What is Carbohydrate Intolerance?

It can be frustrating; you do your best to eat healthy, exercise, and manage your blood sugar. But if you have trouble maintaining a healthy weight and keeping your blood sugar under control, insulin resistance may be to blame. And this can manifest as carbohydrate intolerance. 

What is carbohydrate intolerance? 

When we eat foods that contain starches and sugars (carbohydrates), like breads, rice, pasta, potatoes, fruit, desserts, and sugary drinks, the body breaks them down into sugar and causes a rise in blood sugar (also called glucose). Our bodies need to keep blood sugar controlled within a narrow range - not too high and not too low. So as blood sugar rises, the body signals to the pancreas to release an important hormone, insulin.  Insulin moves blood sugar out of the bloodstream and into cells where it can be stored or used for energy.

Each person has their own unique carbohydrate tolerance. For some, blood sugar returns to normal after a high-carbohydrate meal, which is what’s supposed to happen. These people are sensitive to insulin, which is a good thing and allows blood sugar to move efficiently from their blood into their cells.

If you have insulin resistance, your cells are not taking in sugar as they should, which triggers your pancreas to produce even more insulin in an attempt to clear that sugar out of your bloodstream to return to “normal” glucose levels.  The difficulty that the body has dealing with carbohydrates and keeping the blood sugar levels normal (due to insulin resistance) is carbohydrate intolerance. The body doesn't respond normally to carbohydrate intake, and higher carbohydrate intake only worsens the problem. The longer this goes on, the more likely you are to develop prediabetes, which then often progresses to type 2 diabetes. 

Insulin resistance and carbohydrate intolerance often develop years before the development of prediabetes and diabetes. Without intervention, the carbohydrate intolerance gets worse over time. The pancreas tries to keep up the best it can, but it eventually falls behind. This is when sugar levels start to rise to levels which are in the prediabetes, and eventually diabetes, range.

What causes carbohydrate intolerance?

It's unclear why some individuals handle carbohydrates better than others and why some people progress to insulin resistance, carbohydrate intolerance, and eventually to prediabetes and diabetes. We believe this is probably affected by a number of factors including your genes, how you eat, your activity level, and your weight, but there is no good way to predict if and when this will occur.

If you have a family history of type 2 diabetes, have struggled to lose weight or keep weight off, or have had many years of exposure to a high-carbohydrate diet, you are more likely to have insulin resistance and experience carbohydrate intolerance.

Common symptoms of carbohydrate intolerance 

Common signs and symptoms associated with high blood sugar and carbohydrate intolerance include:

• Fatigue
• Increased thirst
• Dry mouth
• Increased urination
• Erectile dysfunction
• Frequent urinary or vaginal infections
• Increased hunger
• Neuropathy (tingling and numbness in your hands and/or feet)
• Weight gain, particularly around your waist 
• Blurred vision
• Frequent infections
• Slow-healing sores
• Trouble focusing
• Poor sleep
• Small skin tags
• Darker skin around your underarms, neck and skin folds

Carbohydrate intolerance and type 2 diabetes

If you have type 2 diabetes, you are carbohydrate intolerant. When you consume higher amounts of carbohydrates, your sugar level will go up higher and more quickly than it should, and it will require more insulin to lower your blood sugar to a normal range than someone who doesn’t have diabetes. 

How to deal with carbohydrate intolerance

Diseases related to carbohydrate intolerance—such as prediabetes, type 2 diabetes and obesity—can often be reversed and put into remission with the right lifestyle changes.  A low-carbohydrate diet is one of the best-studied methods for reversing these diseases. 

If you are carbohydrate intolerant, it’s important to be cautious of your carbohydrate and sugar intake. Even foods that are usually considered “healthy”—like potatoes, oatmeal and brown rice— raise your blood sugar and can be a challenge for those who are carbohydrate intolerant. Here are some other foods and beverages to limit or avoid:

• Baked goods like breads, bagels, and pastries
•  Rice, potatoes, and pasta
• Snack foods like pretzels, chips, crackers, and candy 
• Beverages like soda, fruit juice, and sweetened coffee, tea, or cocktails
• Sweetened breakfast foods like, sugary cereals and jellies and jams
• Syrups, agave, honey, and other forms of sugar 

Low-carbohydrate foods that are less likely to raise your blood sugar include: 

• Meat, fish, and poultry without breading
• Shellfish, like shrimp, scallops, oysters and mussels
• Eggs and full-fat dairy
• Non-starchy vegetables like asparagus, beets, brussel sprouts, broccoli, cauliflower, eggplant, and more
• Leafy greens like spinach, kale, arugula, and lettuce
• Low-sugar fruits like tomatoes, avocado, blueberries, kiwi, and more
• Olive oil
• Nuts and seeds, and nut butters
• Almond and coconut flour 

While being carbohydrate intolerant can make it harder to manage your diabetes and lose weight, you can take steps to support your health with the right meal plan and medical guidance.  

‍Virta Health utilizes a medically supervised, personalized nutritional approach to reverse type 2 diabetes and prediabetes. This means eating foods that are low in carbohydrates, moderate in protein, and higher in fat. But it’s not just about the food—it’s about the support. Virta provides 1:1 virtual coaching and medical oversight to help make this lifestyle stick. See if you’re eligible for Virta here.