Carbs and diabetes: what to know to stay healthy

Like a polarizing pop star, carbs are loved or shunned in equal measure, and a source of constant gossip and scrutiny. But carbohydrates don’t deserve their controversial reputation. They’re just misunderstood — especially when it comes to their relationship with diabetes.

More often than not, you’ll hear people talking about how people who have diabetes should never eat carbs since they’re horrible for your blood sugar. But, like most things, the truth is a lot more nuanced than that.

Keep reading to learn how different carbs affect your blood sugar, the low-down on low-carb diets for people with diabetes, and how to shave some carbs from your meals without feeling deprived.

How your body uses carbs

Carbohydrates are your body’s primary source of energy. As your body digests them, carbs are turned into glucose, which is then released into the bloodstream (this raises your blood sugar). At that point, your body triggers the release of insulin, helping the glucose get out of your blood and into your body’s cells, tissues, and organs, where it can fuel them.

While carbs are often associated with wheat-based products — dinner rolls, pizza crust, spaghetti — they are actually found in a wide variety of foods including fruit, starchy vegetables, dairy products, and proteins like beans, peas, and lentils.

Under the umbrella of carbs, there are two kinds: complex carbohydrates and simple carbohydrates. Complex carbs — starches and fiber — are found in fruits, vegetables, whole grains, beans, and nuts. If you’re thinking those foods sound pretty healthy, you’d be right. “Carbohydrates are actually the only source of fiber in your diet, which is key for blood glucose regulation, and are rich sources of vitamins, minerals, phytochemicals, and antioxidants,” says Lisa Stollman, RDN, a registered dietitian nutritionist and a certified diabetes care and education specialist based in New York. Fiber also helps you feel full, improves digestive health, and reduces risk of heart disease.

Simple carbohydrates, on the other hand, are refined, meaning they are broken down more quickly by your body and tend to have less nutritional benefit. These include soda and other sugar-sweetened beverages, juice, candy, desserts, and foods made with white flour.

Carbs and blood sugar

Eating carbohydrates can have a significant impact on your blood sugar — especially if you have diabetes. Since your body doesn’t use its insulin efficiently (or doesn’t produce enough insulin), the glucose has a harder time getting converted to energy. Instead, it sticks around in your bloodstream, resulting in elevated glucose levels.

Simple carbs cause glucose to enter the bloodstream in one big surge, but complex carbs behave differently. The fiber in them pumps the brakes on the process — releasing sugars into the bloodstream in a more gradual stream.

Combining carbohydrates with fat or protein, which take longer to digest, can also slow things down and keep blood sugar levels more stable. So pair your breakfast oatmeal with a hard-boiled egg, for example.

Should you cut out carbs completely?

Ultra-low carbohydrate diets, like the keto diet, are marketed as being the best for people living with diabetes, but there’s no reason to ban the food group completely. And in fact, the American Diabetes Association recommends people living with diabetes have fiber-rich carbohydrates every day. One reason why: You’re less likely to stick with an eating plan that prohibits a whole food group — it’s just not sustainable.

“Many of my patients come to me after starting on a keto diet, which is high in fat and has almost no carbs, because they thought it would help them manage their diabetes,” says Leah Kaufman, R.D., a registered dietitian and certified diabetes care and education specialist in New York. “But these diets can be dangerous, sometimes causing low blood sugars and putting the patient at risk for high cholesterol.”

Eating carbs in moderation

While carbohydrates shouldn’t be banned if you have diabetes, they also shouldn’t be eaten with abandon. “Eating fewer — and better — carbs can help decrease overall blood sugar, leading to better diabetes management,” says Kaufman. One way to take the guesswork out of things is to follow the WeightWatchers Diabetes Program. It gives each food a Points value taking into account sugar, fiber, and more, guiding you towards choices that reduce blood sugar spikes.

Here’s how a day of eating carbs on the program may look:

• Breakfast: 2 frozen whole-grain waffles (4 Points) with 1 cup strawberries (1 Point); 1/2 cup plain nonfat Greek yogurt (1 Point); coffee with 2 tbsp unsweetened vanilla almond milk (0 Points value)
• Lunch: Italian Chicken Soup with Vegetables (2 Points); 1 whole-wheat bread roll (3 Points)
• Dinner: Lemon Chicken with Broccoli (1 Point); 1 cup cooked long-grain brown rice (6 Points)
• Snacks: 1 hard-boiled egg (2 Points); Classic Guacamole with carrot sticks and cucumber slices (2 Points); Pumpkin-Oat Cookie with Cranberries (0 Points)

The bottom line

Carbohydrates do cause blood sugar to go up, but if you eat complex carbs, like those found in whole grains, beans, and vegetables, they don’t raise blood sugar as much. You can also help manage your blood sugar by pairing carbs with fat and protein. While you may be tempted to cut out all carbs, it’s better to follow a diet plan you can stick with in the long-term, like the WeightWatchers Diabetes Program.