Spacing carbs and meals for better glycemic control

Our vital organs and brain need a constant supply of glucose during work and rest. The brain alone needs about 1mg/min or 6g/hr of glucose day and night. This means we need to ensure critical minimal blood glucose availability so that the body can function properly.

For diabetics, especially those on hypoglycemic medication, it is imperative that glucose supply is not interfered with. It is also essential for diabetics that too much sugar is not circulating in the system, which again is injurious to the organs and brain.

The following are some important strategies to keep one’s blood glucose (BG) maintained steadily throughout the day avoiding highs or lows.

Space meals

Diabetics who are on insulin, OHA (oral hypoglycemic agents) or weight reduction diet plans need to have three square meals and one or more snacks in a day.

Ideally there should be 5 hours gap (but not more than 6 hours) between breakfast and lunch, and lunch and dinner. Likewise, there should not be more than 10 hours gap between the last eating at night and breakfast the next day.

Skipping a meal or keeping a longer gap between meals will cause the BG to drop causing hypoglycemia, excessive hunger and overeating in the subsequent meal leading to hyperglycemia. A closer eating plan will build up blood sugar causing elevated BG.

Distribute appropriate macronutrients like carbohydrate and proteins in these meals

A meal that is mostly made up of carbohydrates (carbs) is sure to cause unhealthy hyperglycemia.

Spacing meals and carbs is particularly essential for those on insulin. The distribution of carbs in meals and snacks depends on the type of insulin, physical activity and total caloric requirement. An active athlete or a growing up juvenile diabetic may require larger carb containing snack like a sandwich than an obese diabetic who may need a lower carb bite like a plate of salad between meals.

Your nutritionist can help you calculate the total daily-required carbohydrate and space the carbohydrates in your daily meal plan such that your body is neither starved nor overfed with sugars from a single meal.

The inclusion of proteins helps a steady release of sugar in the blood avoiding sudden blood glucose peaks or dips. Protein gives a late postprandial response. Therefore, diabetics, especially those who experience nocturnal hypoglycemia, may benefit from including 10 to 20 gm protein in the bedtime snack.

Eat consistent amounts and at consistent timings everyday.

Consistency in the carbohydrates in each meal is essential for good glycemic control. You cannot eat more today and less tomorrow unless you are expecting changes in physical activities or changing medication dosage. Eat at specified times as far as possible. If you are travelling, carry food/snack with you if you do not have accessibility to food in your journey.

Whatever be your timing of work or lifestyle, meals can be spaced and distributed throughout the day with the help of a nutritionist and medications adjusted so that an acceptable BG control is achieved. This will require several sessions of education and counseling from the dietician and commitment and co-operation on the part of the patient.

Simple rules well followed can go a long way to reaching the target pre or post prandial blood glucose level.

Parvathy R Krishnan.

The writer, a Nutrition and Dietetics expert, is a member of Research Society for the Study of Diabetes in India.

Also read:

Understanding the glycemic index
Coping with carbohydrates
What do you eat to manage diabetes?

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