What is diabetes?
Diabetes is a group of diseases characterized by high blood sugar.
After eating, blood sugar rises. This is a good thing! Our body uses this sugar for energy. A hormone called insulin allows the body to use blood sugar for energy. In diabetes, there is either not enough insulin, or it does not work properly, and the sugar in the blood is not used efficiently. This leads to high blood sugar levels.
Untreated diabetes and prolonged high blood sugar leads to serious health consequences:
Heart disease and stroke
Chronic kidney disease
Nerve damage
Blindness
Foot and leg amputations
Specifically, Type 2 diabetes is a condition in which the cells of the body stop responding to insulin. The body gradually becomes resistant to insulin over time, and blood sugar levels slowly increase. This can take years!
Prediabetes is the stage in which the cells have started to become resistant to insulin, but blood sugar is not high enough to warrant a diagnosis of type 2 diabetes.
Here is a chart of different blood sugar measurements and how they can inform a diagnosis of prediabetes or type 2 diabetes:
Fasting Glucose | 2 hours Post-Meal | Hemoglobin A1c | |
Normal | <100 mg/dL | <140 mg/dL | <5.7% |
Prediabetes | 100-126 mg/dL | 140-200 mg/dL | 5.7-6.4% |
Diabetes | >126 mg/dL | >200 mg/dL | >6.5^ |
Fasting glucose: Your blood sugar reading upon waking, before your first meal of the day. This is a good indication of how well your liver manages your blood sugar overnight.
2 hours post-meal: Blood sugar levels peak around 2 hours after the beginning of a meal. This is the best time to check your blood glucose after a meal.
Hemoglobin A1c: Also called just 'A1c,' this is a measure of the amount of hemoglobin in your blood that has glucose (sugar) attached. It is expressed as a percentage. This reading gives insight into your average blood sugars over the previous 3 months.
What types of foods raise blood sugar?
Carbohydrates have the biggest effect on our blood sugar.
All carbohydrates are digested as sugar, even if they don’t taste sweet.
Protein, fat, and fiber do not raise blood sugar.
People with diabetes do not need to eliminate all carbohydrates from the diet.
Carbohydrates give the body energy
Fiber is found in carbohydrates and is important for digestion
Carbohydrate foods are delicious! Food is meant to be enjoyed. There is no need to deprive yourself of the foods you love.
How to eat carbohydrates in diabetes
There are three main strategies to eat carbohydrates and keep blood sugar in a healthy range:
Pair carbohydrates with protein, fiber, and/or healthy fat
Portion carbohydrates to about 1⁄4 of your plate
Choose higher quality carbohydrates
Pair carbohydrates
Carbohydrates digest very quickly. This allows the body to use sugar for energy almost immediately. In diabetes, these fast-digesting carbohydrates can cause blood sugar to rise very quickly after a meal with a lot of carbohydrates.
Protein, healthy fats, and fiber all digest very slowly
When eaten with carbohydrates, these nutrients allow the carbohydrates to digest more slowly also
This gives the body more time to efficiently process carbohydrates into sugar, preventing a large blood sugar spike
Portion carbohydrates
You may be wondering, how much protein, healthy fat, or fiber is enough to prevent a blood sugar spike?
The Plate Method is a visual of how you should portion your
plate for optimal blood sugar control:
Fill half of the plate with non-starchy vegetables (fiber)
Add protein to 1⁄4 of the plate (protein)
Fill the remaining 1⁄4 of the plate with carbohydrates
Add some healthy fat
If your plate doesn’t look exactly like the diagram, that’s okay!
The important part is to have at least one food that will help prevent a blood sugar spike – protein, healthy fat, or fiber – with carbohydrates at all of your meals and snacks.
Carbohydrate quality
A high quality carbohydrate has additional benefits other than quick energy, which we get from all carbohydrates. They are also called complex carbohydrates.
These carbohydrates help to keep blood sugar stable. Choose these often.
Whole grains have more fiber, protein, and fat than white or refined grains
Choose whole grain breads, cereals, and pastas
Oats, brown rice, quinoa, corn, and popcorn are other whole grains
Starchy vegetables have extra fiber, vitamins, and minerals
Potatoes, sweet potatoes, corn, butternut squash, beans, and peas are all
Fruit has fiber and valuable antioxidants
All types of whole fruit are high quality carbohydrates
Fruit juices are not, because they do not have fiber
Summary
Type 2 diabetes is manageable, and, in many cases, reversible.
Combine all three eating methods – pairing carbohydrates, portion control, and choosing high quality carbohydrates – as often as possible for optimal blood sugar control. If you don't get it perfect every time, that is okay! Remember, each meal is a new opportunity to create a blood sugar balancing plate. What you do most of the time is what will make the most difference in your blood sugars.