What is too much carbohydrate?
| Author: Judy Kohn, RN, BSN, CDE |
| Last Updated: Tuesday, March 28, 2006 |
Q: "How can you tell when you are taking in too much carbohydrate with your meals."
A: This is a very valid question, with no easy response. The short answer is: if your blood glucose 2 hours after the start of a meal is above your target goal, then you might be eating too much carbohydrate (CHO). But it is not that simple.
Target goal: The American Diabetes Association (ADA) has recently emphasized the importance of controlling not only the pre-meal blood sugars, but also the 2-hour post-meal blood sugars. Because target goals should be individualized, based on your age and individual circumstances, you need to verify your target blood glucose goals with your healthcare team.
Weight control: If you are overweight and currently working on lifestyle changes, your healthcare team may allow you to have slightly higher target goals for a while, knowing that as your weight comes down, insulin resistance will decrease, and your blood sugars will improve.
Your individual meal plan: There is no standard amount of carbohydrate allowance that applies to all people-i.e. there is no "one size fits all" diet. National standards for diabetes management dictate that you should have a referral to a dietitian who can assess your particular eating habits and situation (including A1C, blood lipids, etc.) and recommend the appropriate meal plan with a specific amount of carbohydrate for each meal and snack.
Appropriate diabetes medication: You might be eating exactly the amount of prescribed carbohydrate, and exercising regularly, but if you aren't on the proper dose of diabetes medication (insulin or oral agents), your 2-hour post meal blood sugars could run too high. So in this case, the food is not the problem-rather, the diabetes medication needs to be adjusted. Furthermore, I have counseled many people with diabetes who were diet controlled-i.e. on no diabetes medication-who kept reducing their carbohydrate intake until they were barely eating anything, all because their 2-hour post meal blood sugars were still too high. In this scenario, the answer is not to starve to control blood sugars, but rather that likely it is time to consider starting a diabetes medication.
Activity: If you are eating appropriately but have recently decreased your activity, then your blood glucose levels might run higher. So, of course in this case, the cause is not too much carbohydrate, but rather decreased activity.
Summing it up: After taking all the above information into consideration, you can see that the key points are:
- Confirm your target goals with your healthcare team.
- Consult a dietitian for an individualized meal plan.
- Maintain reasonable and regular physical activity.
- Test your blood glucose both before meals and 2 hours after meals to verify that you are in your target range.
- Continue assessing your control, with regular visits with your healthcare team.
Related Questions
Postprandial (Post-Meal) Glucose
Q:
"I have type 2 diabetes. In class much emphasis was put on the blood sugar
2 hours after I stop eating. Why is this so crucial?"
Glucose Goals
Q:
"What is a good blood glucose reading?"
Related Links
America Association of Diabetes Educators (AADE)
http://www.diabeteseducator.org
American Dietetic Association's Nationwide Nutrition Network
http://www.eatright.org
Joslin Diabetes Center
http://www.joslin.org
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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