GOAL:Stable Blood Sugar: 80-120 before meals, 100-140 at bedtime, A1C less than 7 (6.5 is better).
OBJECTIVES:
Diet, Exercise & MedicationsBalance foods that raise blood sugar (carbohydrates) with foods that have little or no effect on blood sugar (proteins & fats). Balance carbohydrates (starch group, fruit group, milk group,) with proteins (meat, meat substitute group, vegetable group) and fats (butter, margarine, cooking oils, salad dressings).
Consistent intake -- Schedule meals and snacks about the same time each day. Space meals and snacks every 2-3 hours like a toddler, eat smaller meals more often.
Increase daily physical movement (as per your physician approval). See the May lesson for more on physical activity and exercise. Optimal goal, 30 minutes of exercise daily and increase daily movement.
Take all medications as prescribed by your healthcare provider. Keep a blood sugar log.
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.
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 and ice cream.
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 because the fat is removed and sugar
is added. If you like natural peanut butter, that is even better.
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. Italian is a good choice if you do
prefer fat free, because typically the removed fat is not replaced with sugar.
For cream cheese and sour cream, choose low fat or fat free. For mayo and
Miracle Whip, choose low fat or fat free.
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 2-3 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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