Diabetes

Type 2 Diabetes Mellitus is the most common form of diabetes and the number of new cases are steadily increasing.  Muscle, liver and fat cells of the body become resistant to insulin due to increased dietary fat in the bloodstream.  Insulin is produced by the beta cells of the pancreas and released when food is eaten.

Carbohydrates, proteins and fats all have an effect on insulin production and its use in the body. Over time, the increased dietary fats, animal proteins and simple carbohydrates result in weight gain, high cholesterol and triglyceride levels, hypertension, increased insulin production, insulin resistance,increased glucose production by the liver and death of beta cells with decreased insulin production due to an overworked pancreas.

Hyperglycemia (high blood glucose) symptoms include: polydipsia (frequent thirst), polyphagia (frequent hunger) and polyuria (frequent urination). Other symptoms may include: fatigue, blurred vision, poor/slow wound healing and recurrent infections. Some people may be unaware of symptoms or may not experience any symptoms.

Diabetes is known as “the silent killer,” as many people report that they feel fine; not realizing that high blood glucose is causing damage in the entire body.

Diabetes may result in kidney failure, liver failure, frequent urinary tract infections, yeast infections, depression, peripheral neuropathy, and other health concerns. Hyperglycemia has a harmful effect on the vasculature and organs of the body, often leading to diabetic retinopathy (affecting eyesight), heart disease, stroke and slow-healing wounds.  Sadly, without glucose control, these wounds may result in loss of toes or part of the lower limbs.  Men often experience erectile dysfunction.

The good news is that type 2 diabetes may be prevented and in some cases,  may be reversed through healthful diet, lifestyle and exercise.  Yes, REVERSED!
Type 1 diabetics may prevent insulin resistance as well as decrease glucose levels, thereby require less insulin, and prevent disease related complications by following these same health guidelines.

See your Diabetes Educator for an individualized, lifestyle plan.
What is a healthful diet?

Carbohydrates
The “good” carbs or complex carbohydrates are found in whole grains (brown rice, whole wheat products, oats,etc), vegetables, and legumes (beans). Simple carbs (found in fruit)which are metabolized faster than complex carbs. Although various foods from either category are metabolized at different rates, these carbs are high in fiber, are therefore, broken down slowly by the body, (compared to bad carbs) do not lead to spikes in blood glucose levels, thereby decreasing the need for insulin. They provide a slow, steady release of energy. The fiber is also beneficial in removing cholesterol from the body, regulating bowel movements and providing for a healthier colon.
*It is important to note that, even from within the good carbs, some foods are better options for diabetics than others. Sweet potatoes instead of white potatoes, for example. Also, it is possible to get “too much of a good thing.” Excess carbs equal excess calories and are stored as fat.

The “bad” carbs or simple carbohydrates are (dairy-milk, cheese, ice cream, etc) and those from the refined (processed foods-removing fiber and nutrients), white flours, chips, cookies, pastas, white breads, sugars, syrups,pastries, juices, sodas, etc.  These foods are not only high in bad carbs, but often contain high levels of salt, fats, artificial ingredients.  They are “empty calorie” foods.  When these carbs are eaten, they cause an quick increase in blood glucose (sugar rush), causing the pancreas to work hard to produce and release insulin to enable the glucose to enter cells.  This may result in hypoglycemia or low blood sugar (crash).  You feel tired, shaky, light-headed, sweaty. The empty calories of simple carbs lead to storage of fat and weight gain.  Without intervention, blood sugar levels continue to rise (hyperglycemia)with insulin resistance and as beta cells die.

