Diabetes Cookbook For Canadians For Dummies. Cynthia Payne

concentrating, difficulty speaking, and even loss of consciousness. Fortunately, the great majority of the time when people with diabetes experience hypoglycemia they will quickly recognize its symptoms and ingest some sugar-containing food, which will quickly bring their blood glucose level back to normal.

      Treating low blood glucose

      If ever you have low blood glucose, you need to treat it quickly in order to return your blood glucose to a safe level.

      As recommended by the Canadian Diabetes Association, these are the steps you should take if you have low blood glucose:

      1. Eat or drink 15 grams of a fast-acting carbohydrate such as

      ● Four 4-gram glucose tablets (for example, Dex4 tablets; this totals 16 grams)

      ● ³/₄ cup (175ml) of juice or regular (not diet or sugar-free) pop (but see the warning following this list)

      ● 3 tsp (15ml) honey or maple syrup; or 3 tsp (15ml) of table sugar dissolved in water

      ● Seven jelly beans

      2. Wait 15 minutes, and then retest your blood.

      If your blood glucose level is still less than 4mmol/L, ingest another 15 grams of fast-acting carbohydrate (as listed in the previous step).

      3. If your next meal is more than one hour away, or you are going to be physically active, eat a snack, such as half a sandwich or cheese and crackers.

      The snack should contain 15 grams of carbohydrate and a source of protein.

      

If you have low blood glucose and you’re about to eat a meal, you must instead first treat your hypoglycemia with the measures we just described. Only when your blood glucose is back to normal (above 4mmol/L) should you then eat your meal.

      Controlling Your Blood Glucose through Nutrition

      Not a day goes by when we aren’t totally blown away by the tremendous power that healthy eating has on helping improve blood glucose control. Indeed, nutrition therapy can reduce your A1C up to 2 percent (which is far greater than most drugs ever achieve). Nutrition is so vital in the management of diabetes that we felt it deserved an entire cookbook devoted to the topic. That would be this book.

      When coupled with regular exercise and weight control, the impact of healthy eating is all the greater.

      

Achieving better health – and needing fewer pills – through the magic of lifestyle therapy

      Martha was a very overweight, sedentary 55-year-old woman who had been living with type 2 diabetes for five years. She was taking three different types of medicine per day – totalling more than ten pills – to control her blood glucose. One day, after witnessing her grandson’s look of alarm as he saw her swallowing a fistful of pills, she decided there had to be a better way of managing her health. Working with a dietitian and her local YMCA, she adopted healthy eating strategies, began regularly exercising, and progressively shed weight. With each passing day her health improved, and within a year she was able, under Ian’s guidance, to reduce the number of her pills from ten down to two.

      “I’m going to soon not need these last two,” she said as she left her doctor’s appointment. “I bet you’re right,” Ian said to her as she left.

      As we discuss in detail in Chapter 2, there are three basic types of nutrients: carbohydrates (“sugars”), proteins, and fats. Each of these has important roles in healthy eating, but when it comes to blood glucose control it is carbohydrates that have the key role. We look at carbohydrates next.

Watching your carbohydrate intake

      Carbohydrates are found primarily in those foods that are grown in the ground (such as rice, potatoes, grains, and fruits), and in dairy products. They provide energy for your body; when consumed in excess of your needs, this extra energy is stored as fat. Also, the carbohydrates you eat are responsible for raising your blood glucose levels. For these reasons, you need to make sure you’re eating the appropriate amount of carbohydrate; consuming too much or too little is unhealthy.

      

The Canadian Diabetes Association recommends that between 45 to 60 percent of the calories you consume come from carbohydrates, the remainder being divided up between protein (15 to 20 percent) and fat (20 to 35 percent).

      Not all carbohydrates have the same impact on blood glucose. Carbohydrates that are especially likely to raise blood glucose are said to have a high glycemic index and, as you might expect, those that that don’t raise blood glucose levels as much are said to have a low glycemic index. We discuss the glycemic index in detail in Chapter 4. Also, fibre, which is a form of carbohydrate, doesn’t raise blood glucose at all.

      When discussing meal plans, we often refer to “Carbohydrate Choices.” One Carbohydrate Choice is equivalent to 15 grams of carbohydrate (excluding fibre). Knowing about Carbohydrate Choices will allow you to map out a meal plan that contains the appropriate amount of carbohydrates. Your dietitian is the best person to teach you about Carbohydrate Choices and how to incorporate them into your nutrition program. (Each recipe in Diabetes Cookbook For Canadians For Dummies – wow, that’s a mouthful of a title! – has the number of Carbohydrate Choices in a serving.)

Timing when you eat

      Having diabetes, you should eat three square meals a day rather than engaging in that popular and ill-advised Canadian pastime of eating almost nothing all day, getting home ravenous after a long day’s work and chowing down on a big supper, and then grazing at the fridge and pantry the rest of the night.

      The goal is to not go longer than six hours between meals during waking hours. If your next meal is going to be longer than six hours from your last one, have a snack to hold you over until meal-time comes around.

      

Consuming a small mid-morning and mid-afternoon carbohydrate-containing snack may, depending on your specific situation, also be helpful in maintaining good blood glucose control. See the next section for more information on scheduling your meals.

Getting nutritional assistance: How a dietitian can help

      If you have diabetes, you need to obtain the expert advice of a registered dietitian. The designation “registered” means that the dietitian has completed a special program of training and has achieved official certification establishing his or her credentials. Many registered dietitians, like Cynthia, have also trained as certified diabetes educators, in which case they have the initials RD, CDE after their names.

      A dietitian can assist you in many ways, including helping you

      ✔ Learn the ins and outs of healthy eating in general and healthy eating when you have diabetes in particular.

      ✔ Balance the amounts of carbohydrates, proteins, and fats in your diet.

      ✔ Master carbohydrate counting. (We discuss carbohydrate counting later in this section.)

      ✔ Figure out how to read food labels.

      ✔ Know what snacks to eat, when to eat them, and how often to eat them.

      ✔ Effectively use nutrition therapy to improve your blood glucose control, your blood pressure, and your lipids, including cholesterol and triglycerides. (See Chapter 4 for information about lipids.)

      ✔ Determine how to get the appropriate amounts of vitamins and minerals in your diet and, when necessary, what supplements of these nutrients you should take.

      ✔ Develop a meal plan that takes into account your particular food preferences as well as any food needs (or restrictions) related to religious, cultural, ethnic, or other factors.

      ✔ Calculate how many