How To Prevent (and Even Reverse) Prediabetes
More than 25.8 million children and adults in the United States live with type 1 and type 2 diabetes, and experts say as many as 79 million more have prediabetes—a condition where elevated blood glucose levels raise your risk of developing type 2 diabetes. So how can you avoid or reverse prediabetes? Start by asking your doctor for fasting plasma glucose (FPG), A1C, and oral glucose tolerance tests (OGTT); then follow these expert recommendations for staying diabetes-free. Diabetes lifestyle educator Get moving. If you are overweight, have high cholesterol, or have a family history of diabetes, you’re at risk. You can lower that risk by up to 58 percent by losing 7 percent of your body weight, which means exercise is essential. Start with 30 minutes of brisk walking five to six times per week; then try low-impact workouts like biking or swimming. Eat better. Reduce sugar intake to less than 6 teaspoons (24 grams) daily for women and less than 9 teaspoons (36 grams) per day for men. People at risk for prediabetes should follow a reduced-calorie and reduced-fat diet. Avoid trans fats and regulate high-caloric healthy fats like olive oil, nuts, and avocado. Make measureable changes. Wear a pedometer to calculate daily movement, start a food journal, and download online applications that track your weight-loss successes with graphs. –Jennifer Pells, PhD, Wellspring at Structure House, Durham, North Carolina Integrative physician Reduce stress. Chronic stress taxes the pancreas (the insulin-producing organ) and increases prediabetes risk. Honokiol, a magnolia bark extract, reduces stress and supports the pancreas by taming inflammation and oxidative stress. Take 250 mg twice per day with meals, for long-term use. Choose the right fiber. Fiber slows sugar’s release in Continue reading >>
Fruits That Raise Blood Sugar
Your body transforms the food you eat into fuel that helps it run smoothly. Its preferred fuel is glucose, a type of sugar that comes primarily from carbohydrates. Over time, too much sugar in the diet can trigger health problems, so it’s best to limit your sugar to natural sources like fruits, which also provide vitamin C and a wealth of other nutrients. Some fruits can raise blood sugar very quickly, however, and others have a more gradual effect. Processed foods with lots of added sugars – sodas, candy, desserts and baked goods – have the most immediate impact on your blood sugar levels. But even on what seems like a healthy diet, some of your food and beverage choices may negatively affect your blood sugar levels, causing them to peak and crash. When this happens, you might feel a brief burst of energy – a sugar rush – followed by a low point where you become tired and need to refuel. Keeping blood sugar levels on an even keel is key to overall good health, even if you aren’t diabetic or prediabetic. A balanced diet of regular meals that include some protein, carbs and fat helps you stay on track and avoid blood sugar levels that swing between being too high and too low. Dried Fruits Packed with minerals like iron and health-promoting phytonutrients, dried fruits are a smart addition to your diet. Because all the water is removed from them though, these fruits are concentrated bites of natural sugar. Pay attention to portion size when choosing dried fruits. A small box of raisins (1 ounce) looks like a modest serving that's super-convenient to bring with you to work, but it contains 20 grams of sugar. Apricots, currants and pineapple are other commonly dried fruits that may elevate your blood sugar. Another issue with dried fruits is that manufacturers m Continue reading >>
Raising Blood Sugars Predictably
What, then, can we use to raise blood sugars rapidly with a predictable outcome? The answer, of course, is glucose. Glucose, the sugar of blood sugar, does not have to be digested or converted by the liver into anything else. Unlike other sweets, it’s absorbed into the blood directly through the mucous membranes of the mouth, stomach, and gut. Furthermore, as we discussed in Chapter 14, “Using Exercise to Enhance Insulin Sensitivity,” we can compute precisely how much a fixed amount of glucose will raise blood sugar. If you have type 2 diabetes and weigh about 140 pounds, 1 gram of pure glucose will raise your blood sugar about 5 mg/dl—provided that your blood sugar is below the point at which your pancreas starts to make insulin to bring it down. If you weigh 140 pounds and have type 1 diabetes, 1 gram of glucose will raise your blood sugar about 5 mg/dl no matter what your blood sugar may be, because you cannot produce any insulin to offset the glucose. If you weigh twice that, or 280 pounds, 1 gram will raise your blood sugar only half as much. A 70-pound diabetic child, on the other hand, will experience double the blood sugar increase, or 10 mg/dl per gram of glucose consumed. Thus, the effect of ingested glucose on blood sugar is inversely related to your weight. Table 20-1 gives you the approximate effect of 1 gram glucose upon low blood sugar for various body weights. If you have handled glucose tablets, be sure to wash your hands before rechecking your blood sugar. If a source of water is not available, lick the finger you intend to prick to remove any residual glucose. You can dry the finger by wiping it on your clothing or a handkerchief. Do not keep glucose tablets near your blood sugar meter or test strips! Many countries have available as candies o Continue reading >>
How Much Avocado Can A Diabetic Eat?
