Carbohydrates supply energy
Carbohydrates, also called carbs, are the sugars and starches in breads and grains, potatoes and other vegetables, and in fruits and beans, and those foods are the major contributors of carbs as a source of energy needed by the body’s cells. After eating carbohydrate foods, the digestion process breaks them down and the glucose content is passed through the walls of the intestines into the bloodstream and there circulates to reach the cells that require glucose.

How can we determine which foods can be considered as low carb foods?
Not all carbohydrates are the same in their immediate impact and speed of entry into the bloodstream, and it is the rate at which they are reduced to the sugar in the form of glucose that helps define whether they are considered as low carb foods or otherwise. Carbs can also be classified as refined or unrefined, with white breads, pastas and white flours being especially considered as refined carbs while foods such as whole grained breads, fruits, beans and most vegetables are classified as unrefined.

To indicate the relative rate of entry of carbs into the bloodstream, a scale has been devised called the Glycemic Index, also referred to as the GI for short. The GI ranks individual carbohydrate food items with an index number that compares them to glucose that has the assigned value of 100. The other food sources are ranked in the relation of their speed of conversion to glucose and for convenience are categorized as follows:

• high carb foods have GI values higher than 70
• medium carb foods have a GI value of 56 to 70
• low carb foods have GI values of 55 and lower

As can be seen, the low carb foods provide sugar at a slower rate of entry into the blood stream and this allows the body to more easily maintain a balanced amount of sugars in the blood. The high carb foods on the other hand, tend to cause spikes, blood sugars elevated to higher levels, not a preferred condition and certainly potentially harmful for people with diabetes or prediabetes.

A great deal more can be said on the topic of carbohydrates. We should distinguish between low carb foods and low carb diets. Low carbohydrate diets restrict the proportion of any types of carbohydrates in relation to the proportions of proteins and fats, whereas low carbohydrate foods can best be described as those that have lower Glycemic Index values.

Many well-known diet approaches using low quantities of carbohydrates have been described in such best selling books such as The Atkins Diet and The South Beach Diet. Taking opposite views to those popular books, there are many advocates of a medium dietary intake, represented by about 50 percent carbs, 25 percent proteins, 25% fats with no more than 10 percent of fat being saturated fats.

On my companion website, Diabetes Menu Guide, you might wish to read a related article on low carbs, to do so, just click on this link Low Carbohydrate Approach in Meal Planning. And check out these link for more on the Glycemic Index and Glycemic Load.

The amount of carbohydrate in a meal or in a food item will not usually comprise the entire calorie amount of any food. To adjust the measurements for this, the Glycemic Index has been modified to produce a companion set of numerical values called the Glycemic Load. The Glycemic Load takes into account that particular amount of carbohydrate in an entire food item, giving a set of values.

High glycemic index carb foods include:

White and non-whole wheat breads, pastas, many breakfast cereals, potatoes, baked goods.

Low glycemic index carb foods include:

Fruits, many vegetables, whole wheat breads, legumes (beans and peas)

When consumed in reasonable amounts, some low glycemic load carb foods are:

Breads - whole grain pumpernickel bread, Soy and flaxseed bread, other whole grain breads.
Breakfast cereals – cooked oatmeal, All-bran, Bran Buds.
Fruits ans berries – grapefruit, strawberries, cherries, watermelon, apples, pears, peaches, plums, grapes, oranges, blueberries, raspberries, and others
Vegetables – cabbage, spinach, lettuce, kale, chard, broccoli, cauliflower, and most others.
Dairy and soy foods – soy milk, low fat milk, low fat yogurt
Nuts and seeds – flax seed, peanuts, cashews, walnuts, almonds, pecans, brazil nuts, hazel nuts – Nuts should be raw or dry-roasted.

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. . . as devised by my health care team

Factors to consider in determining a diabetic food list

The dietitians at the Diabetes Education Center of my local hospital devised a meal plan for me that is based on and built around the amount of carbohydrates they believe should be in my daily diabetic food list. And that, together with the necessary background, is what I would like to share with you, knowing that we are all different but the methods and factors leading to establishing the diet should be similar for most individuals. But first, some general information about foods and nutrient categories.

