Why A Low-carb Diet Should Be The First Approach In Diabetes Treatment
A panel of medical experts, including our own Advisory Board member Dr. Richard K. Bernstein, presents the evidence for low-carbohydrate diets as initial therapy… Please note: the following summary was excerpted by Jennifer Piggot, LECOM PharmD candidate, from the original article which can be found here. We encourage all interested readers to look over the full article and supporting research. The current state of diabetes care in the United States health system shows the inability of existing recommendations to control the epidemic of diabetes, the failure of low-fat diets to improve obesity rates, cardiovascular risk or general health, and the continual reports of serious side effects of commonly prescribed diabetic medications. The success of low carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects point to the need for a reappraisal of dietary guidelines. The immediate benefits of carbohydrate restriction in diabetes patients include reduction of high blood glucose, less requirement for weight loss, fewer side effects than medication therapy and the reduction or elimination of medications. This article outlines the current evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes, and an effective adjunct to pharmacology in type 1. These results represent the best documented and least controversial studies. It is known that diabetics are defective in response to carbohydrates, which can lead to hyperglycemia. Hussain et al. compared a very low carbohydrate ketogenic diet (VLCKD) with a low calorie diet over a 24-week period in diabetics and non-diabetics. Blood glucose dropped more dramatically in the VLCKD group than in those given the low-calorie diet. Patients with Continue reading >>
Meal Planning For Children With Type 1 Diabetes
When you have a child with type 1 diabetes, it's easy to get carried away with the notion of a diabetic diet. But in reality, your child's dietary needs are no different from a child who doesn't have diabetes. Of course, there are certain considerations you need to be aware of, and understanding the carbohydrate content in food is arguably the most important. In this article, you will learn about the importance of carb counting, with a special emphasis on how fiber and sugar alcohols may also affect your child's blood glucose (blood sugar) levels. Nutrition Basics There's really no such thing as a diabetic diet. That's why you should focus instead on providing your child with balanced nutrition. A good nutritional resource to consult is the Food Pyramid. In recent years, the United States Department of Agriculture has made some updates to the standard Food Pyramid that most of us grew up knowing. Instead of being a set-in-stone guideline, now you can create personalized eating plans that are flexible and balanced. To refresh your memory on healthy eating, visit ChooseMyPlate.gov. There are 3 main nutrients in foods—fats, proteins, and carbohydrates. These essential nutrients affect blood glucose in different ways. Fats: Fat typically doesn't break down into sugar in your blood, and in small amounts, it doesn't affect your blood glucose levels. But fat does slow down digestion, and this can cause your blood glucose to rise slower than it normally would. After a high-fat meal, your child's blood glucose may be elevated up to 12 hours after the meal. Proteins: Protein doesn't affect blood glucose unless you eat more than your body needs. In most cases, you need only about 6 ounces or less (which is about the size of 2 decks of cards) at each meal. Carbohydrates: Carbohyd Continue reading >>
Understanding Advanced Carbohydrate Counting — A Useful Tool For Some Patients To Improve Blood Glucose Control
Today’s Dietitian Vol. 15 No. 12 P. 40 Suggested CDR Learning Codes: 2070, 3020, 5190, 5460; Level 3 Take this course and earn 2 CEUs on our Continuing Education Learning Library Click here for patient handout Carbohydrate, whether from sugars or starches, has the greatest impact on postprandial blood sugar levels compared with protein and fat. For this reason, carbohydrate counting has become a mainstay in diabetes management and education. Patients with type 1 or 2 diabetes benefit from carbohydrate counting in terms of improvements in average glucose levels,1,2 quality of life,2,3 and treatment satisfaction.3 Basic carbohydrate counting is used to keep blood glucose levels consistent, while advanced carbohydrate counting helps with calculating insulin dose. Both basic and advanced carbohydrate counting give people with diabetes the freedom to choose the foods they enjoy while keeping their postprandial blood glucose under control. This continuing education course introduces advanced carbohydrate counting as a tool for improving blood glucose management, evaluates basic and advanced carbohydrate counting, describes good candidates for advanced carbohydrate counting, and discusses strategies for counseling patients as well as precautions when using advanced carbohydrate counting. Basic Carb Counting Basic carbohydrate counting is a structured approach that emphasizes consistency in the timing and amount of carbohydrate consumed. Dietitians teach patients about the relationship among food, diabetes medications, physical activity, and blood glucose levels.4 Basic carbohydrate counting assigns a fixed amount of carbohydrate to be consumed at each meal and, if desired, snacks. Among the skills RDs teach patients are how to identify carbohydrate foods, recognize serving s Continue reading >>