If you have diabetes, you know that food plays a big role in controlling your blood sugar levels. Carbohydrate--containing foods, which include sugar, sweets, sugary drinks, grains, starchy vegetables, fruits and some dairy, are converted to sugar during the digestion process and therefore contribute to raising your blood sugar levels after eating. A high--carb intake will result in high blood sugar levels. Video of the Day The nutrition facts for avocado depend on its size. For example, a whole California avocado provides about 227 calories, 11.8 grams of carbohydrates and 9.2 grams of fiber, while a Florida avocado is larger and contains 365 calories, 23.8 grams of carbohydrates and 17.0 grams of fiber. With diabetes, carbohydrates elevate your blood sugar levels, but only the starch and sugar part of the total carbohydrates, not the fiber. Available Carbohydrate and Diabetes To better estimate the effect of avocado on your blood sugar levels, you can calculate their available carbohydrate content by subtracting fiber from the total carbs. In the case of a California avocado, you get 2.6 grams of available carbohydrates, while a Florida avocado contains 6.8 grams of available carbohydates because of its larger size. Usually, diabetics are recommended to limit their carb intake to 45 grams to 60 grams per meal. Avocado contains very small amounts of available carbohydrates and are not problematic for diabetes control, even if you eat a whole, large avocado. Although avocado itself is not likely to hinder your glycemic control, it is often served with high-carb foods such as tortillas, nacho chips and taco shells. If your meal includes foods that have a high carbohydrate content, your blood sugar is likely to rise, so count your carbs to ensure you do not eat more carbo Continue reading >>
Quick-sugar Foods - Topic Overview
If you are at risk for low blood sugar levels because of diabetes or some other health condition, you need to keep with you at all times some type of food that can quickly raise your blood sugar level. Eating quick-sugar food puts glucose into your bloodstream in about 5 minutes. Glucose or sucrose is the best choice. Choose foods that contain about 15 grams of fast-acting carbohydrate. This table is just a guide. So check the nutrition label of the quick-sugar food you use to be sure it equals about 15 grams of carbohydrate. Foods to help raise blood sugar 1 2 3 Food Amount Glucose tablets 3-4 tablets Glucose gel 1 tube Table sugar 1 tablespoon (3 teaspoons) Fruit juice or regular soda pop ½-¾ cup (4-6 ounces) Fat-free milk 1 cup (8 ounces) Honey 1 tablespoon (3 teaspoons) Jellybeans 10-15 Raisins 2 tablespoons Gum drops 10 Candy like Life Savers 5-7 pieces Hard candy (like Jolly Rancher) 3 pieces These quick-sugar foods will help raise your blood sugar in an emergency, because they are made from almost all carbohydrate. If you use a food not on this list to treat your low blood sugar, be sure it does not contain fat or protein. These can slow how quickly your body absorbs the carbohydrate. For example, regular cake frosting is made with both sugar and fat. It is not a good choice as a quick-sugar food. Some clear cake frosting and clear cake gels are made without fat. But you should check the ingredients and the nutrition label to be sure. When in doubt, ask your doctor or registered dietitian. Continue reading >>
Why Some Sugar-free Products Raise Blood Sugar
In the latest “Really?” column, Anahad O’Connor explores why some foods labeled “sugar free” may still raise blood sugar. The culprits are sugar alcohols that are sometimes paired with artificial sweeteners. He writes: Sugar alcohols get their name from their structure, which looks like a cross between a molecule of alcohol and sugar but is technically neither. Companies have added them to more and more “sugar free” products, like cookies, chewing gum, hard candy and chocolate. For people trying to manage their blood sugar, this can make interpreting nutritional labels a little tricky. While sugar alcohols provide fewer calories than regular sugar — in general about 1.5 to 3 calories per gram, compared with 4 calories per gram of sugar — they can still slightly raise your blood sugar. To learn more, read the full column, “The Claim: Artificial Sweeteners Can Raise Blood Sugar,” then please join the discussion below. Continue reading >>
