There is nothing simple or comforting about being told that you are a diabetic. As a person with diabetes you will soon know the disease can go out of control with a diet that is out of control. The following guidelines are have been collected from various sources and will hopefully will help you start getting your diabetes under control. There is no guru, advisor, magazine, book, web site or psychic that can replace your doctor in your fight against diabetes. Discuss this content, and any change in your lifestyle, with your doctor. Make them your partner.
There is some good news...
The good news is that the great majority of diabetics can live a perfectly normal life with a modest lifestyle change. Yes, Lifestyle Change! We hear the term a lot lately. Weight loss programs and their success are often linked to your willingness to adopt a “lifestyle change”. The reason for the emphasis on lifestyle is that any action you take to treat your diabetes must be considered to be permanent. This is not a temporary disease so it follows that as you fight Diabetes that you make a solemn commitment to change your lifestyle. This will help you get the resolve that it takes to move forward. It sounds tough but as you will find it is just a matter of fact. It’s like going to the dentist and taking baths - just needs to be done.
Most of us can deal quite well with our diabetes through understanding, education and awareness. There is more information on the Internet than you can read. And Its free! This is a wealth of stuff you can use to become educated. Your doctor will help you understand the implications of the disease. Don’t be afraid to ask questions to help you understand what can, and is, happening to your body.
You should have a clear understanding that, while there is no cure for Diabetes, awareness of your body will make its impact on your life much easier to deal with. Left unattended it can be catastrophic. Severe forms of Diabetes are a serious problem. However, for most of us, if the disease is managed and treated you can most likely live a long healthy life with no major ill effects.
This information is intended as a start point and therefore is basic in nature. I cannot stress strongly enough that you use this information as a guideline and continue your own research of these issues.
Diabetes can be frightening if you are unaware.
Its up to you to become aware of how diabetes works, and what you can do to mitigate it’s effect on your life. At the end of this article you will find resources and links that will give you more information.
Limit Sweet Foods???
The instant reaction of a person that has been diagnosed diabetic is that sugar is the culprit. This is only partly true. Certainly, sugars and products made of sugar are something you should limit. Bear in mind that sugar is a carbohydrate. Carbohydrates, all of them, sweet or savory are metabolized into glucose.
Glucose, in excess, is the enemy.
In days past Diabetes had a slightly different name. “Sugar Diabetes” is a name that lives on today but it is not completely accurate. Sugars, and foods that are high in sugars, turn into glucose very quickly. That is a problem for a diabetic. But the human body develops “Glucose” from many foods that are not considered sweet. This is due to the “Carbohydrate” content of what we eat.
That doesn’t mean that you can’t have “sweets”. There are many sugar substitutes that can replace sugar. More and more there are sugar free products on the market that are quite good. Sweets are among the highest in carbohydrate content per serving. So... if you must... take sweets in small portions.
Sugar is counted by the world as a carbohydrate. You should count carbs
because the total carbohydrates on a label include sugars as well as any other sources of carbohydrates. Keep in mind that all carbs metabolize into glucose. So....
Limit your intake of carbohydrates!
The great majority of foods carry some level of carbohydrate. In fact the complete elimination of carbs in your diet is a tough solution to deal with for most people. If you’re one of those folks that can modify their diet to strive for “0 Carbs” you are certainly a step ahead of the rest of us where carb control is concerned.
You should however be careful in limiting carbs so dramatically. There are many in the medical community that believe the complete elimination of carbohydrates can cause serious nutritional issues.
Foods with carbohydrates include:
Bread. Cereal, Pasta, Crackers, and Grains
Rice, Beans, Starchy Vegetables ( Potatoes, Corn and Peas)
Fruit and Fruit Juice
Milk, Yogurt, Dairy Products, Ice Cream
Sugar Products, Candy, Normal Soda, fruit drinks,
ALL DESSERTS made with real sugar!
The amount of carbohydrates you can eat depends on many factors. Along
with physical characteristics like weight and height there are many factors that add to the mix. Medications that help your body manage a high blood glucose, your activity level and a host of other variables will determine how many grams of carbohydrates you can ingest daily.
BE CAREFUL... I have looked high and low for a low carbohydrate diet that is not high in fats and cholesterol. That’s a tall order! Don’t fall into the trap of trading one problem for another. Carbs and Protein are necessary for healthy nutrition. BUT - All things in moderation.
There are many diets that make the statement we all have a carbohydrate tolerance level that is different. We all know that we burn calories at different rates so it only stands to reason that we would all metabolize carbs differently. Add this to the level of severity your diabetes has brought to the table and the reality becomes clear. All diabetics are different. The treatment for Aunt Sally’s diabetes most likely won’t work for you.