Carbohydrates, Proteins, and Fats

The nutrients in the foods we eat, and need to eat to keep us alive, are proteins, carbohydrates and fats. We also need water, vitamins, minerals, and fiber. But it is the major nutrient categories that we are concerned with here and the ratios of those nutrients that go to make up our daily food list.

Carbohydrates are the major source of energy needed by all the cells of the body to function and perform their myriad and constant chemical activities. Sources of carbohydrates are breads, pastas, grains, puddings, sweets and deserts – and those are not always the best sources to include in the diabetic food list. For breads choose the whole grain versions. Other carbohydrate sources include vegetables, fruits, beans, nuts, and low-fat dairy products

Proteins are needed for growth and maintenance of muscles, organs, and body tissues among other things and the main sources of proteins in our foods are from beef, fish, poultry, eggs, dairy products, seeds, and nuts.

Fats, also a source of energy, are needed to assist in the functioning of the body. Dietary fat provides essential fatty acids that our bodies do not manufacture. Fats are an important component of a healthy diet.

Although we are all different in body shape and size, most of us maintain our weight within a narrow range of a few pounds through eating similar amounts and types of meals each day. The foods we consume provide the energy needed to sustain life and the amounts of energy provided by the various foods are measured in units called calories.

About food and calories

Any of the calories of energy obtained from our food intake that is not immediately needed by the cells of our body is stored for later use in the body’s fat cells. It is the continued accumulation of that excess energy obtained from the foods we eat that results in us becoming fatter. So to avoid gaining weight, don’t eat more calories than you need each day, but that leads to another topic for discussion elsewhere.

Different categories of food provide different amounts of calories. Food amounts can be measured in grams or ounces, in North America the gram weights are more usual. For each one gram of weight, carbohydrates and proteins provide 4 calories and fats provide 9 calories.

To maintain current weight

The body needs a supply of energy all the time, whether we are active or not. The total number of calories required by an individual each day in order to supply their energy needs, and maintain their current weight, depends on several factors and can easily be calculated. Those are, mainly, current weight, height, gender, and level of physical activity, where the more active and strenuous work and life-style demands will require more calories for their support.

As a general guideline, the American Heart Association answers the question; “How many calories should you eat each day?” by offering a chart showing gender, age, activity levels (sedentary, moderate, active) but does not take into account height and weight. From this chart it can be seen that a moderately active female between 30 and 50 years of age requires 2000 calories per day compared with a male of the same age and activity level who would require 2400 to 2600 calories per day. Those amounts will be too high for people of generally smaller stature.

But there are Calorie Calculators available on the internet that can be a little more precise. I favor the one at Freedieting.com that requires the following input and provides an estimate of calories needed to support them. You will note the appropriate activity level must be enetered.

Maintenance:    XXXX Calories/day

Fat Loss:         XXXX Calories/day

Extreme Fat Loss:     XXXX Calories/day

Using the above calculator, I have determined that my own calorie intake should be about 2000 calories per day, a lot lower than the 2400 to 2600 given by the American Heart Association chart but I am older, perhaps less active too.

Looking further, I see that for a moderate diet it is suggested that the daily food list it should be comprised of 45% carbohydrates – 900 calories, 30% protein – 600 calories, and 25% fat – 500 calories.

That is a lower percentage of carbohydrates than is suggested by the American Diabetes Association, and a higher percentage than is suggested by the doctors who advocate the Low Carbohydrate approach to treating diabetes.

Caution:
Please keep in mind, that the above charts and tables are meant for the healthy non-diabetic person and we diabetics should consider them only for comparison while we continue to seek advise from the medical professionals who are treating us for diabetes.

But now, let us see the percentages of carbohydrates in the diabetic food plan devised for me by my local Diabetes Education Center. To do this go to: My Own Diabetic Food Plan Part 2.

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My Diabetic Food Plan is based on the inclusion of specified amounts of carbohydrates in each meal and snack throughout the day, as listed below.

