Prevention & Management Strategy of Diabetes

Constant Monitoring

According to experts, the best way to prevent type 2 diabetes developing is to observe the healthy lifestyle of someone who already has the condition, and is trying to manage it.

Diabetic people are encouraged to maintain a healthy lifestyle; and of course, this is also true for non-diabetics.

The only difference being, the diabetic may have to take medication to manage their blood glucose levels.

They should also make other lifestyle changes, such as avoiding smoking and drinking too much alcohol. It’s also important to manage stress.

Below are the foundations of diabetes management

  • Frequent blood glucose level testing/constant monitoring 
  • Maintaining a healthy weight, through exercise and diet

How Often Should You Check your Sugar Levels

Diabetes can be unpredictable. When symptoms of hypoglycemia and hyperglycemia appear, it usually means something has already gone wrong and the issue must be addressed fast. However, you should not just take diabetic medication, without knowing which you have.

If a diabetic uses insulin, they should test their blood glucose level at least 4 times a day. It is also recommended they undergo a fasting blood sugar (FBS) test at least twice a month.

For type 2 diabetics, it is recommended they check their blood glucose level at least once a day and have FBS test once a month. It is also recommended that they monitor their blood pressure at least twice a day.

You will need the correct tools to monitor your health; and this is discussed in detail, in the next section.

Equipment a Diabetic Should Invest In

Doctors used to have to monitor blood sugar levels and treat diabetic complications in their clinic or in the hospital. Today, it can be done by the patient at home.

Experts believe it is important diabetics are aware of what to expect with their disease; how to monitor their condition at home, and how to treat complications when they arise. It could help save their life; and could also save time and money, as they don’t need to have the tests carried out in a clinic or hospital.

Diabetic equipment has also become affordable and therefore, easier to invest in.

Diabetics are encouraged to have their own equipment, so they can monitor their blood sugar level. This could help avoid dangerous complications. They also need a first aid kit, to treat themselves until medical help arrives, if required.

Below are some equipments a diabetic should invest in:

1. Glucometer or blood glucose meter

This is used for routine blood sugar monitoring. Every diabetic should have one at home, along with glucose strips.

The result you get from a glucometer is not as accurate as the one you get from an FBS. However, it is accurate enough to tell you whether your blood sugar is at an abnormal level, or not.

It is wise to choose a glucometer that can be operated with one hand. This makes it easier to check a blood sugar level, independently and anytime/anywhere.

2. Lancets and glucose strips

A glucometer is of no use unless these are also present, especially the glucose strips.

Use only medically approved lancets, because regular needles or syringe needles may cause deeper wounds, which could cause complications in a diabetic.

Each brand of glucometer will usually have it’s own specific brand of glucose strip. So, make sure to buy the correct type.

3. Blood Pressure monitor or sphygmomanometer

For younger type 1 diabetics, a blood pressure monitor may not be necessary. But, if a diabetic is over thirty, it is recommended they have their own blood pressure monitor, regardless of the type of diabetes they have.

Fluctuations in sugar level may also affect blood pressure. So, older diabetic patients should monitor their blood pressure, as often as they monitor their blood sugar levels.

A digital sphygmomanometer is highly recommended, as they are easier to use unaided and the results are available quicker.

4. Blood sugar and blood pressure record book

Diabetics are often required to keep a record of their blood sugar level and blood pressure level, especially if they are still adjusting to a diabetic lifestyle.

A regular notebook and pen will do; or there are also journals made for these, which may be available free with other diabetic supplies. Some digital glucometer and sphygmomanometers can store at least 100 results.

5. A small box of hard candy

Diabetics should always have some hard candy at hand. Hard candy is the first line of treatment for hypoglycemia; and is more effective than soft candy, as it releases sugar slower.

6. Weight scales

Though weight scales will not be used as often as other equipment, it is still advisable that diabetics have their own. Fluctuations in blood sugar level can be triggered by weight gain or loss.

7. Insulin and syringe kit

Type 1 diabetics need to have a constant supply of insulin, needles, syringes and sharps boxes. Insulin needs to be stored in a cool place; so, having a thermal insulin kit will keep the insulin cool for a while, if they are out for the day.

