With the Thanksgiving and Christmas holiday seasons upon us, many of us might have visions of sugarplums and other delightful sweets dancing in our heads, but for diabetics, this time of year may be tough to navigate. November is diabetes awareness month, and if you are not familiar with this disease, read on to learn about the causes, risks, and preventative measures from which many of us can benefit, as well as keep in mind for those who depend upon checking and managing their blood sugar levels.
What is Diabetes?
According to the American Diabetes Association, diabetes is a disease in which blood sugar (glucose) rises to higher than normal levels, known as hyperglycemia, but ultimately cannot be broken down and converted into energy. This is because the body either cannot generate or use insulin, which is a hormone that moves the glucose from the blood into cells for energy, thus helping to regulate blood sugar levels. Diabetics often monitor their glucose and may manage this disease with insulin as well as medication, exercise, and yes — meal planning! If diabetes is not managed well or left untreated, people could experience nerve damage, vision issues, kidney disease, gastroparesis (stomach paralysis), heart disease, and stroke.
However, diabetes is of course not a one-size-fits-all type of disease! In fact, there are some very important distinctions to be made about the types of diabetes. Here are the most common:
Type 1: Bethany Say, RD, LDN, CDES, a dietitian and diabetes program coordinator at MMC’s Mind-Body Wellness Center explains: “People with type 1 diabetes do not make any insulin and require insulin from shots or a pump multiple times each day. Their risk factors include genetics and a family history of the disease.” The American Diabetes Association further elaborates that in type 1 diabetes, the immune system mistakenly destroys the cells in the pancreas that make insulin, and when enough of those cells are gone and insulin cannot be made, that is when a type 1 diabetes diagnosis is appropriate.
Type 2: People with type 2 diabetes have developed insulin resistance (the body not using insulin properly) and have trouble moving sugar out of their blood stream. Risk factors in addition to genetics and family history include: being overweight or obese; older age, a sedentary lifestyle (defined as active less than 3 times per week), ethnicity of African American, Latinx/Hispanic, American Indian, Alaska Native, Pacific Islander, and Asian American decent, and a history of gestational diabetes (see below). Type 2 diabetes is often preventable when living a healthy lifestyle.
Some women develop high blood sugar levels during pregnancy, resulting in gestational diabetes. For many women, their blood glucose levels will return to normal after birth, but having had gestational diabetes puts them at high risk of eventually developing type 2 diabetes. There about 1.4 million Americans diagnosed each year with diabetes, and a staggering 96 million Americans living with prediabetes, which is a condition in which blood sugar levels are higher than normal, but not so high as to be diagnosed with type 2 diabetes.
In this very brief summary of the intensive topic of diabetes, the question remains: what can be done to prevent and manage this disease from a nutritional standpoint?
Dietary Changes for Diabetes
With glucose at the root of diabetes, how can one modify their lifestyle to help manage a current diagnosis or to even prevent one? Aside from glucose monitoring and medication, two nutritional topics often stand out: meal planning and understanding carbohydrates. “Carbohydrates (carbs) are foods that become sugar when digested and are transported through the bloodstream to be used for energy or stored to be used for energy later,” says Bethany. “This includes all fruits, starches and grains, starchy vegetables, and food and drinks with added sugar (soda, lemonade, iced tea, juice, etc.).” Sugar is often called out in MMC’s wellness posts as something that needs to be consumed in very moderate quantities, as its inflammatory effects are related to a myriad of health issues.
The American Diabetes Association and other organizations recommend that women consume 45 grams of carbs per meal and men up to 60 grams per meal. Managing your carb intake to prevent hyperglycemia will mean developing new eating habits, most notably the “diabetes plate method,” and often checking food labels for carbohydrate content. Bethany Say indicates that one can start by:
- choosing high quality carbohydrates from non-processed foods, like fresh and frozen fruits and vegetables, whole grains, light yogurt, and beans
- choosing moderate portions of carbohydrate foods, a good rule for which is make only ¼ of your plate carbs
- balance carbs with protein and vegetables, another ¼ and ½ of your plate, respectively
- save carb portion for last at meals, as this practice has been known to minimize blood sugar spikes after the meal
If you have already been diagnosed with diabetes, it is important to develop a nutritional plan tailored to your own needs with the help of a primary care provider, specialist, or dietician. Modifying your diet for appropriate carbohydrate consumption to minimize high sugars after eating will remain essential. For the most part, you can also expect to manage your diabetes by:
- taking prescribed medication per doctor’s recommendations
- checking blood sugars at home to help raise awareness of when blood sugars are high/low
- exercising at least 30 minutes a day, 5 times each week
- managing stress with healthy coping strategies
Additional Resources
Think you could be at risk for type 2 diabetes? Use this handout from the American Diabetes Association to determine your risk assessment, but always consult your primary care provider about your health concerns. Meadville Medical Center’s Mind-Body Wellness Center offers diabetes education for types 1 and 2, as well as for prediabetes diagnoses. Those dealing with prediabetes can also find resources and support through the local YMCA’s diabetes prevention program.
And for those looking for some specific guidance on diabetic-friendly meals, stay tuned for part 2 of this month’s wellness tips!
