People with type 1 diabetes (T1D) have to learn how to count carbs in order to calculate their insulin doses at mealtimes. However, even with years of practice, carb counting remains a challenge for a lot of people.
According to a study conducted in Quebec, people generally underestimate their carb count by about 15 g per meal. This underestimation could be due to a calculation error, or be voluntary, for instance to reduce the risk of hypoglycemia.
However, the study shows that an accurate carb count helps to decrease blood sugar variability, and promotes improved glycated hemoglobin (HbA1c) levels.
Since we’re bombarded with information and options at the grocery store, it can be hard to sort the good from the bad and to make the right choices. For people with T1D, food labels are often a precious tool for managing their blood sugar levels.
Carbs, sugars and fibre on the nutrition facts label
Looking at the nutrition facts label will give you a glimpse of the amount of carbs found in a food. The information on carbs is presented in two sections:
- Sugars are the simple sugars that are naturally found in or added to foods. They are included in the carb count, which means you don’t need to add them to the total carb count.
- Fibre is a type of carbs that is undigested by the body. It does not pass from the digestive tract to the bloodstream, and so, it doesn’t increase blood sugar levels. This means you have to subtract the fibre content from the total carb count.
To calculate the number of carbs in a food that need to be taken into consideration, the fibre content is subtracted from the carbs.
For instance, on the following bread label, for 2 slices of bread, you should include 28 g (31 g of carbs minus 3 g of fibre) of carbs in the carb calculation:
Even though they are not added to the carb count, sugars can sometimes lead to a rapid spike in blood sugar levels because they are quickly digested and absorbed. This means that avoiding excesses could contribute to reducing blood sugar spikes after meals.
As for fibre, our diet generally does not include enough of it. In Canada, fibre needs have been set at 25 grams a day for women and 38 grams a day for men. A high fibre intake could contribute to reducing blood sugar spikes after meals, and also reduce blood cholesterol and constipation. A high intake can also limit the sensation of hunger in between meals.
Other packaging information
Watch out for certain marketing tricks. Some companies use “no sugar added” on their packaging, but this does not mean that the food is carb-free. It simply means that no sugar was added to those naturally found in the food.
Other claims can also be found on food packaging. Here are a few examples:
- Gluten-free: This information can be very useful for people who have celiac disease. However, there is no indication or recommendation that says you should limit your gluten intake if you have not been diagnosed with that disease. In addition, gluten-free products generally have a higher carb count, or contain more rapid-acting sugars than equivalent products with gluten. A little less than 10% of people with diabetes will also develop celiac disease.
- Organic: The word “organic” means that the food item was produced without using pesticides, antibiotics or hormones. However, this does not change its nutritional value. An organic cookie could very well have the same amount of carbs, and sometimes even more, than a non-organic cookie.
- Natural: The term “natural” is very vague and not formally regulated by Health Canada. It means that, at some point in the food’s manufacturing process, one or several natural ingredients were used. Almost any food could be considered natural, and this is definitely not a guarantee of good nutritional value.
- Low in sodium and/or fat: This information is very useful if your healthcare team has recommended that you reduce your salt or fat intake. However, when comparing a regular product with the low-sodium or low-fat version, you might find that the low-sodium/low-fat product has a HIGHER carb content. That’s why it’s important to check food labels carefully.
If you feel overwhelmed by all this information and are having a hard time adapting your diet to T1D, please don’t hesitate to talk to a nutritionist or dietician.
Did you know that we organize one webinar per month? They are free and only available to people living (or whose child is living) with type 1 diabetes in Quebec. Learn more »
- Food Labels 101. Diabetes Québec (n.d.). https://www.diabete.qc.ca/en/living-with-diabetes/diet/at-the-grocery-store/food-labels-101/.
- Fallabel, C. (May 21, 2021). Don’t Be Deceived: How Food Labels Mislead. Diabetes Daily. https://www.diabetesdaily.com/blog/dont-be-deceived-how-food-labels-mislead-686979/.
- Brazeau, A., Mircescu, H., Desjardins, K., Leroux, C., Strychar, I., Ekoé, J., & Rabasa-Lhoret, R. (2013). Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes. Diabetes Research and Clinical Practice, 99(1), 19–23. doi:10.1016/j.diabres.2012.10.024
- Gökşen, D., Atik Altınok, Y., Özen, S., Demir, G., & Darcan, Ş. (2014). Effects of Advanced Carbohydrate Counting on Glucose Control and Quality of Life in Children with Type 1 Diabetes. Journal of Clinical Research in Pediatric Endocrinology, 74–78. https://doi.org/10.4274/jcrpe.1191