A note about sugars- The average American currently consumes over 21 teaspoons or over 84 grams of sugar per day. That is more than 180 pounds per year!  The American Heart Association’s dietary recommendation for sugar consumption is no more than 6 teaspoons or 24 grams per day.  Sugar consumption through the years has dramatically increased:  1700 – 4 lbs per person yearly,  1800- 18 lbs, 1900 123-135 lbs.    Sugar contributes to increased cholesterol and triglyceride levels, obesity, diabetes, osteoporosis and cancer.  Sugar depresses the immune system (even 1 tsp. of sugar), decreasing the body’s defenses against disease, leads to faster aging and wrinkles. The body reacts relatively the same to  all types of sugars – table sugar, brown sugar, molasses, dextrose, high fructose corn syrup, brown rice syrup, *honey, fruit juices.
Refined sugar is a carbohydrate- a bad carb and should be used sparingly.  Read food labels for sugar/carb content.
Agave Nectar is a natural sweetner from a plant source with a low glycemic index. It is 2 times sweeter than sugar and is a good alternative to sugar.

*Honey is not a refined sugar, however, it will raise blood sugar levels (at a slower rate) and should be used sparingly.

Artificial sweeteners (aspartame/Equal, sucralose/Splenda, saccharin/Sweet’n Low,) have been linked with weight gain, cancer, memory loss as well as adversely affecting blood glucose levels.  A 2013 study in Italy found that Splenda caused leukemia in the lab animals. Artificial sweeteners should be avoided.

What can I eat instead of sugary desserts??  Enjoy whole, fresh fruit.  Try a fruit sorbet for an occassional treat.  (See recipes in the dessert category).   A glass of fruit juice contains the liquid of 4 or more whole fruits without the necessary fiber.  Most people would not eat that many pieces of fruit at once. Use honey or molasses sparingly.  Try raisins, dates or applesauce as sweeteners in some recipes.

Fiber  from fresh fruit, vegetables, seeds and nuts. Fiber is vital for optimum health as well as preventing and reversing diverticulosis, constipation, some types of cancer, heart disease, diabetes and other health issues.  Fiber helps to move cholesterol and toxins out of the body.  When considering carbohydrate content of a food, if it contains 5 or more grams of fiber, you may subtract 1/2 of the grams of fiber from the listed grams of carbs.  This is important and exciting news for Diabetics!  Women should get 30-40 grams of fiber per day, while men should consume 40-50 grams.  Remember to drink 6-8 glasses (8 oz. each) of water daily to aid fiber in its work.

Water Our bodies are about 70% water.  Water is essential for proper functioning of all cells, tissues and organs.  Dehydration  can lead to serious consequences, especially for diabetics- dramatically increased blood glucose and hyperosmolar nonketotic syndrome.  Dehydration may result in hypertension (high blood pressure) with dizziness, headache and confusion in any person.  Negative effects of dehydration are quickly seen in kidney and brain function.   Drink water throughout the day, even if you don’t feel thirsty.  Start your day with a glass of water with lemon.

Fats
Unsaturated fats (the “good” fats)  especially omega 3 fatty acids found in flaxseed, quinoa, olives, olive oil, soy, walnuts, leafy greens, avocadoes, legumes, tuna and salmon.  These fats are important for healthy heart function, boosting immune function, anti-inflammatory effects (preventing or helping to manage arthritis, psoriasis, joint pain,asthma), prevent cancer cell growth and diabetes.

Saturated fats (the “bad” fats) are found in meat (beef, pork), poultry skin, palm oil, palm kernel oil, cream, butter, lard, whole milk, sour cream, ice cream, whipped cream. These fats raise the LDL (bad cholesterol) levels, clog arteries and lead to serious health issues. Avoid these types of fats.

Trans fats (bad fats) in fried foods, donuts, cakes, cookies, margarine, shortening, corn oil, cotton seed oil,salad dressings, foods with hydrogenated or partially hydrogenated oils. These fats are double trouble, as they raise the LDL (bad cholesterol) levels and decrease HDL (good cholesterol) levels. Food manufacturers use these fats because are they inexpensive and increase the products’ shelf life without refrigeration. These fats should also be avoided to help prevent heart disease, stroke, diabetes, Alzheimer’s, obesity, cancer and many other diet-related health issues.

