Managing diabetes the healthy way

2014-02-19T06:30:00Z 2014-02-19T09:00:00Z Managing diabetes the healthy wayJane Ammeson nwitimes.com
February 19, 2014 6:30 am  • 

“Whether a person can be managed with or without medication depends on the type of diabetes the individual has,” says Irene Woodruff, MA, RD, CD, a renal dietitian at DSI Duneland – LaPorte and Knox. “Type I DM or diabetes mellitus is the insulin-dependent form and typically affects young people. Type I Diabetes develops as a result of a gradual loss of pancreatic function and insulin production. The person with this type of diabetes is typically dependent on insulin injections to maintain blood sugar control. They will need to balance their carbohydrate intake to the insulin they are taking.”

Type II DM, which results mainly from the loss of cell sensitivity to circulating insulin, commonly affects adults and has hereditary and lifestyle causes such as being overweight. And sadly, Type II, previously seen only in adults, is now seen more frequently in children and has been termed MODY--maturity onset diabetes in the young. It is the type of diabetes that may be managed with healthy lifestyle changes as well. That’s because food and nutrition has a profound impact diabetics because the body digests and absorbs different types of foods at different rates.

“Simple, processed carbohydrate foods eaten on their own are broken down rapidly and contribute to rapid rises in blood sugar,” says Woodruff. “The same simple carbohydrate food eaten as part of a meal containing protein, fat, and fiber, is processed less rapidly and contributes to a less dramatic rise in blood sugar.”

According to Lori Granich, Registered Dietitian at the Midwest Bariatric Institute at Franciscan St. Margaret Health in Dyer, carbohydrates have the largest impact on our blood sugars.

“People with diabetes should not avoid carbohydrates, but they should pick high-fiber carbohydrates and always practice moderation,” she says. “For an overall healthy diet, we should be limiting refined carbohydrates such as candy, soda and high processed snack foods. Instead, we should choose carbohydrates that are higher in fiber because they digest slower, which will prevent a spike in blood sugars. High fiber foods also keep you full and can aid in weight loss. Keeping a food log is a great way for patients to see how certain foods affect their glucose levels. It also gives patients more insight into their eating habits.”

When teaching people how to manage their diabetes, Terri Sakelaris, M.S., a registered dietitian and Certified Diabetes Educator at the Community Hospital Diabetes Center in Munster, talks about how to use carbohydrate counting to help keep blood glucose levels within a patient’s target range.

“Carb counting helps you to keep track of how much carbohydrate you are eating, she says, noting that the American Diabetes Association recommends setting a limit for the maximum amount of carbs to eat combined with the right balance of physical activity and medicine.

Sakelaris also gives her class a meal plan calculated on their weight and height which lets them know how many grams of carbs they get a day.

“Grams are like money,” she says. “It’s a way for people to see what it costs them in terms of what they eat so they can decide what to spend them on.”

Reducing blood sugar levels can be simpler than many diabetics realize.

“Ten minutes of walking can reduce sugar quite a bit,” says Sakelaris. “Drinking water versus beverages with a lot of carbs is also beneficial. Keeping hydrated is very important because if someone is dehydrated, their blood sugar goes up. And if you’re under a lot of stress, you release adrenaline which tells the body to release sugar.”

Julie Mantis, a nurse practitioner and diabetes educator who works with Sakelaris, says that even little things like standing up when a commercial comes on TV and stretching or lifting small weights can help.

“If it gets the heart rate going, that’s good,” she says.

According to Woodruff, the body digests and absorbs different types of foods at different rates. Simple, processed carbohydrate foods eaten on their own break down rapidly, contributing to rapid rises in blood sugar while the same simple carbohydrate food eaten as part of a meal containing protein, fat, and fiber, is processed less rapidly and contributes to a less dramatic rise in blood sugar.

Fiber intake is also important.

“Carbohydrates have the largest impact on our blood sugars,” says Granich. “People with diabetes should not avoid carbohydrates, but they should pick high-fiber carbohydrates and always practice moderation. For an overall healthy diet, we should be limiting refined carbohydrates such as candy, soda and high processed snack foods. Instead, we should choose carbohydrates that are higher in fiber because they digest slower, which will prevent a spike in blood sugars. High fiber foods also keep you full and can aid in weight loss. Keeping a food log is a great way for patients to see how certain foods affect their glucose levels. It also gives patients more insight into their eating habits.”

Fiber is very filling says Sakelaris as it slows down the digestive system and the release of blood sugar.

“Orange juice will spike the release of blood sugar,” she says by way of illustration. “An apple, because of its fiber, slows it down.”

Recent studies indicate that cinnamon may improves glucose and lipids of people with type 2 diabetes.

“Some research has shown that cinnamon reduces blood sugar levels, triglycerides and cholesterol,” says Granich. “Researchers believe that it is decreasing insulin resistance. It is not suggested that people use cinnamon instead of their diabetes medications. Research is still ongoing.”

What works best is simple.

“If you want to prevent diabetes, it is very important to consume a healthy diet and exercise regularly,” says Granich. “Exercise is important for weight loss and can improve insulin sensitivity. Healthy habits are even more important for those people who have a history of diabetes in their family.”

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