8. Ketone strips

These are necessary for type 1 diabetics, but are rarely needed by type 2 diabetics. The strips measure the level of ketones in the body. They can tell whether a patient is suffering from ketosis or ketoacidosis. Ketosis is milder; while ketoacidosis may be a life-threatening situation for a diabetic. Thus, having the ketone strips at hand is recommended.

Attaining and Maintaining A Healthy Weight

Please Note – Most diabetics are under the care of a Specialist at a hospital. They will arrange for you to see a dietician to help you get your diet under control. They can also refer you to the physiotherapy team, and they will give you the correct “safe” exercises to undertake, Exercise should be correctly monitored and increased gradually, especially if you are obese. If you want to lose weight, and/or want to start an exercise regime you must always have a check-up with your doctor first. What follows is a guide to help inform that journey.

Being slender or muscular does not guarantee a person is at a healthy weight. This depends on the person’s body mass index (BMI) i.e. the ratio of the person’s weight in proportion to his/her height.

An overweight person weighs more than 10% of their ideal BMI, but not more than 20%. A person who weighs more than 20% of their ideal BMI, is considered obese.

How to Calculate Your BMI

To calculate your BMI, divide your weight in kilograms, by your height in meters squared.

For example, if Adam weighs 75 kilos (approximately 165 lbs.) and has a height of 1.2 meters (a little less than 4 feet) to calculate his BMI, the equation would be:

BMI 1.2mx1.2m=1.44m2

75kg / 1.44m2 = 52.08

If you live in the United States, where the Imperial measurement system is in practice, use online converters that are available.

What is the Normal BMI?

Underweight: less than 18.5

Normal weight: 18.5 to 24.9

Overweight: 25 to 29.9

Obese: 30 or more

Therefore, in the example above, Adam would be considered extremely obese.

The higher a person’s BMI, the more likely they are to develop diabetes and cardiovascular diseases.

Weight Loss Guide for Diabetics

It is safer and more beneficial that everyone maintains a healthy weight. There are two phases to achieving a healthy weight, especially if you are a type 2 diabetic. The first phase is to lose the excess weight and the second is maintaining a healthy weight. Both tasks are not easy, but the second phase can be harder than the first.

Losing weight naturally may be more difficult, but is preferred, over resorting to surgical intervention; which obviously comes with its own risks. The principle behind natural weight loss is calorie deficit but this should be combined with physical activity. Therefore, the calories that go into your body should be less than the energy needed to use them up. This way, your body will start to use stored fat for energy.

Eating a Low-Calorie Diet

85% of diabetics are obese or overweight and 70% of these are also physically inactive. If a diabetic person eats a high-calorie diet, they need more physical activity to burn the calories. However, please note, it is dangerous for an obese person to start strenuous exercise suddenly.

To make it possible for diabetics to lose weight, without drastically increasing their physical activity, they need to lower their calorie intake.

The daily calorie consumption, for an average person, should not exceed 3000 for males and 2500 for females. It should not usually be lower than 1800 for men and 1200 for women.

For a diabetic, trying to lose weight, it is advised that their new “normal” is 1800 calories for men and 1200 calories for women. This ensures they can still perform exercise or other physical activity.

However, weight loss through diet should be made gradually. A sudden drastic drop in calorie intake may cause shock to the body’s organs, which can result in their own health complications.

Engaging in More Physical Activity

Boosting physical activity enables a person to avoid making drastic changes to the number of calories they consume. The more a person moves, the more calories they burn. As a result, they start to lose weight and benefit from the bonus of endorphin release, which improves mood.

Increasing physical activity should always be done gradually, whether it is for a diabetic or a non-diabetic. This is necessary for the protection of the heart. Make sure you undergo a physical checkup before undertaking any exercise routine.

Experts recommend a daily exercise routine. However, if you can’t find enough time for the gym, or working out at home, changing how you do a few things can help.

• Walk, jog or ride a bicycle to work

According to a study, walking a mile continuously can help you shed up to 100 calories, in 30 minutes. A brisk walk can help you lose up to 180 calories a day. If you jog, then you lose more. Jogging at a speed of 5 miles per hour can help you lose about 240 calories, every 30 minutes. Cycling enables you to lose 180 per 30 minutes.

• Wash clothes by hand

Washing 5 kilograms of clothes enables you to lose 75 to 120 calories. If you do not want the detergent to ruin your hands or skin: Try rinsing your clothes three times and hanging them outside on a clothes line, instead of using the dryer. You could lose 30 to 50 calories!