Normal Lipid levels
Total cholesterol about 150
HDL 40-60 or higher
LDL less than 100 (Less than 70 mg/dL for those with heart or blood vessel disease and for other patients at very high risk of heart disease, such as those with metabolic syndrome)
Triglycerides less than 150

Protein Protein is necessary for building and repairing body cells and tissue, hormones and enzymes. The daily adult requirement is about 44 grams/day for women and 54 grams/day for men (2-3 four ounce servings daily). Quinoa, soy, are two plant based proteins with all 22 amino acids. A variety of vegetable proteins eaten over a period of one day provide all the 22 essential amino acids as well as needed fiber. Plant proteins are also kind to the kidneys and colon friendly.
Animal protein (meat, poultry, fish, dairy, eggs) contain all 22 essential amino acids but no fiber and are linked with higher cholesterol rates, heart disease, hypertension,  and colon cancer. Excess protein can lead to kidney disease as well as leaching of calcium leading to osteoporosis.  Most Americans have too much  protein (100-120 grams –double the recommended amount) in their diet in addition to fats, carbohydrates and excess calories.

Sodium
Limit sodium to 1500 mg -1800 mg (less than 1 teaspoon) per day to prevent high blood pressure (hypertension), heart failure, kidney disease or other conditions with fluid retention. Increased insulin levels cause retention of sodium.
Foods to avoid: Canned foods (soups, vegetables, gravy/sauces), frozen foods, snack foods, pickles, packaged food mixes (mac and cheese, noodle or rice dishes, stuffing mixes), instant foods to which you add water or milk, deli meats, cheeses, canned meats, bullion, msg, bottled sauces (soy sauce, barbecue sauce, steak sauce, etc). Read label for salt/sodium content.
Use herbs and spices to flavor foods. Garlic adds flavor to savory foods with added health benefits. (consult with your healthcare provider about medication and herb interactions).

Exercise
Exercise and weight loss for obesity are key to preventing or reversing type 2 diabetes. Exercise aids in weight loss, reducing blood glucose levels and insulin requirements, reduces blood pressure, increases lung function, blood flow and oxygen to tissues and organs, improves mood and relieves stress.  Walking is a great exercise, does not cost money and can be done outdoors in good weather.  I suggest going to a mall or large department store to walk during foul weather days. Research shows that walking 10,000 steps per day (about 5 miles) results in weight loss and improved insulin sensitivity.   Most people walk between 900 – 3000 steps each day.  Gradually work up to the 10,000 steps. Walk with a friend or family member, listen to your favorite music or enjoy the sights and sounds of nature. A combination of aerobic and resistance exercises,30 mins per day is beneficial.(Check with your healthcare practioner before starting or making changes in exercise and diet.)

Sleep Eight hours of sleep is essential to cell growth, tissue repair, brain, heart, kidney and other organ function.  Sleep also decreases stress hormones and stress levels, helps to prevent weight gain and premature aging, improves mood and memory.

Caffeine Caffeine from coffee, soft drinks, chocolate affects a number of hormones in the body, including cortisol, adrenaline and dopamine which contribute to weight gain, dehydration, mood swings, osteoporosis, sleep problems and increased blood pressure and blood sugar levels. Keep caffeine to no more than 2 cups/servings per day.

Tobacco There are numerous harmful chemicals in cigarettes in addition to the tobacco itself, that lead to addiction, cancer, chronic obstructive pulmonary disease (copd), heart disease as well as other serious health issues.  Carbon monoxide from smoke binds to hemoglobin in the blood (the part of the blood that carries oxygen to all parts of the body), creating carboxyhemoglobin.  Carboxyhemoglobin is unable to carry oxygen to the tissues and organs, leads to oxygen starvation and may result in anemia, osteoporosis, heart disease, cancer, stroke and other health issues.  Second hand smoke is linked with the same health issues.

Stress
Stress has a significant, negative impact on health, affecting multiple organs of the body.  Stress hormones (cortisol and adrenaline) are released. Blood pressure increases. Release of insulin is greatly inhibited during stress (illness or mental stress), resulting in increased blood glucose levels.  Stress can result in a vicious cycle of stress hormone release, food cravings, weight gain, depression….  Exercise, balanced diet, relaxation techniques and most importantly, trust in God will result in decreased stress levels and optimum health.

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