8 Weeks to Maximizing Diabetes Control. Laura Hieronymus

pressure levels in the normal range, or as close to normal as safely possible, as well as a lipid (blood fat) profile that reduces the risk for blood vessel disease.

      • Preventing (or slowing) development of diabetes-related complications by modifying nutrition intake and lifestyle behavior.

      • Taking into account individual nutrition needs and willingness to change, as well as any personal and cultural preferences.

      • Maintaining the pleasure of eating by limiting only those food choices indicated by scientific evidence.

      Meal Planning

      Meal planning can help you reach your blood glucose, blood pressure, and blood lipid goals while managing your diabetes. Adapting eating behaviors to balance carbohydrate intake throughout the day, along levels optimally controlled. Improvement in blood glucose control is proven to reduce the risk of long-term complications in type 2 diabetes.

      Because food is such an important part of our lifestyle, as well as the cornerstone of diabetes management, you will want to take an aggressive approach to making the dietary changes that benefit your health. Gone are the days of buying special foods to meet your diabetes nutrition needs. You can eat the same foods that your entire family eats as long you pay particular attention to the nutrition content and the portion size. Because type 2 diabetes has a genetic component, your relatives are also at risk, so your entire family will benefit from healthier eating.

      An RD can work with you to determine a meal plan that is healthy, fits your preferences, and helps provide balance within your diabetes treatment plan. Studies show that working with a dietitian, and learning about medical nutrition therapy, can lower A1C levels by 1 to 2%. When you schedule the appointment, ask about insurance coverage for the service. Most insurance, including Medicare, will cover the visit the dietitian is considered a provider of medical nutrition therapy or diabetes training.

      There is no time like the present to start eating healthfully. You may feel that you have always tried to eat healthy but wonder why your blood glucose levels and your weight aren’t what they used to be. Keep in mind that type 2 diabetes is a progressive disease and, although some natural insulin is typically present when you are diagnosed, insulin production and diabetes control may decline over time. At some point, medication may need to be added alongside your meal plan to maximize blood glucose control.

      A-Weigh We Go

      Two out of three people with type 2 diabetes are overweight and may want to work toward a healthier body weight. Weight patterns describe where excess weight is located on the body and are typically described as an apple versus a pear shape. An apple shape is when more fat is distributed around the trunk or middle section of the body.

      The apple shape is most common in type 2 diabetes, where excess weight is often concentrated in of weight can interfere the central (middle) part of the body. This type of weight can interfere with metabolism and the breakdown of nutrients, and may cause issues with blood glucose and blood fat breakdown. Therefore, excess weight in this area of the body is more dangerous to your health than weight distributed in the pear shape.

       Body mass index and waist circumference

      The measurements that may be most useful to you as you get started your body mass index (BMI) and waist circumference. Your BMI assesses your size in terms of your height and weight. BMI can help you understand how much total fat is in your body. A BMI of 25 or higher is considered overweight and a BMI of 30 or higher is considered a parameter for obesity.

      To figure out your BMI, you will want to cross reference your height inches to your weight in pounds in the table BODY MASS INDEX TABLE and determine the BMI at the top of the table. For example, if you are 66 inches tall(5′6″) and weigh 192 pounds, then your BMI is 31. The BMI, according to the parameters above, indicate that this individual is obese.

      Your waist circumference can help you figure out how much fat is around your middle section. To check your waist circumference, take a tape measure (one that is flexible and bends easily) and place at your belly button, pulling it snugly around the body. The total number of inches should be less than 35 inches for a woman and 40 inches for a man. If it is greater, there is too much weight in the middle section of your body. If your waist sags in the middle, your diabetes care prescriber may ask you to lie down prior to measuring your waist to help better determine the circumference.

      What Should I Eat?

      Asking the expert what you should eat is the best advice for dietary management in type 2 diabetes. No one person has the same eating habits, so the choices you make should be individualized to your likes and dislikes. When you make those choices, you should consider the main nutrients in the foods (carbohydrates, fat, and protein).

      Nutrition experts recommend a healthful dietary pattern that includes carbohydrates from fruits, legumes, and low-fat milk. Carbohydrate-containing foods are important sources of energy, fiber, vitamins, and minerals. Limiting saturated and trans fat is vital to diabetes management because these types of fat contribute to low density lipoprotein LDL) or “bad” cholesterol. Daily recommendations suggest limiting your consumption of cholesterol to less than 200 mg and making sure that less than 7% of your calories come from saturated fat. Dietary protein for those with diabetes is based on the same standards as the general population—about 15–20% of your daily calories.

      Carbohydrate Awareness

      Carbohydrates are the sugars and starches in the foods you eat. Regardless of the source, carbohydrates affect your blood glucose level more than protein or fat. Carbohydrates are broken down into blood glucose, which enters your bloodstream and causes your blood glucose level to rise after you eat. Although protein and fat don’t affect blood glucose immediately, attention to fat intake is important for heart health when you have diabetes.

      Because carbohydrate-containing foods affect blood glucose levels shortly after eating, be careful to avoid more carbohydrates than the medication to help control blood glucose levels; therefore, it is important to understand how the medication works. Carbohydrate intake may be modified to work with a particular diabetes medication (see Chapter 5). Spreading carbohydrates out over the course of the day is helpful strategy to keep fairly minimal amounts eaten at any given time and to help maintain blood glucose levels and prevent hunger.

      My Pyramid

      It will take some time but you will want to get a handle on the food sources that contain carbohydrates. Experts typically use the My Pyramid, the USDA’s new food guide system, to help the general public (age 2 and older) determine patterns for eating. It is recommended, as discussed earlier, that those with a chronic condition—such as diabetes—consult with health care provider to find the dietary plan that is the right one to meet their health needs. The My Pyramid is a specialized food guide system that determines how many servings of each food group you should consume each day depending on your age, sex, weight, height, and normal physical activity levels. Looking at the My Pyramid can give you a good idea of the various nutrients recommended in the meal plan.

      Understanding what foods are considered sources of carbohydrates will help identify where carbs come from. The My Pyramid is divided into grains, vegetables, fruits, milk, meat and beans, and oils. To get your specialized food pyramid, ask your nutrition expert to assist you.

       Grains

      Any food made from wheat, rice, oats, cornmeal, barley, or other grains is a grain product. Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples of grain products. Fifteen grams of carbohydrate is typically considered a serving of these particular foods. Grains are divided into two subgroups: whole grains and refined grains. Whole grains contain the entire grain kernel, which includes the bran, germ, and endosperm. Some common examples include whole-wheat flour, cracked wheat, oatmeal, and brown rice. Milling, or