• Mop or scrub the floor manually

Instead of using an electric steam mop, 30 minutes of mopping or scrubbing the floor, may help you lose 120 calories.

• Wash your car yourself

By washing a sedan for thirty minutes you can potentially lose up to 180 calories. This includes the actual washing and drying of the car. If you add polishing, you can lose another 30 calories.

• Play a physical game with your children

According to experts, this is better than organised exercise. A short 30- minute playtime with your children, which may include a game of tag or shooting hoops, can help you lose at least 220 calories. The reason you lose more calories doing this is the stress-free factor. According to some studies, smiling while doing an activity may make you lose 20 calories, but laughing while doing an activity may make you lose 40 to 60 calories, every 30 minutes.

Ideal Weight Loss Rate for Overweight Diabetics

This topic is the subject of ongoing debate among experts. Some say a type 2 diabetic should lose weight as fast as possible, while others say it should be done slowly. Many believe however, that it depends on how obese the person is.

If the patient is extremely obese, they need to lose weight more rapidly. The longer a diabetic remains obese, the more quickly complications may arise. However, if the patient is merely a little overweight, they can take it more gradually. The body will automatically force itself to lose weight, as a defense mechanism to balance the level of blood glucose.

However, doctors advise that regardless of how overweight a diabetic is, it is best not to lose more than 5.44kg (12 pounds) a month. To lose more than this, would require the diabetic to eat less than 1200 calories a day, which can also be detrimental to their condition.

Steps to Correct Weight Loss

Establish how overweight you are

You do this by obtaining your BMI. This will determine how much weight you need to lose.

Determine your ideal weight

You can do this by multiplying an amount ranging from 18.5kg (40.78lbs.) to 24.9kg (54.89lbs.), which is the ideal BMI, with the amount equivalent to twice your height.

Say you choose 24.9kg and your height is 1.65 meters.

To find a person’s ideal weight, the equation would look like this: Ideal weight 1.65m + 1.65m = 3.3m

24.9kg x 3.3m = 82.17 kg (181lb.)

Determine how much weight you need to lose

To do this you need to subtract your ideal weight from your current weight. This provides the amount of weight you need to lose.

For Example: Current weight 100.00kg

Ideal weight 82.17kg

You need to lose 17.83 kg

Set a time scale for your weight loss

Since the recommended maximum amount of weight loss per month is only 5.44kg (12 lbs.) you will need approximately 14 weeks to lose 17.83 kg (39 lbs.)

Determine the average calories you need to subtract from your day

You need to do this to achieve your target weight loss for the month.

To do this, keep in mind that 0.45kg (1lb) is equivalent to 3500 calories. Multiply 3500 by a number of kilograms you want to lose and you will get the total calories you need to lose in a month. Then, divide this result by 30.

For example, you need to lose a total 17.83kg (39lb)

17.83kg x 3500 = 62,000 calories/month

62,000/30 days = 2,066 calories per day

This means you need to burn an extra 2,066 calories in a day.

Determine how much exercise you need for a day

You need to subtract the calorie you need to lose from the maximum calories a person should have in a day.

If you are a woman, subtract it from 2500. Subtract it from 3000 if you are a man.

Since the maximum calories a person should have in a day should not exceed 2500 (for women) or 3000 (for men), then using the example in No’ 5 you would only be left with a calorie intake of 434 and 944 respectively.

However, dropping the calorie intake to these numbers is extremely difficult, if you are used to eating far more than the daily-recommended values. You can make this easier by adding exercise into the mix.

N.B: Your dietician will come up with a diet, specifically tailored to you. Please seek their advice. This is to give you the idea of diet/exercise principle.

Choose your diet to exercise proportion

How many calories do you want to lose by exercising and/or by dieting? Knowing your daily physical activity can help with your decision.

  1. If your physical activity involves doing light household chores and sitting at a desk for work or school, you may only be burning 80 to 120 calories for those tasks each day.
  2. If your physical activity involves 30-minutes jogging and aerobics, then you might be burning 200 to 300 calories for those tasks each day;
  3. If your physical activity involves major household chores, heavy training jobs and vigorous sports exercise, you may be burning 400 to 600 calories for those tasks each day.

