Diabetes Websites & Resources
Health Service, Diabetes Program
Diabetes Nutrition & Diet Tips
|• Flexibility in eating what you want while keeping control of your blood glucose is now possible.
• Eat food with less fat, and sugars; include a variety of fresh fruits, vegetables, lean meats and fish.
• The American Diabetes Association recommends that all adults with diabetes see a dietitian every 6 months to 1 year to help with meal plans.
• A healthy intake of fat is 30 percent or less of your daily calories. Less than 10 percent should come from saturated fats (fats that are solid at room temperature), and up to 10 percent should come from polyunsaturated fats (fats from fish and other seafood).
• People with diabetes can reduce their risk for complications if they are educated about their disease, learn and practice the skills necessary to better control their blood glucose levels, and receive regular checkups from their health care team.
Living with Diabetes is a day to day task of monitoring your blood sugar levels and constantly adjusting your diet. We want to offer you some basic information on maintaining a consistant diet to make coping with Diabetes a bit easier. With proper nutrition, monitoring and exercise the effects of Diabetes may be greatly reduced or minimized for some types. There are two forms of diabetes; Type I and Type II. Both forms of this disease have the same effects on the person and have no true cure.
Diabetes is a disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, which usually occurs during childhood or adolescence, and type 2, the most common form of the disease, usually occurring after age 45. Diabetes is a chronic disease that has no cure.
Prevalence of type 2 diabetes among Native Americans in the United States is 12.2% for those over 19 years of age. One tribe in Arizona has the highest rate of diabetes in the world. About 50% of the tribe between the ages of 30 and 64 have diabetes. Today, diabetes has reached epidemic proportions among Native Americans. Complications from diabetes are major causes of death and health problems in most Native American populations. Of equal concern is the fact that type 2, or adult-onset diabetes, is increasingly being discovered in Native American youth.
The serious complications of diabetes are increasing in frequency among Native Americans. Of major concern are increasing rates of kidney failure, amputations and blindness.
Ten to twenty-one percent of all people with diabetes develop kidney disease. In 1995, 27,900 people initiated treatment for end stage renal disease (kidney failure) because of diabetes. Among people with diabetes, the rate of diabetic end stage renal disease is six times higher among Native Americans.
Diabetes is the most frequent cause of non-traumatic lower limb amputations. The risk of a leg amputation is 15 to 40 times greater for a person with diabetes. Each year 54,000 people lose their foot or leg to diabetes. Amputation rates among Native Americans are 3-4 times higher than the general population. Diabetic retinopathy is a term used for all abnormalities of the small blood vessels of the retina caused by diabetes, such as weakening of blood vessel walls or leakage from blood vessels. Diabetic retinopathy occurs in 18% of Pima Indians and 24.4% of Oklahoma Indians.
In ideal circumstances, Native Americans with diabetes will have their disease under good control and be monitored frequently by a health care team knowledgeable in the care of diabetes.
Patient education is critical.
People with diabetes can reduce their risk for complications if they are educated about their disease, learn and practice the skills necessary to better control their blood glucose levels, and receive regular checkups from their health care team.
People with diabetes, with the help of their health care providers, should set goals for better control of blood glucose levels, as close to the normal range as is possible for them.
Health care team education is vital.
Because people with diabetes have a multi-system chronic disease, they are best monitored and managed by highly skilled health care professionals trained with the latest information on diabetes to help ensure early detection and appropriate treatment of the serious complications of the disease.
A team approach to treating and monitoring this disease serves the best interests of the patient.
What are the basics of a nutritious diet for someone with diabetes? Nutrition means getting nutrients protein, carbohydrates, fats, vitamins, and minerals from what you eat and drink. The amounts of carbohydrate, fat, and protein in your daily meal plan depend on your individual needs and tastes. They also depend on your overall health and your treatment goals (blood glucose, blood fat levels, and weight goals). Your nutrition needs change throughout life as your body changes. As your needs change, so should your food choices.
For most people, a healthy diet includes 10-20 percent of daily calories from protein (poultry, fish, dairy, and vegetable sources). If you have kidney disease, you and your doctor should talk about lowering your protein intake to around 10 percent of daily calories.
A healthy intake of fat is 30 percent or less of your daily calories. Less than 10 percent should come from saturated fats (fats that are solid at room temperature), and up to 10 percent should come from polyunsaturated fats (fats from fish and other seafood). Daily cholesterol intake should be 300 milligrams or less. Cholesterol is found in dairy products, eggs, and meats.
In general, Americans eat too much fat. To reduce our risk for heart disease, we all need to eat less saturated fat and cholesterol. Because having diabetes puts you at increased risk for heart disease, you have even more reason to watch your fat intake.
The rest of your daily calories will come from carbohydrates, which are found in fruits, vegetables, beans, dairy foods, and starchy foods such as breads.
Sugar is a type of carbohydrate. For the past 100 years, people with diabetes were told to avoid sugar. It was assumed that sugar, which quickly changes into glucose, would raise blood glucose levels more. But research has shown that this is not true.
Of course, there are still reasons why sugar is not a smart food choice. Your body depends on the nutrients supplied in the foods you eat. Sugary foods often contain empty calories that provide no nutrients. Your dietitian can help work foods with sugar into your meal plan.
