Beyond the Diabetes Diet, Nutrition Connection

Diabetes mellitus is a serious metabolic disease that affects the body’s ability to derive energy from blood sugar, or glucose. It results when the body cannot produce or properly use insulin, a hormone needed for glucose metabolism. Because all human body tissues need a steady supply of glucose, diabetes can affect every organ. In particular, it can lead to heart disease, kidney failure, blindness, and nerve problems.

Old School
Those with diabetes have to give up sweets entirely.
New Wisdom
In moderation, an occasional sweet treat is fine.

About 10% of diagnosed diabetes cases are type 1, also called juvenile-onset diabetes because the disease often develops in children. In this autoimmune disease, body does not produce adequate insulin. People with type 1 diabetes must take insulin daily. They must also strictly control their diet and phywsical activity to maintain near-normal blood glucose levels.

More than 90% of those with diabetes have type 2 diabetes, or non-insulin-dependent diabetes mellitus. Also called adult-onset diabetes, this form typically occurs in older adults who are usually overweight but is increasingly being diagnosed in children and adolescents. Although these people often have adequate or even high levels of insulin, their bodies cannot use the hormone properly. An appropriate diet can prevent or delay consequences of type 2 diabetes.

The effects of hormonal changes and weight gain during pregnancy increase demands on the pancreas and can lead to gestational diabetes with potential complications for both mother and baby.

Before people develop diabetes, they are frequently diagnosed with prediabetes, defined by having higher than normal blood sugar levels; insulin resistance, in which the body does not use insulin properly; or metabolic syndrome, a cluster of risk factors that include excess belly fat, high blood pressure, and high blood sugar levels and that together increase your risk of diabetes, heart disease, and stroke.

Nutrition Connection
Diet is the cornerstone of diabetes management for all types of diabetes, though there are slightly different considerations. Those with diabetes should consult a registered dietitian, especially if cholesterol, blood pressure, or other health issues are a concern.

Here are general guidelines:
-Eat balanced meals and snacks. To maintain healthy blood glucose levels, meals and snacks should be balanced to provide a mixture of carbohydrates, fats, and proteins.
-Seek high quality carbohydrates. Carbohydrates, the basic currency of glucose, should account for 45 to 60% of daily calories spread evenly through the day. Low glycemic load carbohydrates such as whole grains provide vitamins, minerals, and fiber. Limit sugars and sweeteners, which provide mostly calories. -Seek fiber-rich foods. Because the fiber content of carbohydrates slows down the release of glucose, high-fiber starches, such as barley, oats, beans, peas, and lentils, are recommended to help suppress any sharp increases in blood sugar levels after meals.
-Follow a low-fat diet. High-fat diets contribute to obesity, heart disease, and kidney disease. Saturated fats from animal foods and hydrogenated fats in packaged foods should also be limited. On the other hand, monounsaturated and polyunsaturated fats—such as those found in vegetable oils, nuts, fish, and avocados—are good for the heart, slow the digestion process, and may also reduce insulin resistance.
-Limit foods that have a high glycemic index (GI), or load (GL). GI and GL is a measurement of how readily foods are converted to blood glucose. (For more information about GL.) Limit intake of high-glycemic foods, such as potatoes, rice cakes, cornflakes, soft drinks, pretzels, and crackers. Conversely, research has found that eating foods with a low glycemic index or load can improve blood sugar control in those with diabetes. Incorporate more low-glycemic foods, which include peas, beans, lentils, apples, pears, and oranges, barley, bran cereals, whole grain pasta, milk and yogurt.
-Add supplements wisely. A deficiency of the trace mineral chromium, found in foods such as wheat bran, whole grains, chicken breast, mushrooms, and blackstrap molasses, has been associated with reduced glucose tolerance. Research using chromium supplements has shown that they may provide a beneficial effect on blood glucose control for those with diabetes. If you choose to take a chromium supplement, take no more than 200 mcg per day, or speak to your doctor.
-Limit alcohol. Alcohol can cause swings in blood sugar levels. If you use insulin or take oral diabetes medication, speak to your doctor about the use of alcohol. If you do drink, consume alcohol with food.

Beyond the Diet
In conjunction with dietary changes, a healthier lifestyle can help control diabetes or reverse prediabetes symptoms. Consider the following:
-Exercise every day. Exercise can keep blood sugar levels stable. For many, diet and exercise alone can provide effective treatment. Exercise lowers your risk of prediabetes and type 2 diabetes.
-Commit to losing weight. Researchers found that those who lost modest amounts of weight cut their diabetes risk by 58%, even more for people over the age 60.
-Take care of your teeth. Those with diabetes may be prone to gum disease.
Talk to your doctor about medications.
-Talk to your doctor about immunizations. Diabetes can affect immune system, so flu shots and pneumonia shots, among others, may be recommended.
-Get regular blood tests. Early treatment can prevent critical damage to organs. Adults over the age of 50 should have their blood sugar levels tested every two years, or more often if they are overweight or have a family history of diabetes.
-Get a blood test if you are pregnant. Pregnant women should get a blood test between the 24th and 28th weeks of pregnancy. If gestational diabetes is diagnosed, the mother will need to modify her diet and monitor weight gain. Although this type of diabetes usually disappears almost immediately after childbirth, women who have had it are at high risk for type 2 diabetes in later years.