There are no specified amounts for the other nutrients, the proteins and fats, that, although essential to maintain the body in good health, play only a minor role as a source of glucose –  except in the absence of carbohydrates.

The diabetic food plan has been devised for me by the dietitons at the Diabetes Education Center of my local hospital. It is simple and easy to follow and is printed conveniently on one side of a sheet of paper. It merely lists the suggested number of grams of carbohydrate for three main meals eaten about four hours apart and interspersed with a snack about two hours after each meal. And I have added an extra snack at or before bedtime.

The rest of the Food Plan page is taken up with lists of half a dozen foods in 15 gram quantities under the headings Vegetables, Fruits, Dairy, Breads etc., and Snacks. The 15 gram quantities make it easy to calculate how many portions of any category need be selected to make up the required meal amount for carbohydrates, providing a sort of mini diabetic food list.

The details, the amounts of carbohydrates recommended
Breakfast, at 8 0’clock, is 60 grams, Lunch about mid-day is 45 grams, and Supper (called dinner by some) at about 6 pm is also 45 grams. The snacks are each 15 grams, that’s a total of 60+15+45+15+45+15+15 = 210 grams. Those are carbohydrate grams @ 4 calories per gram which equals 840 calories of carbohydrate each day. That is a little less than the amount suggested by the Calorie Calculator referred to in Part 1 of this article, which was 900 calories, but close enough.

There is no limit to the amounts of protein or fat on this dietary plan but common sense tells me that if I eat too much I will gain weight and that is something I don’t wish to do.  The Calorie Calculator suggested that my total calorie intake should be about 2000 calories, with 840 taken up by the carbohydrates, it means 1160 calories for the proteins and fats allowance for the day.

Referring to the Calorie Calculator again, it suggests 25% fats in a 2000 calorie daily food intake, that’s 500 calories @ 9grams of fat per calorie = 56 grams of fat approximately, leaving about 660 grams of protein to provide the 2000 calories.

My plan provide 210 grams of carbohydrates daily
To summarize the rather lengthy description above, my diabetic food plan provides 2000 daily calories from 840 g, carbohydrates, 660 g, of protein, and 56 g. of fat. s

COUNTING CARBOHYDRATES IN A DIABETIC FOOD PLAN

Carbohydrates are the main nutrient source of glucose and will have the biggest effect on  blood sugars. The foods supplying the protein and fat, while providing a minor amount of glucose, will not affect blood sugar levels. Those foods include meat, fish, poultry, eggs, cheese, margarine, and oils — but they can, of course, increase weight and cholesterol if eaten in too large a quantity.

For the carbohydrate portion of a meal, I can choose from the following food list, each item  contains 15 grams of carbohydrate. For more choices, I can add 15 gram amounts of whatever carbohydrate foods I wish to the lists.

For the Newly Diagnosed Diabetic -  Read this First
The cells of our body derive energy from sugars, in the form of glucose, obtained from our daily food intake, especially from the carbohydrate portion of those foods, Food also supplies the proteins and fats that, together with carbohydrate, are essential to the nourishment of the individual.

In a healthy person, the levels of glucose that circulate in the bloodstream, mainly as a result of the digestion of the food consumed, are maintained within a safe range by a series of chemical reactions that constantly take place in the body.

Diabetes, a serious disease, is the condition in which a person’s body is unable to properly regulate and control the levels of sugar in their bloodstream in the way that a healthy person does.

As yet, medical science has not been able to provide a cure for diabetes, To treat a patient suffering from diabetes, referred to as a diabetic, it is necessary to implement a regimen of dietary and exercise procedures that, together with prescription medications, can help control the blood sugar levels that otherwise will inevitably lead to major complications and increase the risk of several serious conditions, including cardiovascular disease, the leading cause of death in the diabetic population.

In addition to the large number of people who are known to be diabetic, there is also a large number of people who have the disease without knowing it, possibly because they have not had a recent, or perhaps any, medical checkup,

Important to note: Anyone who is known to be diabetic must be under the care of a physician.

