If you've just been told by your doctor that you have diabetes, you probably have a lot of questions--things like which types of food you'll have to give up, what you can continue to enjoy and how you should manage your disease when dining out and entertaining with friends. Fortunately, you're in good company. According to the American Diabetes Association, more than 23 million Americans suffer from diabetes. Many have successfully found ways to control their disease through a combination of diet, exercise and medications. Many have also found that they can avoid taking prescription medications just by staying more active and making healthier food choices.
Primer on Diabetes
Diabetes is a serious metabolic disease that interferes with the way the cells of the body use blood sugar. There are two types of diabetes: type I and type II. Type I diabetics fail to produce enough insulin--a hormone made in the pancreas that helps the body's cells use glucose circulating in the blood. Type II diabetics make enough insulin, but their tissues are resistant to it, so blood glucose levels remain high while the cells of the body literally starve from not enough fuel.
Carbohydrates are found in many of the foods we enjoy, from pasta, breads and cereals to cakes and cookies. Once digested in the small intestine, they are broken down into glucose and enter the blood for distribution as fuel. Both types of diabetics have difficulties processing blood glucose. Over time, high levels of blood glucose can cause a number of secondary complications like heart disease, kidney failure, nerve damage and loss of sight.
The Treatment Triad
The normal levels for fasting blood glucose is between 70 to 110 mg/dl. People with impaired fasting glucose (IFG) between 100 to 125 mg/dl are often called prediabetic. Those with glucose levels between 140 to 199 mg/dl have impaired glucose tolerance (IGT). Many people with impaired fasting or glucose tolerance respond well through a combination of diet, exercise and medications, with diet and exercise being the first approaches. If the first two fail to bring the blood glucose to within normal levels, insulin or oral medications may be prescribed.
Diabetes Food Pyramid
There are a number of convenient methods to help diabetics control the quantities and qualities of carbohydrates they eat--the foods that are likely to cause their blood sugar to increase. One way is to use the Diabetes Food Pyramid, made popular by the American Diabetes Association. Not to be confused with the USFDA Food Pyramid, the Diabetes Food Pyramid divides all foods into six groups that fit into the structure of a pyramid and are defined by their relative content of carbohydrates.
At the bottom is the largest group, which contains grains, starchy vegetables and beans. These should represent the largest part of your your diet. Above the grains are vegetables, fruits, milk, meat and meat substitutes, with fats, oils and sweets on the top. As you make food choices higher on the pyramid, your servings will decrease. For instance, diabetics should eat between 6 to 11 servings a day of grains and starches, 3 to 5 servings of vegetables, 2 to 4 servings of fruit, 2 to 3 servings of milk and dairy and 4 to 6 oz. of meat and meat substitutes and save fats, sweets and alcohol as rewards for adhering to the the rest of the pyramid.
Glycemic Index
The glycemic index (GI) is another popular way diabetics can continue to enjoy their favorite foods by balancing them with other types of carbohydrates, fats and proteins. All carbohydrates are rated according to how quickly they cause the blood glucose levels to spike. Low GI foods are rated below 54. Medium GI foods are rated between 55 to 70. Carbohydrates rated over 70 are considered high. The goal is to choose a balance of foods that stabilize the blood glucose levels. For instance, watermelon is rated high at 72. Dates are even higher at 103. Sourdough bread is rated at 54, while white bread rates at 70. Some foods may surprise you. Cherries are rated at 22, and apples are rated at 38. By combining low GI foods with high GI foods and/or fats and proteins, you can continue eating the foods you enjoy without causing your blood glucose levels to spike.
Carbohydrate Counting
Another effective tool for controlling how many carbohydrates you eat is carbohydrate counting. While carb counting takes a little longer to learn in the beginning, after a few weeks, it will become second nature. The secret to carbohydrate counting is learning how many grams of carbohydrates are contained in a single serving of food. Most modern packaging is labeled with the number of servings per container and grams of carbohydrates and fat per serving. Because most of the foods you enjoy are rarely 100 percent carbohydrates, you may have to do some quick calculations for foods that aren't labeled. For example, 224 g of milk and a 160 g slice of watermelon (total weight) each contain the same amount of carbohydrates--12 g.
Determining Carbohydrates Per Day
Determining how many carbohydrates you need in a day is based on how tall you are, how much you weigh and how active you are. As a general rule, your carbohydrate intake should be around 50 to 65 percent of your total daily caloric intake. The average adult make needs around 2,000 calories per day--sometimes a little more, sometimes a little less. That translates into 1,000 calories of carbohydrates per day, divided by three meals, equals 333 calories of carbohydrates per day--the rest should be fats and proteins.
Create Your Plate
One of the easiest ways to control your carbohydrate intake, especially when eating out or entertaining friends, is by using the American Diabetes Association's Create Your Plate approach. Begin by drawing an imaginary line down the center of a standard dinner plate. Divide one half of one side into two equal parts. You now have one large section and two smaller sections. Fill the larger section with nonstarchy vegetables like spinach, carrots, lettuce, green beans or tomatoes. Fill one of the smaller sections with starchy foods like whole grain breads, rice, pasta or cooked beans. Fill the final section with meat or meat substitutes like chicken, turkey, tuna or eggs.