For example: Wendy needs to lose 1200 calories. She works as a teller at a bank, and does not have enough time to do major chores at home or exercise. We can assume Wendy will only lose about 100 calories, each day, for her physical activity.

For example:

Wendy needs to lose: 1200 calories/day

She already burns: 100 calories/day

She needs to burn a further: 1100 calories/day

Should she increase her physical activity more or should she remove calories from her diet?

Wendy decides to lose 800 calories through dieting Then she can lose the other 300 through exercise.

Maintaining a Healthy Weight

Maintaining weight is more difficult for type 2 diabetics, as they must exercise twice as hard to lose weight.

Humans do not always lose weight in a linear manner. If you continue to follow the routine you have developed, by following the steps to losing weight, your weight could plateau, or increase even if you stick to a strict diet. This is due to the body’s natural defense mechanism.

If a person continues to follow the same strict routine to lose weight, their body will go into starvation mode as a defense mechanism. It is afraid it might lose too much weight. It will try to store fat, causing weight gain. According to researchers, after 6 to 8 months of following a routine to shed 4.53 to 5.44kg (10 to 12lb.) a month, they should modify his routine.

Many experts believe the best way to maintain a healthy weight, upon achieving it, is to increase calorie intake by at least 20%. However, this amount should not exceed 1800 calories. You then need to offset the additional calorie intake by increasing physical activity. The body does not go into starvation mode, if it loses calories through exercise but when it loses calories by the loss of nutrients.

So, if after six months, Wendy achieves her healthy weight, she should consider changing her routine.

Based on the example in the previous topic, Wendy is planning to take 1700 calories a day. She may need to increase her calorie intake to 2040 calories after six months. Since there are an additional 340 calories in her diet, Wendy may need to add more exercise, or add any physical activity that will help counteract these calories.

Exercise Routines

A diabetic should consult with his/her physician before taking part in any exercise routines. There are routines or activities that may not be safe for diabetics. A person with prediabetes may not have a limit to any exercise routines, provided they have no other ailments.

6 Exercise Routines for Diabetics

Below are some popular exercises that a diabetic may be able to do:

Jogging

A thirty-minute jog, every day, can help lose at least 240 calories daily. Aside from losing calories, it also helps strengthen ankle and leg joints. It also helps prevent neuropathy in the legs. Moving the legs often, may also reduce the risk of edema in the feet.

It improves the circulatory system and strengthens the cardiovascular and respiratory system.

Aerobics

Thirty minutes of aerobic exercise burns about 180 to 240 calories; and has the same benefits as jogging. However, an obese diabetic needs to be very careful. If they have not done this type of exercise before, they must do it gradually. Some exercise routines put a lot of pressure on the legs, which can cause injury to obese people.

Swimming

A thirty-minute swimming can help you lose 210 to 360 calories, depending on your speed. This is a good exercise for the lungs and the heart. In fact, many experts claim it is the best exercise for diabetics. It helps to burn calories quickly and doesn’t put pressure on the joints.

Ball Games, e.g. basketball, volleyball, football

Engaging in these sports for thirty minutes can cut 180 to 270 calories. These sports can help burn more calories, as they are usually played with others, which helps increase the “feel good factor.”

Shadow kickboxing

You would need to be already fit to undertake this exercise. However, it can help to shed more calories. At least 300 for thirty minutes. It not only helps you lose weight, but tones your muscles.

Diabetics with heart ailments or chronic respiratory ailments might still be able to do this type of exercise, but they would need to do it lightly and with the approval of their doctor.

Yoga

An hour of basic yoga moves can help you lose about 280 calories. Routines that specifically target certain areas of the body may help you lose a few more calories.

Yoga is considered a good choice for diabetics, as it improves blood circulation. It also relaxes the body, but awakens the sensitivity of the nerves.

Types Of Exercise To Avoid

A pre diabetic person can try these exercise routines, but for those with chronic diabetes, some exercise poses a dangerous risk.

Body building exercises

Using weights during exercise is not dangerous, and in fact may be recommended, but there are limits.

A diabetic person should not lift weights that are so heavy they put a strain on their muscles. This could worsen diabetic neuropathy. Lifting heavy weights also put extra pressure on the eyes and nerves of the diabetic. This could damage the small vessels and cause the nerve to become numb.