Carbohydrates And Blood Sugar
Carbohydrates (or carbs), proteins, and fats are the main nutrients in food that give your body energy. Sugars and starchy foods are examples of carbs. Carbs can raise blood sugar levels more than other nutrients. That’s why it’s important to be aware of the amount of carbs you eat. Natural sugars found in foods like milk and fruits are called simple carbohydrates. Simple carbohydrates may also be added to certain foods when they are made, like heavy syrup that is added to canned fruit. Simple carbohydrates, which are broken down faster than complex carbohydrates, will begin to raise blood sugar levels very soon after you eat them. Complex carbohydrates, like starches, take longer to break down in the body. As a result, complex carbohydrates take longer to impact blood sugar, causing the amount of sugar in the blood to rise more slowly. Fiber is the third type of carbohydrate. It is the part of plant foods, like vegetables, fruits, nuts, beans, and whole grains, that cannot be digested. Fiber helps prevent constipation. It also helps you feel full after eating and may lower cholesterol levels. Starches—bread, cereal, crackers, grains, rice, pasta Starchy vegetables—potatoes, corn, peas, beans All fruits and fruit juices Milk and yogurt Sugary foods—candy, regular soda, jelly Sweets—cakes, cookies, pies, ice cream Food groups that don’t normally have carbohydrates are proteins and fats. Because carbohydrates raise blood sugar more than other types of foods, you may wonder why you should eat them at all. You need to eat foods with carbohydrates because they provide your body with energy, along with many vitamins and minerals. Sweets are okay once in a while, but remember that sweets usually have a lot of carbohydrates, calories, and fat, with very little nut Continue reading >>
Demystifying Sugar
People with diabetes can enjoy sugar with a balanced diet. Contrary to popular opinion, people with diabetes can eat sugars and still meet their blood sugar goals. In the past, people with diabetes were told to avoid sugar as a way to control diabetes. And even today, you may hear someone you know tell you the same information. But the truth is, research has shown that people with diabetes can enjoy sugar and sugar-containing foods, in the context of a balanced diet. This section demystifies sugars. In this section, you will learn about: Understanding sugars Contrary to popular opinion, people with diabetes can eat sugars and still meet their blood sugar goals. Research shows that the total amount of carbohydrate you eat has the biggest effect on your blood sugar level. So how does sugar fit in the picture? Sugar is found in: Table sugar Brown sugar Molasses Honey Powdered sugar Cane sugar Raw sugar Agave nectar Syrups, like corn syrup and maple syrup Other names of sugar you might read are glucose, fructose, dextrose, maltose and sucrose Sugar, like all carbohydrates, contains food energy. Every gram of carbohydrate has about 4 calories. One teaspoon of sugar has about 5 grams of carbohydrate, and 20 calories. One tablespoon of sugar has about 15 grams of carbohydrate, and 60 calories. So it may be no surprise that sugar and sugar-containing foods still have an impact on your blood sugar and body weight, just like other carbohydrate foods. Can I include sugar in my meal plan? You can occasionally eat sugar and sugar-containing foods. Just like other carbohydrate foods, count the grams of carbohydrates in your sweets, and be sure to stay within your carbohydrate budget for the meal or snack. Sweets or desserts will need to replace another carbohydrate choice in order to Continue reading >>
Counting Carbohydrates Like A Pro
