If you ask people what do people with type 2 diabetes need to avoid the most common answer is sugar. This isn’t actually what we recommend in practice because we think people should be entitled to enjoy the odd treat like any of us.
That said, people with type 2 diabetes need to have the appreciation that lots of sugar will more than likely spike their glucose levels.
I was recently writing a previous post about whether you can eat fruit with diabetes. The direction of the post started to discuss how you can still enjoy sugar in your diet without spiking your levels.
Therefore, today I thought I’d take some time to explain how this works in practice and give some practical tips you can use as of today.
First, what spikes glucose levels?
Any carbohydrate containing food will increase your blood glucose levels. This is because all carbs are turned into glucose when we eat them and it is glucose we measure in your blood.
Carbohydrate is an umbrella term and so includes many different types of foods. These include starchy carbohydrate, fruit, processed sugar, milk sugars, beans, pulses, lentils and even vegetables. This doesn’t mean you can’t eat these. What it does mean though, is you need to be careful of how much you are eating. Especially with the foods with lots of carbs in them.
How to think about carbohydrates
Your blood glucose response is directly related to the amount of carbohydrate you eat. Some carb containing foods will have low values of carb compared to others.
High carb foods are usually the more starchy foods like rice, pasta, cereal and potatoes and highly processed foods like sweets, chocolate, sugary drinks, juices and sauces.
Lower carb foods are fruits, vegetables, beans, pulses, lentils and milk sugars.
Granted some fruits have a higher carb content compared to other low carb foods. Examples include bananas, grapes and dried fruit but if eaten in a portion controlled manner they are fine.
With type 2 diabetes total carb portions at meals and as snacks are the most important element. If you frequently have too many carbs your blood glucose levels will be high.
This is why we recommend basing your diet around the lower carb foods with modest amounts of the higher carb foods. It means you can have carbs in your diet, which is healthy, without causing big spikes in your glucose levels.
See the bigger picture
The amount of times I hear patients tell me a healthcare professional has told them to cut out bananas is amazing. Just bananas. Nothing else. Then they go home and have a massive plate of pasta or rice or continue eating everything else.
Remember, your glucose levels relate directly to the amount of carbohydrate you eat. So it is the total amount of carbs that is important. Whether that comes from starch, fruit, sugar or milk sugars.
So if you eat rice with dinner, followed by some crisps, fruit and a chocolate bar, you have eaten quite a lot of carb at that meal.
Sometimes this can lead people down a path of cutting out healthy foods such as fruit or slow releasing starchy foods.
Whereas just reducing the portions of carbohydrate at the meal would have done the trick. If you want to improve your glucose levels after meals, it’s down to you to decide which type of carbs you want to reduce or cut out.
I’m always weary of isolated thinking focusing solely on glucose levels because it can lead to healthy foods being cut out. Fruit compared to crisps or chocolate will be much more nutritious even if they have the same amount of carbs. Therefore, I’d recommend reducing the crisps or chocolate before reducing fruit in your diet.
Exchanging any carb containing food for non carb based foods will help improve your glucose response after the meal. I’d recommend starting with foods like chocolate and crisps because these are low in nutrients.
However, I appreciate these foods are tasty and I would struggle to cut them out too. So if you are going to have them, perhaps reduce the amount of starch on your dinner plate or elsewhere in your diet to help compensate for this.
Less carb doesn’t always mean less food. Food swaps allow you to keep similar meals portions but help glucose levels remain stable. Simply reducing the carbohydrate foods and replacing them with foods that have a very limited or no effect on glucose levels can be a good solution. Foods like like vegetables, poultry, meat, fish, beans, pulses lentils are ideal for this.
Another good option is mixing foods like rice and pasta with vegetable alternatives such as cauliflower rice or courgetti. If like me you don’t quite have a taste to completely replace the rice or pasta, just a 50/50 split can make a big difference. This means you can have bigger portions but with less carbs and calories.
Okay, so how can I have my cake and eat it already?
Hopefully you’ve grasped the concept by now. The more carbohydrate you eat the higher your blood glucose levels will rise.
So if you know your going to eat pudding or any other delicious treat what do you need to do?
Did you say eat less carbohydrates before the treat or eat less of the treat? Correct!
If you are going to eat these foods you need to watch the total carbohydrate at that meal or snack. With a small treat like a small chocolate bar you may still get away with a normal portion of carb at your main meal. If it is a chocolate fudge brownie cake with ice cream perhaps not so much. It’s probably a good idea to have only protein and vegetables at the main meal. I.E. no carb with the main meal.
This stops you stacking carbs upon carbs and reduces post meal spikes.
If this is a once in blue moon occurrence and usually your glucose levels are good then you can probably just go for it – within reason. A one off spike in your glucose levels will not do you much harm. It is only if they remain elevated it becomes a problem.
You can use the above food swaps for ideas and there are plenty more available online.