How much carbohydrate and sugar can a diabetic take?

Q: My wife is suffering from diabetes. How is carbohydrate intake related with sugar in a diabetic? What is the amount of carbohydrate and sugar one can take in one's daily diet to keep blood sugar under control?

A:There is a problem with carbohydrate metabolism in diabetes as the glucose absorbed is not properly delivered to the tissues due to lack of insulin or insulin not working properly (insulin resistance). This does not mean you stop taking carbohydrates, as this is the main source of energy. You should be taking carbohydrates with a large amount of fibre in it, so that the absorption of carbohydrates is slow and the glucose rise is gradual rather than sudden. For example, you can take mostly all kinds of fruits, including a small amount of mangoes, as they have high fibre content. The food with high glycaemic index should be avoided, such as cornflakes, maida and suji based products compared to chapattis. There is also a misconception that you can takes biscuits but not fruits, which is also wrong. The role fruits play in preventing heart disease is very well established and just because fruits are sweet you should not stop eating fruits. Most of the fruits and vegetables have low glycaemic index, except watermelon . Most Indians take large amount of melons, but this has high glycaemic index compared with mango or banana. It is important to ensure an adequate and balanced nutritional intake. The aim to provide 50%-55% energy intake from carbohydrates (remaining 30% from fat and 15% from protein) by increasing intake of complex carbohydrate and fibre rich foods (e.g. chapatti compared to refined foods like naan or bread made from maida) and also limit the intake of rapidly absorbed carbohydrates. Ensure that complex carbohydrate foods (starchy foods) are eaten at each meal / snack. The meal should be taken regularly. Overall, fat intake should be around 30% and only small amount should be from saturated fats (e.g. ghee/dalda, etc.) of energy intake. Body weight should be monitored, maintained and reduced, if necessary.In brief, you should eat meals which are less processed, e.g. instead of juice, eat oranges, and have chapatti instead of naan or bread. The traditional Indian food has high fibre intake as long we avoid fried foods (puree and sweets). At the same time, there is no need to follow a modified Western diet like having brown bread if you can have wheat bread, chapatti and vegetables. Dalia is much better than cornflakes.