Diabetes - Part 3: Diet and Nutrition in the Management of Diabetes

Overview
If you have been diagnosed with diabetes, you know that it means your body is not handling sugar properly. With type 2 diabetes, you may be producing insulin, but the cells are just not responsive to the insulin. So, instead of the sugar entering the cells where it can be used for energy, it just kinda hangs around in the blood. This leads to high blood glucose (sugar) levels, which in turn can create all kinds of health problems. These problems are discussed elsewhere. For now, I want to focus on the importance of diet and nutrition in controlling diabetes.

Goal of Dietary Management of Diabetes
Your primary goal in treating diabetes should be to get your blood sugar to a safe level and maintain it that way. Ideally, you would want it to be between 70 and 99 mg/dL. Your doctor will work with you to determine what is a safe, desirable and sustainable level for you.

It is important to understand that high blood sugar can lead to heart disease and stroke over time. It can lead to blindness, cuts, bruises or infections that are slow to heal, nerve damage and kidney failure. But by controlling your blood sugar, you can reduce the chances of these conditions developing. In effect, proper control of your blood sugar will help to improve your overall health.

Dietary Strategies for Controlling Your Blood Sugar
The most important thing that you can do to control your blood sugar is to eat a diet that is rich in vitamins, minerals, fiber and other health-promoting compounds. Of course, consuming a healthy balance of energy nutrients, namely protein, fat and carbohydrates, is also critical. At the same time, you will need to avoid foods that are loaded with added sugar, trans fat or saturated fat and salt/sodium.

If you are overweight or obese, you have a greater risk of having diabetes than people who are at a normal weight. Numerous studies show that losing weight can help to improve blood sugar levels and thus reduce other health risks. Even if you lose just 10 percent of your body weight, you can see tremendous health benefits in terms of improvement in your blood sugar and other conditions, such as cholesterol levels.

Exercise is another important consideration. Getting regular exercise will help to lower your blood sugar levels, lose weight and improve circulation, all of which are important to total health.

Tips for Eating to Control Your Blood Sugar
Here are a few basic strategies that can help to control your blood sugar:

• Eat a variety of colorful fruits and vegetables. These foods are high in nutrients and offer a wide-range of health-promoting benefits.
• Eat foods that are high in fiber. Whole grains, fruits and vegetables, nuts, seeds and dried beans and peas are excellent choices.
• Eat foods that are high in omega-3 fats and monounsaturated fat. These fats act as powerful antioxidants to help prevent damage to your vital organs.
• Get an ample supply of vitamin D. A few minutes of exposure to the UVB rays of the sun daily should provide the vitamin D you need. But for extra insurance, the government recommends that you consume foods that have been fortified with vitamin D. Aim for 400 IUs of vitamin D from food.

Other Strategies to Manage Your Diabetes

• Eat meals and snacks at regular times each day. This will help to prevent your blood sugar from becoming dangerously high or dangerously low. If you are taking medication to lower your blood sugar, meals must be timed accordingly.
• Be consistent with the amount that you eat. Pay attention to how much protein, carbohydrate and fat you are eating. Learn what is a portion for each food group and plan meals and snacks accordingly.
• Get regular exercise. This will help to reduce the amount of sugar in your blood. It will also help you to lose weight if you are overweight.
• Lose weight if you are overweight or obese. As mentioned earlier, even losing a small amount of weight can have tremendous health benefits. In some cases, people have been able to decrease the amount of medication needed or to come off of medications altogether after losing weight and controlling their blood sugar with diet and exercise.
• Talk to a registered dietitian. You might be surprised at how clear all the "diet talk" becomes when you talk to a dietitian. Don't skip this important step. You can find a registered dietitian by going to the American Dietetic Association website: www.eatright.org and key in 'Find a dietitian,' to find a diet and nutrition professional near you. 

If you are not able to control your blood sugar by eating a healthy diet, exercising and losing weight, your doctor will prescribe a glucose-lowering drug. If medication is prescribed, you still have to pay attention to what and how much you eat. Making smart food choices is the secret to proper diabetes management. So, take medications as prescribed and follow a sensible diet.

Summary

If you have been diagnosed with diabetes, it is important to focus on lowering your blood sugar and maintaining it at an acceptable level. You can achieve this by paying attention to what and how much you eat, getting regular exercise and losing weight if you are overweight. Keep in mind that registered dietitians are the healthcare professionals most qualified to help you create a diet and nutrition program that is uniquely suited to your needs. So, ask your doctor for a referral if he hasn't given you one.