But sugary foods can't take the place of foods that supply vitamins and minerals. There is no reason to avoid table sugar in favor of other sweeteners, such as fructose (the sugar found in fruit), corn sweeteners, corn syrup, fruit juice or fruit juice concentrate, honey, molasses, dextrose, and maltose. On the other hand, there is no reason for people with diabetes to avoid foods that naturally contain sweeteners, such as fructose (fruits and vegetables) or lactose (dairy products).
Unless you have special health concerns or problems, you can follow the same guidelines for eating fiber and sodium as the general public. If you eat a variety of healthful foods, you don't need to take extra vitamins and minerals.
The warnings the public hears about alcohol also apply to you. If you have well-controlled diabetes, you can work one or two drinks into your meal plan. Do not drink alcohol on an empty stomach. It can cause very low blood glucose. If you take insulin or diabetes pills, you need to know how alcohol affects your blood glucose level by testing during and after you drink.
You may have tried meal plans or diets only to fail time and again. You may have lost weight only to gain it back. Just the thought of changing your habits may seem overwhelming. The American Diabetes Association suggests that you think about food choices in a new way: Don't try to do it alone. Working food choices into a diabetes treatment plan is a complex task. It takes teamwork. You want to wind up with a meal plan that fits you. Get the help of a registered dietitian and your doctor. A dietitian is a health-care professional with training and expertise in the field of food.
The American Diabetes Association recommends that all adults with diabetes see a dietitian every 6 months to 1 year to help with meal plans. Look for one who has worked with many people with diabetes, because you want a dietitian who knows the current American Diabetes Association guidelines. Look for the initials RD (registered dietitian), which indicate that the dietitian has passed a national credentialing exam. Many states also require dieticians to have a license, so you'll often see the initials LD (licensed dietitian). Good sources of recommendations are your primary care physician, area hospitals, The American Dietetic Association, and The American Diabetes Association (see below).
Dietitians teach you many useful skills, such as how to:
--Use Exchange Lists for Meal Planning, published by the American Diabetes Association and The American Dietetic Association
--Count dietary carbohydrate and fat
-- Read food labels
-- Handle eating out in restaurants
-- Make healthy food choices when grocery shopping Dietitians help you discover a range of nutritional resources, including cookbooks and reference materials, so you can learn how to prepare healthy, delicious, and satisfying meals.
Start with what you are doing now. You and your dietitian should begin by looking at your current habits. This is called a nutrition assessment. Building on what you do now, you can come up with a plan that will help you meet your health goals. It should fit your food tastes, family or cultural customs, and lifestyle while it helps you meet your health goals. You do not have to give up all your favorite foods. Make changes slowly.
For example, your goal might be to lose 10 pounds. You may be able to reach this goal by making some small changes:
--Cut down on portion size.
--Eat less fat.
--Eat more fresh fruits and vegetables.
--Walk briskly for 20 minutes three or four times a week. Because there is no one diabetic diet, you have lots of food choices. As you change, your plan can change too.
Know your health goals. How does your meal plan help you meet these goals? By testing your blood glucose and having other regular health assessments, you get a picture of how your food plan is affecting your diabetes control. Talk to your doctor about how often you need to test your blood glucose at home. Keep track of your test results.
Staying healthy with diabetes will always be a challenge. When you work with your health-care team on your meal plan, you are working on one of the most important tools for feeling your best. Although you need to follow a healthy eating plan, its a blueprint that includes many choices. its up to you to help shape a plan that you can live with.
Flexibility in what you want while keeping control of your blood glucose is now possible. The guidelines emphasize that everyone with diabetes will benefit from an individual consultation with a registered dietitian because a standard meal plan cannot address all the issues for each individual. An individual's plan must be tailored to the type of diabetes, the type of treatment, other health concerns and the person's personal tastes and other lifestyle factors.
Previously, the dietary treatment of diabetes has been to avoid simple carbohydrates and replace them with complex carbohydrates like potatoes, cereals, and grains. But research now shows little evidence to suppot the necessity to exclude all sugars.
Instead, the total amount of cargohydrates, rather than the type, is the critical factor in affecting blood glucose levels. The guidelines state that sucrose (sugar) as part of a meal plan doesn't impair blood glucose control. But if you use sucrose-containing foods, you must substitute them for other carbohydrates and foods, not simply add them to the meal.
Don't take this to the extreme- the guidelines don't mean that you can simply add concentrated sweets to your meals. Instead, substitute an equal amount of carbohydrates in your meal plan to account for the sweets.
Basically, what's healthy for someone with diabetes is what's healthy for anyone who wants to eat nutritiously. Therefore, the guidelines are the same: Eat food with less fat, and sugars; include a variety of fresh fruits, vegetables, lean meats and fish.
Your meal plan should provide you with enough calories to stay at a healthy weight. This is a weight you can achieve and maintain, and one that you and your physician agree on. And yet it may not be the "ideal" body weight on the height/weight charts.
Your food choices can help you reach several important health goals. In addition, these choices can also help prevent or delay side effects of diabetes such as kidney disease, gastropareses, high blood pressure, heart disease and helping you control your blood glucose level.