Karla Robinson, MD
November is American Diabetes Month. While we are working to increase the awareness among those who may have the disease and not know it, it is also necessary to educate those known diabetics about the importance of blood sugar control and the fact that it is possible to live a healthy life with the disease.
Diabetes is a disease in which the body has too much glucose in the bloodstream. This occurs because of a lack of adequate insulin production by the body or the inability to effectively use the insulin that has been produced. This condition causes elevated blood glucose levels or “high blood sugar”. Uncontrolled diabetes can lead to severe complications such as heart and kidney disease, blindness, limb amputations, and death.
It is estimated that 15% of all African Americans aged 20 and older have diabetes. That is a rate of approximately 1 in 7 African American adults living with this disease. While these statistics may be startling, diabetes is a disease that can be managed allowing you to live a life very much like that of a non-diabetic.
Managing the diet plan
The key factor in managing diabetes is the diet. At issue in blood sugar control is carbohydrate intake in the diet. Carbohydrates include sugars and starches and are the body’s main source of energy.
The total carbohydrate amount eaten per meal, not the type of carbohydrate, seems to have the biggest impact in controlling diabetes. You and your doctor or nutritionist should determine an appropriate carbohydrate target per meal. Often times this is based on your current weight, medication plan, and blood sugar levels after meals. This method of assessing the carbohydrates in each meal is called “carb counting”. This can only be achieved by reading the nutritional labels on the foods that you eat. If you happen to eat out at restaurants a lot, ask for the nutritional values of the foods they are serving. This information is becoming increasingly available on menus as public awareness is increasing.
Studies have shown that people are more likely to stick to eating plans that don’t eliminate “forbidden” foods, but where they are eaten in moderation. With carb counting, the focus is more on the portion sizes allowing you to occasionally eat those foods that have traditionally been excluded from the “diabetic” diet.
This is how it works:
- Remind yourself of your carbohydrate target per meal as determined by your physician and/or nutritionist (Let’s say 45 grams per meal in this example)
- Determine the carbohydrate content in each food item you plan to eat at this meal. This can only be done by reading the total carbohydrate per serving on the nutritional labels. (Let’s use this for a dinner example: Chicken-2 grams, Green beans- 4 grams, Dinner roll-15 grams, Roasted Potatoes-24 grams )
- If you happen to want a “sugary” treat for dessert be sure to swap out other items from the meal that equal the amount of carbs in your treat. This allows you to stay at or below your target carbohydrates per meal. (Let’s say a chocolate chip cookie has 15 grams of carbs. Simply swap out the dinner roll for the chocolate chip cookie.)
It is important to note that “sugary” carbohydrates should be kept to a minimum as they tend to be high in fat and have excess calories. It is still necessary to have a balanced diet.
Getting the right balance
In addition, you should try to aim for at least 25-30 grams of fiber per day. Fiber has been shown to improve blood sugar control and cholesterol levels. Some foods high in fiber include beans, vegetables, whole grains, granola, and oats. Fruits are also high in fiber, but you may want to avoid those that are high in sugars like mangoes, raisins, watermelons and pears. Instead, stick to fruits like blackberries, apricots, prunes, and strawberries which cause less of a rise in your blood sugar.
Protein is also a necessary component of the diet. Most clinicians agree that 15-20% of all daily calories should come in the form of protein. Some good lean proteins include fish, lean meats, and egg whites. Protein helps you to feel full, ultimately helping to prevent overeating.
While you may be using insulin or other medications to control your blood sugar, it is important to recognize that the diet plays a huge role in diabetes management. By establishing carbohydrate targets and keeping carbohydrate intake to a minimum, you might find that less medicine is needed to keep your blood sugar under control. If you have not established a carbohydrate goal, discuss this with your doctor.
Make the dietary change a lifestyle change. Involve your household and adopt a healthy eating plan for the entire family. The notion of a “diabetic” diet is a faulty one. Everyone can benefit from a balanced, healthy diet, diabetic or not.