Diabetic Diet

• Achieve and maintain desirable weight. Many people with diabetes can control their blood glucose by losing weight and keeping it off.
• Maintain normal blood glucose levels.
• Prevent heart and blood vessel diseases, conditions that tend to occur in people with diabetes.

• A doctor can recommend a local nutritionist or dietitian.
• The local American Diabetes Association, American Heart Association, and American Dietetic Association can provide names of qualified dietitians or nutritionists and information about diet planning.
• Local diabetes centers at large medical clinics, hospitals, or medical universities usually have dietitians and nutritionists on staff.

• Many experts, including the American Diabetes Association, recommend that 50 to 60 percent of daily calories come from carbohydrates, 12 to 20 percent from protein, and no more than 30 percent from fat.
• Spacing meals throughout the day, instead of eating heavy meals once or twice a day, can help a person avoid extremely high or low blood glucose levels.
• With few exceptions, the best way to lose weight is gradually: one or two pounds a week. Strict diets must never be undertaken without the supervision of a doctor.
• People with diabetes have twice the risk of developing heart disease as those without diabetes, and high blood cholesterol levels raise the risk of heart disease. Losing weight and reducing intake of saturated fats and cholesterol, in favor of unsaturated and monounsaturated fats, can help lower blood cholesterol.

For example, meats and dairy products are major sources of saturated fats, which should be avoided; most vegetable oils are high in unsaturated fats, which are fine in limited amounts; and olive oil is a good source of monounsaturated fat, the healthiest type of fat. Liver and other organ meats and egg yolks are particularly high in cholesterol. A doctor or nutritionist can advise someone on this aspect of diet.

Studies show that foods with fiber, such as fruits, vegetables, peas, beans, and whole-grain breads and cereals may help lower blood glucose. However, it seems that a person must eat much more fiber than the average American now consumes to get this benefit. A doctor or nutritionist can advise someone about adding fiber to a diet.

Exchange lists are useful in planning a diabetes diet. They place foods with similar nutrients and calories into groups. With the help of a nutritionist, the person plans the number of servings from each exchange list that he or she should eat throughout the day. Diets that use exchange lists offer more choices than preprinted diets. More information on exchange lists is available from nutritionists and from the American Diabetes Association.

Continuing research may lead to new approaches to diabetes diets. Because one goal of a diabetes diet is to maintain normal blood glucose levels, it would be helpful to have reliable information on the effects of foods on blood glucose. For example, foods that are rich in carbohydrates, like breads, cereals, fruits, and vegetables break down into glucose during digestion, causing blood glucose to rise. However, scientists don't know how each of these carbohydrates affect blood glucose levels. Research is also under way to learn whether foods with sugar raise blood glucose higher than foods with starch. Experts do know that cooked foods raise blood glucose higher than raw, unpeeled foods. A person with diabetes can ask a doctor or nutritionist about using this kind of information in diet planning.

Alcoholic Beverages

• Alcohol has calories without the vitamins, minerals, and other nutrients that are essential for maintaining good health. A doctor can discuss whether it's safe for an individual with diabetes to drink. People who are trying to lose weight need to account for the calories in alcohol in diet planning. A dietitian also can provide information about the sugar and alcohol content of various alcoholic drinks.
• Alcohol on an empty stomach can cause low blood glucose or hypoglycemia. Hypoglycemia is a particular risk in people who use oral medications or insulin for diabetes. It can cause shaking, dizziness, and collapse. People who don't know someone has diabetes may mistake these symptoms for drunkenness and neglect to seek medical help.
• Oral diabetes medications-tolbutamide and chlorpropamide-can cause dizziness, flushing, and nausea when combined with alcohol. A doctor can advise patients on the safety of drinking when taking these and other diabetes medications.
• Frequent, heavy drinking can cause liver damage over time. Because the liver stores and releases glucose, blood glucose levels may be more difficult to control in a person with liver damage from alcohol.
• Frequent heavy drinking also can raise the levels of fats in blood, increasing the risk of heart disease.

Points to Remember

• A diabetes diet should do three things; achieve ideal weight, maintain normal blood glucose levels, and limit foods that contribute to hear disease.
• A nutritionist or dietitian can help plan a diabetes diet.

Exercise

Exercise has many benefits, and for someone with diabetes regular exercise combined with a good diet can help control diabetes. Exercise not only burns calories, which can help with weight reduction, but it also can improve the body's response to the hormone insulin. As a result, following a regular exercise program can make oral diabetes medications and insulin more effective and can help control blood glucose levels.

Exercise also reduces some risk factors for heart disease. For example, exercise can lower fat and cholesterol levels in bloods which increase heart disease risk. It also can lower blood pressure and increase production of a cholesterol, called HDL, that protects against heart disease.

However, infrequent, strenuous exercise can strain muscles and the circulatory system and can increase the risk of a heart attack during exercise. A doctor can decide how much exercise is safe for an individual. The doctor will consider how well controlled a person's diabetes is, the condition of the heart and circulatory system, and whether complications require that the person avoid certain types of activity.

Walking is great exercise, especially for an inactive person, and it's easy to do. A person can start off walking for 15 or 20 minutes, three or four times a week, and gradually increase the speed or distance of the walks. The purpose of a good exercise program is to find an enjoyable activity and do it regularly. Doing strenuous exercise for six months and then stopping isn't as effective. People taking oral drugs or insulin need to remember that strenuous exercise can cause dangerously low blood glucose and they should carry a food or drink high in sugar for medical emergencies. Signs of hypoglycemia include hunger, nervousness, shakiness, weakness, sweating, headache, and blurred vision. As a precaution, a person with diabetes should wear an identification bracelet or necklace to alert a stranger that the wearer has diabetes and may need special medical help in an emergency.

A doctor may advise someone with high blood pressure or other complications to avoid exercises that raise blood pressure. For example, lifting heavy objects and exercises that strain the upper body raise blood pressure.

People with diabetes who have lost sensitivity in their feet also can enjoy exercise. They should choose shoes carefully and check their feet regularly for breaks in skin that could lead to infection. Swimming or bicycling can be easier on the feet than running.

Points to Remember

• Exercise has three major benefits; it burns calories, improves the body's response to insulin, and reduces risk factors for heart disease.
• An exercise program should be started slowly and with the advice of a doctor.

Diabetes Diet
from www.webmd.com

For more information on diabetes visit:

• American Diabetes Association
• National Institute of Diabetes and Digestive and Kidney Diseases, (NDIC)