Wednesday, 20 April 2011

All carbs are NOT created equal!!!

This statement reminds me of the George Orwell book, 'Animal Farm', when the animals are making their rules....'All animals are equal' but by the end of the book the statement has changed to 'All animals are equal, but some animals are more equal than others'.
Carbohydrates, carbs, complex carbs, simple carbs, whatever term you use to describe them are basically the ideal source of energy for the body. This is because they can be converted more easily into glucose, the form of sugar thats transported and used by the body, than proteins or fats can.
We have been counting carbohydrates for about a year now , and the concept is straight forward. For every 10g of CHO (carbohydrate) that Samuel eats he requires 1 unit of insulin for breakfast, and 0.5 units for lunch and dinner. Simple, most foods have the nutritional information on the labels, or if not the information can be found in my carbs & cals book, or I can check online. Its just a matter of weighing out Samuels food, calculating the amount of carbohydrates in the meal and working out how many units of insulin he needs. He will then have perfect blood glucose levels 24 hours a day, 7 days a week! In theory it sounds perfect, and simple, and the answer to our prayers.
However, back in the real world and for those of us who live alongside diabetes know that it is not that simple. It SHOULD be simple though, but as the title says 'all carbs are NOT created equal'.
For example, breakfast..... a bowl of rice krispies (45 g), or two weetabix. Both have a total carb value of 30. So for Samuel 30g CHO requires 3 units of novo rapid insulin, asy. But, what we also have to take into consideration is the GI (glycaemic index) value. The GI is a measure of the effects of the carbohydrate on the blood suger levels. Carbohydrates that break down and realise glucose into the bloodsream quickly have a HIGH GI, thand those that breakdown slowly have a LOW GI.
Rice krispies have a high GI value, so the glucose is realeased quickly, this can result in a rapid spike in blood glucose level, and an equally as rapid drop, so hypos can occur mid morning. Weetabix on the other hand has a low GI so the process is much slower, and the rapid spikes don't occur.
So know we understand the effect of the GI value we have it sussed, but no, what about the effect of the fat content of the food. White bread, and a jacket potato both have a high GI value, however put butter, or sunflower spread etc on them, and the release of glucose is slowed down, as the body works on digesting the fat first.
In all honesty I have to say, that a year ago, before we started I thought that carb counting would be easy, it's just maths, and I am quite good at maths. It's just a numbers game, and let's face it everything to do with diabetes is numbers. What quickly becomes apparent though is that the body is an amazing machine, especially when it is working correctly. We can eat what we like, it's digested, and the blood glucose levels remain level as the pancreas steps in and releases that all important hormone insulin. Maintaining that balance artificially is hard! It's complicated, and the most important thing I have realised is that diabetes plays by, and changes it's own set of rules.
It would be so much easier if 'all carbs were created equal' but it's just not meant to be. So we plod along, doing our maths, doing the best we can, hoping that it is good enough.

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