Carbohydrate Counting For People With Type 2 Diabetes
Carbohydrate counting is an effective medical nutrition therapy option for adults with type 2 diabetes. This meal planning tool has increased in popularity as a result of research demonstrating the benefits of intensive therapy in individuals with type 1 diabetes.1 It can also lead to improved diabetes control and weight loss in adults with type 2 diabetes. This article describes our experience in teaching carbohydrate counting in a diabetes specialty practice using "carbohydrate homework." In my full-time practice with an endocrinologist and diabetologist, I see a large population of patients with type 2 diabetes. Nutrition services are provided in one-to-one consultations, and 8–12 patients are seen per day. Our type 2 diabetes population spans the spectrum in terms of educational and socioeconomic level. Whether working or retired, many eat the majority of their meals out or on the run, because their spouse has died, their children are grown, or busy lifestyles don't allow for meals at home. Most have a misconception of the role nutrition plays in their diabetes control. When patients enter our practice, they often express frustration with their lack of glycemic control, lack of success with weight loss, and continuing problems with weight gain. Patients report frustration that, although they are following a meal plan and their premeal blood glucose levels are close to target, their HbAlc levels are still elevated. It is often at this frustration point that a patient first meets with the dietitian, and the concept of carbohydrate counting is introduced. Carbohydrate counting with fat- gram counting is an effective way to work on weight loss and to improve the control of diabetes. Carbohydrate is converted to blood glucose almost 100% within approximately 90 minutes Continue reading >>
Avoiding Blood Sugar Spikes
Do you ever get that “2 o’clock feeling when all you really want is a candy bar? What about a mid-morning headache along with fatigue, confusion, and brain fog? You might be riding the blood sugar roller coaster, which is when your blood sugar goes from low to high frequently throughout the day. Most of us opt for a quick fix and that usually involves eating sugar. But brushing these symptoms off can cause insulin resistance over time and lead to health problems in the future including diabetes and heart disease. So what causes blood sugar fluctuation? While there are a few reasons why it could occur (stress, lack of sleep, etc.), the simple answer is carbohydrate (carb) consumption. Carbohydrates are the only macronutrient that can raise blood sugar significantly, whereas protein and fat act as carbohydrate buffers, helping to keep blood sugar stable throughout the day. Because carbohydrates make up a major portion of the standard American diet, many may be unaware that their blood sugar could be troublesome. There are a few different things you can do to control it, but it’s important to get your diet in check first. Start with the simple tips listed below. 1. Balance your meals with fat and protein. These two macronutrients have a minimal effect on your blood sugar levels. Not only will they help you feel full and stay full, they slow the digestion of carbs, keeping your blood sugar from spiking rapidly. Here is an example of a meal that includes a good balance of protein, fat, and carbs: a serving of chicken (protein) sautéed in coconut oil (fat) with broccoli and carrots (carbs) on the side, along with a small serving of berries (carbs) for dessert. 2. Eat 3 meals a day, and a few snacks if you need them. Another option is eating smaller meals more frequentl Continue reading >>
Diabetes
What is diabetes? When a food containing carbohydrate is eaten, your body digests the carbohydrate into sugar (called glucose), which can then be used as energy by the cells in your body. Diabetes is a condition where your body can’t properly control the amount of glucose in your blood. A hormone called insulin is needed for transferring glucose from the bloodstream to enter the body cells and be converted to energy. In people with diabetes, blood glucose levels are often higher than normal because either the body does not produce insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes). High levels of glucose in the bloodstream can lead to short term complications such as: passing large amounts of urine being extremely thirsty and drinking lots of fluids being tired having blurred vision having frequent skin infections and being slow to heal Blood glucose levels are normally between about 4.0 and 8.0 mmol/L. People with diabetes should aim for blood glucose levels as near to normal as possible, but individual targets should always be discussed with your diabetes health care professional. Controlling diabetes is important to prevent serious long term complications such as: heart and circulation problems infections kidney disease eye problems, which can lead to blindness nerve damage to the lower limbs and other parts of the body Types of diabetes There are three types of diabetes: Type 1 diabetes Type 1 diabetes affects less than 1% of all Australians. It can appear at any age, but most commonly in childhood and early adult life. People with type 1 diabetes cannot produce enough insulin, and therefore they must inject themselves with insulin several times a day. Type 2 diabetes Type 2 diabetes is the most common form of diabetes, affecting 7.1 % of a Continue reading >>