Practical Tips for Accurate Counts Let’s get this straight: There is no such thing as a “pro” when it comes to carbohydrate counting. There is no master’s degree or PhD in Carbohydrate Science at any major university, nor is there a course focusing on counting carbohydrates in any dietetics or nutrition science program. And I’ve yet to meet anyone at a circus or carnival who, for a mere dollar, will “guess the carbohydrates” in your favorite food item, lest you win a valuable prize. So why would anyone with diabetes want to count carbohydrates “like a pro”? Simple. When it comes to keeping blood glucose levels in control, carbohydrate counting works better than any other system. Better than counting calories. Better than avoiding sugar. And certainly better (and simpler) than the exchange system. Carbohydrate is what raises blood glucose level abruptly after meals. Not fat or protein or vitamins or minerals. Just carbohydrate. Counting and managing the amount of carbohydrate in your diet has important benefits. If you take multiple daily injections of insulin or use an insulin pump, carbohydrate counting allows you to match doses of mealtime rapid-acting insulin to the foods you eat. This allows for almost unlimited dietary flexibility and helps to prevent post-meal highs and lows. If you control your diabetes with diet and exercise, pills, or just one or two insulin injections a day, you can also use carbohydrate counting to improve your control. Researchers at the University of Texas School of Allied Health Sciences in Galveston found that consistent carbohydrate intake (eating the same amount of carbohydrate at the same meals every day) in people with Type 2 diabetes leads to improvements in blood glucose control, whether or not a person also loses Continue reading >>
Treating Low Blood Sugar
You are at risk of having a low blood sugar reaction if you: Skip or delay a meal or snack Take too much insulin or eat too few carbohydrates Exercise Drink alcohol, especially without eating carbohydrates Check your blood sugar if you have any of these symptoms: Weakness and/or fatigue Headache Sweating Anxiety Dizziness Shaking Increased heartbeat If your blood sugar is less than 70 milligrams per deciliter (mg/dl): Eat 15 to 30 grams of carbohydrate (sample foods listed below) Wait 15 minutes and then recheck your blood sugar If your blood sugar is still less than 100 mg/dl, take another 15 grams of carbohydrate and retest your blood sugar in another 15 minutes. Repeat if necessary. Important: If you have frequent low blood sugars speak to your doctor. You may need changes in your medication and/or meal plan. Quick Carbohydrate Guide for Treating Low Blood Sugars If your blood sugar is less than 70 mg/dl, you need 15 to 30 grams of a quickly absorbed carbohydrate, like the ones listed below. Each of the following servings provides 15 grams of carbohydrate. Candies and Other Sweets 5 small gum drops 12 gummy bears 6 large jelly beans 5 Life Savers 15 Skittles 1 Tablespoon honey, jam or jelly 1 Tablespoon sugar in water 4 Starburst Beverages 1/2 cup apple juice 1/2 cup orange or grapefruit juice 1/2 cup pineapple juice 1/2 cup regular soda (not diet) 1/3 cup grape juice 1/3 cup cranberry juice 1/3 cup prune juice 1 cup fat free milk Fruits 1/2 banana 1 small apple 1 small orange 1/2 cup applesauce 2 tablespoons of raisins 15 grapes Other 3 to 4 glucose tablets 1 tube glucose gel Note: The foods listed above are easily absorbed and will raise blood sugar levels quickly. Foods that contain protein or fat — such as chocolate, candy bars, ice cream, cookies, crackers and Continue reading >>
Sugar And Cancer
Question: Does sugar feed cancer? Answer: While researchers continue to investigate the connection between sugar and cancer, it remains a source of anxiety-inducing speculation and misinformation in the media and on the internet. Of course, the undeniable answer is that glucose (the form of sugar used most in the body) feeds every cell in the body, and is so important to the function of your brain that the body has several back up strategies to keep blood sugar levels normal. Even without any carbohydrate in the diet, your body will make sugar from other sources, including protein and fat. The idea that sugar could directly fuel the growth of cancer cells can lead some people to avoid all carbohydrate-containing foods. This is counter-productive for anyone struggling to maintain their weight while dealing with side effects of cancer and treatments. More importantly, the inevitable anxiety of trying to completely avoid “all sugar” creates stress. Stress turns on the fight or flight mechanisms, increasing the production of hormones that can raise blood sugar levels and suppress immune