Whether you’re pre-diabetic or have type 2 diabetes, you’re likely well aware of the many complications of type 2 diabetes—and if you’re reading this, you’re probably looking for ways to manage your diabetes with food and diet. In this post, we’ll dive into carbohydrates and how a healthy balance of carbs in your diet can contribute to good health.

A healthy diet can affect type 2 diabetes and pre-diabetes in two key ways. Firstly, it can stabilise and reduce blood sugar levels, decreasing the probability of more serious health complications. Secondly, the diets we choose can also contribute to maintaining weight loss and sustaining a healthy weight, with evidence now showing that a sustained 10-15% reduction in weight can lead to full diabetes remission.

This article will explore the impact of carbohydrates on blood sugar levels and provide recommendations for incorporating carbohydrates into a diet suitable for type 2 diabetics and pre-diabetics looking to build and maintain a healthy lifestyle and weight.

The basics of carbohydrates and blood sugar

On a molecular level, carbohydrates are simply a type of sugar which is readily used for fuel by the body. There are carbohydrates in lots of foods we wouldn’t classify as “carbs”, like milk and fruit, because they contain sugars. 

Because carbs are so readily broken down, they lead to much bigger spikes in blood sugar (as opposed to, for example, protein, which has a much more attenuated blood sugar response when consumed).

There are two main types of carbohydrates:

1. Complex carbohydrates (low glycemic index)
2. Simple carbohydrates (high glycemic index)

The impact of carbohydrates on blood sugar is measured using the glycemic index. To put it simply, carbohydrates with a lower glycemic index raise blood sugar less, and thus are generally a better choice for individuals suffering from type 2 diabetes. A lower glycemic index is mainly explained by a higher level of fibre, vitamins, minerals, protein, and healthy fats. 

Complex carbohydrates and their impact on blood sugar 

Complex carbohydrates have higher levels of fibre and vitamins than simple carbohydrates, and tend to come from unprocessed foods. Whole grains are one example of complex carbohydrates—and unsurprisingly, the research shows that whole grains significantly reduce and draw out the blood glucose response after eating when compared to refined grains. This is because our bodies require more time to break down complex carbs—meaning there isn’t one huge spike, but rather a longer, more drawn out response.

As a result of this, blood sugar levels will remain at a more stable level. This means that you will feel fuller for longer—and perhaps more importantly, that you will be less likely to develop metabolic diseases associated with type 2 diabetes (or if you have type 2 diabetes, that your blood sugar levels will remain more steady than they would if you were to eat a simple carb).

Examples of unrefined grains include:

• Quinoa
• Whole wheat products
• Bulgur wheat
• Oatmeal

Complex carbohydrates are also found in starchy vegetables; these are high in nutrients, and higher in carbohydrates than green vegetables, but lower in glucose than simple carbohydrates. These are well-served as part of a balanced plate including protein and green vegetables. These include:

• Sweet potatoes
• Corn
• Squash
• Root vegetables
  

Legumes like beans and lentils also count as complex carbs—and have higher levels of protein as a bonus! The carbohydrates in fruit also count as complex carbohydrates—particularly fibre-rich fruits like bananas, berries, and apples. 

Simple carbohydrates and blood sugar spikes

Simple carbohydrates and aptly named because, well, they’re more simple. That is, they don’t contain the fibre, vitamins, and antioxidants to slow down absorption, and thereby cause a rapid spike in the body’s blood glucose levels.

The body’s response?

• A release of insulin, which does its job of shunting glucose away from the bloodstream and towards cells that need it. When those cells are “full” (i.e. they’ve used all the energy they need)—which they inevitably will be when you consume a huge amount of glucose at once—the excess gets stored as fat.
• Because your body is so good at keeping blood glucose levels tightly regulated, the circulating glucose will return to normal levels quickly—and sometimes even drop below normal, triggering hunger signals. If you’ve ever wondered why you felt hungry soon after a high-carb meal (particularly if it was made up of simple carbs), this is part of the reason.
• Elevated blood glucose over time can wear out your insulin-producing cells leading to or worsening type 2 diabetes.

Indeed, research shows that higher refined grain consumption is linked to increases in waist circumference, blood pressure and blood sugar, “bad” cholesterol”, blood triglycerides (fats), and insulin resistance. Whether pre-diabetic, or type 2 diabetic,

Therefore, regardless of whether you have type 2 diabetes, pre-diabetes, or you’re just looking to achieve better health, it’s best to limit your intake of simple carbs, such as the following:

• Sugar
• White pasta
• White bread
• White potatoes
• Cookies, pastries, breakfast cereals and sweets
• White flour
• Soft drinks
• Fruit juice
  

Top tips for incorporating complex carbohydrates in a healthy diet

Mind your portions 🍽

Moderation is key when it comes to carbohydrates. Although carbs aren’t inherently bad, in large amounts they can lead to weight gain and increased cardiovascular risk, so bear in mind the guidance that carbs should make up only about ¼ of your meals. We’ll reiterate here that this doesn’t mean you can’t have pasta or pizza, but make them an act rather than the whole play. If you do overload on carbs in one meal, try to balance out your day by going lighter on the carbs and heavier on proteins and veg in your other meals.

Opt for whole grains 🌾

Having seen the many ways in which refined grains fall short of their whole grain equivalents, as often as possible, choose whole grains: This means brown rice over white rice, brown bread over white bread, wholewheat pasta over normal pasta, etc. There are a number of other whole grains you might want to experiment with, too, like quinoa and bulgur wheat.  

Stay vigilant about food labels 👀

“Whole grain” on a food label doesn’t necessarily mean healthy. Many whole grain foods also contain nasty preservatives and added sugar (such as this wholemeal bread, for example), particularly amongst breads and breakfast cereals. In addition, many brands have latched onto the sneaky term “multigrain”. This sounds good, but doesn’t actually mean whole grain at all—but rather that there is more than one type of grain in the bread (they could all still be refined). When doing your shopping for things like cereals and bread, look for 100% whole wheat or 100% whole grain to get the maximum health benefit from your carbs. 

Make it about balance ⚖️

All of the above said, we’d much rather you practice balance than try (and fail) to rule out every refined grain in your life. When you’re eating out, you won’t always have whole grain options. And perhaps more importantly, sometimes you just can’t fulfil a craving for fresh pasta or your favourite pizza with a whole grain alternative, and that’s perfectly fine. As we’ve discussed before, make indulgences a conscious choice and enjoy them—just don’t make them your default choice for the carbs on your plate. 

Whether pre-diabetic, or type 2 diabetic, these tips can help mould an approach to incorporating carbohydrates into a healthy diet. This is particularly recommended for diabetics and pre-diabetics post-TDR or post a significant weight loss.