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Basic Diabetes Meal Plan
Diabetes meal planning starts with eating a well-balanced diet that includes carbohydrates (carbs), protein, and fat. Carbs (found in starches, fruit, vegetables, milk/yogurt and sweets) turn into sugar (glucose) in the body. The body needs carbs for energy. Eating too many carbs can raise blood glucose levels too much, but it is important not cut out these foods. Eating too few carbs may cause your blood glucose to go too low. Eating a moderate amount of carbs at each meal, with a balanced intake of protein and fat, will help your blood glucose stay in a healthy range. Here are some tips to get you started. Your dietitian will give you more specific information when you meet with him or her. Limit your intake and portion sizes of high-sugar foods to 2 or 3 times a week or less. These include: Cakes (frosted, layer, plain), pies, and cookies Candy (hard tack, chocolate, nougats, etc.) Jelly, jam, and preserves Table sugar, honey, molasses, and syrup Regular ice cream, sherbet, regular and frozen yogurt, fruit ices, and Popsicles Regular soft drinks, fruit drinks (canned or concentrated), and drink mixes with sugar added Milkshakes, chocolate milk, hot cocoa mix Sugar coated cereals, granola, breakfast/snack bars Canned fruits with heavy syrup, dried fruit, fruit roll-ups, candied fruit Iced sweet breads, coffee cakes, breakfast rolls, and donuts Avoid the following: Table sugar, honey, molasses and syrup Regular soft drinks, fruit drinks (canned or concentrated), and drink mixes with sugar added Milkshakes, chocolate milk, hot cocoa mix Canned fruits with heavy syrup Eat 3 well-balanced meals a day and a small snack at night. Each meal should contain both carbs and protein. When planning meals, select a variety of foods from each food group, and watch your portion sizes Continue reading >>
Diabetes Management
The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance. The pancreas of a person with type 2 diabetes may be producing normal or even abnormally large amounts of insulin. Other forms of diabetes mellitus, such as the various forms of maturity onset diabetes of the young, may represent some combination of insufficient insulin production and insulin resistance. Some degree of insulin resistance may also be present in a person with type 1 diabetes. The main goal of diabetes management is, as far as possible, to restore carbohydrate metabolism to a normal state. To achieve this goal, individuals with an absolute deficiency of insulin require insulin replacement therapy, which is given through injections or an insulin pump. Insulin resistance, in contrast, can be corrected by dietary modifications and exercise. Other goals of diabetes management are to prevent or treat the many complications that can result from the disease itself and from its treatment. Overview[edit] Goals[edit] The treatment goals are related to effective control of blood glucose, blood pressure and lipids, to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies. The targets are: HbA1c of 6%[1] to 7.0%[2] Preprandial blood Continue reading >>
Principles Of Biochemistry/glucose, Glycogen And Diabetes
Glucose (C6H12O6, also known as D-glucose, dextrose, or grape sugar) is a simple sugar (monosaccharide) and an important carbohydrate in biology. Cells use it as a source of energy and a metabolic intermediate. Glucose is one of the main products of photosynthesis and starts cellular respiration. Glucose exists in several different structures, but all of these structures can be divided into two families of mirror-images (stereoisomers). Only one set of these isomers exists in nature, those derived from the "right-handed form" of glucose, denoted D-glucose. D-glucose is often referred to as dextrose. The term dextrose is derived from dextrorotatory glucose. Solutions of dextrose rotate polarized light to the right (in Latin: dexter = "right"). Starch and cellulose are polymers derived from the dehydration of D-glucose. The other stereoisomer, called L-glucose, is hardly found in nature. The name "glucose" comes from the Greek word glukus (γλυκύς), meaning "sweet". The suffix "-ose" denotes a sugar. The name "dextrose" and the 'D-' prefix come from Latin dexter ("right"), referring to the handedness of the molecules. Glucose is a monosaccharide with formula C6H12O6 or H-(C=O)-(CHOH)5-H, whose five hydroxyl (OH) groups are arranged in a specific way along its six-carbon backbone.[1] In its fleeting open-chain form, the glucose molecule has an open (as opposed to cyclic) and unbranched backbone of six carbon atoms, C-1 through C-6; where C-1 is part of an aldehyde group H(C=O)-, and each of the other five carbons bears one hydroxyl group -OH. The remaining bonds of the backbone carbons are satisfied by hydrogen atoms -H. Therefore glucose is an hexose and an aldose, or an aldohexose. Each of the four carbons C-2 through C-5 is chiral, meaning that its four bonds conne Continue reading >>
