When many of us think about managing diabetes, watching sugar intake comes to mind. But just as important as the sugars we consume are carbohydrates.

“The terms sugars, starches and carbohydrates are often used interchangeably because they all break down into simple sugars in the body,” says Jackie Matsunaga, MMN, RDN, LMNT, LD, CDES, Nebraska Medicine certified diabetes care and education specialist and nutrition therapist.        

Despite the negative rap carbs often receive, getting a minimum amount of carbohydrates in your daily diet is essential for energy and brain function, says Matsunaga. Carbohydrates break down into glucose, the primary energy source for your brain.

If you have diabetes, your body does not process carbs as efficiently as nondiabetics. “Determining how many carbs you should have daily is not a perfect science because everyone processes carbs differently,” says Matsunaga. “So how many you can have and what types of carbs work best in your diet is very individualized according to your body and possible medications you may be taking.”

The key to managing your carbohydrates is moderation, being aware of the types of carbs you’re eating and pairing them with proteins and healthy fats, Matsunaga says.

When you think about sugar and carbs, it’s good to know which ones are better for you than others, notes Matsunaga. Think about them this way:

Types of carbs and sugars include:

• Simple sugars are the building blocks of carb foods and are processed more quickly in the body. These include added sugars, discussed later, but also are in fruits (fructose) and dairy (lactose). While you need to be aware of these sugars, they should not be eliminated from your diet, as some provide many essential vitamins and minerals. For instance, milk and other dairy provide calcium, vitamin D and protein. Fruits offer fiber and other vitamins and minerals that provide your body with many benefits.
   
• Added sugars are sugars added to foods such as candy and processed foods. Foods with lots of added sugars can cause big spikes in your blood sugar level and provide no nutritional benefit.
   
• Refined carbohydrates are found in foods such as white bread, white rice and white pasta. These are carbs that have been stripped of fiber and beneficial nutrients. They can cause a larger spike in your blood sugar level because your body processes them more quickly.
   
• Complex carbohydrates are whole grains, which contain fiber and other important nutrients. They typically don’t cause as large of a spike in your blood sugar level as refined carbohydrates because it takes longer for your body to process them with the added fiber.

“To simplify things, I like to tell my patients to pay attention to the total carbs when looking at labels, as total carbs include the fiber, sugar, and added sugars content,” Matsunaga says.

To help determine if you are making a healthy food choice, Matsunaga also recommends looking at the fiber content and the amount of added sugars in a product. The more fiber and the less added sugar, the better the food choice.

Obviously, there are no labels to check carbs for fruits and vegetables, so you do need to be aware that some vegetables are starchier than others, just as some fruits have a higher sugar content. With these foods, you need to reduce your portion size, notes Matsunaga.

Starchy vegetables include corn, peas, potatoes, sweet potatoes and winter squashes like acorn and butternut squash. On the other hand, vegetables like green beans, broccoli, cauliflower and Brussell sprouts have very low carb and high fiber; therefore, we often call them free, says Matsunaga.

Fruits like bananas, grapes and mangos typically have a higher sugar content than others, requiring smaller portions. Berries, on the other hand, are generally lower in sugar and high in fiber, allowing for larger portions.

“We recommend you eat whatever fruits and vegetables you enjoy, as they provide great nutrition. However, with starchy vegetables and fruits you need to be mindful of portion sizes,” Matsunaga says.

Examples of one-carb servings include:

• Small apple
• One kiwi
• Half a banana
• 1 cup of berries
• Medium peach
• 1 slice of bread
• 1 cup of nonfat yogurt
• 1 small ear of corn
• Half a medium potato

At mealtimes, Matsunaga recommends using the plate method to help you determine proper portions. First, identify which items in your meal are carbs. The goal is to allow one-quarter to one-third of your plate to carbs. The remaining part of your plate should be divided between your protein and non-starchy vegetables. “Keeping your carbs in check is about portion control and balancing your plate,” says Matsunaga.

Also, try to shoot for a consistent pattern in your eating habits. For instance, don’t save all your daily carbs for one large pasta meal at dinner. “This puts a big load on your body to process and metabolize all at once,” says Matsunaga. “It’s better to eat smaller amounts of carbs throughout the day.”

When it comes to snacks, Matsunaga recommends pairing a carb with a protein and/or healthy fat. This will help you moderate your carb intake, get protein for sustainability and provide a more controlled rise in blood sugar.

Healthy carb and protein combo snack options include:

• Whole grain crackers with cheese
• Apple with peanut butter
• Popcorn with nuts
• Greek yogurt with granola
• Hard-boiled egg with a small slice of toast

While managing carbs is key to maintaining a good diet for those with diabetes, says Matsunaga, remember that carbs are good for you in moderation. They are even better for you when combined with fiber and protein, providing more sustainable energy throughout the day.