Adversarial contact sports

Doing shadow-contact sports can be good for a diabetic, but actual contact sports are dangerous. Diabetics heal more slowly than healthy people. If they are injured or wounded during the match, they may develop further complications.

8 Exercise Safety Measures

A diabetic should always be prepared when they are working out. Doing physical activity without careful preparation may cause complications or at worst, life-threatening situations.

Ensure you do the following prior to exercising:

Eat at least one hour before exercising

A diabetic should not carry out any physical activity on an empty stomach. It increases the risk of hypoglycemia and ketoacidosis.

Eat a light snack, prior to exercising. Many diabetics prefer to exercise an hour after breakfast.

Always carry water and hard candy

Diabetics are usually thirstier than healthy individuals, especially during exercise. It is important they have water at hand, to counter dehydration.

Having your box of hard candies with you, may prevent you from a sudden hypoglycemic attack.

Hard candy is seldom required by a type 2 diabetic, but it does no harm to have them there in case hypoglycemia occurs.

Check your blood glucose level before exercising

Vigorous physical activity or exercise can make the body react in two ways. It Can cause sugar levels to drop, which is the usual reaction for type 1 diabetes. With type 2 diabetics it could cause sugar levels to rise.

So, before undergoing any exercise, a diabetic should check their glucose levels. If their level is below 5.5mmol/L, the diabetic should consider eating something sweet before exercising. However, it is probably best to refrain from rigorous exercise.

If the blood sugar level is above 15mmol/L, a diabetic should not take part in any rigorous exercise. Their high blood sugar may go higher due to exercise.

Check your blood pressure

This is necessary for type 2 diabetics, although Type 1 diabetics over twenty-five years old are also advised to do the same. Exercise increases the blood pressure; and it is dangerous for a diabetic to exercise when their blood pressure is high.

Protect your feet

Diabetics needs to know how their feet will be affected, by the exercise or the physical activity they are planning to undertake. They need to protect their feet from injury.

Be careful when choosing shoes for exercise. Make sure they support the ankles and won’t cause blisters.

Do not exercise an hour after you have had your insulin injection

The effect of insulin usually peaks an hour after it was injected. This means the blood sugar level will drop. Exercising at this point can be dangerous, as the exercise will also lower the blood sugar levels. This will result in a hypoglycemic attack.

Don’t exercise alone

Whatever exercise you choose, do not do it alone. Having a friend or family member present during exercise can help if an emergency arises i.e. a hypo or hyperglycemic attack

Never ignore your body’s signals

Stop or do not exercise, as soon as you feel any symptoms of hypoglycemia, hyperglycemia or hypertension. If it occurs post exercise, consider doing a ketone test, glucose test and blood pressure test. If the level of any of the tests is abnormally low or high, seek medical attention immediately.

Exercise routines can do wonders for your health. Just keep safety in the forefront of your mind when engaging in any physical activity.

Diabetic Meal Plans

Many nutritionists believe the diet followed by diabetics is a good diet for everyone. Anyone who follows it lowers their risk of developing diabetes and other health conditions.

Many diets have claimed to be the best for diabetics. A few examples are: a ketogenic diet; a vegan or vegetarian diet; a Mediterranean diet; or other diets that have a low carbohydrate and low glucose intake. However, which is the best for diabetics? This module is dedicated to answering this question.

5 Characteristics of a Diabetic Diet

Experts say that the ideal diabetic diet has the following characteristics:

It is low in calories

Diabetics should eat a low-calorie diet, as opposed to a low carbohydrate diet, especially type 2 diabetics. Lowering calories means you lower the actual amount of carbohydrate and fat you need to burn.

Low-carbohydrate and low-fat diets may not work for diabetics, as they may then increase proteins in the digestive tract and the bloodstream to a dangerous level. Diabetic people, especially those with type 2 diabetes should not consume a large amount of protein, as it may increase their risk of neuropathy and other complications. If the amount of fat and carbs, in the diet, is significantly decreased, while the amount of protein remains at a proportionate level, the diabetic may suffer from malnutrition. Thus, the solution is to lower overall calorie intake.

The amount of carbohydrates should not be less than 45%, but no more than 60% of the total calorie intake each day.

These levels of carbohydrates (45% to 60%) are considered the safe amount for a diabetic to consume.

