Should I use carbohydrate counting or the glycemic index for my diabetes?

Carbohydrates (or carbs), like proteins and fats, are an essential part of any person's healthy eating plan. In the case of diabetes, carbs are even more important, as they play a key role in balancing blood glucose levels. However, eating carbs alone will not keep your blood glucose in check. You need to do this while also taking your prescribed medication, exercising regularly and consistently monitoring your blood glucose levels.

It is important to count the number of carbohydrates (or carbs) that you are eating if you have diabetes. While proteins and fats will also affect your blood glucose levels over time, carbs will have a more immediate effect. It is therefore essential that you understand the effect the portions and content of carbs will have on your body, particularly if you are taking insulin.

The trick with carbs is to ensure that you are eating the right amount for your body—and especially your blood glucose. There are three basic principles involved in doing this successfully:

• You need to eat about the same amount of carbs at the same time every day so that you will be able to safely predict their effect on your blood glucose. This is especially important for people with type 1 diabetes who take insulin.
• You need to be clever about food by keeping your meals healthy, fun and filling. Don't feel that every day, every meal must be the same—only your carb quantities should be. Experiment with new recipes, but always keep an eye on the carbs. At the same time, you need to be more aware about food than others. This means that you will need to read food labels, count carbs and create meal plans that work for you. Try to avoid pure sugar in all its forms (syrup, dextrose, etc.) where you can, particularly in packaged or restaurant meals, as these will raise your blood glucose levels.
• Watch your portion sizes. Over time you will learn to almost instantaneously assess the carb count of a plate of food and the effect it will have on your blood glucose. In the meantime, carefully monitor your medication and test your blood glucose frequently.

Research shows that both the amount and the type of carbohydrate in food affect blood glucose levels. Studies also show that the total amount of carbohydrate in food, in general, is a stronger predictor of blood glucose response than the glycemic index (GI).

Based on research, for most people with diabetes, the first tool for managing blood glucose is some type of carbohydrate counting. Balancing total carbohydrate intake with physical activity and diabetes pills or insulin is key to managing blood glucose levels.

Because the type of carbohydrate does have an effect on blood glucose, using the glycemic index (GI) may be helpful in "fine-tuning" blood glucose management. In other words, combined with carbohydrate counting, it may provide an additional benefit for achieving blood glucose goals for individuals who can and want to put extra effort into monitoring their food choices.

Carbohydrates include vegetables, fruits, cereals, grains, pastas, breads and milk. These foods are loaded with nutrition. They provide easily used energy, fiber, vitamins and minerals. They also tend to be lower in calories than foods in other groups.

Sugar is also a carbohydrate. It has long had a bad reputation, especially among people with diabetes. People used to think that eating sugar would cause blood glucose levels to rise much more rapidly than other types of carbohydrates, such as bread or potatoes. So although bread and potatoes were okay to eat, pure sugar or sugar-laden treats were considered taboo. Well, it turns out that the total amount of carbohydrates and its combination with other nutrients, such as fat, are much more important.

Foods that contain sugar can be part of your diabetes plan. You’ll just need to account for the calories and carbohydrates. Keep in mind, sugar has little nutritional value, so filling up on sugars won’t allow you to eat as much as the nutrient-rich carbohydrates.