NYTimes: Diabetics Count Carbs, but Can't Give The...

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> June 6, 2004

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> Diabetics Count Carbs, but Can't Give Them Up

> By SARA IVRY

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> COUNTING carbs? Diabetics were doing it long before low-carbohydrate

> diets like Atkins or South Beach were all the rage.

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> But with some important differences, according to experts in diabetes

> and nutrition. Diabetics, they say, should not do without starches

> entirely, as the Atkins and South Beach diets do in their opening weeks

> and some diets advocate as routine.

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> Carbohydrates need to be kept in check by diabetics because of the

> metabolic changes they set off, said Cathy Nonas, a spokeswoman for the

> American Dietetic Association. " When we eat carbohydrates and they're

> broken down into blood glucose, insulin is sent out, " Ms. Nonas said.

> " If you watch out for your number of carbohydrates, you won't tax your

> pancreas as much, you won't need so much insulin. That would be one

> reason to count carbohydrates. "

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> That means limiting how many grams of carbohydrates are eaten each day,

> which is the chief method diabetics use to watch glucose levels. Gram

> amounts are available on food packaging.

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> M. Austin, president-elect of the American Association of

> Diabetes Educators, said that did not mean there was a " magic number of

> how many carbohydrates you should eat, even for people with diabetes. "

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> Calculations of an acceptable number of carbohydrates depend on factors

> like total caloric intake, weight and height, amount of exercise and

> whether a person is trying to maintain weight or lose it.

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> For diabetics, other factors enter the equation — what medications a

> person takes and how much insulin goes into the body. A doctor should

> be consulted about changes in diet to assure that insulin and

> medication are adjusted accordingly.

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> Ms. Austin says that the South Beach and other low-carb diets have

> spurred some of her patients to greater consciousness about what they

> eat and in what quantities.

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> But doing away with carbohydrates, nutritionists agree, is misguided

> and dangerous for diabetics; they can upset a vulnerable balance in the

> bloodstream.

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> Carbohydrates are a vital source of energy and critical for brain

> function. Diabetics who eat too little or do not adjust their

> medications as they change their diet risk low glucose levels that lead

> to a precipitous fall in energy and to hypoglycemia — dizziness,

> headache and sweating. Left untreated, hypoglycemia can lead to coma.

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> " It's really that old adage, " Ms. Nonas said, that applies to diabetics

> and nondiabetics as well: " to eat a variety of healthy foods and to

> watch your portion size. It's really very unromantic. "

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