Doctors monitor the diabetic condition of their patients, guided by the results of periodic blood tests, and will prescribe medication if deemed necessary. Aided by nutritionists or other health-care providers, the doctor will probably advise the steps that the patient should take to lower and control the blood sugar levels, also referred to as blood glucose levels, to within a close to normal range.

Five factors in the management of diabetes

The first factor: To be effective, the management of diabetes requires that an appropriate daily food plan be diligently followed, not special foods, but the right foods chosen from the vast amount and range of foods available. Available, that is, to the citizens in the developing world, and then again, diabetes is the growing disease of the developing Western World. There are few foods that are off-limits but quantity and quality must be taken into consideration.

The second factor is the requirement for regular exercise, not necessary at the athletic level but more than a casual stroll each day. Commonly suggested is to take a brisk walk for half an hour each day, or at least five times a week. Or it could be swimming or bicycle riding or whatever achieves at least that equivalent minimum amount of exercise.

The third factor involves weight-loss. If a diabetic person is overweight it increases the level of serious heart and other health risks. The first two factors, described above, can help reduce weight if properly applied, but before implementing any weight-loss program, a consultation with a doctor would be wise.

The fourth factor is that a once-a-day personal in-home blood test should be taken. The blood test is done with the aid of a simple and easy to use measuring device, just takes ten or twenty seconds to obtain a reading that indicates the amount of glucose in the blood stream. If done once each day then most likely it should be on rising, before breakfast or any food intake, in other words a fasting blood sugar level – as it is commonly referred to.

Monitoring the blood glucose levels at home each day enables the diabetic to know their condition and if necessary, make adjustments to their dietary plan and/or lifestyle in a best effort to correct blood sugar levels. This may require more daily blood tests than just the morning test. It is a fact of diabetes that much of its management is in the hands of the diabetic personally and requires frequent checks to try to gain control.

The fifth factor: Periodic attendance at the doctor’s office for checkups, and blood tests, known as the A1c or Hemoglobin A1C blood test. The blood for these tests, a simple painless procedure, is taken by a technician at a medical clinic, and are normally required every three or four months. These tests provide essential information of the estimated average glucose content existing in the blood over the prior period of about 3 months. This test result is possible because the life-span of blood cells, that are constantly manufactured by the body, is approximately 12 weeks, so some of the blood cells are just newly born while others will be of any age up to about 12 weeks. With the A1c blood test results available, the doctor can monitor and assess, and adjust if necessary, the treatment to best combat diabetes.

For a further explanation of blood tests, visit Blood Testing for Diabetics on my companion site where you will also find other items of interest to diabetics under the site name:  Normal Blood Sugar Levels and Diabetes.

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The Glycemic Index, or GI for short, is a list of carbohydrate containing foods that have been rated for their speed of conversion to glucose, and the release of that glucose into the bloodstream, compared to a standard reference value of 100 assigned to pure glucose. Pure glucose being very speedily released into the bloodstream since it does not require any further chemical breakdown by the digestive-system as would other food items.

The higher the numerical grading of a food the faster it is absorbed into the bloodstream compared to other foods of lower numerical value. Examples of this would be the breakfast cereals:

All-Bran with an established GI of 42,
Shredded Wheat with a GI of 67, and
Corn flakes with a GI of 84,

indicating that the carbohydrates in Corn flakes are converted much more quickly into glucose than the other two cereals with All-Bran taking the longest time. A faster release of glucose causes a faster and higher spike in blood sugar elevation, something to be avoided, or at least minimized if possible, leading to the conclusion that All-Bran is a better cereal choice than the others to include on the diabetic food list.

But not all high GI foods are bad and there are times, such as before, during, and after exercising, when they are beneficial. The body reacts to the higher blood glucose by releasing insulin, a hormone that assists the body in building muscle, although we must always keep in mind that the diabetic person’s body has an impaired ability to deal with insulin and higher blood glucose. These matters would be better discussed and commented on by the diabetic’s doctor or qualified health team members.

