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Published on November 25, 2011

What is a Good Diabetic Diet?

A healthy diet is good for EVERYONE, not just those with diabetes! Here Nancy Donahae, RD shows a plate with the new diet recomendations. More fruit & vegetables, smaller meat & starch make colorful, portion control plates!

A few facts to counter misconceptions about eating and diabetes:
With National Diabetes Month about to come to an end, the subject is certainly "top of mind" lately. There are more than a few misconceptions about eating and diabetes.

Below are some facts to counter them.

1. Diabetes is not caused by "eating too much sugar" Yes, the disorder was once known as sugar diabetes because it involves high levels of sugar or glucose in the blood. But this happens not because a person eats too much sugar but rather because the body becomes unable to process carbohydrates.

All carbohydrates that are eaten–potatoes as well as cookies–are converted into glucose during the digestion process. Glucose in the blood triggers the release of insulin by the pancreas to allow this glucose to be taken into cells to be used for energy or stored as fat.

Type 1 or insulin-dependent diabetes occurs because the pancreas becomes unable to produce insulin. Without insulin, cells fail to get the energy they need and glucose accumulates in the blood, causing damage to blood vessels and nerves in the heart, eyes, kidneys and virtually every part of the body.

Type 2 diabetes develops because the pancreas becomes unable to produce enough insulin or because cells are resistant to the action of insulin. As a result, glucose tends to accumulate in the blood unless action is taken to control it. Eating dessert does not cause the pancreas to malfunction, but eating too many desserts, with their empty calories, will certainly contribute to weight gain, which in turn can lead to insulin resistance. Most type 2 diabetics carry excess weight, particularly around the abdomen.

Although diabetic diets in the past were restrictive regarding sugar and concentrated sweets that is no longer the case. Persons with both type 1 and type 2 diabetes can and do eat desserts in moderation as part of a healthy meal plan.

2. There are no special diabetic foods or meals. Whether you have type 1 or type 2 diabetes, you can and should eat regular meals with your family and friends. Coronary artery disease and high blood pressure are major complications of diabetes. As a result, a good diabetic diet is heart healthy–low in saturated and trans fats but with adequate quantities of omega-3 fatty acids (from fish) and monounsaturated fats (from nuts and olive oil).

The DASH diet to control hypertension includes five servings of fruits and five servings of vegetables every day plus whole grains and low fat dairy products.

3. Carbohydrates raise blood sugar, but they are an important source of nutrients and energy.
There is no reason to restrict intake, although type 1 diabetics must monitor how many carbohydrates they eat at any one meal. Blood sugar control requires a delicate balance among carbohydrate intake, insulin injections and physical activity. If you’re on a fixed dose of insulin, the number of carbohydrates you consume at each meal and snack should be consistent as well.
Particularly for children, special occasions like birthdays or Halloween may mean extra sweet treats. That’s okay as long as there is a comparable adjustment in the number of carbohydrate grams from other sources (potatoes, rice, pasta) consumed during the rest of the day. Nutritionists point to an important distinction between simple carbohydrates such as those in candy, fruit and milk and complex carbohydrates such as beans, chick peas, cereal and starchy vegetables such as potatoes. Most of the latter are high in fiber, and studies have found that eating a high-fiber diet can improve blood sugar control and cholesterol.

4. Protein and fat take longer to be converted into glucose and have a less powerful effect.

But most foods that are high in protein are laden with saturated fat and cholesterol. And both protein and fat are associated with in insulin resistance. A low carbohydrate/high protein regimen has been found effective for weight loss, and some studies have found it conducive to good blood sugar control as well. Over the long term, though, there are questions about the safety of such a diet for a person with diabetes.
There is no one diabetic meal plan that’s best for everyone. It’s up to the patient to work out a sensible plan with her doctor and/or dietitian–a plan that is flexible while bringing about good control of blood glucose.

REFERENCES:
American Diabetes Association, “Diabetes meal plans and a healthy diet,” “Carbohydrate counting,” “What can I eat?” “Sugar and desserts.”
Laurie Barclay, M.D., “Low-carb or low-fat diet may similarly affect weight, A1C in patients with type 2 diabetes,” Medscape Medical News, July 21, 2009; Diabetes Care, 2009;32:1147-1152.
Laurie Barclay, M.D., “Nuts instead of carbs may be beneficial in diabetes,” Medscape Medical News, July 13, 2011; Diabetes Care, June 29, 2011.
Laurie Barclay, M.D., “Low glycemic-index Mexican diet helpful in obese type 2 diabetic Mexicans,” Medscape Medical News, July 2, 2003; Diabetes Care, 2003;26:1967-1970.
Kendra Blanchette, RD, CDE, “The ‘diabetic’ diet,” Diabetes & Hormone Center of the Pacific.
Neil Canavan, “ACTID results emphasize diet alone over diet and exercise,” Medscape Medical News, June 26, 2011; Lancet, June 25, 2011.
K. Esposito, et al, “Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial,” Annals of Internal Medicine, 2009;151:306-314.
Marion J. Franz, MS, RD, LD, CDE, “Protein controversies in diabetes,” Diabetes Spectrum, 2000;13:132-ff.
M. James Lenhard, M.D., “Treatment of the obese diabetic patient,” Medscape Diabetes and Endocrinology, October 23, 2001.
Kate Marsh, Ph.D., and Jennie Brand-Miller, Ph.D., “Vegetarian diets and diabetes,” American Journal of Lifestyle Medicine, 2011;5(2):135-143.
MedlinePlus, “Diabetic diet,” updated October 26, 2011.
Nancy A. Melville, “Walnuts shown to improve endothelial function in diabetes,” Medscape Medical News, February 22, 2010; American Academy of Pain Medicine 26th Annual Meeting, February 19, 2010.
National Diabetes Information Clearnghouse (NDIC), “What I need to know about eating and diabetes,” NIH Publication No. 08-5043, October 2007.
J. Wang, et al, “Dietary energy density predicts the risk of incident type 2 diabetes: the European Prospective Investigation of Cancer (EPIC)–Norfolk study,” Diabetes Care, 2008;31:2120-2125.
Shelley Wood, “Fewer carbs mean fewer calories, improved insulin sensitivity, and lower triglycerides, new study shows,” Medscape Medical News, March 14, 2005.

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