Jan 13 2010

How to Manage the Diabetic Condition

Category: ContentJimR @ 4:44 pm


The “Plus” in this blog’s title of Diabetic Food List + Plus refers to those topics, other than food related, that are more general in subject content than would be found on the diabetes food list, but are important enough or may be of interest to my fellow diabetics. The following falls into the latter category.

For the Newly Diagnosed Diabetic -  Read this First
The cells of our body derive energy from sugars, in the form of glucose, obtained from our daily food intake, especially from the carbohydrate portion of those foods, Food also supplies the proteins and fats that, together with carbohydrate, are essential to the nourishment of the individual.

In a healthy person, the levels of glucose that circulate in the bloodstream, mainly as a result of the digestion of the food consumed, are maintained within a safe range by a series of chemical reactions that constantly take place in the body.

Diabetes, a serious disease, is the condition in which a person’s body is unable to properly regulate and control the levels of sugar in their bloodstream in the way that a healthy person does.

As yet, medical science has not been able to provide a cure for diabetes, To treat a patient suffering from diabetes, referred to as a diabetic, it is necessary to implement a regimen of dietary and exercise procedures that, together with prescription medications, can help control the blood sugar levels that otherwise will inevitably lead to major complications and increase the risk of several serious conditions, including cardiovascular disease, the leading cause of death in the diabetic population.

In addition to the large number of people who are known to be diabetic, there is also a large number of people who have the disease without knowing it, possibly because they have not had a recent, or perhaps any, medical checkup,

Important to note: Anyone who is known to be diabetic must be under the care of a physician.

Doctors monitor the diabetic condition of their patients, guided by the results of periodic blood tests, and will prescribe medication if deemed necessary. Aided by nutritionists or other health-care providers, the doctor will probably advise the steps that the patient should take to lower and control the blood sugar levels, also referred to as blood glucose levels, to within a close to normal range.

Five factors in the management of diabetes

The first factor: To be effective, the management of diabetes requires that an appropriate daily food plan be diligently followed, not special foods, but the right foods chosen from the vast amount and range of foods available. Available, that is, to the citizens in the developing world, and then again, diabetes is the growing disease of the developing Western World. There are few foods that are off-limits but quantity and quality must be taken into consideration.

The second factor is the requirement for regular exercise, not necessary at the athletic level but more than a casual stroll each day. Commonly suggested is to take a brisk walk for half an hour each day, or at least five times a week. Or it could be swimming or bicycle riding or whatever achieves at least that equivalent minimum amount of exercise.

The third factor involves weight-loss. If a diabetic person is overweight it increases the level of serious heart and other health risks. The first two factors, described above, can help reduce weight if properly applied, but before implementing any weight-loss program, a consultation with a doctor would be wise.

The fourth factor is that a once-a-day personal in-home blood test should be taken. The blood test is done with the aid of a simple and easy to use measuring device, just takes ten or twenty seconds to obtain a reading that indicates the amount of glucose in the blood stream. If done once each day then most likely it should be on rising, before breakfast or any food intake, in other words a fasting blood sugar level – as it is commonly referred to.

Monitoring the blood glucose levels at home each day enables the diabetic to know their condition and if necessary, make adjustments to their dietary plan and/or lifestyle in a best effort to correct blood sugar levels. This may require more daily blood tests than just the morning test. It is a fact of diabetes that much of its management is in the hands of the diabetic personally and requires frequent checks to try to gain control.

The fifth factor: Periodic attendance at the doctor’s office for checkups, and blood tests, known as the A1c or Hemoglobin A1C blood test. The blood for these tests, a simple painless procedure, is taken by a technician at a medical clinic, and are normally required every three or four months. These tests provide essential information of the estimated average glucose content existing in the blood over the prior period of about 3 months. This test result is possible because the life-span of blood cells, that are constantly manufactured by the body, is approximately 12 weeks, so some of the blood cells are just newly born while others will be of any age up to about 12 weeks. With the A1c blood test results available, the doctor can monitor and assess, and adjust if necessary, the treatment to best combat diabetes.

For a further explanation of blood tests, visit Blood Testing for Diabetics on my companion site where you will also find other items of interest to diabetics under the site name:  Normal Blood Sugar Levels and Diabetes.

