Diabetes: A Primer (Part 2)


Last month, I provided some basic information about diabetes, pre-diabetes and how they are diagnosed. If you recall, diabetes is characterized by insulin resistance, which is the condition of having high blood sugar. Having sustained periods of high (or low) blood sugar can have serious implications on your health, and can lead to multiple co-morbidities, such as heart disease, kidney disease, blindness and neuropathy. Fortunately for many of those with diabetes, the condition can be improved or even managed completely through diet and lifestyle changes. However, very few make the diet and lifestyle changes that can improve their health.

Let’s review the dietary component of diabetes.

Our diets are made up of three different macronutrients: protein, fat and carbohydrate. One of them, carbohydrate, has the biggest impact on our blood sugar. The digestion of carbohydrates immediately raises our blood glucose levels, and we depend on insulin to remove those sugars from the bloodstream. Those with diabetes don’t produce enough insulin, or perhaps don’t even produce insulin, the glucose can’t be removed from the bloodstream to be turned into energy.

Carbohydrates include grains, dairy, fruits and vegetables. The term ‘carbohydrate’ is really a fancy word for sugar. So, food items with natural sugars (like fruit) or added sugars (like candy) are high in carbohydrates. Different foods have different amounts of carbohydrates; breads, potatoes and fruit have more natural sugars than, say, spinach.

Diabetes can be managed with diet and lifestyle changes alone, medication alone, insulin alone, or a combination. Type 1 diabetics need insulin injections because their bodies don’t produce insulin. Type 2 diabetics can often control their blood sugar levels with diet and lifestyle changes, yet many rely on oral medications and, sometimes, insulin injections as well.

A ‘consistent carbohydrate diet’ is a way to manage your blood sugar without medication. By giving your body approximately the same amount of carbohydrates at each meal and snack, you help your blood sugar stay at even levels throughout the day. Following a CCD diet takes only the ability to read a nutrition label and do some simple math. All you need to know is that one carbohydrate serving = 15 grams. By familiarizing yourself with how many grams of carbohydrate are in the foods you eat most often, you can easily control the amount of carbohydrate you consume at each meal. Nutrition labels include a line for TOTAL CARBOHYDRATES. Using that number and the serving size specified, you can easily determine how much carbohydrate is in the amount you plan to consume. For example, a slice of most sandwich breads is approximately 15 grams, so one slice = one carbohydrate serving. If you make a sandwich for lunch, you’ve used up two carbohydrate servings. Add a small apple and glass of milk and you have two more carbohydrate servings, for a total of four servings in one meal. Most adults should aim for three to four carbohydrate servings (45-60 grams) per meal, and one to two (15-30 grams) per snack. Active adults may need more carbohydrates in their diets.

For optimal metabolism, combine carbohydrate choices with sources of fat and protein. Both fat and protein take longer to digest, which blunts the rise in blood sugar and promotes greater satiety, which helps you feel fuller for longer periods of time. For example, instead of just eating an apple mid-afternoon, combine that apple with a cheese stick or an ounce of nuts.

In addition to dietary changes, there are other adjustments you can make to help control your blood sugar.

Exercise causes our bodies to remove glucose from the blood stream in order to turn it into energy. So, exercising lowers blood sugar. Consider taking a walk after a meal to help lower your blood sugar. Those who manage their diabetes with insulin need to be mindful of the timing of their meals, exercise and insulin injections so they do not lower their blood sugar levels too much.

Maintain a healthy weight. If you need to lose weight, remember that losing even just 5-10% of your current body weight can yield health benefits.

For more information about managing diabetes, consider working with a Registered Dietitian or Certified Diabetes Educator (CDE).



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