Champions of Health: Thriving with Diabetes - A Comprehensive Guide
November is World Diabetes Month and on the 14th, we join hands to raise awareness and promote understanding of this prevalent condition.
As a dietitian, I've had the privilege of working with numerous patients dealing with both type 1 and type 2 diabetes. The least I can say is that this subject is very dear to my heart!
In this article, we'll delve into the basics of diabetes, its symptoms, complications, and most importantly, how to manage it effectively.
Understanding Diabetes:
Diabetes occurs when the level of glycemia (blood sugar) becomes higher than the normal range. The main symptoms of diabetes include excessive thirst, increased urination, weight changes, fatigue, hunger, dry skin, blurry vision, and susceptibility to infections.
Risk Factors and Prevention:
Type 1 Diabetes results from an immune reaction where the body mistakenly attacks itself. Risk factors include:
· Family history of type 1 diabetes (parent, sibling).
· Onset can occur at any age, but it's more common in children, teens, and young adults.
· In the U.S., White individuals have a higher likelihood of developing type 1 diabetes compared to African American and Hispanic or Latino individuals.
· Currently, there is no known way to prevent type 1 diabetes.
Type 2 Diabetes’ Risk Factors include:
· Prediabetes.
· Excess weight.
· Age of 45 or older.
· A parent, sibling with type 2 diabetes.
· Less than three days of physical activity per week.
· A history of gestational diabetes or have given birth to a baby weighing over 9 pounds.
· Belong to certain ethnic groups: African American, Hispanic or Latino, American Indian, or Alaska Native individuals. Some Pacific Islanders and Asian American individuals also have higher risk.
· Non-alcoholic fatty liver disease may increase the risk of type 2 diabetes.
Diagnosing through Blood Tests:
For your reference, a fasting blood sugar level:
· < 100 mg/dL (5.6 mmol/L) is normal.
· From 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes.
· > or = 126 mg/dL (7 mmol/L) on two separate tests indicate diabetes.
An A1C or HbA1c test result reflects your average blood sugar level for the past two to three months. It measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated):
· < 5.7% is normal. 5.7% to 6.4% is diagnosed as prediabetes.
· > or = 6.5% on two separate tests indicate diabetes.
Complications of Uncontrolled Diabetes:
If left unmanaged, diabetes can lead to various complications such as nerve damage, heart disease, foot problems, oral health issues, vision impairment, chronic kidney disease (CKD) and even mental health challenges.
Taking Control:
The primary goal for individuals with diabetes is to maintain blood sugar levels within the recommended range. This can be achieved through a combination of healthy eating habits, weight control, regular exercise, and, when necessary, medication prescribed by a healthcare professional. Those who require insulin should also be mindful of their carbohydrate intake.
Nutritional Recommendations for Type II Diabetes:
1. Weight Management:
If your BMI falls within the overweight (>25) or obese range (>30), gradual weight loss can significantly improve blood sugar levels and reduce associated risk factors like high cholesterol and high blood pressure.
2. Consistent Meal Patterns:
Eating regular, balanced meals and snacks at consistent intervals helps stabilize blood glucose levels. It's essential to maintain portion sizes and not skip meals, especially breakfast.
3. Portion Control:
Even with nutritious meals, portion control is crucial. Large portions can lead to weight gain, a major risk factor for diabetes.
4. Complex Carbohydrates:
· Eating a consistent amount of carbohydrate & choosing the right type of carbohydrate at each meal can help regulate your blood sugar levels as they take longer to digest, which keeps you feeling full for a longer period and regulates your blood sugar levels.
· Although carbohydrates have a big impact on your sugar levels, you should not eliminate them from your diet.
· Choose complex carbohydrates like brown rice, quinoa, sweet potatoes, and whole-wheat pasta. These are slower to digest, providing sustained energy and stabilizing blood sugar levels.
5. Sugar Management:
Limit the intake of simple sugars found in candies, cookies, and sugary beverages including fruit juices. Make sure to include whole fruits daily and enjoy natural sweeteners like fruit spread in moderation.
6. Healthy Fats:
· Go for heart-healthy unsaturated fats like olive oil, nuts, and seeds. Reduce saturated fat intake by choosing low-fat dairy options and trimming visible fat from meats.
· Consume at least 2x/week fatty fish such as salmon, tuna & sardines to increase your consumption of omega-3 fatty acids
7. Sodium Control:
Minimize salt intake by using herbs and spices for flavoring. Avoid processed foods and fast foods that are high in sodium.
8. The plate method:
The plate method offers a straightforward visual approach to ensuring you include an ample amount of non-starchy vegetables and lean proteins in your meals, while moderating your intake of higher-carb foods that can have a notable impact on blood sugar levels.
Using a plate approximately the size of a business envelope, follow these guidelines:
· Allocate half of the plate for non-starchy vegetables, such as salad, green beans, broccoli, cauliflower, cabbage, and carrots.
· Dedicate one quarter of the plate to a lean source of protein, like chicken, turkey, beans, tofu, or eggs.
· Reserve the remaining quarter for carbohydrate-containing foods. This category encompasses items like grains, starchy vegetables (e.g., potatoes, peas), rice, pasta, beans, fruit, and yogurt. Additionally, a cup of milk or yogurt is also classified as a carbohydrate-rich food.
9. Physical Activity:
· Regular exercise is crucial for managing diabetes and promoting overall health. Consult your physician before starting any exercise routine.
· A target of at least 150-minutes per week of moderate-intensity physical activity is important in managing your diabetes. Examples of exercise include walking, swimming, dancing, playing tennis
· It is recommended you check your blood sugar levels prior to doing any type of exercise
· If your blood sugar levels are 250 mg/dl with or without the presence of ketones; one should not exercise.
· Remember to stay hydrated with water and avoid fruit juices!
10. The Risks of Alcohol Consumption for Individuals with Diabetes:
· The primary concern is the potential for hypoglycemia (low blood glucose), particularly when alcohol is combined with common diabetes medications like insulin and sulfonylureas. It's important to note that a glass of wine with a meal is typically less concerning than a mojito on an empty stomach during happy hour.
· The liver, responsible for stabilizing glucose levels and detoxification, faces a challenge when alcohol is introduced. It prioritizes metabolizing alcohol over maintaining blood glucose levels, potentially leading to hypoglycemia. This tendency is more pronounced when alcohol is consumed without accompanying food.
· In addition, contrary to common belief, alcoholic drinks, particularly wine and spirits, are low in carbohydrates, with only a trace in spirits and approximately four grams in a five-ounce glass of wine.
· Therefore, opting for high-carb drinks may not necessarily prevent or address low blood sugar episodes occurring hours after consumption, as liquid sugars are quickly absorbed. Food, on the other hand, is digested more gradually, providing better protection against lows. Thus, snacking or enjoying a meal while drinking is advisable.
To sum up, managing diabetes is a holistic endeavor that requires a balanced approach to nutrition, physical activity, and healthcare support. Seek guidance from healthcare professionals, including diabetes educators, endocrinologists, and dietitians, to navigate this journey effectively.
You are warriors and champions in your own health journey!
Take care of your body and wellbeing; and remember that help is always available!
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Stéphanie