I know, I’m kind of on blog diabetes over-load lately. I got a great reader question, however, and I thought I’d answer it here, as well. Diabetes is a complex disease and with the Western diet we consume, I believe we are ALL at increased risk of developing insulin resistance and type 2 diabetes.
If you’re sick of diabetes, you can skip on down to my garden update. Things were a’growin’ while I was in San Jose! 😀
Heather of Get Healthy with Heather: Could you write about the different types of diabetes and ways to treat them with food and exercise? At my work diabetes is a big problem and we want to start taking steps to reduce it and help improve employee’s health. Thanks!
Prevention RD: Great question, Heather! Type 2 diabetes is the most common form of diabetes and is characterized by insulin resistance. Insulin in the hormone in the body which acts as the carrier for glucose (energy) into the cell for proper metabolic processes. When insulin resistance appears, insulin is no longer working effectively due to the cell’s decreased sensitivity to insulin or a glucose (energy) load, particularly from carbohydrates, that exceeds the capacity of the body’s needs. Muscle cells are more receptive to insulin and for this reason, insulin resistance is more common in overweight and obese individuals.
Type 2 diabetes is attributable to both genetics and lifestyle factors such as overweight and obesity, inactivity, high blood pressure, and poor diet high in total carbohydrates and/or simple carbohydrates (sugars and starches). Screening for diabetes is being performed much earlier in the US because symptoms often times take years to develop. Common symptoms of diabetes (all types) include: excessive thirst, excessive urination, fatigue, weight loss, and fruity-smelling urine.
Type 2 diabetics are twice as likely to develop cardiovascular disease. Uncontrolled diabetes can lead to other complications such as retinopathy leading to blindness, neuropathy (loss of feeling and sensation in the extremities and digits) which can lead to amputations, nephropathy leading to kidney failure and dialysis, and erectile dysfunction. Depression is also common in many diabetics.
Type 1 diabetes is an auto-immune disease which requires insulin therapy due to the pancreas’ inability to produce insulin. Type 1 diabetes is typically diagnosed in the younger years with most type 1’s being diagnosed before their 20th birthday. A strict insulin and diet regimen are required for proper health.
Gestational diabetes is commonly coined a “carbohydrate intolerance” and is first diagnosed during pregnancy. Risk factors for gestational diabetes include: obesity, family history of diabetes, non-Caucasian descent, and older maternal age. Most women resolve their carbohydrate intolerance after giving birth, but they are at increased risk for developing type 2 diabetes in the future. The baby of a gestational diabetic is more likely to become overweight or obese and have impaired glucose tolerance and/or diabetes later in life.
While there are several types of diabetes, they are all treated the same. I am an advocate of eating like a diabetic to avoid diabetes. A diabetic meal regimen focuses on regular meal times and macronutrient balance. Diabetics should be counseled on basic carbohydrate counting techniques and aim to consume a carbohydrate-controlled diet of approximately 45 grams per meal, and a 15-30 gram carbohydrate snack (plus protein) before bed. Ideally, 2-3 ounces of protein (or more) is included at each meal.
General rules of thumb for diabetics and carbohydrates:
- Emphasize complex carbohydrates over simple carbohydrates (complex carbs include fiber)
- Increase fruits, vegetables, and whole grains in the diet
- If lower carbohydrate intake is good, less is not better. The brain needs glucose!
- An evening snack should be consumed no more than 60 minutes before bed. Include protein!
- Check labels! Look for portion size, servings per container, grams of total carbohydrate, and fiber content
- Do not check sugar on a label! Sugar on a label cannot differentiate between lactose and sucrose, so it is not an accurate means of determining the effect on blood glucose
- Fiber and protein help blunt the curve of the post-meal glucose spike – they are important to include at every meal.
- If you include snacks throughout the day, aim for high-protein and healthy fat snacks (2% cheese, nuts, seeds, etc.)
- Increase exercise! Activity helps to lower blood glucose and increase muscle mass which is more sensitive to insulin than adipose (fat)
What are some examples of balanced 45 gram meals?
- A meat and/or 2% cheese sandwich on 2 slices of whole grain bread, a side salad with light dressing, and a piece of fruit
- 3-4 ounces of meat with 2/3 cup rice or noodles, 1 cup of mixed vegetables, and 1 dinner roll
- 2 chicken or beef tacos with 1/3 cup rice or ½ cup beans
45 grams gone and you’re still hungry?
Some meals are a “rip off” in terms of carbohydrate grams for portion size (ex: rice and pasta). These foods can still be consumed, but they will require smaller portions. If these portions are not enough to feel satisfied, consider increasing the amount of protein and non-starchy vegetables on your plate. There are lots of ways to add bulk to your meal without adding additional carbohydrates.
What fruits and vegetables are carbohydrates?
Technically, all of them. All fruits are carbohydrates and need to be counted. Starchy vegetables that contain significant proportions of carbohydrates include: potatoes, peas, corn, and squash. All other vegetables are very low in carbohydrates and don’t need to be counted until the portion has exceeded 3 cups (that’s a lot!). So, more or less, they’re freebees…eat more!
Heather, I recommend…
If I were you, I would create a free, anonymous survey on Survey Monkey and send it to your co-workers. Find out how much of a problem diabetes is for your co-workers and their families. Ask questions that relate to diabetes (i.e. How many fruits and vegetables do you eat each day? How many times a week do you regularly exercise? Do you have a mother, father, brother, or sister with diabetes?) to find out what needs the most attention.
Most people don’t know much about diabetes and how to prevent diabetes. More individuals than we can estimate are walking around with advancing insulin resistance and type 2 diabetes. Early intervention is extremely important! The longer diabetes goes undetected, the grimmer the future is for diabetics as far as complications and pre-mature death. Diabetes is a progressive disease and gets worse over time, requiring more to control its effects. Education is so important!
I wish you lots of luck in your endeavors to inform and help your co-workers live long, healthy, and happy lives!
Diabetes is preventable if we do something about it before it’s too late!
And for the Lily lovers out there: Lily is feeling much better it seems! Another week to go til we find out about surgery. Thank you for all your prayers and well wishes for our baby girl! 😀
Question: Do you limit your carbohydrate intake at all? If so, why? What do YOU consider to be a low-carbohydrate diet? Do you think low-carbohydrate diets are advisable? Why or why not?
I think everyone has a different take on this, so I’m curious to hear what you guys think!
Random Question: Over dinner with Andrea the other night, we talked about how important it is to keep posts concise. I am not good at this always (see above!), but I try to be. Do you find that you enjoy blogs that are less time-consuming to keep up with? Or does length not really deter you from reading a blogger’s posts?
Have a great day!