If a diabetic observes an 1800-calorie daily allowance, the number of carbohydrates he/she eats should be within 810 to 1080 calories.

For pregnant and breastfeeding women, the amount should not be less than 50%.

The amount of protein should not exceed 1 gram, for every 0.45kg of his/her ideal weight, and no lower than 0.4 grams.

Diabetic patients, especially those with type 2 diabetes, should not consume too much protein. It may worsen their nephropathy and make them more prone to dehydration.

Previously, nutritionists suggested the protein intake of diabetic patients should be 15 to 20% of their total calorie-intake for the day. However, it has recently been discovered that the amount of protein should be proportionate to the weight of the person.

The amount of fat in a diabetic’s diet should not be more than 25% of the amount of the ideal total calorie allowance for the day.

Some dieters often allocate the remaining amount of the “ideal total calories” each day to fat. So, if the remaining amount is 35%, that would be the amount of fat in their diet.

Many experts disagree. The percentage of fat should be low, especially if the person is over twenty-five years old. Too much fat, whether from a good source or not, can still lead to complications, such as heart disease and hypertension. Also, it interferes with insulin receptors, causing glucose levels to rise.

Their diet should have less fried and processed food

Fried and processed foods are high in unhealthy fat and refined carbohydrates. They increase the level of glucose in the blood, blocking insulin receptors and increasing cravings for sweet and greasy food.

Foods that retain their natural flavor are usually high in fiber and low in sugar. Fiber aids digestion and helps “choose” which nutrients are absorbed, or not, by the body.

How To Calculate Your Daily Carbohydrate, Protein and Fat Requirements (5 Steps)

Using the characteristics of a diabetic diet, we can calculate the ideal amount of carbohydrates, proteins and fat needed for a balanced diet. Here is a step-by-step approach to balancing the type of food in the diet.

Step 1: Know your ideal weight.

The formula to work out your ideal weight is discussed in the previous module.

Step 2: Choose your ideal total calorie intake for the day.

To work this out, follow step 5 of “steps in losing weight” in the previous module.

Step 3: Calculate how much protein you need in calories.

Since proteins must be proportional to your weight, it is better to calculate this first. Multiply your ideal weight by an amount within 0.4 to 1 gram per pound. Multiply the result by four.

Step 4: Calculate the amount of carbohydrates.

The ideal amount is usually somewhere between 45-60%. It should be proportional to the degree of the person’s physical activity. If they are very active, they could consume as much as 60%.

Step 5: Allocate the remaining amount to fat.

This should not exceed 25%. The remaining amount of calories can be allocated to fat. However, if the level of fat exceeds 25% of the total calorie intake, then the ideal total calorie intake should be lowered.

For children under seventeen years of age, the amount of fat can be increased to 30%.

Converting Grams to Calories

Most food manufacturers on the market list their product facts using grams. It is enforced by states, but also a marketing strategy. The number of grams is smaller than the number of calories. If a consumer sees the product only has 15 grams of fat, he might not be too worried. However, if they see the product contains 135 calories from fat, they might think twice.

Ignoring these totals is not an option for diabetics. They need to be more vigilant in knowing how many grams/calories they consume each day. They must convert the weight in grams to calories. Knowing this helps to them to arrange the correct meal plan for the whole day.

Some might think that this is too complex. However, diabetics do not always have to calculate the calorie value for each food. Diabetic associations often supply dietary guides that include conversions.

If you cannot find a manual, you can do it using the table below:

  1. 1 gram of carbohydrate is the equivalent of 4 calories.
  2. 1 gram of protein is equivalent to 4 calories.
  3. 1 gram of fat is the equivalent of 9 calories.

Using the example of Wendy above, her diet for the day should be composed of food with the following weights:

  • 60 grams of protein. That is 240 calories divided by 4.
  • 202.5 grams of carbohydrate. That is 810 calories divided by 4. 
  • 50 grams of fat. That is 450 calories divided by 9.

Getting Macronutrients from the Right Source

Another vital aspect of a diabetic plan is choosing the source of your food. A diabetic may be eating the correct amount of protein, carbohydrates and fats, but if they are coming from a bad source, his/her diet will not be healthy.

According to nutritionists, diabetics should source their carbohydrates, fat and protein from natural and unrefined foods.

