During my recent annual physical, my primary physician and I were yapping. She mentioned that many of her diabetic patients are Hispanic and by virtue of their heritage eat very high carb foods which cause major blood sugar problems. Specifically, she said her patients eat a lot of rice and beans.
As an entirely insulin dependent diabetic, rice is very, very tough. Sometimes it works and sometimes I need to just stay away from it. I dislike beans other than baked beans and that’s an even bigger problem than rice because of all the molasses and brown sugar. So, those are a big no-no in my world.
It got me to thinking though. Though, I highly limit rice, I have eaten it successfully. How? And what is my definition of success? In my mind, success is matching up insulin to the digestion of food so that blood sugar does not spike out of the target range.
The attainment of success for an entirely insulin dependent person relative to carb ingestion is different than for a non-insulin dependent person relying on diet only or an insulin sensitivity medication. Insulin-dependent diabetics can attempt to take insulin, wait a few minutes and try to match up the insulin to the food. A non-insulin dependent person is not afforded the luxury of rapid acting insulin. They must rely on their own naturally made insulin, insulin sensitizers and/or exercise.
Some of the key techniques are the same, however.
- Test about an hour before planning to eat. If out of range, find a way to lower blood sugar to be in range prior to eating. If insulin-dependent, take a correction dose. If you don’t take insulin, maybe take a brisk walk. I never eat carbs if my blood sugar is greater than 110. I wait until I’m back in range or I eat green veggies and protein.
- Know the rice. They’re different. The color of the rice is not important for blood sugar; it is how quickly the “sugars” break down. That can vary, for instance, by length of the rice. For example, “minute rice” is meant to cook and break down quickly and thus, will digest and raise blood sugar more rapidly. Arborio rice is also going to break down well. Long grain rice, on the other hand, tends not to be so quick to digest.
- Eat rice slightly al dente. Cooking technique and cooking duration tend to also alter the speed with which it digests. If you sauté and brown the rice before you add liquid, it will stay firmer and not break down as quickly. In addition, the longer you cook the rice, the faster it digests. So slightly al dente cooking might be beneficial to decrease the risk of blood sugar spikes.
- Add protein and healthy fat to the meal. This slows down the digestion which will aid both insulin dependent and non-insulin dependent diabetics. For those taking insulin, protein helps slow down digestion enough to catch up to the insulin. For those who take insulin sensitivity medications and still make some of their own insulin, with this technique there’s a better chance that insulin will work and not create a blood sugar spike.
- Eat protein, healthy fats and veggies first. Save the carbs for last. Again, it helps insulin catch up to avoid a blood sugar spike.
- If necessary, cook your rice in a separate pan (from the family pan). Caloric content for rice is based on uncooked rice. So if you try to just scoop it out the pan with everyone else’s, the numbers just will not compute. It’s a little more work but it makes a world of difference.
- Get a food scale. Don't even bother trusting a measure cup - especially for those taking insulin, precision matters. Use the gram count on the nutritional packaging label - such as from Uncle Ben's converted rice. As an example, if one unit of rapid acting insulin corresponds to 75 points of blood sugar or 15 carbs; over or under estimating 10 carbs is a big deal.
- Eat small amounts. One serving of most plain white or brown rice translates to approximately 36-38 carbs. That should be sufficient with protein and veggies to fill-up most people without making it impossible to control blood sugar in the 30, 60, 90 or 120 minute periods.
Those who rely on diet only may still not be able to successfully eat rice. You may not have enough Phase 1 insulin (the equivalent of rapid acting) to keep you from spiking in the first hour or so.
Experiment with very small quantities (say ½ a serving) to determine your body’s response times. Try testing at least at 30, 60 and 120 minutes when testing any food. Watch the curve; watch how you feel. Are you in target? Do the carbs only make you hungrier than you were to begin with (always a bad sign to me)? As always, write it all down, so you can reference what does and doesn’t work the next time you try to eat that particular food.