Many foods, such as proteins and fats, do not contain significant amounts of carbohydrate and are not listed on the glycemic Index.

The glycemic index is a useful tool to aid in choosing carbohydrate containing food items to include in a diabetic food list, enabling an emphasis on those with lower index values. But the inclusion of low GI foods in a diabetic food plan is only one of several considerations in determining an appropriate dietary regimen to follow over the long term.

GI range of values

Low GI values are 55 or less
Medium GI values are 56 to 69
High GI values are 70 and above.

The Glycemic Load
But what if the carbohydrate food we eat is only part of a larger meal that is otherwise devoid of carbohydrates, perhaps a meal of mostly protein and fat, of meat, vegetables, fruits, that have little or no carbohydrate content? In that case, measuring by weight in terms of grams, the carbohydrates would  be only part of the total grams in the meal and from this an adjusted GI value can be obtained by applying a simple formula..

To cover that situation, there is an extension and enhancement of the glycemic index known as the Glycemic Load. The glycemic load derives a set of values from those of the GI by taking into account the quantity, or quantities, of carbohydrates that are actually in the total meal of food item.

It becomes more practical to consider the GL of a food item when it is only a relatively small portion of the food being consumed, even if it is has a high GI rating,.

For a simplified example: when  knowing that one cup of the 84 GI cornflakes weighs about 30 grams, we can easily calculate the proportion of the cornflakes to the weight of the total meal. When being considered as part of a larger breakfast meal of 120 grams weight, it would be 25 percent of the total and that becomes the glycemic load value. 25 percent of the 84 GI is 21, the GL value of the cornflakes in the breakfast.

GL ranges of values
A GL value of 21 is still rather high, the substitution of a lower GI cereal such as Bran flakes or oatmeal porridge  would achieve a much lower GI rating. A GL value below 10 is considered to be low and above 20 is high in the opinion of most nutritionists.

An important decision regarding carbohydrate consumption
A major decision rests on what percentage of carbohydrates will be included in the overall diabetic food plan, whether to follow the American Diabetes Association’s recommendations of a high ratio of carbohydrates, or the opposite approach of lower carbohydrates, or somewhere in between. This is a controversial subject for many health care practitioners and needs careful consideration and discussion elsewhere. There are strong advocates whose differing views are worth hearing, even though a diabetic patient mainly depends on his or her personal physician to provide guidance, much of the management of the diabetic condition is in the hands of the individual diabetic.

The food lists available from this blog-site do provide the nutrient content and information for many common food items, indicating whether high or low on the GI and some food groups in general are summarized. For a very complete listing of GI values the following resources are suggested – although doing the research can get rather complicated and time consuming:

1.  The University of Sydney, Glycemic Index Web site.

2.  David Mendosa, blogger and medical writer.

3. There is also a very good article and explanation by staff of the Linus Pauling Institute at Oregon State University. That explanation references the GI to cardiovascular disease, a major complication of diabetes, and to obesity, to cancer, and to gallbladder disease. With its comments on several other topics of interest, it is worth a read and can be reached at Linus Pauling Institute.

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Food Lists – with essential supplementary information

This site provides a link to the Food Lists on our companion blog-site, Diabetic Menu Guide, where  the various categories of food items such as Vegetables, Meats, Fats, Fruits, Fish, Cereals, Dairy, Breads, Jams and spreads, and Drinks are shown together with nutrition details.
To access that information, click:  The Food Lists,

The importance of carbohydrates
Foods are comprised mainly of carbohydrates, proteins, fats, and fiber, and of course, water. One of the most important factors of our diabetic foods is the amount of carbohydrates in our meals. Carbohydrates are a primary source of the glucose that enters our bloodstream and every newly diagnose diabetic should become familiar with the effects of the carbohydrate portion of their meals.

The speed at which carbohydrates are broken down by the body into glucose varies with the individual food item, in some foods it is fast in others not so fast, and the slower it is the better it is for the diabetic.

