Answer to Question 1
As long as Tammy is consistent with her insulin injections while adhering to a routine exercise schedule she does not necessarily need to focus upon specific carbohydrates. However, the concept of glycemic response (the change in blood glucose following the ingestion of a specific food) is often considered for an individual requiring fine-tuning of their dietary choices to optimize regulation of blood glucose.
If Tammy were to choose her foods based upon the glycemic response (GR) they elicit, then she would want foods in her daily diet that routinely provide a lower response. Foods with lower GR would have glycemic index (GI) scores of lower than 55 on a scale of 1-100. Using Figure 4.16, some examples of low-GI food choices might be: oat bran cereal, white rice, fresh corn, popcorn, cracked wheat bread or cereal, apples, bananas, potato chips, apple muffins, lentil soup, grapes, apple juice, grape juice, plums, and even chocolate. It should be noted that a wide variety of food items have low GIs.
Answer to Question 2
An individual with diabetes does not have enough insulin, so, when Tammy stopped her insulin injections, not all the glucose entered her cells for energy or storage. In fact, some of Tammys glucose remained circulating in her blood and was filtered out by the kidneys, resulting in many calories lost as glucose in the urine. Thus, Tammy lost weight when no additional insulin was provided.
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