Information for patients

Carbohydrates and Diabetes

Sheffield Dietitians

There are many things that can affect your blood glucose levels. These include what you eat, activity, stress, illness, alcohol and your diabetes medication. This leaflet will focus on food and, in particular carbohydrates. Carbohydrates can cause big changes to your blood glucose levels. Understanding more about carbohydrates will help you to better manage your diabetes.

1. Know Your Carbohydrates Foods containing carbohydrate Starchy carbohydrates Bread, crackers, pitta bread, thick sauces and soups, breadcrumbs, pastry and Yorkshire pudding. Potatoes Rice Pasta and noodles Breakfast cereals Oats Starchy vegetables such as plantains, yams and sweet potato. Baked beans and other pulses such as chickpeas

Naturally sweet carbohydrates Fruit - fresh, tinned and dried. Fruit juice Milk Yoghurt

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Sugary carbohydrates Cakes and biscuits. Ice cream, desserts and puddings. Sugar and honey. Sugary drinks. Jam and marmalade. Sweets and chocolate.

Foods containing very little or no carbohydrate Protein foods

Meat, poultry, fish, cheese, eggs and nuts.

Fatty foods Butter, margarines and other fat spreads, oils, mayonnaise, oily salad dressings and cream.

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Vegetables

Most vegetables and salad

Flavourings Salt, pepper, soy sauce, garlic, ginger, herbs and spices etc.

Sugar free drinks Sugar free drinks - Tea, coffee, sugar free fizzy drinks, sugar free cordials, sugar free flavoured water etc.

Artificial sweeteners Saccharin and aspartame etc. 4

2. Understanding carbohydrates and diabetes How do my meals affect my blood glucose levels? Our meals and snacks are made up of a mixture of carbohydrate, protein and fat. Each one of these affects our blood glucose levels differently. Carbohydrates have the biggest effect on our glucose levels after a meal, as all carbohydrate foods are digested and broken down into glucose. This glucose is then absorbed into our blood stream and causes blood glucose levels to rise. Foods high in protein and fat have less of an immediate effect on your blood glucose levels after a meal. This is because these foods contain very little or no carbohydrate.

Healthy Tip Taking care with your portions of protein and fatty foods will be of benefit to your weight (which affects many aspects of your health including your long term blood glucose levels), blood pressure and blood cholesterol levels.

Is it just the sugary carbohydrates that cause my blood glucose levels to rise? No, it's all carbohydrates. Whether the carbohydrate comes from a starchy food like bread, a sugary food like chocolate or a naturally sweet food like an apple, they are all broken down in the digestive system to the same thing - glucose. So therefore all carbohydrate foods will cause a rise in your blood glucose levels. How much the levels rise, largely depends on how much carbohydrate you eat. 5

Would it be better to avoid eating carbohydrates? Carbohydrates are important to all of us. They are our body's main source of energy. It is important to include these foods every day to fuel your body. Your insulin, diabetes treatment and any physical activity you do will help control the rise in your blood glucose levels after you eat carbohydrates. They help glucose to move from your blood into the cells of your muscles and brain where it is needed for energy. When this happens your blood glucose will return to its usual level.

Healthy Tip For a healthy diet aim to choose mostly unprocessed carbohydrates rich in goodness such as wholegrain foods (whole-grain breakfast cereals, oats, granary bread), potatoes, pasta and rice, fruits, pulses, low fat milk and yoghurt. These are naturally low in fat, and contain vitamins, minerals and fibre. Many of these are low in salt and also have a lower glycaemic index, which is a good thing for people with diabetes. Avoid adding fat to these foods or keep fat to only very small amounts.

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3. Keeping the Balance. Eat carbohydrates in the right amounts at the right times. This is the way to get steady blood glucose levels. Learn how to do this by following steps 1 to 3 below.

Step 1 Similar carbohydrate portions Keep your portions of carbohydrate the same day to day. Each day you are taking the same doses of your tablets and/or insulin. So in a similar way, it is best to keep the amounts of carbohydrate you have at each meal about the same. As a rough guide, approximately one third of your plate should be carbohydrate foods.

Step 2 Eat at the right times Eat a breakfast, midday meal and evening meal, 4 to 6 hours apart. Your food is best balanced with your diabetes treatment when it is spread out evenly over the day. It is not essential that you eat at exactly the same time each day. However, you should take care not to have meals and snacks too close together or too far apart.

Step 3 Take care with snacks Avoid unnecessary snacking and if you need one, choose a small low fat carbohydrate snack. (See ‘Carbohydrate Snacks’ leaflet for ideas). 7

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PD6366-PIL1801 v1 Issue date: July 2011. Review date: July 2013