Carbohydrates

The recommended range of carbohydrate intake is 45-65% of total calories. Both the amount (grams) of carbohydrates and the type of carbohydrate in a food influence blood glucose levels. However, with regard to the glycemic effects of carbohydrates, the total amount of carbohydrate in meals or snacks is more important than the source or type. Monitoring total grams of carbohydrate, whether by use of exchanges or carbohydrate counting, remains a key strategy in achieving glycemic control. The use of the glycemic index (a measure of the glycemic effect of types of carbohydrate) can provide an additional benefit over that observed when total carbohydrate is considered alone. Low carbohydrate diets (restricting total carbohydrate to <130 g/day) are not recommended in the management of diabetes.

Carbohydrates are recommended in each meal of the day. Foods containing carbohydrates from whole grains, fruits, vegetables, and low-fat milk should be included in the diet. Like the general population, patients with diabetes are encouraged to consume fiber-containing foods (such as whole grains, fruits, and vegetables) because they provide vitamins, minerals, fiber, and other substances important for good health. However, there is no reason to advise people with diabetes to consume a greater amount of fiber than non-diabetic individuals.

As sucrose does not increase glycemia to a greater extent than isocaloric amounts of starch, sucrose and sucrose-containing foods do not need to be restricted by people with diabetes. However, they should be substituted for other carbohydrate sources in the diet. Non-nutritive sweeteners (saccharin, aspartame, acesulfame potassium and sucralose) are safe when consumed within acceptable daily intake levels.

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