The suggestion is often made that a diabetic should limit carbohydrate
intake to 60 gm per meal. That adds up to 180 gm per day. Of course
this is just a guideline. Some treatments require upwards of five smaller meals per day to gain a better control of average Blood Glucose.
Again, consult your physician about this and all other major changes in your nutritional lifestyle.
Eat high fiber foods
Foods that are high in fiber have a tendency to digest slowly. That means your digestive system has to work harder to break down the food and turn it into glucose. You will still get all of the glucose, but the delivery will take longer. The longer it takes for a food to digest the less the chance of a “spike” in blood glucose. This is a desirable result. Hence the suggestion that you should search out high fiber foods.
Foods that are high in fiber include whole grains, beans and starches. Increasing your fiber intake is usually a simple decision between two foods that you are eating. As an example look at two pieces of bread. One white and one whole grain wheat. They are both high in carbohydrates (usually 12-15 grams of carbohydrate per slice) however one is higher in fiber. Given this choice you should eat the wheat bread because you need the fiber. There are many foods that are like this. If you do your research you can make make good decisions and eat good food in the process. The Nutritional Values section in the DMC will help you make the right decisions.
Control your weight
You would be hard put to find a health care professional that would not agree that maintaining proper weight is a major consideration in the fight against Diabetes. If you are overweight you are most likely making the disease worse than it needs to be. In fact many type 2 diabetics have experienced complete recovery with no adversity from diabetes by simply loosing weight through diet and exercise. Again your doctor is key in this program. Don’t go anywhere without them.
Diabetes is not the only medical problem that is made worse by being overweight. Heart disease, kidney disease, vision, circulation, and a host of other health problems are linked to obesity and diabetes. There is no question that an overweight diabetic has a more serious problem than a diabetic of “normal” weight.
Monitor your blood glucose levels
No one likes to punch a hole in their finger to read the level of glucose in their blood. You’re not alone! Unfortunately there is no other way to make this information available. Knowing the levels that occur during each day determine how you and your doctor treat your diabetes.
The blood glucose level readings, if done correctly, will uncover spikes in blood glucose. This is part of the reason for high fiber foods in your diet. Remember - if it takes longer for your body to metabolize a food there is less chance of a blood glucose spike that you that your system can’t overcome. It’s all a balancing act where you are the controller. A combination of medication, planning, awareness, activity and action will help mitigate the impact of diabetes and keep you in balance.
What should your blood glucose target be?
It depends on who you ask. The American Diabetes Association and The Association of Clinical Endocrinologists are two organizations that publish guidelines for what you should look for in readings. The next source of this information is your doctor. Remember your situation is unique to anyone else and is dependent upon many variables. There are no published targets specifically for you! That’s what your doctor does.
Here are a few guidelines for blood glucose:
American Diabetes American Association of
Association Clinical Endocrinologists
Fasting and 90 to 130 mg/dl <110 mg/dl
Two hours after <180 mg/dl <140 mg/dl
the start of a meal
Hemoglobin A1c <7 % <6.5 %
Source: Diabetic Living Magazine / Winter 2005 / Page 24 /Blood Glucose Goals
What is Hemoglobin A1c ?
The Hemoglobin A1c test gives your doctor a picture of the average amount of glucose in the blood over the last three months. The lower the better. This test, among others, is key to the diagnosis of Diabetes Mellitus.
This test is also known as glaciated hemoglobin or HbA1c. Hemoglobin is found inside red blood cells. Its job is to carry oxygen from the lungs to all the cells of the body. Hemoglobin, like all proteins, links up with sugars such as glucose. The glucose that attaches to your hemoglobin is expressed in percentages. I suppose that this gets a little technical. Suffices to say that the higher your A1c the less efficient your hemoglobin. Considering the job it does, that’s not so good.
In terms of change, a 1% drop in A1c reflects a change of about 30 mg/dl in average blood glucose. For instance, an A1c of 6% corresponds to an average blood glucose of 135 mg/dl. An A1c of 9% corresponds to an average glucose of 240 mg/dl. If a diabetic can keep their A1c at 6% or lower, the better their diabetes is in control. As the A1c increases, especially above 6%, so does the risk of complications.
Again everyone is different. Your doctor will use this test and others to determine how effective the treatment they have designed for you is.
When should I take Blood Glucose readings ?
When you rise in the morning. This is called a “fasting” reading
and assumes that you have not taken food for 8+ hours.
Two hours after you begin to eat. This will tell you the affect of
the meal you ate preceding the test. Remember that you are
looking for spikes.
