There's a lot to know about the way that carbohydrates affect blood glucose in addition to the grams of carbohydrates eaten (see the previous section). Carbohydrates aren't usually eaten alone, and as I mention earlier in the chapter, the other foods eaten with them play a role in how rapidly the carbohydrates are absorbed and raise blood glucose. Check out these facts about how carbohydrates work with other foods:
1 When your child eats carbohydrates that tend to be swallowed in larger pieces like rice and pasta, absorption is slowed by the need to break down those pieces in the intestine. His blood glucose rises more slowly.
1 When your child eats carbohydrates with fat, the fat slows down the movement of food through the intestine, so the blood glucose rises more slowly.
1 Chewing food thoroughly means that food is broken down into small pieces; therefore, the carbohydrate is absorbed more rapidly.
1 Whole fruit, like an orange, requires breakdown of cell walls in the intestine, but that breakdown has already occurred in orange juice. The carbohydrate in orange juice is absorbed more rapidly than the carbohydrate in a whole orange. The same is true of finely ground flour, as found in white bread compared with whole-grain bread.
1 Drinking a beverage with a meal makes the food pass more rapidly into the intestine where it's absorbed, so blood glucose rises more rapidly.
1 Light exercise like walking speeds up the absorption of glucose, whereas heavy exercise like running slows it down.
1 Very cold or hot food slows down the emptying of the stomach, thus slowing the absorption of glucose.
1 Smaller meals with snacks in between result in a more consistent level of blood glucose.
These effects help to explain why the blood glucose rises as much as it does after some meals and rises very slowly after others. Being aware of them allows you to adjust the timing of your child's insulin to match the absorption of the glucose. For example, if he takes rapid-acting insulin and you know that a particular meal will result in slower absorption of glucose because it's high in fat, you may want to give his insulin after the meal rather than before. That way the insulin is active when the food is being absorbed. Flip to Chapter 10 for full details on using insulin properly.
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