Processed foods may contain the same amount of nutrient, but they break down into synthetic chemicals that may be harmful to the body.

Types Of Food To Eat & Those To Avoid

1. Carbohydrates

When choosing carbohydrates, you should always try to eat those from unrefined sources, whether you’re a diabetic or not. Unrefined sources have higher amounts of dietary fiber and do not break down into simple sugar.

2. Sugar and Sugar Substitutes

Another bad source of carbohydrate are sweeteners, such as table sugar. You may only be consuming a small amount, but they increase the glucose level in an instant. However, you do not need to eliminate them from your diet, but you must limit them.

Products like honey, molasses, brown sugar, coconut sugar and stevia are claimed to be safe for a diabetic person. There are no studies or approved research that prove this fact. The only proven fact is that these products break down slower than refined white sugar. The body absorbs them slower and hence, they do not have such a drastic effect on the body. Thus, experts still advise diabetics to use them sparingly.

Experts recommend using natural sweeteners found in fruits and vegetables. If a sweetener must be used, honey e.g. manuka honey is preferred, because it is lower calorie and has other health benefits.

3. Fat

There are many good sources of fat, but processed fat has become the most accessible. Some products claim to be low in fat or nonfat, but they have hidden and dangerous types of fat.

There are four types of fat. These are:

• Polyunsaturated fat

Omega 3 and Omega 6 are examples of polyunsaturated fat; they help to control cholesterol.

Aside from lowering cholesterol and reducing the risk of heart diseases, they also aid in cell growth. New cells help improve the way glucose is received and therefore, reduces the risk of developing diabetes; or having uncontrolled diabetes.

Sources of polyunsaturated fat include flax oil, sunflower oil, almonds, avocado and oily fish e.g. mackerel.

• Monounsaturated fat (MUFA)

MUFA also controls cholesterol in the body; reduces the risk of heart disease and the risk of developing diabetes, or uncontrolled diabetes. MUFA retains its liquid form, unless it is chilled.

Good sources of monounsaturated fat are olive oil, avocado, nuts, sesame seeds and fish.

• Saturated fat

Many people think saturated fat is unhealthy fat. Nutritionists claim that all fats are good fats, even saturated fat. However, it is consuming too much that is bad for your health.

Studies show saturated fat helps lower the blood sugar in the body, as it helps increase the body’s sensitivity to glucose. However, if the amount of saturated fat consumed exceeds 6%, it can cause complications by increasing the level of cholesterol in the bloodstream.

Sources of saturated fat include butter and coconut oil.

• Trans fat-or hydrogenated oil.

Trans fat is unhealthy for diabetics, and even to non-diabetics. Almost all unnatural and processed food contains trans fat. Do not be deceived by “0- gram” claims on the labels. Companies often claim a product has “0- gram” trans-fat, when it does contain trans-fat – it is just that the amount does not exceed 0.5 grams. Therefore, eating a large amount of food that claims to have “0-gram” trans-fat might still make you consume a lot of trans fat.

Foods high in trans-fat are processed French fries, cakes, muffins, margarine and shortening.

4. Protein

Protein is required for building and repairing tissues. It is also essential in the production of hormones and other nutrients. It helps in the production of insulin, which is also a type of protein.

Plant-based proteins are a healthier source for diabetic patients, than animal- based. The former is more efficient in producing hormones and other nutrients essential for the body, and they also contain fewer calories.

Nuts, soybeans, legumes and kale are good sources of plant-based protein.

For animal-based protein, fish and free-range, lean meat is a good source of protein.

Distributing your Daily Calorie Needs

Knowing how many grams you need and the type of food to fulfil your daily calorie needs is only one side of the equation. The second part of planning is dividing your daily calorie needs among your meals.

One suggested approach is that you reduce the size of your meals as nighttime approaches. Specifically, you should:

  1. Eat a heavier breakfast; 
  2. Eat a moderate lunch;
  3. Eat a light dinner/supper.

However, some believe this rule is not acceptable for all diabetics; and in fact, many experts state this approach is only suitable for prediabetics. It is not advisable for type 1 diabetics, as they may suffer from hypoglycemia while they sleep, due to the lack of carbohydrates.

Recommended schedule of meals

A more acceptable schedule is eating five small meals a day, with sufficient interval between meals. Below is one recommended schedule of meals for a diabetic.