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Jan 11 2010

The Glycemic Index and the Glycemic Load

Category: ExplanationJimR @ 9:21 pm


When considering various foods that you might wish to add to a diabetes food list, it can be helpful to know their Glycemic Index rating.

The Glycemic Index, or GI for short, is a list of carbohydrate containing foods that have been rated for their speed of conversion to glucose, and the release of that glucose into the bloodstream, compared to a standard reference value of 100 assigned to pure glucose. Pure glucose being very speedily released into the bloodstream since it does not require any further chemical breakdown by the digestive-system as would other food items.

The higher the numerical grading of a food the faster it is absorbed into the bloodstream compared to other foods of lower numerical value. Examples of this would be the breakfast cereals:

All-Bran with an established GI of 42,
Shredded Wheat with a GI of 67, and
Corn flakes with a GI of 84,

indicating that the carbohydrates in Corn flakes are converted much more quickly into glucose than the other two cereals with All-Bran taking the longest time. A faster release of glucose causes a faster and higher spike in blood sugar elevation, something to be avoided, or at least minimized if possible, leading to the conclusion that All-Bran is a better cereal choice than the others to include on the diabetic food list.

But not all high GI foods are bad and there are times, such as before, during, and after exercising, when they are beneficial. The body reacts to the higher blood glucose by releasing insulin, a hormone that assists the body in building muscle, although we must always keep in mind that the diabetic person’s body has an impaired ability to deal with insulin and higher blood glucose. These matters would be better discussed and commented on by the diabetic’s doctor or qualified health team members.

Many foods, such as proteins and fats, do not contain significant amounts of carbohydrate and are not listed on the glycemic Index.

The glycemic index is a useful tool to aid in choosing carbohydrate containing food items to include in a diabetic food list, enabling an emphasis on those with lower index values. But the inclusion of low GI foods in a diabetic food plan is only one of several considerations in determining an appropriate dietary regimen to follow over the long term.

GI range of values

Low GI values are 55 or less
Medium GI values are 56 to 69
High GI values are 70 and above.

The Glycemic Load
But what if the carbohydrate food we eat is only part of a larger meal that is otherwise devoid of carbohydrates, perhaps a meal of mostly protein and fat, of meat, vegetables, fruits, that have little or no carbohydrate content? In that case, measuring by weight in terms of grams, the carbohydrates would  be only part of the total grams in the meal and from this an adjusted GI value can be obtained by applying a simple formula..

To cover that situation, there is an extension and enhancement of the glycemic index known as the Glycemic Load. The glycemic load derives a set of values from those of the GI by taking into account the quantity, or quantities, of carbohydrates that are actually in the total meal of food item.

It becomes more practical to consider the GL of a food item when it is only a relatively small portion of the food being consumed, even if it is has a high GI rating,.

For a simplified example: when  knowing that one cup of the 84 GI cornflakes weighs about 30 grams, we can easily calculate the proportion of the cornflakes to the weight of the total meal. When being considered as part of a larger breakfast meal of 120 grams weight, it would be 25 percent of the total and that becomes the glycemic load value. 25 percent of the 84 GI is 21, the GL value of the cornflakes in the breakfast.

GL ranges of values
A GL value of 21 is still rather high, the substitution of a lower GI cereal such as Bran flakes or oatmeal porridge  would achieve a much lower GI rating. A GL value below 10 is considered to be low and above 20 is high in the opinion of most nutritionists.

An important decision regarding carbohydrate consumption
A major decision rests on what percentage of carbohydrates will be included in the overall diabetic food plan, whether to follow the American Diabetes Association’s recommendations of a high ratio of carbohydrates, or the opposite approach of lower carbohydrates, or somewhere in between. This is a controversial subject for many health care practitioners and needs careful consideration and discussion elsewhere. There are strong advocates whose differing views are worth hearing, even though a diabetic patient mainly depends on his or her personal physician to provide guidance, much of the management of the diabetic condition is in the hands of the individual diabetic.