The Glycemic Index
A widely accepted tool in diabetic food planning is the Glycemic Index, GI for short. The GI is a numerical ranking of how fast individual food items are reduced to glucose and enter the bloodstream compared to a reference standard such as sugar or white bread. The GI is another reference source for diabetics to learn about. In a companion post on this site we provide an explanation of the Glycemic Index and the Glycemic Load.

The Practical Value of the Food Lists Provided on this Site

Since there are few foods that are “off-limits” to the diabetic, it is the accompanying information regarding the nutritional content of the individual servings of the specific food items that is important.

From these values, the total nutritional content can be determined for selected food items that comprise a meal and it can then be seen whether they meet the objectives of the menu plan regarding calories, and the preferred ratios of carbohydrates to proteins to fats.

Although most food items are acceptable to the diabetic, some may require modest proportions and certainly some items are less desirable compared to others, for instance, whole wheat breads are a better choice that white breads.

The diabetic food list includes many food entries and a lot of supplementary information. Why it is necessary to know the nutrient and calorie content of foods is explained below.

If You Are Newly Diagnosed as Diabetic:
The following might be of interest: click on for details
About Diabetes, from my own experience
About Diabetes, a simple explanation

More is needed than just a list of foods
To feed yourself properly, you will need to include the right combination of Proteins, Carbohydrates, and Fats, the primary nutrients needed by the body to sustain life, the building blocks, so to speak, to maintain good health.

So as well as the basic food lists, we include the amounts of Proteins, Carbohydrates, and Fats in those foods, and will be adding the Glycemic Index values and the Glycemic Load values shortly.

And more is needed than just a list of foods and their nutrient content
Why? Because you need to know how much of those foods to include in your diabetic menu to provide the energy needed to carry out your daily activities in the workplace and to support your personal life style activities. Food energy is measured in Calories  so the calorie content of the individual foods is also listed in our lists of diabetic foods.

Calorie content based on individual needs and a target weight
As well as calorie content, even more information is needed to plan and prepare foods for your daily meals. The total daily calories required for individuals varies and should be known at the beginning when first establishing a diabetic meal plan and that can be based on the weight you wish to maintain, or the weight you may wish to gain or lose.

Do not follow a quick weight loss diet plan if you wish to lose weight,  we suggest that weight reduction can best take place in small increments over an extended time in that way the weight lost  is likely to stay “off” – whereas it has been shown that weight loss through quick weight-loss diets almost always is regained. Visit our post on the role of weight-loss in diabetes.

Now in Preparation:
More details on specific food items such as Seeds, Nuts, Fats and Oils, Grains, Vegetarian and Vegan dietary approaches, Regional dietary habits: Mediterranean, Okinawan, etc. High and Low carbohydrate approaches to diabetic menu planning. Etc etc.

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An explanation

Although the main focus of this blog-site is, by definition, on diabetic foods and diabetic food lists, there is much general information regarding diabetes that is worth dealing with here. Information that may be of interest especially to anyone recently diagnosed as having diabetes. And that includes simple explanations of diabetic topics that I myself wanted to find out about when I first became a “diabetic”.

Diabetes is a serious non-infectious chronic and progressive disease affecting about 25 million persons in North America. By chronic and progressive we mean that it is of long duration and tends to grow worse over time. There are three main types of diabetes, known as type-1, type-2, and gestational diabetes, but we will concentrate here on type-2 diabetes the version that occurs in more than 90 percent of all diabetes cases. A brief description of type-1 and gestational forms of diabetes is given elsewhere on this site.

Diabetes is the condition in which too much glucose is circulating in the bloodstream.
This occurs because of an impaired mechanism that normally operates in the body in a series of steps prompted by signals from other organs that react when food enters the stomach after eating.

The procedure involves an organ called the pancreas that produces insulin, a hormone that has the ability to join with glucose in the blood as it travels to the organs and cells of the body. Glucose is a simple sugar, a carbohydrate, and is the major source of energy needed by all the cells of the body in the performance of their metabolic functions. Some cells, such as brain cells and red blood cells, depend solely on the delivery of glucose from the blood stream.

