Diabetes Treatments

Diabetes Treatments

From About.com

Diabetes is a complicated disease. It can affect many areas of your body as well as many areas of your life. Treatments for both type 1 and type 2 diabetes can bring on many new challenges. What you eat, medications, testing your blood glucose, exercising...all these play a role in successful management of diabetes.

Nutrition

Good nutrition is a key element of managing diabetes. What, when, and how much you eat all influence your blood sugar.

The Three Major Diabetes Food Plans:

There are three main food plans that people with diabetes use to manage their eating -- the exchange plan, the counting carbs plan, and the continuous carbohydrate plan. Why do you need a food plan? Using a food plan helps you keep track of your food intake, and eating close to the same amount of carbs, proteins and fats everyday helps you figure out how your body reacts to food. Knowing how foods affect your blood sugar gives you the tools to maintain better control. Keeping track of carbohydrates is something that people with either Type 1 or Type 2 diabetes should do.
Before You Start:

Carbohydrates are the most important part of the food you eat. They directly affect your blood glucose almost immediately after you eat them. All three plans detailed below help you keep your carbs in balance. For each of the plans, 15 grams of carbohydrate equals one carb choice. How do you know what 15 grams of carbs is? It's not always easy. First, set up an appointment with a dietitian, if you can. Also, most food labels list nutrition facts like carbs. There are also books, and online resources to help you figure it all out.

* Carbohydrate FAQ's
* Diabetes Exchange List

Exchange Meal Plan:

This plan divides food into six categories: starches, fruits, vegetables, milk, meat and fats. The serving sizes listed have similar amounts of calories, proteins, carbohydrates and fats. There is a food list to help you see what category your food falls into. It's called the exchange plan because it offers you the flexibility to trade one food on the list for a similar food. For example: exchanging 3/4 cup of cold cereal for a half of an English muffin. Exchange food lists are available from your dietitian. They can also be found in books, or online.

* The National Heart Lung and Blood Institute Food Exchange List

Counting Carbohydrates Food Plan:

Counting carbohydrates is a more flexible plan. It only keeps track of your carbs. Carbs affect blood glucose levels quickly. Insulin works with the carbs and breaks them down for energy. You adjust your dose according to the amount of carbs you are going to eat at that meal. The units of insulin per grams of carbs is figured out by your doctor or dietitian based on your body's response to carbs. This requires careful tracking and blood glucose testing to see how carbs affect your blood sugar.

Several websites provide free tools for tracking your daily intake.

* Weight Loss and Diet Journal
* Track Your Carbs

Constant Carbohydrate Food Plan:

This plan is the simplest to use and is the choice for many when they are first starting out. You only need to keep track of the carbohydrates in your diet. A dietitian or your doctor will help you establish how many carbs you should eat everyday. Usually insulin or other diabetes medication doses also remain constant. You keep the number of carb choices the same at each meal. Try to keep your daily eating and exercise routine the same.

* Why Should My Carb Intake Be Consistent?
* Exercising When You Have Diabetes

Summing It Up:

No matter which plan you use, remember to check blood glucose levels often and write down the numbers and also how many carbs you have eaten that day. Good record keeping will give you and your doctor an accurate picture of how effective your food plan and medication schedule are. And that helps you maintain good control and keep your numbers in a good range for you.

* Quick Facts for Eating and Diabetes
* Recommended Blood Glucose Levels for Diabetes
* How To Use A Glucometer

Sources:

Clark RD, LD, Amanda, Stephanie Kovarick, RD, LD, CDE, Melissa Voigt, BA, and Joy Hayes, MS, RD, LD, CDE. "Using the MyPyramid.gov Website as a Tool for Diabetes Self-Management Education." Diabetes Spectrum 2006 19:122-126. 11 Jan. 2006.

"Carbohydrates and Diabetes." The Cleveland Clinic Health Information Center. 18 Mar 2002. Cleveland Clinic. 11 Jan 2007.

