Updated 13 February 2017

'If you have diabetes, you can't eat carbs'

Many people believe that if you have diabetes you can't eat carbs.


Many people believe that if you have diabetes you can't eat carbs. However, this is not true. The carbs debate has been raging for years among diabetics and non-diabetics. Carbohydrates are not the enemy. On the contrary, your body needs them to function optimally. Carbs are fuel for your body and without them you will have very little energy. They form the foundation of any healthy diet, whether you are diabetic or not.

As carbs are your main source of fuel, it should come as no surprise that they also have the greatest effect on your blood sugar levels. When you eat, your body processes the food into fuel. Even non-diabetics will see a raise in their blood glucose levels after eating – after all, your body’s energy levels are being replenished.

The secret, though, lies in 1) the kind of carbs that you eat and 2) your portion sizes. This is important for both diabetics and non-diabetics. If you eat too many carbs, you will definitely gain weight. And, if you eat carbs that are digested too quickly, it can cause a spike in blood sugar levels followed by a crash.

Carbohydrates are divided into simple carbs and complex carbs. Simple carbs are simple sugars which are digested quickly and are therefore a quick energy source. These are found in nutritious foods such as fruit, vegetables and dairy products, as well as empty-kilojoule foods (with no nutrients) such as table sugar, sweets, alcohol beverages and sweetened soft drinks.

Complex carbs are found in grains, starchy vegetables and legumes. These are rich in B-vitamins, fibre and iron and are burned in a constant, time-release manner, which is excellent to help manage blood sugar fluctuations and to provide sustained energy. An added benefit of the fibre in complex carbs is that it can help lower blood cholesterol when eaten as part of a low-fat diet, and promote weight loss by making you feel full for longer.

What many people don’t understand is that when complex carbs are being refined (by stripping the fibre away) they start to act as simple carbs – they are digested rapidly, causing a spike in blood sugar levels followed by a crash. Refined carbs include cakes, pies, pastries, white bread and flour and white rice – foods found, unfortunately, in abundance in the typical Westernised diet.

To ensure steady blood sugar levels and sustained energy levels, rather stick to whole grains (brown bread, brown rice, wholewheat pasta, high-fibre cereals), peas and legumes (lentils, chickpeas and beans) and starchy veggies such as mealies, potato, sweet potato, butternut and pumpkin. If you are familiar with the Glycaemic Index (GI) you will note that these are also the foods with a lower GI.

Limit your size and number of carbs portions. A diabetic woman with a normal body weight should eat between 3 to 4 carbs serving per meal (45 to 60 grams). Diabetic men with a normal weight can eat 4 to 5 servings per meal or (60 to 75 grams). One carbs serving equals a slice of bread, a small potato, ½ cup of cooked oats, 1/3 cup of cooked rice, 3/4 cup of high-fibre cereal, ½ glas of orange juice, 1 glass of milk, 1 small apple or ½ a banana.



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Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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