function. Both of these things may reduce any possible benefit of eliminating sugar in the first place. Much research shows that it is sugar’s relationship to higher insulin levels and related growth factors that may influence cancer cell growth the most, and increase risk of other chronic diseases. Many types of cancer cells have plenty of insulin receptors, making them respond more than normal cells to insulin’s ability to promote growth. All carbohydrates you eat are broken down to simple sugars in the intestine, where they are absorbed into the blood, increasing blood sugar levels. The pancreas releases insulin in response, which travels throughout the blood stream, and performs Continue reading >>
Hypoglycemia (low Blood Sugar) In Type 1 Diabetes
I was diagnosed with type 1 diabetes in 1968, at the age of 8 years old. At the time, there were no fingerstick blood sugars available for use. One had to regulate diabetes by measuring urine sugars, a very imprecise way to monitor blood sugar control. I recently obtained copies of my medical records from that 12-day stay, and found the following comment in the discharge summary: “He had one mild episode of shocking without loss of consciousness or convulsion.” I remember that episode. I could not have known that it was to be the first of hundreds of low blood sugar reactions that I would experience over the next 46 years. Though a hypoglycemia episode is always disruptive and never a pleasant experience, most were mild, ones that I could treat myself. But occasionally they were severe, requiring assistance from family or co-workers, or 911 calls. I was driven to achieve ‘tight control’ and prevent the long-term complications of diabetes, which I have managed to do. But there was a high price. I felt like I was playing a game of Russian roulette with hypoglycemia. I could no longer tell when I was low. Hypoglycemia unawareness had developed. I was fortunate enough to have developed T1D at a time when treatment for it has steadily improved. I started on an insulin pump in January 1982, and that helped me to reduce my frequency of hypoglycemia. The availability of insulin glargine (Lantus) and insulin detemir (Levemir) were great advances over older basal insulins (NPH, lente, ultralente) that had more intense and less predictable peaks, a very real problem at night. While I have not used them, because they became available after I started on a pump, better basal insulins have helped many T1Ds reduce night time hypoglycemia. Faster insulins (insulin lispro/Humalog Continue reading >>
Fitting Sugar Into Your Meals
It is commonly thought that people with diabetes should avoid all forms of sugar. Most people with diabetes can eat foods containing sugar as long as the total amount of carbohydrate for that meal or snack is consistent and sugar foods are added within the context of healthy eating. Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carbohydrates, the blood sugar levels will go up. Which will have the greater effect on blood sugar? ____ 1 tsp sugar or ____ 1/2 cup potatoes The potatoes will contribute about 15 grams of carbohydrates, while a level teaspoon of sugar will only give 4 grams of carbohydrates. Therefore, the potatoes will have about three times the effect on blood sugar as compared to the table sugar. Meal Planning Practice Using the following foods, plan two breakfast meals containing approximately 45 grams of carbohydrate. Notice that there are some foods on this list you might think would not be "allowed" on your meal plan. But again, any of these foods can be used as long as you limit the amount of carbohydrates you eat at a given meal to what is indicated on your individualized meal plan. (In the example below, this means you can choose whatever foods you want as long as the total carbohydrate equals no more than 45 grams). Food Amount Carbohydrate Grams 1% fat milk 1 cup 12 Bran Chex 2/3 cup 23 Frosted Flakes 3/4 cup 26 Raisin Bran 3/4 cup 28 bread/toast 1 slice 15 sugar. white table 1 teaspoon 4 pancakes - 4 inches 2 15 low-fat granola 1/2 cup 30 yogurt, fruited 1 cup 40 yogurt, fruit with NutraSweet fruit juice 1 cup 19 fruit juice 1/2 cup 15 banana 1/2 15 pancake syrup 2 tablespo Continue reading >>
What Are The Effects Of Sugar Alcohols?
