People with type 2 diabetes are frequently overweight, so advice about nutrition is directed not only at controlling carbohydrate intake, but also at limiting calories. (I discuss caloric restriction and weight loss in Chapter 10.) If you have type 2 diabetes, there are several reasons why you still need to estimate the carbohydrate content of your food:
• Limiting the carbohydrate intake and substituting some of the calories with monounsaturated fats can help reduce your triglyceride levels and increase HDL cholesterol levels.
• Abnormalities in insulin secretion mean that eating a high-carbohydrate meal results in high glucose levels immediately after the meal. You want to avoid these high postmeal glucose levels because they can contribute to increases in HbA1c levels (see Chapter 5).
• Estimating carbohydrate content is also important if you are taking sulfonylureas, nateglinide, or repaglinide. This is because with these medicines, too few carbohydrates can cause low glucose levels.
• According to the ADA, a normal, healthy diet for people with diabetes should consist of
• 45 to 65 percent of total daily kilocalories from carbohydrates
• 25 to 35 percent of total daily kilocalories from fat
• 10 to 35 percent of total daily kilocalories from protein
• The glucose rise after eating is due to the carbohydrates in the meal, and therefore all people with diabetes should learn carbohydrate counting.
• If you are on insulin, your dose should be based on the amount of carbohydrates in your meal.
• When taken on an empty stomach, alcohol can lower glucose levels.
DID YOU KNOW?
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