Nutrition for diabetics

The type of foods eaten, the amount of foods eaten, and when food is eaten are important facts for people with diabetes to know in order to control their blood sugar. Carbohydrates are compounds that include sugars, fibers, and starches. They maintain healthy functioning of the organs and are a major source of energy for the body, especially the brain and nervous system. Carbohydrates supply calories just as protein and fats do and are essential to a healthy body and healthy diet.

When foods with carbohydrates are eaten and digested, they turn into blood sugar, also called blood glucose. If diabetics eat too much, their blood sugar can go too high and cause a serious problem. (Not taking the right amount of diabetes medicine can also cause blood sugar to rise too high or drop too low.) People with blood sugar levels that are constantly too high can get heart, eye, foot, kidney, or other problems. Problems can also occur when blood sugar levels drop too low. To prevent or slow down diabetes problems, it is necessary to keep your blood sugar at a healthy level.

Diabetics should check with their healthcare provider to find out what their healthy blood sugar level is and what blood sugar levels they need to target. For most diabetics, the targeted range before meals for blood glucose levels is 90 to 130. One to 2 hours after the start of a meal, the levels should be less than 180. To keep blood glucose at a healthy level, be sure to:

• not skip meals or snacks
• eat your meals and snacks about the same times each day
• eat about the same amount of carbohydrate foods each day
• take your medicines at the same times each day and
• exercise at about the same times each day

Diets that are filled with foods that cause big spikes in blood sugar levels are linked to an increased risk for heart disease, eye problems, kidney disease, and diseases of the nerves and blood vessels. The measurement system for this is known as the glycemic index. It measures the speed and strength of the blood sugar spikes after the food has been eaten. A food's glycemic index is determined by many factors, especially by how highly processed its carbohydrates are. The spiking of blood sugar levels is caused by highly processed carbohydrates, such as white flour and white rice, which have the outer bran and inner germ layer removed from the original kernel of grain. Whole-grain foods (like whole wheat flour and brown rice) have a lower glycemic index than their highly processed counterparts.

Other factors that influence how quickly carbohydrates in food raise blood sugar levels include:

• fiber content (the sugars in fiber-rich foods are absorbed more slowly because the fiber slows digestion of the carbohydrates)
• ripeness (more sugar is in a ripe fruit or vegetable than when it is still green so the glycemic index is higher)
• type of starch (different types of starch in foods affect how fast carbohydrates are digested and absorbed; potatoes have a high glycemic index for this reason)
• fat content and acid content (carbohydrates in foods with higher fat or acid content are converted and absorbed more slowly) * physical form (coarsely ground flour has a lower glycemic index than finely ground flour)

Carbohydrates come from a wide variety of foods. High-glycemic carbohydrate foods include potatoes, bananas, white bread, white rice, french fries, refined breakfast cereals, white spaghetti, soft drinks, and sugar. Low-glycemic carbohydrate foods include most legumes (beans), whole fruits, whole wheat, oats, bran, brown rice, bulgar, barley, couscous, and whole-grain breakfast cereals.

Starches include bread, grains, cereal, pasta, or starchy vegetables like corn and potatoes. Replace white starches such as rice, bread, and pasta with brown rice and whole grain products and whole grain cereals.

Minimize the trans and saturated fats in your diet by reducing your intake of commercially prepared foods (such as commercially prepared baked goods, snack foods, and processed foods, including fast foods). At least 2 servings of fish should be eaten per week because eating fish provides healthy polyunsaturated fats called omega-3 fatty acids.

Balance carbohydrates with proteins. Eat at least 8 grams of protein per 20 pounds of body weight. Eat a variety of foods to be sure that you get all of the amino acids you need. Trade beans for meat in chili and soups 2 to 3 times per week. Soybeans, tofu, and other soy-based foods are excellent alternatives to red meat. Eat 2 to 4 servings of soy a week. A high protein diet (such as red meat, cheese, and full-fat dairy products) that is high in saturated fat and low in vitamins and minerals may increase the risk for heart disease. Cut back on highly processed carbohydrates (like commercially prepared foods) and increase protein to improve levels of blood triglycerides and HDLs.

Select sugar-free foods and avoid sweets as much as possible. Eat potatoes only occasionally because of their high glycemic index. For snacks, eat fresh fruits, raw vegetables, whole grain crackers, and high fiber cereals.

How many calories and the amount of food diabetics should eat depends on the person's size and activity level. A dietitian or diabetes health educator can make a meal plan that fits the way a person usually eats, their daily routine, and their diabetes medicines.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File NUTR3306.rf2 VRS# 6960 Data Version 7.0 Copyright 1999, 2002-2003 McKesson Health Solutions LLC. All rights reserved.