Managing diabetes can be as easy as '1-2-3'

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For a diabetic who understands how to count carbohydrates as a means of managing his/her diabetes, then an apple and a cappuccino should be preferred over a banana and a milkshake.

The reason is that the apple and the cappuccino each contains 15g of carbohydrates, whilst the banana has 30g and the milkshake a whopping 90g.

For a diabetic, these choices have potentially serious consequences and this was the theme of a workshop hosted by the team from the Diabetes Center of Excellence at the American Hospital Dubai.

Diabetic patients - young and older - from across the community were invited to the special workshop to learn about 'carbohydrate counting' - the key to the successful nutritional management of diabetes.

Why carbohydrates?

Diabetes, which is very common in the Gulf region, is a condition in which the body has trouble regulating blood sugar (glucose). There is no cure but it can be treated with insulin, which absorbs sugar into the cells of the body. Carbohydrates ('carbs') are the body's main source of energy, once digested they fuel the body with sugars. For a diabetic, the ratio of carbs to insulin needs to be balanced to maintain the correct blood sugar level. The more carbs you eat, the higher the blood glucose rises; the higher the blood glucose, the more insulin is needed in the blood to move the sugar into the cells.

The group responded enthusiastically to the presentations led by May El Moghrabi, Clinical Dietitian and member of the American Dietetic Association; with the support of Caroline Arzoumanian, RN, diabetic patient educator; and Mariam Saleh.

Speaking at the workshop, Mariam Saleh, Clinical Dietitian at the Diabetes Center of Excellence, explained:

'Nutrition is a cornerstone of the management of diabetes. The skill lies in reading and understanding food labels, for packaged foods, and in knowing the carb values for fresh foods and for prepared dishes. Of course, in addition, we also need to ensure that diabetics eat well and enjoy a balanced and healthy diet, so this is another factor to consider when making food choices and means variety rather than staying with a limited range of foods that have easily identifiable carb content.'

The experts from the Diabetes Center of Excellence recommend 65g of carbohydrates per meal, in a diet of 1500 calories per day for a female diabetic; and 75g of carbohydrates and 1800 calories per day for a male.

Personal needs may vary according to body mass index.

Weight control is also an important factor for diabetics and weight loss can help lower insulin resistance and improve blood pressure.

'We must also take other nutritional factors such as calories and fat content into account, but carbs are the focus for obvious reasons,' adds Mariam Saleh.

'There are no food labelling standards for carbohydrates and so labels can be misleading - especially when you consider snack foods such as biscuits, cereal bars and chocolate, all of which can contain surprisingly high levels of carbohydrates. Then, there are even some foods with zero carbs. The information is generally available on labels and in specialist books and it's just like learning any other skill.'