How much do you know about diabetes?

“Oh, diabetic people just have higher blood sugar, but I don’t know why high blood sugar can make them sick.”

Is this you? According to the CDC, 1 in 4 people living with diabetes don’t know they have the condition. More than 100 million people in the U.S are living with diabetes or prediabetes. In fact, diabetes was the 7th leading cause of death in the U.S in 2015.

Diabetes is a disease in which the body’s carbohydrates metabolism function is impaired due to no insulin or inadequate insulin production, with the clinical manifestations including elevated blood sugar, elevated glucose in urine, frequent urination, frequent thirst, and frequent feelings of hunger, etc.

Diabetes Neuropathy

Without managing blood sugar properly, the long-term health complications of diabetes can include vision loss, cardiovascular disease, kidney failure, amputation of toes, feet, or legs, etc. Similar to HIV, diabetic people may not die because of the condition of having high blood sugar, but rather because of the serious complications caused by diabetes. Uncontrolled high blood sugar circulating in the bloodstream can gradually damage your periphery arteries and nerve endings, which can cause blindness, nerve death in your toes or feet, heart disease, stroke, and kidney failure. Most of the dialysis clients have kidney failure caused by poorly managed diabetes. They have to visit the dialysis center for 3 days every week, 3-5 hours for each dialysis, unless they can successfully receive a kidney transplant. People who have diabetes can still live a healthy life and delay the onset of health complications as long as they take care of their blood sugar effectively.

How many types of diabetes?

You often hear people say type 1 or type 2 diabetes, but do you know the differences? In fact, there is even a lesser-known third one, gestational diabetes. Type 1 diabetes is also called juvenile diabetes, usually onset at an early age during childhood or adolescence. People with type 1 diabetes can produce little to no insulin. They have to rely on insulin injections for the rest of their lives. Insulin is a hormone that helps body cells to take up the blood glucose. Insulin is like a key to allow blood sugar to enter cells to use it for energy. Those with type 2 diabetes can still produce insulin or cannot produce enough insulin. Another problem might be the body is not sensitive to insulin or insulin resistant. It usually has a later onset during adulthood. Type 2 diabetes is the most common diabetes. Gestational diabetes occurs only in pregnant women during pregnancy. Once babies are born, their blood sugar levels usually return to normal range.

Diabetes Risk Factors

Certain factors can increase the risk for diabetes, including family history, race, age, diet, obesity, inactivity, etc. While some of the risk factors are out of our control, we can change other risk factors such as our diet, weight and physical activity level. Obesity is the major risk factor for type 2 diabetes. People with a BMI ≥ 25 are considered overweight, and BMI ≥30 are considered obese. Figure out your BMI number by visiting our

Nutrition Calculators

. The ideal BMI is between 18.5 – 24.9. Consuming a healthy and balanced diet can help maintain a healthy body weight. Visit our Weight Loss for useful weight loss tips. Increase your physical activity level if you live a rather inactive or sedentary lifestyle. Having an active lifestyle not only helps you maintain a healthy body weight, but also contributes to other healthy benefits such as increasing insulin sensitivity and improving cardiovascular health.

What do blood glucose levels mean?

Low fasting blood glucose level: less than 70 mg/dL (less than 3.9 mmol/L)

Normal fasting blood glucose level: 70-99 mg/dL (3.9 – 5.5 mmol/L)

Prediabetes fasting blood glucose level: 100 – 125 mg/dL (5.6 mmol/L – 6.9 mmol/L)

Diabetes fasting blood glucose level: >126 mg/dL (7.0 mmol/L)

Low Glycemic Index/Load Foods

The Glycemic index (GI) assigns a number score to each food based on how fast the food raises your blood sugar after ingesting it. The number ranges from 0-100, compared to the reference food, the pure glucose given the GI number of 100.

High GI foods have GI of ≥ 70

Moderate GI foods fall between 56-69

Low GI foods fall ≤ 55

Glycemic load (GL) considers both GI and portion size of the food equivalent to the net grams of carbohydrates. High GL foods have a GL number that is greater than 20. Glycemic load is more realistic to the dietary plan as it accounts for the portion size of the food people normally eat. Diabetic people want to stick to low and moderate glycemic load foods. Foods high in soluble fiber are usually lower in GI. Eating the high GI foods with protein and fat foods can help lower the GI number.

Carb Counting and Meal Planning

Carbohydrate is the macronutrient that turns into blood sugar after digested. Foods containing carbohydrates include grains, starchy vegetables, fruits, dairy products, etc. Each person has different calorie and carbohydrate (carb) needs. You want to know and stay consistent on your carb counts, so that your blood sugar doesn’t reach dangerously high or low throughout the day. One carb count equals to 15 g of carbohydrate. It can be ⅓ cup of cooked brown rice or one slice of wheat bread. You may have to adjust your carb needs due to the change of your physical activities, medications, food choices, etc.

When meal planning, make sure to pick from the low GI foods more often, for example: if you really want to choose a high GI food with lunch today like a bowl of white rice, make sure you fill the rest of the meal with low GI foods like beans, chicken, or green salads. Refer to the table above for the combination of food choices. Try to include at least 6 servings of fruits and non-starchy vegetables, 6-8 servings of carbohydrate from grains, starchy vegetables, and beans (at least 3 servings are from whole grain), at least 2 servings of milk, milk products, or milk alternatives.

Reading Food Labels

Reading food labels is a must known skill for carb counting. Follow the steps in the picture below.

