, fried fatty foods, white bread, white flour, cakes, puddings etc.

Healthy eating habits are a must for leading a healthy lifestyle. Also, Yoga and meditation helps to a certain extend. Daily brisk walks are essential for keeping a control over sugar levels.

So, in short what we must be able to achieve in our diet plan!!!!

  • Lower in calories
  • Higher in complex carbohydrates found in vegetables, fruits, beans, and whole grain cereals
  • Lower in saturated fats like butter, cheese, and fatty meat
  • Higher in mono and polyunsaturated fat like olive oil or canola oil

Foods and drinks to avoid include:

  • Fried foods and other foods high in trans fat and saturated fat
  • Foods high in salt, also called high sodium
  • Sweets, such as baked goods, candies and ice cream
  • Beverages with added sugars, such as juice, regular soda, and regular energy or sports drinks

Drink water instead of sweetened beverages. Consider using a sugar substitute in your coffee or tea. Stevia would be a good alternative.

If you drink alcohol, drink moderately—no more than one drink (30 ml) / a glass of wine a day if you’re a woman or two a day if you’re a man. When you use insulin or diabetes medicines that increase the amount of insulin your body makes, alcohol can make your blood glucose level drop too low. This is especially true considering you haven’t eaten in a while. It’s best to eat some food when you drink alcohol. Also avoid smoking.

Best wishes for a healthy and happy life.

Dr. Nikhil Prabhu ( Diabetes Specialist )

Dr Nikhil Prabhu is a consultant Diabetologist from mumbai. he has been practicing for more than 10 years and currently over 7000 patients are under his treatment for diabetes and thyroid disorder from mumbai and navi mumbai area. | you can book his appointment for tele-consultation on 9082523295 | follow us on YouTube for more diabetes & health related tips

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Health Benefits of Healthy Breakfast

Health Benefits of Healthy Breakfast :

  1. Enough fuel to help you perform daily activities without feeling lethargic or sluggish.
  2. Helps in weight loss.
  3. Helps improve motor skills in children.
  4. It influences what you indulge in eating the rest of the day.

Have your breakfast between one hour of waking up.
A good 😊 breakfast should compromise of complex carbohydrates, low fat protein and fruit.
Food 🍲 items like upma, poha, idlis, dalia can be replaced with ready to eat and ready to cook ereals like oats, cornflakes, wheat flakes or muesli.

dontskipbreakfast
Options for breakfast:

  • Moong dal chila
  • Oats vegetable idli or uttapam
  • Multigrain pancakes
  • Sprouts poha
  • Vegetable dalia
  • Rava dhokla

Symptoms of skipping breakfast :

  • Reduced attention level
  • Hypoglycemia
  • Weakness
  • Lethargy
  • Headache
  • Weakness
  • Fatigue

Jayti Shah

Jayti Shah, a dietitian consultant and a certified diabetes educator at Haut Diabetes Care Clinic and Good Health Superspeciality Clinics and Diagnostics.

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