Saturday, March 26, 2011

Diabetes and milk

Question:  I have type 2 diabetes and cannot tolerate milk.  What may I substitute for my recommended two milk servings per day?  Would I substitute a carbohydrate or a protein?

Answer:  If you cannot tolerate milk due to lactose-intolerance, consider lactaid milk as a substitute or try using lactase enzyme supplements to help you tolerate foods with lactose better.  Some people who are lactose-intolerant with milk may still tolerate other dairy products such as yogurt - 6-8 oz. yogurt could subsitute for a serving of milk since it has similar carb and protein content and also provides you with a large amount of your daily calcium needs.  Soymilk would also be a good substitute for regular milk as it has a similar amount of carb and protein, and often can be found with calcium added. 

 If you do not tolerate any milk products due to severe intolerance, milk allergy, or choose not to consume dairy for moral or religious reasons, substitute your milk servings with soy milk or another form of healthy carbohydrate (healthy starches, fruit, or beans).   Look for foods that have ~15g carb (1 carb choice or 1 bread/starch/fruit serving) and ~7g protein.  Since dairy products continue to be the best bioavailable source of calcium and vitamin D in the diet, it is also very important in this case to make sure you are getting adequate calcium from other sources in your diet and/or from supplements. 

Wednesday, March 9, 2011

diabetes and vegetables

Questions:  I have a very big issue when it comes to having diabetes and that is I do not eat vegetables.  I have tried.  I want control my diabetes and be around to raise my young children.  What suggestions do you have to add vegetables to my diet?

Answer:  While it is not an absolute necessity to eat tons of vegetables if you have diabetes, I'm sure all health professionals (including myself) would highly encourage it.  Vegetables are low in calories and  provide us with many disease-fighting antioxidants and phytochemicals, as well as a good dose of fiber which is good for cholesterol and blood sugar levels.  Non-starchy vegetables can also act as a free filler at meals and snacks to help fill you up without adding many extra calories or carbs.

 Usually when I show people who claim to not like a vegetables a list of non-starchy veggies, they can usually pick out at least a few that they are willing to eat.  I like to keep bagged salad mixes and precut/prewashed veggies like carrots, celery, tomatoes, broccoli and cauliflower on hand to add quick salads to lunch and/or dinner.  Maybe consider adding extra veggies into things like pastas, stews, soups, or sandwiches to "hide" the flavor of the veggies with other ingredients. If it's been a while since you've tried certain veggies, consider retrying them as our tastes do change as we get older.

 If you are absolutely opposed to all veggies you can still get some of their nutritional value, antioxidants, and phytochemicals out of vegetable or fruit/vegetable juice combinations and possibly out of dietary supplements.

Thursday, March 3, 2011

What does the A1C test mean?

Question:  I was recently told by my doctor I have pre-diabetes and that I need to lose weight, eat right, and get my sugar levels down.  On a 12 hour fast, my glucose level was 73 yet my A1C was 6.1%.  If my glucose is low, why is my A1c still high?  What can I do?

Answer:  The A1C test is an average of blood sugar control over the past 90 days.  It is measured in a percentage which correlates with an estimated average glucose level.  For example,  a person with an A1C of 6.0% has had an estimated average glucose of 126 mg/dL over the past 90 days.  Some people may have a lower blood sugar when they wake up, but may experience spikes in their blood sugars throughout the day due to food intake, stress, meds, etc, resulting in an elevated average.  The fact that your fasting blood glucose is low is a good sign.   Usually post-prandial, or after-meal, numbers are the first numbers to rise when diabetes is starting to develop.  This is likely where you are at and this is a perfect time to make lifestyle changes to prevent the further progression of diabetes.  Research has shown that weight loss, exercise, and healthy eating habits can decrease the risk of diabetes progression up to 58%.