The Carb-Glucose Connection

Type 1 Diabetes For Dummies

Carbohydrates, proteins, and fats are macronutrients. People need them in relatively large amounts as compared to micronutrients, such as vitamins and minerals, which are required in smaller amounts. Here's what they do:

Carbohydrates provide glucose, the body's primary fuel.
Proteins contribute amino acids for building and repairing tissues and cells.
Fats provide fatty acids, assist in the absorption of fat-soluble vitamins and, along with glucose, are used for energy.
Vitamins and minerals are essential nutrients required for hundreds of jobs throughout the body. To obtain the full complement of vitamins and minerals needed for health, choose a wide variety of wholesome foods.

Glucose is so critical for human function that the body stockpiles glucose in the muscles and the liver. The storage form of glucose is glycogen. Glycogen reserves can be tapped into when the body is running low on glucose. If glycogen reserves become depleted, the liver will make glucose from scratch (but it may cost you a little muscle tissue . . . because you can't make something from nothing).

Diabetes interrupts the delicate balance of glucose regulation. Managing dietary carbohydrate intake is one of the most important lessons when learning to self-manage your diabetes. It's not only the amount and timing of the carbohydrate; it's also the quality of the carbohydrate and what it's mixed with. In the bigger picture, carbs must be balanced with medications and exercise. The table lists the most significant variables affecting blood-glucose levels for people with diabetes.

Variables Affecting Blood-Glucose Regulation

Hyperglycemia (High Glucose Levels)	Hypoglycemia (Low Glucose Levels)
Too much carbohydrate	Not enough carbohydrate
Concentrated sweets, soda, juice	Alcohol
Mismatched timing of meds and meals	Mismatched timing of meds and meals
Illness, stress, hormonal surges	Skipping a meal
Lack of insulin or insulin resistance	Too much insulin or too many diabetes pills
Medication dosing errors	Medication dosing errors
Lack of physical activity	Strenuous or unplanned activity
Certain medications, steroids	Certain medications

Diabetes imposes the need to understand how to juggle carbs, exercise, and medications, but it can be done. No one has perfect blood-glucose control, so set realistic expectations. Use a blood-glucose monitor and have A1C levels checked regularly. You and your healthcare team can use glucose data to make adjustments to your self-care regimen. If your medications put you at risk for low blood glucose, find out more about preventing, recognizing, and treating hypoglycemia.

Nutritional needs and diabetes management strategies change and evolve through all ages and stages of life.

About This Article

About the book author:

Sherri Shafer, RD, CDE, is a senior registered dietitian and a certified diabetes educator at the University of California San Francisco Medical Center. She teaches diabetes self-management workshops and provides nutrition counseling for individuals with type 1 diabetes, type 2 diabetes, prediabetes, and gestational dia-betes. She is also the author of Diabetes Type 2: Complete Food Management Program.