Diet and Diabetes Management

 

Diabetes, a chronic condition now growing and presenting rapidly across the globe, happens when the human body is not able to produce enough insulin or process insulin in the body. It is further diagnosed by noting the increased levels of blood glucose in the blood stream.

Because of the lack or inability to process insulin, the accumulating high levels of blood glucose stays in the blood stream, which can cause other health complications which can affect eyes, kidneys and nerves.

Why do persons with Diabetes have to cut down their rice intake?

Understanding how your body derives blood glucose is key to discovering why rice intake in diabetes should be monitored. There are 2 main types of carbohydrates: sugars and starches. Carbohydrates present in rice fall under the starch type category which is also found in foods like cereals, bread, pasta, potatoes etc

Starches get digested and broken down into blood sugar and for a patients with diabetes, they are unable to properly process the blood glucose and it remains circulating in the blood stream - leading to a diabetic symptom called hyperglycemia.

Different types of rice present with different amounts of carbohydrates - hence due to the high amount of carbohydrates (30-50g per serving) present in most rice types, diabetic patients may sometimes need to cut down on their intake.

1. Glycemic Index (GI)

According to Harvard T.H. Chan School of Public Health, the glycemic index (GI) ranks carbohydrates on a scale from 0 to 100 based on how quickly and how much they raise blood sugar levels after eating.

Foods which have high GIs, are said to digest quickly and hence cause an increase or fluctuation in blood sugar. Compared to foods which have a low GI, these are digested and absorbed slower, and lead to a more controlled and slower uptake of blood sugar. 

The glycemic index (GI) is a measure of the blood glucose-raising potential of the carbohydrate content of a food compared to a reference food (generally pure glucose). Carbohydrate-containing foods can be classified as high- (≥70), moderate- (56-69), or low-GI (≤55) relative to pure glucose (GI=100)

2. Glycemic Load (GL)

However, the glycemic index (GI) alone may not give us a full picture of the total amount of carbohydrates in each food. Hence, there is another contributing factor to determining appropriate food choices called the Glycemic Load (GL). This factors in the amount of carbohydrates in the food and its effect on blood glucose. 

For a typical serving of a food, GL would be considered high with GL≥20, intermediate with GL of 11-19, and low with GL≤10.

For example, watermelon has a high GI of 72. However, it has only a GL of 2 (in every 100g serving).

So how does understanding this help me with Diabetes and Diet Management?

Select foods that are not only low in GI, but also low in GL - or have lower amount of carbohydrates. Seeing that a food is low GI should not be your only criteria when coming to select foods which will help with achieving control.

It is always good to check the nutritional labels and know the amount of carbohydrates each food contains before choosing to get something off the shelf.

 

References:

1. IDF Diabetes Atlas, 7th Edition, 2015, International Diabetes Federation

2. https://www.knowdiabetes.org.uk/know-more/achieving-type-2-remission/understanding-carbohydrates/

3. https://www.hsph.harvard.edu/nutritionsource/carbohydrates/

4. Willett W, Manson J, Liu S. Glycemic index, glycemic load, and risk of type 2 diabetes. Am J Clin Nutr. 2002;76:274S-80S.

5. https://www.glycemic-index.org/watermelon-nutrition.html

6. Oregon State University https://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load#references