Breakfast should not be more than twelve hours after supper.

Some dieticians may disagree with this. Blood sugar levels could drop to dangerous levels if the person fasts for more than 10 hours. However, some doctors and experts still recommend a twelve-hour interval between supper and breakfast.

A diabetic is advised to drink a glass of milk before bedtime, to avoid hypoglycemia.

Snacks should be between two to three hours after meals (Breakfast and Lunch.) Snacks should not be skipped, even if the diabetic does not feel hungry.

Diabetics often complain of hunger two to three hours after eating a meal, when in fact, they are not hungry. It is the body sending a misleading signal to the brain and other organs. If the diabetic ignores these signals, the body wants to defend itself and the organs try to protect themselves from hunger by conserving energy. Diabetic complications may arise as a result of this. So, doctors suggest eating a small amount of food, regularly. This helps produce enzymes that convince the body it is not hungry.

Lunch should not be more than 6 hours after breakfast.

Diabetics should on no account skip lunch, especially type 1 diabetics. Diabetics need a regular intake of carbohydrate to maintain their blood sugar level. Skipping lunch or any meals may trigger ketoacidosis.

Dinner/Supper should be more than 6 hours, but not more than 10 hours from lunch.

Supper is just as important as breakfast, for diabetics. The body needs a store of carbohydrates and fat, for the body to process while it is asleep. If there is nothing to process, it can trigger hypoglycemia and in some cases for type 1 diabetic, ketoacidosis.

Step by Step Guide to Distributing your Calories to Each Meal

Here are the steps to help you allocate the number of calories for each meal:

  • Divide your ideal daily calorie needs into four. Though you need five meals a day, you only need to divide your total calorie needs into four because one portion is divided into two snack portions.
  • Let’s assume your ideal daily calorie needs are 1800. Then, each meal should be approximately 450 calories, with two snacks of 225 calories.
  • Calculate how much carbohydrate, protein, and fat do you need for the day. For this, we would use the plan we calculated for Wendy:
    • 240 calories of protein
    • 810 calories of carbohydrates.
    • 450 calories of fat
  • List what you would like to eat for each meal. A diabetic diet does not limit your choice, but ideally it needs to be healthy, unrefined and within your daily calorie allowance.
  • List the carbohydrate, and fat and protein for each meal.

Tabulate everything. Compute the total of the calories, grams of fat, protein and carbohydrates.

Compare the meal total planned with your ideal distribution. You need to check whether your meals fit within your ideal calorie distribution.

In the tabulation above, the carbohydrate is less than the required amount, while the protein is above it. So, does this fit within your ideal calorie distribution?

If you base it purely on the numbers, you would have to say “no”. However, if you consider the fact that the values we used are based on Wendy, who is 54.4kg (120lb.), the distribution is still balanced.

The total calories do not fall below 1200.

The value of protein 328 calories is still within the limit for the daily protein requirement (1g per pound).

The fat does not exceed 450 grams.

The only problem is the carbohydrate. It is below 45%, or is it? Nutritionists suggest setting an allowance, when you are planning a calorie based diet. It’s likely you will be using mass produced ingredients, especially spices and seasoning.

Many of these products often contain hidden fats and carbohydrates. The manufacturers may not declare the correct amount/type of carbohydrates or fats, to make the calorie levels appear lower. So, in this case, the deficit of 258 calories may possibly be compensated for by hidden carbohydrate from the bread and sauces used for the meals.

What if the amounts in your tabulation are too low, or too high, compared to the ideal distribution?

The planned meal is too low from the ideal distribution, if it falls below 1000 calories. It is too high, if it exceeds 2500 calories.

Falling or exceeding your ideal calorie distribution for one or two days may not cause problems but, doing so on a regular basis often causes complications.

If your actual calorie intake is significantly lower, then the diet is not providing the correct nutrition your body requires. This could result in malnutrition, frequent weakness, and frequent hypoglycemia.

If it is significantly higher than the ideal calorie distribution, it will not control blood sugar levels and increase the risk of diabetic complications.

In module 11 there are a few recipes to help prevent diabetes developing or for taking control of your diabetes. The recipes have the corresponding calorie values, which make it easier for you to adjust the portions depending on your calorific needs.

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