Not all carbohydrates are created equal

This is actually going to be a non-astrophysics post. But it is going to be about science, if a little more personal than normal, and in fact, biology related.

First things first, I'm diabetic. Have been for about 13 years now, and for a lot of that time, have had pretty good control over my sugar levels. The times I haven't have been because meds have stopped working, or due to circumstances beyond my control I've had to eat things that do not work well with my body chemistry. Even when controlled, certain foods (rice, wheat bread, etc) will cause my blood sugars to spike up like a spiky thing. So I've learnt, with the aid of recipe books, with the aid of websites like The Glycemic Index what works, what releases carbohydrate slowly into my blood stream, what causes spiky spikes, what I can and cannot eat and how to balance my meals in order to maintain best control. In other words, I treat my diabetes like a science experiment. I figure out what works, read the research to find the "best practice", then put it into motion to help me keep control of this thing. Also, I've learnt that fewer calories + exercise -> body going into starvation mode -> no weight loss.

So imagine my surprise today at the diabetes management class my endo required me to attend. The nutritionist gave the normal advice of "eat less, exercise more", which is true to an extent, but not always. And then we moved onto label reading and carbohydrate counting. Somewhat naïvely, I now realise, I expected a long lecture re complex versus simple carbohydrates, the "carbohydrate" versus "sugars" lines on food labels, and advice that you probably wanted "sugars - dietary fiber" to be less than ~10% of the total carbohydrate load. Basically, foods full of complex carbs, that would be digested slowly, releasing a steady stream of glucose into the bloodstream, that would keep one fuller for longer. I also expected more about glycemic loads and how to put into practice the fact that some foods release carbs faster than others, and are, in many ways, more lethal for one's control than just chugging pure glucose. (There's also the role of acids in slowing glucose uptake, but I figure now, that that's really advanced stuff.)

How wrong was I. Her basic advice was "eat a lot less, count your carbs, but don't actually pay attention to where those carbs are coming from." Oh, she conceded that stuff without added sugar was better, but really, if it didn't have added sugar, it didn't really matter if your 15g of carbs came primarily from sugars or from other sources. I almost headdesked. Repeatedly. I asked about glycemic loads and indices, and was told that "well, its not FDA approved so we can't say that it works." Because research from the rest of the western world doesn't count, obviously. My comments of "these are the regimens that doctors in France and England had me on, and it worked" was met with "well, it could have been the meds". The fact that since I went back onto a low GI diet, I saw immediate improvement didn't sway her. She blithely insisted that it was only the total number of carbs that mattered in a meal, not the source of said carbs. Really lady, because a diabetic having a brownie for lunch and a diabetic having a green leafy salad, with grilled chicken, croutons and some form of multi-grain bread are going to have identical blood sugars 2 hours after lunch.

I can understand being nervous for a totally unproven therapy, but is approved in most near rest of the world, and is a proven way to help diabetics keep blood sugars under control. What I absolutely cannot fathom though is the "all carbs are created equal" line. They're not, at all, and anyone with half an iota of awareness of how their bodies function will tell you this. FFS, they taught us this in high school.

Drugs to control diabetes are all well and good, clinically necessary, and I am thankful for mine as they keep me alive with a very high quality of life. But as is emphasised in the rest of the class, this is a condition that affects one's entire self, and so, it should be treated, IMO, holistically (in the entire body sense of the word). And yes, that includes proper diet, teaching people about proper diets and how different carbohydrate sources do affect you differently. In other words, not all carbohydrates are created equal. And the more that people that realise this and act accordingly, the easier it becomes to control your diabetes.