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Diabetes: Part 3 of 4

When you are confronted with a diagnosis of diabetes, or even pre-diabetes, the first line of suggested treatment is often lifestyle modifications.  Changes to diet and exercise are often recommended.  Information about these suggested changes often comes along with a slew of other paperwork and information to digest.  It can be quite overwhelming.

Whenever possible, it is advisable for a patient and the members of his immediate household to have a follow up visit with his physician specifically about lifestyle modifications.  If not the physician, perhaps a nurse, nutritionist, or other member of the office team who can really take the time to describe the type of changes that are recommended, how to incorporate them, and the results they can potentially have.

When such resources are not available, a basic understanding of the role of diet and exercise in diabetes management can still be helpful and produce positive results.

Many people mistakenly think that diabetes management has only to do with sugar…as in candy, sweet treats, and desserts.  And while foods like this, that are very high in processed sugar, are certainly a concerning part of one’s diet, for a diabetic, any food containing carbohydrates is of significance.

All foods containing carbohydrates are eventually broken down and used in the same way by the body.  So why does it matter, then, if one eats a bowl of whole oats vs. a brownie?  Because the simpler the form of the carbohydrate as it is being consumed, the faster it is processed and put into circulation in the blood.  As discussed in previous writings, the amount of sugar circulating in the blood at any given time is what is compromised in a diabetes patient.  Therefore, consuming foods that are slowly broken down by the digestive system and slowly enter the blood stream is advisable.

Where possible, swaps can be made between the white or processed versions of foods already being consumed and their more whole grain counterparts.  Examples include switching white breads, bagels, English muffins, wraps, etc. for whole grain versions.  The same is true of cereals, white to brown rice, and whole grain pastas.  Even if the total carbohydrate count per gram consumed is the same, the quality of the carbohydrate and the rate at which it will be digested and put into circulation is what is of importance.

While most vegetables are naturally low in carbohydrates, the same cannot be said of many fruits.  Some fruits, like berries, are naturally low in sugars while others, like bananas, are higher in carbohydrates.  Likewise, the whole fruit version of anything, an apple vs. applesauce, for example, is always preferable to the processed version.  That being said, almost any fruit is a preferable choice to a prepared dessert.  Even the sweetest whole peach will have fewer negative effects on blood sugar than peach cobbler, for example.

For a diabetic patient, the key is not to cut carbs altogether.  In many cases, this is impossible or at least undesirable.  Having unrealistic goals about how many carbohydrates can be cut from one’s diet immediately often leads to failure, as a massive change in diet is neither practical nor sustaining.  Small, gradual swaps are better.  Likewise, limiting the amount of carbohydrates you consume in any one sitting can be a realistic goal.

For example, a diabetic can still consume a serving of pasta.  He should not also have a side of garlic bread with it.  A diabetic can still eat a club sandwich.  He should not also have a bag of chips with it.  When eating an omelette for breakfast, he should have either a side of toast or a side of potatoes, not both.  Making small cuts like this is far more realistic than saying “cut the carbs out altogether.”

A change that many patients find simple is to go from drinking regular, sweetened beverages like cola, white sugar in coffee, and sweet tea, to the diet versions of these items.  However, artificial sweeteners often have an effect on the way insulin is utilized by the body.  So while diet versions of these beverages are seemingly preferable, they do still have an effect on blood sugar and should be consumed in moderation.

Likewise, patients must be mindful when grocery shopping.  Marketing can be very misleading, and just because a food is labeled as sugar free or diet does not mean that it is healthy.  In fact, many of these foods have added fat and artificial sweeteners to compensate in taste for a lack of sugar.  This does not make them health foods.  As with everything, reading food labels and sticking to foods that have fewer than 15-30 grams of carbs per serving is ideal.

Exercise, in even its lightest forms, can have positive impacts on blood sugar.  Exercise helps the body use the insulin it produces more efficiently, and allows red blood cells to take up carbohydrates more easily, thus reducing blood sugar levels and their harmful effects.

Walking and aquatics programs are particularly popular, especially among the elderly, because they can be low impact which is desirable where joint issues are concerned.  Biking, Thai Chi, and low impact aerobics are also recommended.  In reality, anything is better than nothing!  So even if your ability to be physically active is limited, any activity is advisable.  Also, activity is cumulative.  Three, ten minute walks a day are just as desirable as one thirty minute session, so a lack of stamina or ability to endure long workout sessions should not be a deterrent.  As with any exercise routine, check with your doctor to confirm what is safe for you.