Glycemic index_ the 4th dimension of diabetes management

If you think you’ve mastered everything there is to know about carb counting, it’s time for a little revelation. Banana bread food com Not all carbs are created equal. 5 star banana bread Another factor to consider is the influence of the Glycemic Index.

Glycemic Index (GI) refers to the speed with which carbohydrates convert into blood glucose.

Banana bread greek yogurt While virtually all carbohydrates (except for fiber and a portion of sugar alcohols) convert into blood glucose eventually, some forms convert much faster than others. Almond flour banana bread Technically, GI tells us the percentage of carbohydrates that have entered the bloodstream as glucose within the first two hours. Coconut flour banana bread For example: BREAD/CRACKERS

Foods with a high GI (greater than 70) tend to digest and convert to blood glucose the fastest, with a significant blood glucose “peak” occurring in 30-45 minutes. Spelt flour banana bread Examples include bread, potatoes, cereal and instant rice. Coconut flour banana bread vegan Foods with a moderate GI (approximately 45-70) digest a bit more slowly, resulting in a less pronounced blood glucose peak approximately 60 minutes after eating. Oat flour banana bread Examples include ice cream, orange juice, cake and pizza. Almond meal banana bread Foods with a low GI (below 45) tend to make a gradual appearance in the bloodstream. Baking soda substitute for banana bread The blood glucose peak is usually quite modest, and may take several hours to appear. Banana muffins without baking powder Examples include pasta, chocolate, milk, yogurt and beans.

Most starchy foods have a relatively high GI; they digest easily and convert into blood glucose quickly. Banana bread with cream cheese frosting Exceptions include the types of starches (called “straight chain” starches) found in pasta and legumes. Banana bread cookies Because these starches pack together very tightly, digestive enzymes take a while to break them apart – thus causing a slow, progressive blood glucose rise.

Foods that contain dextrose tend to have a very high GI, and are optimal for treating hypoglycemia. How to keep banana bread fresh Fructose (fruit sugar) and lactose (milk sugar) are slower to convert into blood glucose. No egg banana bread recipe Table sugar (sucrose) has a moderate GI because it contains a combination of glucose (which is very fast) and fructose (which is somewhat slower). Banana bread cookies recipe Foods that contain fiber or large amounts of fat tend to have lower GIs than foods that do not.

Why is glycemic index important? Because the effect of dietary carbohydrates is what really matters. Banana bread with pecans High-GI foods tend to make blood sugars spike quite high right after eating. Low sugar banana bread recipe This rapid rise and fall can be detrimental to one’s physical & mental performance on a daily basis, and may increase the risk for long-term complications.

The slower a carbohydrate digests, the less immediate and dramatic its impact will be. Icing for banana bread Low-glycemic index foods tend to make blood sugars rise more gradually. Banana and walnut bread recipe They enhance satiety and help to curb appetite. Banana bread bread maker They help to lower triglyceride levels and prevent “reactive” hypoglycemia, and they serve as excellent fuel sources in preparation for endurance exercise.

For those who take rapid-acting insulin at mealtimes, knowing the glycemic index also helps to determine the optimal timing of the insulin.

If the main source of carbohydrate in a meal has a high GI value (greater than 70), it is best to take mealtime rapid-acting insulin 20-30 minutes prior to eating. No baking soda banana bread This will allow the insulin peak to coincide as closely as possible with the post-meal blood glucose rise. Famous banana bread recipe Taking insulin for high-GI foods just before or during a meal would produce a significant after-meal “spike”, as the insulin would lag behind the blood glucose rise by about half an hour. Resep banana cake breadtalk Of course, if your blood glucose is low or dropping quickly prior to a meal, it is best not to delay eating after taking your insulin.

For meals with a moderate GI (approximately 45-70) taking rapid-acting insulin 20-30 minutes before eating could produce a blood glucose drop soon after the meal. Banana bread in bundt pan It is best to take the insulin 10-15 minutes prior to foods with a moderate GI.

For foods with a low GI (below 45) taking insulin prior to eating is likely to lead to hypoglycemia about an hour later, followed by a delayed blood glucose rise once the food finally kicks in. Jamaican banana bread recipe Instead, try taking the insulin soon after eating. Is banana bread good for you A second option is to split the rapid-acting insulin into two parts: half given with the meal, the other half about an hour later. One egg banana bread A third option is to take Regular insulin with the meal, rather than a rapid-acting analog. Is banana bread healthy For those who use an insulin pump, the bolus delivery can be extended over 60-90 minutes. Is banana bread bad for you A Matter of Accuracy

How accurate is the glycemic index? Given the variability in digestion and the impact of mixing foods with different glycemic index values into one meal, there is no way to tell exactly when a specific food or meal will cause the blood glucose level to peak. Bread maker banana bread What glycemic index is good for is categorizing foods according to their relative impact: slow, medium and fast.

