LIVING WELL WITH DIABETES

 

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AG00051_.gif (1652 bytes) GOAL:

AG00051_.gif (1652 bytes) OBJECTIVES:  Diet, Exercise & Medications

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Basic Information About Diabetes

What is Diabetes?  A group of diseases characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action or both.

Incidence of Diabetes.  There are 23.6 million children and adults in the United States, or 7.8% of the population, who have diabetes. While an estimated 17.9 million have been diagnosed, unfortunately, 5.7 million people (about one-third) are unaware that they have the disease with more than 57 million Americans with prediabetes (insulin resistance with slightly high BS but not diabetes levels) in 2007.  It is the seventh leading cause of death in the United States, with an estimated 233,619 deaths in 2005, according to federal statistics.  1.6 million new cases of diabetes were diagnosed in people aged 20 years or older in 2005.  The total annual economic cost of diabetes in 2007 was estimated to be $174 billion.   http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf

In the developing countries only, a 170 percent rise is projected  from 84 million to 228 million.   Worldwide, a 122 percent rise is projected from the total of 135 million to 300 million, more than a twofold global increase.  Why?  Because of population aging and growth, obesity, unhealthy diets and a sedentary lifestyle all associated with urbanization and industrialization according to the World Health Organization.

How do I know if I have it?  See your doctor.  If your fasting (no food for 12 hours) blood sugar is 60-99, that is normal.  A fasting blood sugar of 100-125 is prediabetes.  If no changes are made, expect the diagnosis of diabetes within the next 3-7 years, maybe sooner!  A fasting blood sugar of 126 or greater is a diagnosis of diabetes.  A confirmation test may be give called an oral glucose tolerance testing.  After drinking a glucose solution, the blood sugar is checked one, two and three hours later.  If the two-hour is greater than 200, it is a diagnosis of diabetes.  If the two-hour is 140-199, the diagnosis is prediabetes.  Normal is less than 140. 

Types of Diabetes.  Type I (body makes no insulin), Type II (body makes ineffective, and eventually very little insulin), Gestational (high blood sugar during pregnancy), and other.  Most people have Type II.

Complications of Diabetes.  Heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease, amputations, dental disease, complications of pregnancy.  Diabetes does not kill you, the complications do!

Possible Signs & Symptoms.  Thirst and excessive urination, tingling and numbness (especially in hands and feet), skin infections and slow healing, vaginal infections in women, impotence in men, blurred vision, unexplained fatigue and malaise, frequent episodes of excessive sweating and shaking.  If you are experiencing any of these, see your doctor.

For more detailed information about signs & symptoms of diabetes, types, complications and statistics, visit http://www.diabetes.org or http://www.cdc.gov/diabetes.

 

 The 50/50 Plan

AN EASY WAY TO PLAN MEALS

The purpose of the 50/50 Plan is to make meal planning easy for people with diabetes.  It is a simple tool for diabetes meal planning.  It is centered around the Diabetic Food Guide Pyramid.  The Diabetic Pyramid is a little different than the regular pyramid.  Click here to view the Pyramid:   http://www.mamc.amedd.army.mil/ncd/diabetic-pyramid.htm  We like to make a couple small changes to the pyramid.  Include sweets in the grain group, include ice cream 1/2 cup in the milk group, include nuts 1/3 cup in the meat group.  Keep the tip of the pyramid fats only. Alcohol is important but a separate issue, scratch it off the pyramid for now.   We recommend people with diabetes give up alcohol.  Lastly, no more than 1-2 servings of starches (bottom group on pyramid) per meal--not 4!

The 50/50 plate is based on the idea of balancing your carbohydrates with proteins and fats at meals for better control of blood sugar.  The balanced meal is digested more slowly, therefore, causing a slower rise in blood sugar.

We eat three nutrients:  carbohydrates, proteins and fats.