Resources
What I need to know about Eating and Diabetes
Diabetes and Diet - Disease Management and Prevention Information brought to you by the American Dietetic Association

Diabetes – Part 1: Know Your Risks

Overview 
Diabetes is a condition in which there is too much sugar (glucose) in the blood. In you have type 2 diabetes, the body either does not produce enough insulin or the insulin produced does not clear the sugar from your blood. Too much sugar in your blood could lead to numerous health problems, including heart disease and stroke. Knowing your risk can help you to make smart food and lifestyle choices to prevent or delay the onset of diabetes.

Know Your Risk for Diabetes 
How likely are you to develop diabetes? There are certain conditions, called risk factors, that tend to predict the likelihood of your developing diabetes. If you have any of these risk factors, your chances of developing type 2 diabetes are greater than someone who does not have any of those risk factors.

Here are some common risk factors for diabetes:

• Family history of diabetes/genetics
• Obesity
• Aging
• Lack of exercise
• History of gestational diabetes
• Race/ Ethnicity: Being African American, Hispanic American, Hawaiian or Native American

Tests for Type 2 Diabetes

If your doctor suspects that you might have diabetes or that you might be at risk, he will order a blood test. Initial blood glucose testing is fairly simple. A blood sample is taken and tested to determine the amount of glucose in your blood.

Fasting blood glucose. To take a fasting blood glucose test, your doctor will ask you not to eat anything for at least 8 hours before the blood test is scheduled. A blood sample is then taken and checked for glucose. A normal fasting blood glucose level is 70 to 99 mg/dL.

If your test comes back at 100 to 125 mg/dL, you are considered to be pre-diabetic. It means that your body is not handling the sugar efficiently.

Above 125 mg/dL you are likely to be diagnosed as having diabetes.

Oral glucose tolerance test. Another test for diabetes is the oral glucose tolerance test. This test is done after you have fasted for at least 8 hours. After the 8-hour fast you are given a sugar (glucose)-containing drink. Your blood is tested for glucose two hours after you have had the drink.

If your blood glucose level is less than 140 mg/dL, your blood glucose is considered to be normal.

If your test shows that your glucose level of 140 to 199 suggests that you may have pre-diabetes.

If your blood glucose level is 200 mg/dL or greater, you will most likely be considered to be diagnosed with diabetes. A repeat test should be done to confirm the diagnosis.

Gestational diabetes. Gestational diabetes is a condition that occurs in many women during pregnancy. This test is a part of the standard care for pregnant women. The blood sugar levels needed to render a diagnosis of gestational diabetes are a little different from those used for non-pregnant women.

Summary
If you are at risk for diabetes, it does not mean that you will absolutely develop diabetes. It just means that you have a greater chance than someone who does not have any of those risk factors. Get tested and talk to your doctor and a registered dietitian about steps you can take prevent or delay the onset of diabetes.

Next Blog Post: Part 2: Signs That You Might Have Diabetes 

Resources
Your Guide to Diabetes Type 1 and Type 2

Diagnosis of Diabetes

CDC Diabetes Public Health Resources
Glucose Tests: The Tests

Health Benefits of Pomegranate

Overview

Pomegranate contains high levels of polyphenols, which act as powerful antioxidants that help to protect the cells from oxidative damage. These polyphenols have been shown to have a number of health benefits in laboratory studies as well as in epidemiological studies in humans. In fact, due to the high level of polyphenols and the health benefits observed in a number of scientific studies, pomegranate has been listed as a "superfruit" by the Food Marketing Association.

Polyphenols in Pomegranate

A number of studies show that polyphenols in pomegranate act as powerful antioxidants in laboratory animals and in humans. These compounds act as scavengers, mopping up free radicals in the blood and protecting healthy cells from oxidative damage.

Health Benefits of Pomegranate

A number of studies have been done to determine the health benefits of pomegranate. These studies show that regular intake of pomegranate and pomegranate juice can help to promote health and prevent a number of diseases. The health benefits observed are associated with the high content of polyphenols in pomegranate. According to these studies, pomegranate and pomegranate juice may help to:

• Prevent hardening of the arteries
• Protect against heart disease
• Prevent blood clots
• Slow down the growth of cancer cells (breast and prostate cancer)
• Fight bacterial infection
• Increase glucose and insulin sensitivity (reducing the risk of type 2 diabetes)
• Improve cholesterol profile (markers for heart disease risk)
• Promote brain health and protect against Alzheimer’s

Eat More Fruits Like Pomegranate

The food guide pyramid calls for Americans to eat at least 2 to 3 servings of fruits daily, along with at least 2 to 3 servings of vegetables.

Eating pomegranate or drinking pomegranate juice daily or at least 3 times a week will help you to meet this goal. You will also be able to enjoy the health benefits that the polyphenols in pomegranate provide.