Physical Activities

It is important that you stay active throughout the day. Physical activity helps with body cells’ insulin sensitivity. It is recommended that you should perform moderate to intensive aerobic exercise at least 3 days a week, and for 50 minutes each time. Regular physical activity also helps with maintaining a healthy body weight, which helps reduce the risks of other chronic diseases like heart disease.

Herbal Supplements

There are a lot of traditional remedies for treating diabetes. However, most of them don’t have strong scientific evidence to prove the effectiveness of these herbal supplements. Researchers have recommended some of the more effective ones, such as bitter melon, cinnamon, fenugreek, ginger, etc. Bitter melon contains four anti-diabetic ingredients including charanti, vicine, lectin, and insulin-like polypeptide-p. These active substances have blood sugar lowering effects. Cinnamon can improve blood sugar and cholesterol levels in diabetes, and thus reduce the risk factors associated with diabetes. There are two common types of cinnamon you can purchase on the market, however, the only type beneficial to diabetes is the Ceylon cinnamon (less common on the market), not Cassia bark cinnamon. If you consider taking cinnamon, make sure you get the right type. Fenugreek seeds contain high soluble fiber. As we mentioned earlier that foods high in soluble fiber are usually lower in GI, and have a low effect on blood sugar. Fenugreek is also high in vitamins, minerals, and antioxidants, which brings other benefits to your health. Ginger rhizome, which is the main component in ginger root, aids in glucose uptake at muscle level. Researchers also reported that ginger aids in insulin secretion in diabetes type 2, which helps with glucose uptake. Ginger has many other health benefits as well, such as enhancing immunity and digestion. Please consult your doctor before taking any of these herbal supplements.

Vitamins and Minerals

A nutrition balanced diet has overall health benefits because it can provide vitamins, minerals, antioxidants our body needs for growing, repairing, anti-aging, and proper body functioning. Missing any vitamin, mineral, or antioxidant can cause health problems. A few examples of vitamins and minerals that help with diabetes include, ALA (alpha-lipoic acid), GLA (gamma-linoleic acid), biotin, chromium, inositol, manganese, magnesium, and vitamin D. ALA and GLA are naturally occurring antioxidants which help with the nerve damage (neuropathy) associated with diabetes. Biotin increases the activity of the enzyme glucokinase for increasing insulin production. Chromium helps raise glucose tolerance in both types of diabetes. It helps with lowering blood glucose level, cholesterol level, and insulin level. Inositol can reverse the nerve damage caused by diabetes. Manganese and magnesium deficiencies are associated with diabetes, so including those in your diet could help prevent or manage type 2 diabetes. Clinical trials reported that diabetic people have significantly lower in manganese and magnesium than normal healthy people. These minerals are involved in the metabolism of carbohydrates. Vitamin D can boost the sensitivity of insulin and make it more efficient for lowering blood sugar. Please consult your doctor before taking any of these supplements.

Fiber

There are two types of fiber, soluble fiber and insoluble fiber. Both fibers contribute to digestive health benefits. Learn more about digestive health. Soluble fiber has a positive impact on diabetes. Soluble fiber is dissolvable in water and forms viscous gel like bulk which delays glucose from releasing to the bloodstream. Foods rich in soluble fiber are typically low in GI. The RDA (Recommended Dietary Allowance) for fiber is about 25 g/day for women and 38 g/day for men. Most vegetables, fruits and beans are rich sources for fiber. Increase your fiber intake gradually, otherwise stomach bloating or cramping can occur if you consume large amounts of fiber foods suddenly. Drink adequate amounts of fluid when you eat a lot of foods with fiber in order to prevent dehydration.

Monitoring Your Blood Sugar Regularly

If you are an insulin-dependent diabetic, then it is very important that you check your blood sugar in the morning, before and after meals or snacks, at bedtime, after physical activity, etc., and even more often if you have a daily routine change, health condition change, diet change, or medication change, etc. By frequently checking your blood sugar, you can figure out how different factors affect your blood sugar. Gradually, you will be better at predicting how your blood sugar is going to respond to different factors. If applicable, report concerns to the doctor for better diabetes management. Preventing very high or very low blood sugar is another reason to keep monitoring the blood sugar as very high or very low blood sugar can cause life threatening medical conditions or diabetic coma. If a diabetic person is experiencing headaches, high fevers, shakiness, weakness, anxiety, sweating, hunger, dizziness, confusion, etc, check the blood sugar immediately, and seek immediate medical attention if blood sugar reading is very high or very low. Take sugar tablets as needed when experiencing very low blood sugar to boost your blood sugar right away. If you run out of sugar tablets, apple juice or orange juice can do the job as well.

Keep in Touch with Your Doctor and Dietitian

If diabetes runs in your family, it is critical that you complete your routine wellness screening every year. Early prevention is the key to offset diabetes in your life. A diabetic patient may have experienced high blood sugar levels or have prediabetes diagnosis years before diabetes diagnosis. Never hesitate to talk to your doctor or meet with a RD to discuss more about diabetes prevention. Once you are diagnosed with diabetes, blood sugar monitoring becomes a lifetime management. Adapting a healthy lifestyle is the only way to prevent or delay diabetes associated neuropathy and cardiovascular disease. But don’t be scared, you still can live a healthy life if you manage your blood sugar very well.

Diabetes One-Day Menu Sample

For diabetes meal planning, you want to spread your meals and snacks throughout the day and on the same schedule to flatten your blood sugar curve. Choose more low GI foods. Continue monitoring your blood sugar regularly if you are insulin dependent. Follow the diabetes sample menu below when planning your meals. This menu is based on 1500 kcal/day.