The food lists available from this blog-site do provide the nutrient content and information for many common food items, indicating whether high or low on the GI and some food groups in general are summarized. For a very complete listing of GI values the following resources are suggested – although doing the research can get rather complicated and time consuming:

1.  The University of Sydney, Glycemic Index Web site.

2.  David Mendosa, blogger and medical writer.

3. There is also a very good article and explanation by staff of the Linus Pauling Institute at Oregon State University. That explanation references the GI to cardiovascular disease, a major complication of diabetes, and to obesity, to cancer, and to gallbladder disease. With its comments on several other topics of interest, it is worth a read and can be reached at Linus Pauling Institute.

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Jan 06 2010

About Foods and Diabetic Food Lists

Category: Food ListJimR @ 11:02 pm

Food Lists – with essential supplementary information

This site provides a link to the Food Lists on our companion blog-site, Diabetic Menu Guide, where  the various categories of food items such as Vegetables, Meats, Fats, Fruits, Fish, Cereals, Dairy, Breads, Jams and spreads, and Drinks are shown together with nutrition details.
To access that information, click:  The Food Lists,

The importance of carbohydrates
Foods are comprised mainly of carbohydrates, proteins, fats, and fiber, and of course, water. One of the most important factors of our diabetic foods is the amount of carbohydrates in our meals. Carbohydrates are a primary source of the glucose that enters our bloodstream and every newly diagnose diabetic should become familiar with the effects of the carbohydrate portion of their meals.

The speed at which carbohydrates are broken down by the body into glucose varies with the individual food item, in some foods it is fast in others not so fast, and the slower it is the better it is for the diabetic.

The Glycemic Index
A widely accepted tool in diabetic food planning is the Glycemic Index, GI for short. The GI is a numerical ranking of how fast individual food items are reduced to glucose and enter the bloodstream compared to a reference standard such as sugar or white bread. The GI is another reference source for diabetics to learn about. In a companion post on this site we provide an explanation of the Glycemic Index and the Glycemic Load.

The Practical Value of the Food Lists Provided on this Site

Since there are few foods that are “off-limits” to the diabetic, it is the accompanying information regarding the nutritional content of the individual servings of the specific food items that is important.

From these values, the total nutritional content can be determined for selected food items that comprise a meal and it can then be seen whether they meet the objectives of the menu plan regarding calories, and the preferred ratios of carbohydrates to proteins to fats.

Although most food items are acceptable to the diabetic, some may require modest proportions and certainly some items are less desirable compared to others, for instance, whole wheat breads are a better choice that white breads.

The diabetic food list includes many food entries and a lot of supplementary information. Why it is necessary to know the nutrient and calorie content of foods is explained below.

If You Are Newly Diagnosed as Diabetic:
The following might be of interest: click on for details
About Diabetes, from my own experience
About Diabetes, a simple explanation

More is needed than just a list of foods
To feed yourself properly, you will need to include the right combination of Proteins, Carbohydrates, and Fats, the primary nutrients needed by the body to sustain life, the building blocks, so to speak, to maintain good health.

So as well as the basic food lists, we include the amounts of Proteins, Carbohydrates, and Fats in those foods, and will be adding the Glycemic Index values and the Glycemic Load values shortly.

And more is needed than just a list of foods and their nutrient content
Why? Because you need to know how much of those foods to include in your diabetic menu to provide the energy needed to carry out your daily activities in the workplace and to support your personal life style activities. Food energy is measured in Calories  so the calorie content of the individual foods is also listed in our lists of diabetic foods.

Calorie content based on individual needs and a target weight
As well as calorie content, even more information is needed to plan and prepare foods for your daily meals. The total daily calories required for individuals varies and should be known at the beginning when first establishing a diabetic meal plan and that can be based on the weight you wish to maintain, or the weight you may wish to gain or lose.

Do not follow a quick weight loss diet plan if you wish to lose weight,  we suggest that weight reduction can best take place in small increments over an extended time in that way the weight lost  is likely to stay “off” – whereas it has been shown that weight loss through quick weight-loss diets almost always is regained. Visit our post on the role of weight-loss in diabetes.

Now in Preparation:
More details on specific food items such as Seeds, Nuts, Fats and Oils, Grains, Vegetarian and Vegan dietary approaches, Regional dietary habits: Mediterranean, Okinawan, etc. High and Low carbohydrate approaches to diabetic menu planning. Etc etc.

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