There really is not much difference between a food with a GI of 50 and one with a GI of 60. Banana bread whole wheat flour But there should be a significant difference between an 80 and a 35. Banana loaf cake recipe Try adjusting the timing of your insulin to better match the expected rate of digestion, and see what happens – particularly with your after-meal blood glucose levels. Banana and walnut loaf recipe Diabetes management, by its very nature, is all about “trial and adjustment,” so if you don’t get it right the first time, don’t give up!

Brand-Miller, J, et al, The Glucose Revolution. Banana and walnut cake recipe 1998, Marlowe & Company, NY, NY.

Brand-Miller, J. Banana bread with bread flour and Foster-Powell, K. Homemade banana nut bread New Glucose Revolution Low GI Guide to Diabetes. Banana muffins with coconut flour 2006, Marlowe & Company, NY, NY.

Geil, Patti. Banana cake with plain flour From Jelly Beans to Kidney Beans: What Diabetes Educators Should Know About the Glycemic Index. Banana bread with coconut milk The Diabetes Educator. Eggless banana cake with condensed milk 2001; 27:4. Banana poke cake with condensed milk 505-508.

Editor’s note: Gary Scheiner is owner and clinical director of Integrated Diabetes Services (; 610-642-6055), a private practice specializing in advanced training and management of children and adults on intensive insulin therapy. Banana pudding recipe with condensed milk and cream cheese His team of CDEs (all of whom have Type-1 diabetes) provides consultations worldwide via phone and the internet. Healthy banana bread applesauce Gary is author of several books including “Think Like A Pancreas” and was named 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators. Bread machine banana nut bread Feel free to submit questions and comments to

Read more about AADE, Apple, exercise, glycemic index, insulin, insulin pumps, low blood sugar.

I realize the impact of High GI foods but for myself I choose not to cut them out of my diet.I was diagnosed 50 years ago with Type 1 (actually Juvenile Diabetes). Recipe for banana chocolate chip muffins Until 1982 I had not idea what my BGs were, in 1982 I got my first home testing meter. Starbucks banana nut bread calories But since then I have kept an eye on my BGs. National banana bread day For the last 5 years my A1c averages just a hair under 6.0 with a max of 6.3 and a min of 5.2. Banana oatmeal bread recipe I have been using a pump for the 14 years and a CGM since 2010.So what am trying to say, if you have high GI foods, like everything else, do it moderation. Difference between banana bread and banana cake Then, test and test or use a CGM, know how to react but don’t stack insulin.

After my type 2 diagnosis in 1998 I was determined to manage this health condition without the use of any diabetes specific medications. Banana recetas The Glycemic Index was just catching on at the time, so that was my starting point. 1 banana banana bread For example, instead of rice Id cook pearl or pot barley, seasoned with chicken or vegetable stock. Banana comic Barley has a very good GI rating of around 22. Banana pictures funny Instead of boiling or baking potatoes I went to using various forms of squash. Banana pictures I limited my pasta to Fettucini. Banana chiquita In the course of about two weeks I found my two hour after dinner readings had dropped from around 250 to below 180. Healthy banana and blueberry bread Definitely an improvement but not good enough. Calories in starbucks banana bread Then while doing research online I stumbled on the chatroom at the Joslin diabetes center website. Calories in banana nut bread Asking what I needed to do get my readings down to a normal range, in addition to using the Glycemic Index, a wonderful fellow from Virginia, screen name Hector, offered up some advice. Banana bread recipe Hector was type 1, in his early 70s and by cycling up to 50 miles a day he had been able to reduce his insulin dosages by about a third. Recipe for banana bread His advice was regular walking or cycling, not the sissy stuff that diabetes associations recommend but real workouts. Easy banana bread recipe And he emphasized the importance of exercising immediately after eating, in order to direct blood glucose to energy rather than have them lie dormant and then turn into fat. Easy banana bread Well it took about half a year but by then I had not only achieved my 6.0 hba1c goal but by hba1c was closer to five, like 5.4. Best banana bread recipe Also, without even thinking about it, in this half year I had lost 40 lbs.

My conclusion was that neither the glycemic index alone or exercise alone is a magic bullet for managing diabetes. Banana nut bread However, in combination they are dynamite. How to make banana bread Following the GI guide delays absorption of glucose until I get a chance to start metabolizing the blood sugars for activity/exercise. Moist banana bread recipe And exercise effectively burns off those sugars before they are converted to body fat, or eventually go out with the urine.

For optimal blood glucose results I steered clear of all the foods listed here, even the ones categorized as low GI. Moist banana bread Why? Because all the best foods that optimise one’s own biochemistry to full advantage (for optimally low glucose ketone index) are not even on these GI lists… non starchy plant based foods, meat, fish, healthy fats, nuts. Banana nut bread recipe Eat these, combined with HIIT activity to attain optimal self management and remission then operationally cured status (where applicable). Healthy banana bread GI listed foods are way way too high carb!

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