I am confused about the effects of sugar alcohols. How do I figure them into my daily sugar intake? — Penny, Ohio Sugar alcohols (polyols) are carbohydrates that occur naturally in many fruits and vegetables. They are also made by food manufacturers from starches, glucose, and sucrose, and are commonly added to foods. Corn syrup is most commonly used to make polyols. Sugar alcohols have a couple of properties that make them attractive for people who would like to reduce their carbohydrate intake but still enjoy sweets. Here are a few things to remember: First, polyols are slowly and not completely absorbed from the gut. This reduces the quantity of carbohydrates the body absorbs and converts into glucose in the bloodstream. Second, most polyols have fewer calories than table sugar. The most common polyols are: Sorbitol (2.6 calories per gram) Maltitol (2.1 calories per gram) Lactilol(2 calories per gram) Erythritol (0.2 calories per gram) Isomalt (2 calories per gram) Hydrogenated starch hydrolysates (3 calories per gram) Mannitol (1.6 calories per gram) Xylitol (2.4 calories per gram) Maltitol syrup (4.32 calories per gram) These substances have been used extensively by food manufacturers to make sugar-free and reduced-carb products. Their texture and feel can help make artificial sweeteners palatable, and they're often used as bulking agents. They are found in sugar-free candies, chewing gum, desserts, baked goods, chocolates, and ice cream. They're also found in some over-the-counter medications, including throat lozenges, cough syrup, and chewable vitamins. Many diabetics, in their efforts to reduce their carbohydrate consumption or lose weight, have turned to reduced-sugar, sugar-free, or low-carb food products. Although polyols can raise after-meal sugar levels, Continue reading >>
A Beginner’s Guide To Carbohydrate Counting
Pia has a Bachelors Degree in Clinical Nutrition from Cornell University and a Masters of Science in Nutrition from New York University. She completed a dietetic internship at the Bronx Veterans Medical Center in order to become a registered dietitian. Prior to joining BD, Pia educated people with diabetes about medical nutrition therapy in a private physicians office, an outpatient clinic at a hospital and a nursing home where she counseled patients one-on-one and in group classes. This slide show explains: • What foods contain carbohydrates • How much of these foods you can eat • Where to look up the carb content of foods Next slide This is not true! Carbohydrates (carbs) have the greatest effect on your blood sugar. 90 to 100 percent of the carbs you eat appear in your bloodstream as blood glucose within minutes to hours after you have eaten. You may be asked to count the carbs that you eat. The carbs you will need to count are both: • starches that break down slowly into sugar • simple sugars that break down into blood glucose almost right away Many people believe that a diabetes meal plan means that you just have to cut back on sugar. Previous slide Next slide Products made from grains, such as pasta, bread, rolls, bagels, crackers, cereals and baked goods Starches include certain vegetables, all grains, and products made from grains All of these foods contain starches: Starchy Vegetables Regular and sweet potatoes, corn, fresh peas and lima beans Legumes Dried beans and peas Grains Grains like wheat, oats, barley, and rice Sugars include the natural sugars in fruit and milk, plus certain sweeteners added to prepared foods and drinks Fruit and fruit juices Foods that contain fruit or fruit juices such as jams, jellies, and fruit smooth Continue reading >>
