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 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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Jan 06 2010

Establishing Food Plans – Considerations

Category: ExplanationJimR @ 9:12 pm

Different approaches to establishing food plans

The objective of a dietary plan or diabetic food list for the diabetic person is primarily to aid in the control the amounts of glucose in the bloodstream and to keep the glucose levels within as narrow a range as possible so that they do not exceed acceptable levels by too great an amount.

There will be spikes in blood glucose levels after eating a meal or snack that will vary based on the type of food eaten and its carbohydrate content and the speed in which the resulting glucose is produced when digestion of the food takes place. That is why it is good to know, when compiling a diabetes food list, which foods are the source of the highest carbohydrate content and are the speediest broken down to glucose,  so that they can be eliminated or at least limited in quantity. Those can be identified by reference to the Glycemic Index and Glycemic Load index avail able elsewhere on this site.

To maintain glucose levels as evenly as possible throughout the day it is often suggested that meals should be of about the same size and interspersed with snacks, rather than any one meal being much larger than the others.

The essential nutrients needed by the body for its energy and maintenance are obtained from the carbohydrates, proteins, and fats in the foods consumed each day. Those foods are broken down to their nutritional chemical components in the digestion process and released through the walls of the intestine to be carried in the bloodstream to the many organs of the body where they are then selectively taken up as required into the body’s millions of cells.

When present, the carbohydrate fraction of the foods is the main source of glucose in the bloodstream and so it is the carbohydrate content of foods that is the major factor around which diabetic food plans are constructed. The more carbohydrates there are, the more glucose will end up in the blood stream. After a meal or snack, when glucose is produced, the impaired body mechanisms of the diabetic person in the production of insulin, needed to conduct the glucose into the cells that require it, and the desensitized sensors on the outer membranes of those cells, results in the unhealthy levels of the glucose remaining in the blood.

From that statement the question could be asked:
“Then why not reduce the amounts of carbohydrate to a minimum so that less glucose is produced to overload the bloodstream?”

That is a good question that would seem to require an answer in the affirmative. But the diabetic associations of most countries do not seem to concur.

The High Carbohydrate approach
The ADA (American Diabetes Association) and others recommend what can be considered a high carbohydrate diet of 50 to 60 percent Carbohydrates, 15 to 20 percent proteins, and 25 to 30 percent fats based on total calories consumed. A calorie is the unit applied to the measurement of energy provided by components of food.

The Low Carbohydrate approach
Although in the minority, many physicians advocate an “Anti-ADA” approach that, conversely, recommends a low carbohydrate content in meals to minimize the amount of glucose that can enter the bloodstream.

A number of books have been published by doctors providing details on diets that have successfully brought their patients to a reversal or near reversal of their diabetic condition or at least a very good control of their glucose levels. The carbohydrate content of those diets is low, from about 20 to 35 percent. There are many different versions, you’ve probably heard of the Dr.Atkins and South Beach Diets, but there are others, some less extreme than those.

The American Academy of Family Physicians defines low carbohydrate diets as:
“Low-carbohydrate diets restrict caloric intake by reducing the consumption of carbohydrates to 20 to 60 g per day (typically less than 20 percent of the daily caloric intake). The consumption of protein and fat is increased to compensate for part of the calories that formerly came from carbohydrates.”

It should also be noted that the American Diabetes Association, after carrying out their own clinical studies with patients on a low carbohydrate diet, agreed that the low carbohydrate was successful in achieving lower blood glucose levels. However, their stated opinion was that such a diet was not likely to be adhered to for a sufficiently long period of time and they therefore keep to their current recommendations regarding carbohydrates. For additional information on lower carbohydrate foods, see our companion site: Diabetic Menu Guide and the reference to low carbohydrate effectiveness can be found in our post :  Low Carbohydrate Approach.

There are other health concerns voiced by members of the medical and health care profession in which reservations are expressed regarding the adoption of a low calorie diet.

Caution:
All matters of diet, exercise, weight-loss, and especially any changes being contemplated, should be discussed with your doctor who will provide guidance on your treatment and should refer you to other health care professionals for more complete answers if necessary.

One other factor regarding carbohydrates is that they exist in several different forms that are usually classified as either “simple” or “complex”. The difference being in their chemical structure that results in a speedier breakdown to glucose for the simple form and a longer time for the complex forms. This makes the complex forms generally more favorable to include in a diabetic menu plan and a special index, known as the Glycemic Index, has been devised to rate the varying speeds of conversion of carbohydrates to glucose.

Vegetarian, Vegan, and Others
There are other dietary approaches that are effective in the management and control of blood glucose and that do not so much emphasize the carbohydrate content of foods. Among these are the Vegetarian and Vegan life styles that have many virtues from a viewpoint of nutrition. They concentrate on vegetables and fruits that are automatically low on the Glycemic Index, the speed in which their carbohydrate content is converted to glucose.

However, in North America, only a small percentage of the population follow a vegetarian or vegan regime, we are a meat-eating and fat-rich food consuming nation.

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