For Type 1 individuals, the onset of uncontrolled diabetes is rapidly apparent and can lead to medical emergency situations. For people with Type 2 diabetes, the disease may go undetected until diagnosed in association with a variety of medical symptoms. In both cases, unmanaged diabetes can lead to cardiovascular disease, renal disease, blindness, peripheral neuropathies leading to amputations and, ultimately, death.
Comprising sugars, starch and fiber, carbohydrates play the most important role in diabetes management. The amount and type of carbohydrate ingested, as well as the form in which it is eaten, and with what it is eaten, manifests itself in plasma BG readings two to four hours later. The nutrition goal is either to correctly supply the body with the appropriate amount of insulin to counteract BG levels (Type 1), or to make existing insulin more potent via weight loss and physical activity (Type 2). The American Diabetes Association advocates a dietary approach which manages the total number of carbohydrates ingested. An alternate emerging approach monitors the glycemic index of foods—the extent to which different carbohydrate-containing foods affect BG levels and subsequent insulin levels.