Carbohydrates raise blood sugar because they are high in carbohydrates AND are digested the fastest of the three nutrients.  Carbohydrates include the starch group - grains, dry beans, starchy vegetables, the fruit group - all fruits and fruit juices, and the milk group - milk, yogurt, ice cream.  Starchy vegetables include peas, corn, all potatoes.  Grains made with white flour and refined sugar spike the sugar rapidly.  Choose whole grains with 10% fiber which raise the sugar more slowly.  Look for the first ingredient to include the word "whole", and check the Nutrition Facts Label for 10% or more fiber.  See March Lesson for more on food labels.  Fiber is a stabilizing agent for blood sugar.  When the blood sugar spikes rapidly, the pancreas tends to overproduce insulin.  High levels of insulin are hard on the heart and tell the brain to store more calories as fat.  Choose whole fruit over juice for extra fiber.  Choose low fat or fat free milk, yogurt.  For ice cream, compare the original and the low fat.  Sometime the low fat has extra artificial ingredients.  Then look for ice cream with natural ingredients.

Proteins have little or no effect on blood sugar because they contain very small levels or no carbohydrates AND are digested more slowly than carbohydrates.  Proteins include the meat group - meat, poultry, fish, and meat substitutes like cheese, cottage cheese, nuts and peanut butter, and the vegetable group - all regular vegetables.  Choose loin and round cuts of meat and steer clear of the breading (white flour, bread crumbs, Bisquick, corn flakes).  Choose low fat cottage cheese and Italian cheeses for less fat.  Beware of the extra added fats we "dump" on our vegetables.  Choose regular peanut butter over low fat.  In in the low fat version, the heart-healthy fat is removed and sugar is added.  If you like natural peanut butter, that is even better.  Look for the word 'natural' on the label and NO hydrogenated fats or oils in the ingredient list.  Choose name brand peanut butters for safety reasons.

  Fats have virtually no effect on blood sugar because true fats contain no carbohydrates AND are digested the slowest of the three nutrients.  The fat group includes butter, margarine, cooking oils, lard, shortening, cream cheese and sour cream.  Beware of fats with added sugar like salad dressing or fats with added flour like gravies.  Added sugar and flour raise blood sugar.  Some fats come in low fat or fat free versions.  Be careful, manufacturers remove fats and replace them with sugar such as in fat free salad dressings or fat free cookies.  Choose oil and vinegar or Italian salad dressing, but choose less.  Stay away from French, Thousand Island and Catalina which all have too much added sugar and then fat free is even higher in sugar.  There is no reason to choose lite or fat free Italian dressing if it is made with olive oil.  Our heart loves the plant fats.  Remember, most fat free versions of salad dressing have the 'removed fat' replaced with sugar.  For cream cheese and sour cream, choose low fat or fat free, because the fat is animal fat.  Our heart does not need much animal fat.  For mayo and Miracle Whip be careful.  Compare the original with the lite and see if more sugar or artificial ingredients have been added.  If so, just choose the regular version, but watch portion size.

  Carbohydrates are called carbohydrates; and proteins and fats are called managers.  Imagine a line down the center of your plate with half your meal selections carbohydrates and half managers (proteins and fats).  Easy on the extra added fats.  It is best to try and limit carbohydrates to three servings per meal.  One serving of carbohydrates is 15 grams of carbohydrates or about 45 grams of carbohydrates per meal.  An easy guide is one starch, one milk, one fruit as your three servings of carbohydrates.

Learn to eat a balance of carbohydrates and managers.  Choose for each meal one portion of starch, fruit, milk, vegetable, meat or meat substitute and fat.  Balance snacks with one portion carbohydrate and one portion manager, such as whole grain crackers and cheese, cottage cheese and fruit, nuts and dried fruit, whole wheat bagel and fat free cream cheese.

Small meals and snacks spaced every 3-4 hours, balanced between carbohydrates and managers is the optimal way to eat.  Give yourself time to change.  Start with not skipping any of the three meals.  Then learn to balance carbohydrates with proteins and fats.  Then change to smaller portions and be prepared with a balanced snack.  If we change to smaller meals and don't control our hunger with a balanced snack, most likely we will overeat at the next meal.

 

Go to "Monthly Topic" above for detailed description of monthly lessons.


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