Understanding & Managing Diabetes
Understanding & Managing DiabetesI
n the United States, there are 27 million people over age 65 with diabetes. Thirty-five percent of US adults have prediabetes, which means that unless changes are made most will develop the most common form of diabetes, Type 2. The elevated blood sugar is part of a group of features often called the “metabolic syndrome” or “syndrome X”. People who are prone to diabetes may have a family history of diabetes, elevated blood pressure, a waist circumference over 35” in women or 40” in men, low HDL (healthy cholesterol), and high triglycerides (blood fat). All of these factors can cause damage to our body in the form of more heart disease and strokes and more nerve, kidney, and eye damage.
If your blood sugar is only a little bit high, you won’t feel differently. If it’s very high, you may feel thirsty, tired, and have blurry vision. You may visit your physician who may ask you to make some dietary changes or refer you to a dietitian or diabetes educator.
What sort of changes can you make?
First, learn about carbohydrate in food. All of the carbohydrate we eat is digested and broken into sugar in our body. A piece of bread has 15 grams of carbohydrate. A cookie has 15 grams of carbohydrate. A piece of bread or a cookie will raise your blood sugar an equal amount. Of course the bread has more nutrition, but sometimes you want something sweet. The carbohydrate we eat takes usually 1 to 2 hours to travel through our stomach into our intestines then into our blood. The sugar in our blood is supposed to enter our cells with the help of a hormone called insulin. If you have Type 2 diabetes you either don’t make enough insulin or it’s not working like it should. If you eat too much carbohydrate at one time, your blood sugar after eating could soar very high around 1 to 2 hours later. Your insulin isn’t working well enough to push that much sugar from your blood into your cells. If you eat the same amount of carbohydrate, but split it up over 2 to 3 meals or snacks, your blood sugar won’t go as high and you’ll feel better.
What foods have carbohydrate? Fruits, milk, starches and sweets. Most vegetables have very little carbohydrate, and meats and fats have none. Does that mean that we should eat a high protein, high fat diet? Probably not. You will be eliminating important nutrients found in fruit and milk. And a June 2012 study in the British Medical Journal showed that long term use of a high protein, high fat diet can increase the risk of heart disease.
Second, if you are overweight, especially in the middle, try to lose a little weight. If a person that weighs 300 pounds loses even 15 pounds or 5% of their weight, they will often find the weight loss helps their insulin work better to get the sugar out of the blood and into the cells. It also helps to cut back on fats (they are highest in calories) and doing that also helps improve your cholesterol, HDL, LDL, and triglycerides.
Third, try to increase your activity. This can lower blood sugar and raise HDL. It can help your blood pressure. Some people won’t start an activity plan because of the word “exercise” or because if they start they are worried that their family will nag them every day to keep it up and they don’t want to disappoint or fail. So rephrase your exercise talk. Say “I’m going to get a breath of fresh air” or “I think the dog needs to go for a walk.” Just keep moving.
People with diabetes can lead full and active lives. Keeping blood sugar, cholesterol and blood pressure in control are all important. If you have diabetes or prediabetes, ask your physician to refer you to a diabetes educator. Diabetes educators are trained to help people achieve the best control possible while living the lifestyle they choose.
Dietitians knowledgeable in diabetes can make a big impact on many lives. Bonner General Hospital offers some free classes and serves patients with a referral from their physician. Most insurances cover diabetes education and some cover nutrition counseling done by a registered dietitian. There are 3 Certified diabetes educators at BGH-2 Registered Dietitians, Leah Erban and Audrey Buck, and one nurse, Jody Thoreson RN CDE. Contact the BGH Diabetes Education and Nutrition team at 208-265-1116.