If we think about that for just a moment, we can understand why our diabetic condition, with its impaired ability to deliver glucose to our brain and other cells, is so serious and that we must take appropriate actions to minimize the negative effects.

When we eat food it passes into our stomachs where digestion takes place and the mechanical and chemical actions of digestion process the food and produces the many nutrients, including glucose that is mainly obtained from the carbohydrate content of the foods we have eaten. The nutrients are absorbed through the walls of the intestines and pass into the bloodstream that will then distribute them to all the organs and cells of the body.

The body can keep a constant supply of glucose for the cells by maintaining a constant level of glucose in the blood. When needed it is there for the cells and when, after eating, an excess builds up and an over-supply occurs, the body, through its marvelous mechanisms, stores the excess glucose in the liver and muscles by converting the glucose into glycogen, which is a long chain of glucose molecules. If glucose levels become low, the stored glycogen is available for conversion back to glucose and at the same time the body stimulates the brain to urge you to eat more food.

But the glucose cannot get into the cells without assistance, assistance that is provided by a hormone called insulin that is mainly produced by another organ, the pancreas. The pancreas also produces a hormone called glucagon (not to be confused with the previously mentioned glycogen, and it is confusing I know) but glucagon plays an opposite role to insulin, It comes into play when the glucose levels begin to get too low and then assists in the conversion back to glucose of the previously mentioned stored glycogen in the liver and muscles.

The actions of both of those hormones, insulin and glucagon, work constantly to keep glucose concentrations in the blood to within an acceptable ranges for good health. In the case of the diabetic that balance is impaired and the glucose levels are not maintained within the appropriate ranges.

Insulin performs several important functions, one of which is to carry glucose molecules and conduct them to receptors that are on the outer membrane of cells where the unique structure of the insulin molecule complements the unique structure of the receptors, allowing them to “dock”, that is, to join together, and thereby the glucose is released and enters into the cell, another almost miraculous process of life.

In diabetics, this system does not work properly if at all
For several possible reasons, in persons suffering from diabetes the system does not operate in the way described above. Sometimes the pancreas does not produce enough insulin and sometimes the receptors of the cells become desensitized and do not react properly to the presence of insulin, not permitting the absorption of glucose into the cells and sometime it is a combination of both of those conditions.

Because of this the glucose stays in the bloodstream, and insulin too, both of which are unhealthy conditions. And too high a level of glucose in the blood, by definition, is diabetes.

So it is worthwhile to learn about certain foods and whether they are appropriate, as a diabetic,  to eat as an everyday item. A single favorite treat,  such as a muffin eaten at snack time each day by many people, is probably too much of a burden for the diabetic. That and a few others may have to be left off the diabetic food list, perhaps to be included only occasionally when in good control of blood sugar levels.

Also, a dietary adjustment, as recommended by dietitians and health care professionals may alleviate the diabetic conditions to some extent.  But even the adoption of a new dietary regimen may not be sufficiently effective and medications may need to be prescribed. For many, including myself, that becomes a path to increased medications and potential problems – but we will deal with that elsewhere together with other aspects of diabetes.

Meanwhile, for information on a variety of other topics dealing with diabetes, in addition to this site, you can check out my companion sites at Normal Blood Sugar Levels and Diabetes and Diabetic Menu Guide.

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The objective of a dietary plan or diabetic food list for the diabetic person is primarily to aid in the control the amounts of glucose in the bloodstream and to keep the glucose levels within as narrow a range as possible so that they do not exceed acceptable levels by too great an amount.

There will be spikes in blood glucose levels after eating a meal or snack that will vary based on the type of food eaten and its carbohydrate content and the speed in which the resulting glucose is produced when digestion of the food takes place. That is why it is good to know, when compiling a diabetes food list, which foods are the source of the highest carbohydrate content and are the speediest broken down to glucose,  so that they can be eliminated or at least limited in quantity. Those can be identified by reference to the Glycemic Index and Glycemic Load index avail able elsewhere on this site.

To maintain glucose levels as evenly as possible throughout the day it is often suggested that meals should be of about the same size and interspersed with snacks, rather than any one meal being much larger than the others.

