Carbohydrates & Diabetes

Overview

Carbohydrates, or carbs, are one of the three big nutrients that make up food. (The others are protein and fat.) Carbs are the “fuel” that the brain and muscles need to work well and get through the day. That’s why foods with carbohydrates are an important part of a healthy diet for everyone. For kids and teens with diabetes, carbs really matter because they turn into sugar (glucose) and raise blood sugar levels.

Learn about the types of carbs, how they affect blood sugar, and how to choose healthy carbs to help your child better manage diabetes.

Three Kinds of Carbs: Sugar, Starch, & Fiber

Carbohydrates come in three forms: sugar, starch, and fiber. Getting the right balance of these forms is key to keeping blood sugar in a healthy range.

Sugar

Added sugars raise blood sugar quickly. Try to have your child avoid all drinks with sugar (like soft drinks) and limit foods with added sugar — like cake and cookies — because they make blood sugar spike. Sharp increases in blood sugar make it harder to manage and over time can lead to serious health problems. On food labels, you might see added sugar listed as “sugar,” “corn syrup,” “dextrose,” “sucrose,” or “fructose.”

Foods that naturally contain sugar (like fresh fruit, milk, and Greek yogurt) don’t cause blood sugar to rise as quickly as added sugars and offer a lot more nutrition.

Starch

Some starches raise blood sugar fast, while others raise it slowly. It often depends on how processed a starchy food is. Processed foods are made from ingredients that have been changed from how they are naturally, like hot dogs or potato chips.

Starchy foods that are processed a lot — like white rice and white bread — can raise blood sugar more quickly. In general, starches that are less processed — like whole wheat bread, brown rice, lentils, and oatmeal — tend to raise blood sugar more slowly because they also have fiber.

Fiber

Fiber helps slow down sugar absorption. A diet with plenty of fiber can help people with diabetes keep blood sugar levels in a healthy range. The fiber in foods helps carbs break down and become sugar more slowly, so there's less of a peak when blood sugar rises. Smaller peaks mean blood sugar doesn’t jump too high at once.

Fiber also helps you feel full, and it keeps the digestive system running smoothly. Good sources of fiber are whole fruits and vegetables, nuts and seeds, and whole grains.

What Happens When You Eat Carbs?

After eating, everyone’s body breaks down carbs into glucose (sugar). Then glucose moves into the bloodstream, and the blood sugar level rises. As blood sugar rises, the pancreas releases insulin, a hormone that helps move glucose into cells.

People with diabetes have a problem with insulin:

• In type 1 diabetes, the pancreas doesn’t make insulin.
• In type 2 diabetes, the pancreas makes insulin, but the body doesn’t use it as it should.

In both types of diabetes, when glucose can't get into the cells, the blood sugar level gets too high. This is unhealthy and can make people sick.

Understanding how carbs and diabetes affect blood sugar is an important part of managing diabetes.

Carbs & Your Child’s Blood Sugar

For people with diabetes, the goal isn’t to avoid carbs — it’s to choose them wisely and balance them with insulin and activity. These tips can help your family make smart choices:

• Pick healthy carbs. Get most carbs from whole grains, vegetables, and fresh fruit. These foods are better carbs because they also contain fiber, vitamins, and other nutrients.
• Limit highly processed foods and foods with added sugar. These can make it hard to manage blood sugar levels. Avoid all beverages with carbs (except milk). They don’t provide good nutrition and cause blood sugar levels to spike. Use them only to treat low blood sugar (hypoglycemia).
• Count carbs. Read food labels to help you keep track of carbs. When eating out with your child, look up nutrition information online before you go. Or, ask your server about low-carb foods or how many carbs are in the foods you choose.
• Weigh and measure food. Use a scale and measuring cups to help you count carbs more accurately. This makes it easier to match insulin doses to the carbs your child eats and helps improve blood sugar levels.
• Encourage activity every day. Regular exercise makes insulin work better and can help keep blood sugar in a healthy range.

Knowing how carbs fit into a balanced diet makes it easier to keep your child’s blood sugar where it should be. If you need help figuring out what foods are carbohydrates or how many carbs your child should have in a day, ask the dietitian on your child’s care team.