"Meal Plans and Diabetes." Children's Hospital of Pittsburgh. Apr 2005. Kids Health. 11 Jan 2007.
Suggested Reading

* Home Cooking and Health
* Obesity and Nutrition
* Navigating the Buffet Line

When you're diagnosed with diabetes, everything you eat becomes important. If you have Type 1 diabetes, gaining good control means balancing what you eat with the correct amount of insulin to help use the glucose in your blood. A dietitian or certified diabetes educator (CDE) can help you figure out how much insulin you need.

If you have Type 2 diabetes, oral medications help you use the insulin you already produce more effectively, to keep blood glucose levels in a normal range. Both kinds of diabetes require a plan of food, exercise, weight control and medication.

Sometimes it's hard to know where to start. Here are some basics that may help you on your way.
What's a Healthy Weight?

Try to maintain a normal body weight. Many doctors use the Body Mass Index (BMI) as a guide for determining your ideal weight. Your BMI is calculated from your weight and height and puts more focus on body fat instead of just weight. The formula, for those who like math, is "body mass index = mass (in kilograms) divided by height (in meters) squared". For those of us who would rather live without math, many free BMI calculators are available online. The National Heart Lung and Blood Institute (NHLBI) has one that is easy to use.

* Calculate Your Body Mass Index
* What's a BMI?

A BMI of 20-25 is considered normal. 26-29.9 is overweight, 30-39.9 is obese and 40 or more, morbidly obese.
How Many Carbs Should I Eat?

The American Diabetes Association (ADA) recommends keeping your carbs at 55% to 65% of your daily intake. The American Association of Clinical Endocrinologists (AACE) advises between 55% to 60%. Both organizations state that even though carbs directly affect blood sugar, they are not the enemy. They contain many nutrients that your body needs. Carbs are what your body uses for energy by breaking down into glucose.

In diabetes, the body can't use the glucose for energy because it needs insulin to move the glucose to the cells. In type 1 diabetes, no insulin is produced by the body. That's why people with diabetes need to take insulin. If someone has type 2, they might produce their own insulin, but it isn't effective enough to move the glucose from the blood to the cells. Oral medications help their insulin work better.

* Carbohydrates and Diabetes FAQ's
* What is Type 1 Diabetes?
* What is Type 2 Diabetes?

According to the ADA, fat should make up 25% to 30% of your diet and protein intake should be approximately 11% to 18%. Less emphasis on fatty animal protein and more on lean types of protein such as egg whites, white meat chicken and turkey, and soy products help to keep cholesterol levels down.
What's the Deal with Fiber?

Fiber is an important part of eating for diabetes. Even though fiber is considered a carbohydrate it doesn't raise blood glucose levels, and increased fiber intake has been shown to actually decrease glucose levels in people with diabetes.

The recommended amount of fiber varies but all sources agree that 25 grams should be the minimum grams of fiber in a day. A large-scale analysis of medical research, published in the Journal of the American College of Nutrition recommends a range of 25 to 50 grams per day.

Many people don't eat enough fiber. Increasing your consumption of high-fiber foods like whole-grain breads, cereals and pastas, oats and other whole grains, brown rice, lentils and beans, fruits, vegetables and nuts can help you reach your goal. If you're increasing your fiber intake, remember to drink at least 8 glasses of water throughout the day, to help keep things moving.

* Fiber and Diabetes Health

What's the Glycemic Index?

The glycemic index rates carbs by how much they raise blood glucose. Carbs like candy, sugar, cake and cookies have a high glycemic index, while whole-grains have a lower glycemic index.
The glycemic index can help when trying to figure out which carbs are the best for you. Since all carbohydrates don't affect blood glucose levels the same way, knowing which carbs have a lower glycemic index can help you plan your meals more effectively.

You can get glycemic index charts from your dietician, from books, or free from on-line sources such as the University of Sydney, Australia sponsored website, "Home of the Glycemic Index". This site has a database that shows the glycemic index for many foods and offers information about using the glycemic index for rating your carbs.

Sources:

"NEJM Study Shows Fiber's Great Benefits in Type 2 Diabetes." Joslin Diabetes Center. May 2000. Joslin Diabetes Center. 7 Jan 2007.

"Carbohydrate and Fiber Recommendations for People With Diabetes." American Diabetes Association (ADA). 7 Jan 2007.