Any Time that you feel that your blood glucose may be out of
Your physician should be consulted with regard to the level of testing and reporting they feel is appropriate. I have talked with diabetics that have told me that their physician felt that testing was not important because they relied on other tests to get the information. My suggestion to them has been to ask their doctor again and if they get the same answer…get another doctor. If you don’t test you don’t know!
Keep track of what you eat
It is frustrating when you take a reading and find that your blood sugar has gone through the roof for no apparent reason. When this happens it means that, even with the best of intentions, your program is out of control. This can mean many things. You might have eaten too much food that is off the program. You may also have a medication problem. Unless you have a record of what you ate that day, and the nutritional values of those foods, you are operating in the dark - and so is your doctor.
Planning and reporting your meals properly will make certain that you don’t fall off of the program and will help you make the lifestyle changes necessary to manage diabetes. The meal planner and meal reporter included in the DMC will help get you there.
We have all been given the guides for food measurement. A thumb is an ounce of cheese for example. I have heard all of these “Measurement Helpers” but the one that really impacted my thinking was offered by a diet program. It offered the rationale that your stomach is roughly the size of your fist, and therefore no meal should be physically larger than your fist. Now, hold your fist up and look at it compared to the meal you had for dinner. If you are like me they don’t match.
The dietary management of diabetes requires that you know what you are eating as well as how much. How do you tell that a 6 ounce steak is really 6 oz. by looking at it? I know that if I don’t measure the food I will miss the mark. You need a scale for measuring food at least in the beginning. After a while you will have made portion control a habit. When that happens you will know what is to much. Until then a scale is your best friend.
A competent scale is one that will account for the container holding the food. This is called a “null” of “tare” feature. It works like this: You put a plate on the scale, zero the scale and add food in the proper amounts. By zeroing the scale you don’t have to futz around with deleting the weight of the plate from everything. If you prepare servings this way you can’t miss the mark. Another way to eat less is a smaller plate. Sounds so simple but we are creatures of habit. Nothing you do to help you get on track is to goofy.
When you plan your meals or report the foods you have eaten be as specific as you can with regard to the portion. You would be amazed how much difference there is at the bottom line when you don’t fudge. Resist the urge to report less than you really are eating. If you think a portion is a little over 5 ounces, call it 6. If you do this you will get a better overall picture of reality.
A little exercise goes a long way
If there is anything thing more difficult than changing our eating habits it has to be starting an exercise program. Although it’s tough, you need to be aware that the benefits of exercise for a diabetic are astounding.
Weight Loss - Goes without saying that the more active you
are the less extra weight you will carry.
Lower Blood Sugar - A Normal by product of exercise is the
use of fuel in the body.
Increased Circulation - A major and necessary plus if your
Less emphasis on your dietary intake. The more active
you are the more capable you body is in handling dietary excesses.
Too Many benefits to list! Look at almost any health malady and
you will see benefit from exercise.
OK, its no surprise that exercise would give benefit and make life easier for most of us. If that’s the case, a logical question would be - why don’t we just do it?
Most of us that are diagnosed as diabetic have other issues that caused us look into our health. These issues can make us tired, possibly in pain and reluctant to move more. Pain is a lousy motivator! But motivate it must. If there is no exercise your quality of life is sure to get worse.
Just finding out that you have diabetes can bring on depression. It’s hard to get going when you are not depressed let alone when you are. Take this seriously and council with your doctor. Tell them how you are feeling emotionally as well as physically.
Whatever the difficulty, you must increase your level of exercise. Do what you can. Start slowly and increase as time goes by to get to a higher level. Try to get your heart rate up. If you need to work up to that, park farther away from the stores at the mall or take the stairs at work. Walk faster if you can. Even sitting with both of your feet on the floor uses more energy than propping up your feet. That’s exercise!
Remember that there is no exercise that is unacceptable. Be creative and look for ways to change how you do things. General rule of thumb: - If it’s uncomfortable you are burning calories and reducing your blood glucose.
The message delivered here is that Diabetes can be controlled. It’s effect on you life is in direct proportion to your reaction to the disease. We invite you to get involved. Talk to other diabetics. Embark on a quest to become aware of the disease and what makes it get worse, or get better. Listen to the good advise of the thousands of health care advocates at your disposal. And remember always the future is good and in your hands.
U.S. Department of Agriculture, Agricultural Research Service, USDA Nutrient Data Laboratory. 2008. USDA National Nutrient Database for Standard Reference, Release 21.
The American Diabetes Association / http://www.diabetes.org
The American Society of Clinical Endocrinologists / www.endo-society.org
The Hormone Foundation - www.hormone.org
Diabetic Living Magazine / Winter 2005 / Page 24 /Blood Glucose Goals