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.
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 webpage Here. 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 webpage Here 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: <70 mg/dL (<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.
|Food||Glycemic Index||Food||Glycemic Index|
|Corn tortilla||46±2||Vegetable soup||48±5|
|Spaghetti, whole||48±5||Taro, boiled||53±2|
|Spaghetti, white||49±2||Potato, french fried||63±5|
|Sweet corn||52±2||Sweet potato, boiled||63±6|
|Rice noodle||53±7||Pumpkin, boiled||64±7|
|Brown rice, boiled||68±4||Potato, boiled||78±2|
|White rice, boiled||73±4||Potato, instant mash||87±3|
|Whole wheat/meal bread||74±2||Dairy and Alternatives|
|White wheat bread||75±2||Soy milk||34±4|
|Breakfast Cereals||Milk, skim||37±4|
|Porridge, rolled oats||55±2||Milk, full fat||39±3|
|Millet porridge||67±5||Yogurt, fruit||41±2|
|Instant oat porridge||79±3||Ice cream||51±3|
|Apple, raw||36±2||Soya beans||16±1|
|Apple juice||41±2||Kidney beans||24±4|
|Orange juice||50±2||Potato Crisps||56±3|
|Mango, raw||51±5||Soft drinks||59±3|
|Watermelon, raw||76±4||Rice cracker/crisps||87±2|
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.
|1 Serving ~ about 15 g carbohydrate||1 Serving ~ about 15 g carbohydrate|
|1 slice bread (1 oz)||1 small whole fruit|
|1 tortilla (6-inch size)||½ cup canned fruit|
|¼ large bagel||½ cup frozen fruit|
|½ hamburger||½ cup melon or berries|
|¾ cup ready-to-eat unsweetened cereal||6 large grapes (3oz)|
|½ cup cooked cereal||12-15 small grapes|
|5 saltine crackers||1 cup unsweetened fruit juice|
|⅓ cup cooked pasta or rice||¼ cup dried fruit|
|½ cup beans||Dairy|
|½ cup mashed potatoes||1 cup of low fat or skim milk|
|¾ oz potato chips, tortilla chips||1 cup soy milk|
|3 cups popcorns||1 cup almond milk|
|Vegetables||Sweets and Dessert|
|1 ½ cup cooked non-starchy vegetables||2-inches square cake|
|3 cups green leafy salad||½ cup ice cream|
Reading Food Labels
Reading food labels is a must known skill for carb counting. Follow the steps in the picture below.