Skinny Diabetes: What is a carbohydrate?

daily lunch ritual includes canned tuna, lots of non-starchy veggies and avocado

The other day I was talking diet with a friend and she said "I don't really eat carbs, I hardly ever eat bread," then she proceeded to eat her usual breakfast of Activia fruit yogurt, light granola and a ripe banana. Unbeknownst to her, this breakfast was pretty much all carbohydrates and high in sugar. It dawned on me then that the definition of carbs can be a bit murky for some and sometimes limited to hamburger buns, pasta and cookies. Carbohydrates are so much more than this and today we are going to do a 101 on carbohydrates, which is really important for skinny diabetics and anyone wanting to reduce their overall glycemic load.

The Science

Scientifically a carbohydrate is a compound made up of carbon, hydrogen and oxygen and nutritionally it comes in two forms: simple form as in sugars and complex forms as in starches and fiber. All carbohydrates, with the exception of fiber, get broken down into a simple sugar called glucose in the body. Fiber is an indigestible carb which is why high-fiber foods are especially good for diabetics and moves things along in the large intestine. In essence all carbohydrates are sugars and if you need to reduce your sugar intake, then you must look at your overall carbohydrate intake.

Defining Carbs

As a skinny diabetic, I'm sensitive to all carbohydrates which I only discovered by measuring my blood sugars post meals. Not only do I have to be mindful of the quality of my carbohydrates, but the quantity plays an equally important part in keeping my blood sugars stable and in a healthy range. However, in my experience this advice isn't emphasized enough and what I find are Type 2 diabetics eating wholewheat bread and whole grain cereals with reckless abandon. 

In the beginning of my diabetic journey, my definition of carbs was limited to the usual suspects like cookies, desserts, french fries and anything bread-y. Now when I hear the word carbohydrates the following comes to mind:

• healthy whole grains including gluten-free grains, whole wheat bread & pasta, all breakfast cereals
• starchy beans including black beans, lentils and dips like hummus
• dairy which includes all milks, yogurts especially the non-Greek variety with fruit and anything creamy
• root vegetables especially when cooked like carrots
• all fruit
• any processed food claiming health or marketed as low-fat, fat-free, low-sugar or sugar-free

If you're a skinny diabetic or have blood sugar issues, then you've got to be careful with even the healthiest of carbohydrates as I've listed above. My doc told me to get a blood glucose meter and to learn how my body reacts to various carbs and portions and I recommend the same to you. Also as a rule of thumb always eat your carbs with healthy fats and/or protein and limit your servings. My doctor said a serving size of starchy carbs is 1/2 cup, but I find this challenging and tend to overeat. In general I swap out carbs for non-starchy vegetables which are low-carb and high in fiber.

It's now been three years since being diagnosed as pre-diabetic and it's taken this long to finally get where I am in terms of understanding it all and managing my blood sugars. Am I perfect? No. Have I reversed my diabetes? No, but I'm much better at being consistent and accepting what is. Next I'll talk about various ways you can approach a low-carb diet, but I'll wrap this up with some advice. One of the first things my doctor said to me was that if I focused on the foods I couldn't eat, I would lose. Instead focus on all the wonderful foods that you can enjoy and in recent months, this really has sunken in. 

Skinny Diabetes: Weight Loss

When I was diagnosed as pre-diabetic in 2013, one of the first things I did was look into books on preventing and reversing diabetes. One of Amazon's top sellers is Dr. Neal Barnard's 21-Day Kickstart which is a vegan whole foods diet plan that is low in fat and high in carbs. I devoured this book and it opened my eyes about the environmental impact and ethical issue related to consuming animals products. It also helped me understand the relationship between food and health, because up until this point I believed that I could exercise my way out of a bad diet and that being somewhat slim equated to being healthy. This book catapulted me into veganism and I loved the idea that I could eat all the carbs I wanted and reverse my diabetes, as long as it was low-fat whole foods and vegan. Needless to say this plan didn't work out for me for many reasons, one being that I wasn't overweight.

The majority of people who develop pre-diabetes and Type 2 diabetes are overweight and it's this excess body fat that has lead to insulin resistance and diabetes. That is why when you research treatment for Type 2 diabetes, weight loss is key to reversing the disease. Here's how it works in layman's terms. When we consume any kind of carbohydrate, the sugars and starches get broken down into glucose and our pancreas secretes the hormone insulin to carry that glucose out of the blood and into our fat, muscle and liver cells for energy use or stored energy. If you have too many fat cells tucked into your muscle cells, then the muscle cells find it difficult to absorb the glucose and it starts to accumulate in the blood also known as high blood sugar. Eventually your pancreas will dump more insulin into the blood in order to bring down the elevated blood sugar and this leads to insulin resistance, where the cells are not responding to the effects of insulin. Left untreated and Type 2 diabetes begins, when blood sugar is elevated all the time. This is one way people develop Type 2 diabetes and weight management is a huge factor in this scenario. So if an overweight Type 2 diabetic adopts new healthy habits that result in weight loss, they should see improvement in their blood sugar readings. This is one of the reasons that people find success on Dr. Neal Barnard's plan because they swap processed, refined and highly fatty foods with healthy naturally low-fat whole foods which leads to weight loss. But what if you're a skinny diabetic and weight loss isn't an issue?

Information and treatment for skinny diabetics is hard to come by and I've had to dig deep and piece information together to understand why I developed diabetes and what's a healthy and sustainable path to reversing my Type 2. As a skinny diabetic I can tell you that learning how my body reacts to carbohydrates has been crucial to managing fasting blood sugar levels; as well as, learning about body composition and "skinny-fat" syndrome, having a balanced exercise regime with an emphasis on resistance training and understanding how an unhappy stressful mind can lead to diabetes. I'll address each of these points in future posts under Skinny Diabetes.

(***Picture up top was taken a few months post diagnosis)