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Type 2 Diabetes Treatment
Although diabetes cannot be cured, it can be treated successfully. If a high blood sugar level is brought down to a normal level, your symptoms will ease. You still have some risk of complications in the long term if your blood glucose level remains even mildly high - even if you have no symptoms in the short term. However, studies have shown that people who have better glucose control have fewer complications (such as heart disease or eye problems) compared with those people who have poorer control of their glucose level. Therefore, the main aims of treatment are: To keep your blood glucose level as near normal as possible. To reduce any other risk factors that may increase your risk of developing complications. In particular, to lower your blood pressure if it is high and to keep your blood lipids (cholesterol) low. To detect any complications as early as possible. Treatment can prevent or delay some complications from becoming worse. Type 2 diabetes is usually initially treated by following a healthy diet, losing weight if you are overweight, and having regular physical activity. If lifestyle advice does not control your blood sugar (glucose) levels then medicines are used to help lower your blood glucose levels. One medicine (usually metformin) is used first but two or even three medicines may be needed. Most of the medicines for type 2 diabetes are given in tablet form. However, some people with type 2 diabetes need insulin injections to help control blood glucose levels. Some people gain a great deal of benefit from insulin injections and these are sometimes used fairly soon after the diagnosis of type 2 diabetes has been made. Insulin injections can be used in combination with other medicines to further improve glucose control. Lifestyle - diet, weight control an Continue reading >>
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Diabetes Diet Or Insulin? How To Best Control Blood Sugar
Finding out you have type 2 diabetes can be overwhelming to say the least. Your diet suddenly becomes even more important, as you closely track and learn to what to eat to control your blood sugar. Darlene Turner, ARNP, CDE, UnityPoint Health, offers diabetes diet tips and also discusses when it might be necessary to use insulin. Diabetes Diet or Medication? Type 2 diabetes occurs when the body becomes more resistant to the insulin naturally produced and released by the pancreas. The pancreas becomes overworked when large amounts of carbohydrates are consumed, and the body can’t keep up with the amount of insulin needed. Turner says type 2 diabetes management depends on whether the diagnosis is made early or late in the disease process. “Sometimes, we find type 2 diabetes early, and we can treat it with diet changes and possibly oral medication,” Turner says. “However, sometimes we diagnose it when the person has already had it a long time, and the pancreas is hardly making any insulin. In that case, we need to have insulin from the beginning in order to gain control of their blood sugars.” Turner says that many people with type 2 diabetes who manage the condition for years will still need insulin at some point, due to the natural progression of the disease. Diabetes Diet Tips to Start Today There are three parts to type 2 diabetes management: dietary changes, an activity plan and medication. Turner recommends learning all you can about diabetes to get it controlled quickly, before more insulin resistance is created from high blood sugar levels. “Our bodies respond better to lifestyle changes early in the disease process, rather than allowing uncontrolled diabetes to go on for a few years before getting serious about taking care of the condition. Lifestyle c Continue reading >>
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Hyperglycaemia (high Blood Sugar)
Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It's a common problem for people with diabetes. It can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes. It can occasionally affect people who don't have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack, or have a severe infection. Hyperglycaemia shouldn't be confused with hypoglycaemia, which is when a person's blood sugar level drops too low. This information focuses on hyperglycaemia in people with diabetes. Is hyperglycaemia serious? The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you're likely to experience hyperglycaemia at some point. It's important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated. Occasional mild episodes aren't usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods. Very high blood sugar levels can cause life-threatening complications, such as: diabetic ketoacidosis (DKA) – a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma; this tends to affect people with type 1 diabetes hyperosmolar hyperglycaemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar; this tends to affect people with type 2 diabetes Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts Continue reading >>
> Carbohydrates And Diabetes
