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Nothing is more frustrating to my diabetic patients than diet. In a culture that doesn't encourage healthy eating habits, it's hard to know what a healthy diet looks like. I hesitate to even use the word "diet" because so many people will immediately think "Oh no! I have to go on a diet?"

Well, no not that kind of diet. The healthy diet I'm talking about could best be described as the total of all nourishment you supply to your body. It includes materials for activity, growth, repair, and enough energy to complete that work. Simply stated, what you eat, when you eat, and how much you eat are the factors that must be confronted if you are going to get control of your blood sugars.

Let's review some basic principles of nutrition first. All of the foods we eat fall into three categories; proteins, fats and carbohydrates. All edible foods are made up of one of these types or a combination of the three. Each has its own special purpose in the body, so finding a proper balance is very important.

Carbohydrates are our "fuel foods" and are classified as either simple (sugars) or complex (starch). They provide most of our energy, about four calories per gram, and are proper and necessary for an active, energetic person. In fact, the more active you are, the more carbohydrates you need in your diet. Lance Armstrong, the famous bicycle racer, brings in 70% of his calories from carbohydrates. Clearly this is because he has enormous energy demands that must be met. Those of us with slower metabolic rates, and who aren't training for the Tour de France, need to adjust our carbohydrate intake downward to a more reasonable level. An average adult gets about 50% of their calories from carbohydrates, but I think you could lower that to maybe 40% if you struggle with high blood sugars after meals.

Carbohydrates, being the simplest foods we eat, will always raise blood sugars faster than protein or fat. But remember the simpler or more processed the carbohydrate the faster it's released into the blood and the faster your blood sugars will rise. Too many carbohydrates in your diet, especially simple carbs like sugar and refined or processed carbohydrates, will make it difficult to maintain stable blood sugars and will also leave your stomach with nothing in it, reinforcing the notion that you're hungry leaving you craving to eat again. Carbohydrates from boxes and bags are usually highly processed and have had much of the nutrition and fiber removed, so they should generally be avoided. Quick burning carbohydrates flood the blood with sugar and create the equivalent of a sugar traffic jam. This quick rise in blood sugar is called an after meal or post-prandial spike and has been shown to be very harmful to your blood vessels.

The concept I'm describing is called Glycemic Index and I think it offers a good strategy to follow if you're struggling with your meal planning. The idea is based on a simple observation: Foods don't digest and supply usable energy at the same rates. Some digest slowly and some digest quickly. This concept might be more obvious to you if you think about starting a fire in your fireplace. You know to be careful of lighter fluid because it burns so quickly. Kindling burns slower and helps to stoke the fire and get it going, and a log burns most slowly and provides slow continuous energy. In the same way we need to find a healthy balance in the types of foods we eat.

You usually won't have to eliminate any type of carbohydrate from your diet if you switch to slower burning less processed types. Try whole grain breads instead of white bread or brown rice instead of white, and remember to combine slower burning fats and proteins with each meal so you can avoid those after-meal blood sugar spikes. The secret is to eat the type of carbohydrate and the amount that best matches your energy demands.

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