Guide for Counting Carbohydrates
How would you like your favorite entree if it is served without that perfectly boiled rice or a well-blended mashed potato? Anywhere in the world, whatever form they are in, there is an almost universal preference for carbohydrate-rich foods. A day would not seem complete without eating a serving, especially for Filipinos.
Carbohydrate, to a lot of people, means sugar and starches. Technically, this macronutrient is divided into simple and complex. The store-bought table sugar, the candies and lollipops, regular soft drinks, syrups, desserts, fruits, and milk comprise the simple ones. The grains (rice, wheat, oats, barley, corn), legumes (beans and peas), tubers (potatoes, yam, cas-sava), cellulose and other fibers (pectin, hemicelluloce, lignin,gum, mucilage) make up the complex carbohydrates.
Except for fibers which are in-digestible by the human enzymes, and thus, do not provide the body with the needed energy, all of these carbohydrates, whether simple or complex, are converted into the so-called “energy currency” – the blood sugar or what is called glucose.
Primarily, carbohydrate supplies the body with the immediate energy that it needs and secondly, it spares protein (another macronu-trient) from being used for energy so that it can carry out its unique function of building and repairing tissues.
Every cell in the body depends on glucose for optimal functioning. A blood glucose below or above the normal level could have del-eterious effects in the individual, especially in someone with diabe-tes. Hypoglycemia or a blood sugar below normal is characterized by excessive sweating, faintness, headache, pounding of the heart, impaired vision, irritability, and personality changes. Chronic elevations in blood sugar on the other hand, increases the risk for microvascular (retinopathy*, neuropathy*, and nephropathy*) and macrovascular (coronary artery diseases*, cerebrovascular diseases*, peripheral diseases*) complications.
Because of the impact of carbohydrate on the blood glucose after meals, it is important that a diabetic be aware of how much carbohydrate he or she takes. Since most of the simple sugars are easily absorbed and have an immediate effect on the glycemic level, diabetics are advised to take them sparingly and that they should always be covered by oral medication or insulin. Fruits, vegetables, whole grains, and low-fat dairy products are significant components of a healthy diet while providing the glucose for the brain and other organs for them to function efficiently.
For diabetics, especially those who are dependent on insulin in managing their blood glucose level, the amount of carbohydrate in the meals determines the meal time doses of insulin, specifically of rapid-acting (lispro or aspart), short-acting (regular), and inter-mediate (NPH) insulins. Because of the fixed doses of the insulin, which often consists of injections before breakfast and evening meal, these individuals need to eat similar amounts of carbohydrate at regular times that are concurrent with the time actions of their insulin(s), e.g. peak hours and duration.
A health professional, usually a nutritionist-dietitian, can help the individual formulate a simple meal plan and meal pattern showing the daily allowance for carbohydrate.
The total carbohydrate computed for the day will be divided into three major meals and snacks (based on the individual’s preference). Total insulin dose is determined by supplying 0.5 to 1.0 unit per kilogram body weight. Approximately 10 to 15 grams of carbohydrate is needed for every 0.5 or 1.0 unit of insulin. The lower end is used for small people while the upper end may be given to diabetics of big frame size.
A Food Exchange Lists (FEL), one of the basic tools in nutrition, showing the various food groups and their carbohydrate content can help in the planning of meals. The FEL is divided into seven groups or “lists”. The foods included in each list have approximately the same amount of carbohydrate, protein, fat, and calories per exchange and thus, may be substituted or “exchanged” with another food found in the list.
Each diabetic has a unique tolerance for carbohydrate (carbohydrate load). It would be helpful if blood glucose monitoring is done religiously to determine the amount of carbohydrate that can be eaten at a particular meal or snack each day so that adjustments can be made regarding the meals and insulin dose.
While the right kind and amount of food is deemed important in the efficient management of diabetes, a diabetic should not fail to remember that there are other vital factors that can affect glycemic control such as stress, physical activity and illness.
As a famous personality once quoted, “Health is not everything, but without it, everything is nothing.” Effective diabetes management depends on the balance between diet, exercise, and medication. Being in control and knowledgeable in all these enables the diabetic to have power over his/her condition rather than the other way around. So go on, have that delicious lasagna, it will not hurt so long as you know your limit.
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