Keeping your blood sugar levels on track means watching what you eat, plus taking medicines like insulin if you need to. Your doctor may also have mentioned that you should keep track of how many carbohydrates (carbs) you eat. But what exactly are carbohydrates and how do they affect your blood sugar? The foods we eat contain nutrients that provide energy and other things the body needs, and one of these is carbohydrates. The two main forms of carbohydrates are: sugars such as fructose, glucose, and lactose starches, which are found in foods such as starchy vegetables (like potatoes or corn), grains, rice, breads, and cereals The body breaks down or converts most carbohydrates into the sugar glucose. Glucose is absorbed into the bloodstream, and with the help of a hormone called insulin it travels into the cells of the body where it can be used for energy. People with diabetes have problems with insulin that can cause blood sugar levels to rise. For people with type 1 diabetes, the pancreas loses the ability to make insulin. For people with type 2 diabetes, the body can't respond normally to the insulin that is made. Because the body turns carbohydrates into glucose, eating carbohydrates makes blood sugar levels rise. But that doesn't mean you should avoid carbohydrates if you have diabetes. Carbohydrates are a healthy and important part of a nutritious diet. Some carbohydrates have more health benefits than others, though. For example, whole-grain foods and fruits are healthier choices than candy and soda because they provide fiber, vitamins, and other nutrients. Fiber is important because it helps you feel full and keeps your digestive system working properly. In fact, eating lots of fiber can even help to slow the body's absorption of sugar when eaten together with s Continue reading >>
Diabetes And Healthy Eating
People with diabetes do not need a special diet. Include a wide variety of healthy foods in your diet. You may need to reduce serving sizes to maintain or achieve a healthy weight. Meals should be based on high-fibre carbohydrates and be low in total saturated fats, added sugar and salt. On this page: Diabetes can be well managed with healthy eating, combined with regular physical activity and weight management. If you have diabetes, it is recommended that you follow a healthy eating plan based on plenty of vegetables and legumes (such as chickpeas, lentils, low-salt baked beans and kidney beans). Include some high-fibre carbohydrate foods such as wholegrain breads and cereals and fruit, as well as some lean protein sources and reduced-fat dairy products. Reduce your intake of saturated (unhealthy) fat and added sugars, and choose foods low in salt. Reducing the serving size of your meals can also help you to maintain a healthy body weight and allows for better blood glucose management. It is recommended that you see a dietitian who can work with you to develop a healthy eating plan that is just right for you. Healthy eating and diabetes If you have diabetes, healthy eating can help you to: maintain general good health better manage your blood glucose levels achieve target blood lipid (fat) levels maintain a healthy blood pressure maintain a healthy body weight prevent or slow the development of diabetes complications. Healthy eating for people with diabetes is no different than for everyone else. You do not need to prepare separate meals or buy special foods, so relax and enjoy healthy eating with the rest of your family. Physical activity and diabetes Along with healthy eating, physical activity is important. Be as active as possible in as many different ways as possi Continue reading >>
Diabetes Treatment (type 1 And Type 2 Medications And Diet)
Diabetes type 1 and type 2 treatment facts Controlling blood sugar (glucose) levels is the major goal of diabetes treatment, in order to prevent complications of the disease. Type 2 diabetes may be managed with non-insulin medications, insulin, weight reduction, or dietary changes. The choice of medications for type 2 diabetes is individualized, taking into account: the effectiveness and side effect profile of each medication, the patient's underlying health status, any medication compliance issues, and cost to the patient or health-care system. Medications for type 2 diabetes can work in different ways to reduce blood glucose levels. They may: increase insulin sensitivity, increase glucose excretion, decrease absorption of carbohydrates from the digestive tract, or work through other mechanisms. Medications for type 2 diabetes are often used in combination. Proper nutrition is a part of any diabetes care plan. There is no one specific "diabetic diet" that is recommended for all individuals. Pancreas transplantation is an area of active study for the treatment of diabetes. What is the treatment for diabetes? The major goal in treating type 1 and type 2 diabetes is to control blood sugar (glucose) levels within the normal range, with minimal excursions to low or high levels. Type 2 diabetes (T2D) is treated: Oral medications are prescribed when these measures fail to control the elevated blood sugars of type 2 diabetes. If oral medications become ineffective treatment with insulin is initiated. Adherence to a diabetic diet is a critical aspect of controlling blood sugar in people with diabetes. When considering an ideal diabetic diet, a number of factors must be taken into consideration, including the amount and type of carbohydrates consumed as well as the amount of fib Continue reading >>
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