Diabetes and Nutrition

Free Assistance for those with Diabetes without insurance - Question of the Week
Here is the question of the week: "I am trying to find a class for our grandson. He is 19 and has a part-time job but no insurance. He just found out last week that he is a type 1 diabetes after losing a lot of weight and his blood sugar was 523. He is on insulin but needs to go to a class to manage is diabetes without going hungry. Where do we start? Any suggestions would help us a lot."

My first suggestion would be to ask the health professional who made the diagnosis. He/She may know of a free program/class that your grandson may be able to attend.

Another suggestion is to check with your area hospital. Many of the hospitals do host free diabetes clinics/classes. For example, I was able to find one that is held almost monthly at a medical center located in Southern New Jersey http://www.sjhs.com/inCalendar/CalendarEvent.aspx?selcontact=&page_id=1625&view=27&category=1,2,3,4&mode=U&order_by=&selcat=1,2,3,4&evt=880&date=2/24/2010&site_id=1&kwd=&selloc=. Try googling the terms free+diabetes+classes+your city or state's initials. You may be able find a local free diabetes clinic.

Yet another option is to utilize the internet for the information. Of course, make sure that the site you are going to use is reputable. Websites that utilize the extensions ".gov " and ".edu" are your best bets. If you are linking to sites through the web sites such as the American Diabetes Association or the American Association for Diabetes Educators, that information should be valid.

Finally, check with your public health department. You may find that they host a clinic in for people in your community. Other places to look - check for listings in your local community newspaper or your local YMCA or YMHA.

Newly Diagnosed with Diabetes - How many Carbs and how much sugar can I have?
The following question was posed: "I was diagnosed with type 2 diabetes last month. I'm having difficulty understanding how many carbs and sugar I can have each day. I'm finding that nearly everything contains carbs and sugar! Can you help me with this?"

The answer varies from person to person. It isn't necessarily important to know simply how much carb or sugar to eat in a day, but rather what types of carbohydrates and how those carbohydrates are distributed throughout the day.

My first recommendation is for you to attend a diabetes class and speak with your physician or a registered dietitian to learn the specific amount of carbohydrate you should be consuming daily. Information regarding diabetes classes can be found in my previous blog post. They will be able to help you determine the amount of carbs/sugar that works best for you based on individualized factors such as: your height/weight, lab values, type of medication you may be taking, weight goals, the amount of physical activity you partake in daily, et al. The Recommended Dietary Allowance (RDA) for carbohydrate has been set at 130 grams/day as a frame of reference, however please speak to your diagnosing practitioner/registered dietitian for an individualized plan.

Keep in mind that you should be distributing your carbohydrate intake evenly throughout the day instead of eating them all in large meals. Spreading it throughout the day in small meals will help you keep your blood sugar levels from spiking. Be sure to read your food labels!

Also, the carbohydrates that you are choosing should be of the complex nature and nutrient dense. Whole grains, whole fruits, whole vegetables, and low fat dairy are optimal. Best to eliminate any white foods (white breads, white pasta, anything with white sugar), white rice, and fruit juices as they will cause your blood sugar levels to spike. Cakes and cookies are considered "empty calorie" carbs and should be consumed minimally if not eliminated from your diet.

Fiber intake should be optimal at 25-35 grams daily. Choose foods high in fiber as it will help you delay sugar absorption and help you control your blood sugar levels. If you are not currently eating alot of fiber in your diet - increase your intake 3 - 5 grams/daily to avoid constipation and be sure to drink lots of water.

Portion control is another important factor when it comes to monitoring your carbohydrate intake (see my first blog post for some useful measuring tips). You can achieve optimal blood sugar levels by watching the size of your carbohydrate portions.