
July 6, 2002
Meal Planning, Food and Diet
Question from Hawaii, USA:
I have just been told that I have type 2 diabetes, but I won’t take any classes for about a month, and until then, I would like to know how many carbs I can have. I know that I need to cut out sugars and carbs, but everything has some carbs in it. what range should I stay in (such as up to 50 carbs)?
Answer:
The dietary management aspects of diabetes need to be individualized for you by a dietitian, as this will depend on a number of factors including your current blood sugar levels, your weight management goals, your caloric intake, and your activity levels. Even prior to the diabetes education classes that you will be taking, you can meet one-on-one with a dietitian to develop a meal plan to meet your needs.
A lower carbohydrate approach can certainly be helpful in controlling the blood sugar elevations that occur with meals. Generally, limiting carbohydrate in the meal to 30-45 grams and in snacks to only 15-20 grams will cause less of a rise in blood sugar and would be considered lower in carbohydrate. You may find the book The Schwarzbein Principle by Diana Schwarzbein, MD to be helpful in presenting this approach. Using your glucose meter to check blood sugars one to two hours after a meal or snack will show you what effect that particular carbohydrate intake had on your blood sugar level.
DMW
Additional comments from Lois Schmidt Finney, diabetes dietitian:
The limiting of carbohydrates, whether in someone with type 1
or type 2 diabetes certainly has proponents both ways, but I think most dietitians go with limiting of fats, not carbohydrates, due to the much higher risk of cardiovascular disease in those with diabetes. I did read the article in the New York Times and found it quite interesting/provocative.
I think the jury is still out on many issues with regards to diabetes and nutrition, as the
glycemic index and the whole high or low carb diets. Basically I say moderation is best, but some new studies due to come out should help answer some questions. To me, it seems like increasing the use of omega three fatty acids in those with diabetes may be the way to go, and those calories have to come from some place. So, I have been recommending that we take those calories to cover the omega 3s from CHO foods, thus decreasing the percentage of calories from carbohydrate to about 45% or less.
LSF