The essential nutrients needed by the body for its energy and maintenance are obtained from the carbohydrates, proteins, and fats in the foods consumed each day. Those foods are broken down to their nutritional chemical components in the digestion process and released through the walls of the intestine to be carried in the bloodstream to the many organs of the body where they are then selectively taken up as required into the body’s millions of cells.

When present, the carbohydrate fraction of the foods is the main source of glucose in the bloodstream and so it is the carbohydrate content of foods that is the major factor around which diabetic food plans are constructed. The more carbohydrates there are, the more glucose will end up in the blood stream. After a meal or snack, when glucose is produced, the impaired body mechanisms of the diabetic person in the production of insulin, needed to conduct the glucose into the cells that require it, and the desensitized sensors on the outer membranes of those cells, results in the unhealthy levels of the glucose remaining in the blood.

From that statement the question could be asked:
“Then why not reduce the amounts of carbohydrate to a minimum so that less glucose is produced to overload the bloodstream?”

That is a good question that would seem to require an answer in the affirmative. But the diabetic associations of most countries do not seem to concur.

The High Carbohydrate approach
The ADA (American Diabetes Association) and others recommend what can be considered a high carbohydrate diet of 50 to 60 percent Carbohydrates, 15 to 20 percent proteins, and 25 to 30 percent fats based on total calories consumed. A calorie is the unit applied to the measurement of energy provided by components of food.

The Low Carbohydrate approach
Although in the minority, many physicians advocate an “Anti-ADA” approach that, conversely, recommends a low carbohydrate content in meals to minimize the amount of glucose that can enter the bloodstream.

A number of books have been published by doctors providing details on diets that have successfully brought their patients to a reversal or near reversal of their diabetic condition or at least a very good control of their glucose levels. The carbohydrate content of those diets is low, from about 20 to 35 percent. There are many different versions, you’ve probably heard of the Dr.Atkins and South Beach Diets, but there are others, some less extreme than those.

The American Academy of Family Physicians defines low carbohydrate diets as:
“Low-carbohydrate diets restrict caloric intake by reducing the consumption of carbohydrates to 20 to 60 g per day (typically less than 20 percent of the daily caloric intake). The consumption of protein and fat is increased to compensate for part of the calories that formerly came from carbohydrates.”

It should also be noted that the American Diabetes Association, after carrying out their own clinical studies with patients on a low carbohydrate diet, agreed that the low carbohydrate was successful in achieving lower blood glucose levels. However, their stated opinion was that such a diet was not likely to be adhered to for a sufficiently long period of time and they therefore keep to their current recommendations regarding carbohydrates. For additional information on lower carbohydrate foods, see our companion site: Diabetic Menu Guide and the reference to low carbohydrate effectiveness can be found in our post :  Low Carbohydrate Approach.

There are other health concerns voiced by members of the medical and health care profession in which reservations are expressed regarding the adoption of a low calorie diet.

Caution:
All matters of diet, exercise, weight-loss, and especially any changes being contemplated, should be discussed with your doctor who will provide guidance on your treatment and should refer you to other health care professionals for more complete answers if necessary.

One other factor regarding carbohydrates is that they exist in several different forms that are usually classified as either “simple” or “complex”. The difference being in their chemical structure that results in a speedier breakdown to glucose for the simple form and a longer time for the complex forms. This makes the complex forms generally more favorable to include in a diabetic menu plan and a special index, known as the Glycemic Index, has been devised to rate the varying speeds of conversion of carbohydrates to glucose.

Vegetarian, Vegan, and Others
There are other dietary approaches that are effective in the management and control of blood glucose and that do not so much emphasize the carbohydrate content of foods. Among these are the Vegetarian and Vegan life styles that have many virtues from a viewpoint of nutrition. They concentrate on vegetables and fruits that are automatically low on the Glycemic Index, the speed in which their carbohydrate content is converted to glucose.

However, in North America, only a small percentage of the population follow a vegetarian or vegan regime, we are a meat-eating and fat-rich food consuming nation.

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