Dietitians Dish: Living with diabetes
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By Elizabeth Sommerfeld November is National Diabetes Month. The American Diabetes Association indicates that 25.8 million, or 8.3 percent of adults and children in the United States, have diabetes. Another 79 million people are considered to have prediabetes.
These numbers are defined by elevated fasting glucose tests (blood sugars first thing in the morning before eating) and Hemoglobin A1C (measures the average of blood sugar levels over three months). Diabetes can be diagnosed in several forms, such as prediabetes, Type 1, Type 2 or gestational.
In all forms of diabetes, diet is a huge factor in controlling blood sugar levels. Prediabetes can be "reversed" with diet, exercise and weight loss, but if no changes occur, it will progress to Type 2 diabetes.
Type 1 diabetes is caused by the pancreas no longer being able to produce insulin, and therefore, the person must be on insulin for the rest of their lives.
Type 2 diabetes can be controlled with diet, exercise and medication. Type 2 diabetes is a progressive disease, and the longer people have the disease, the more measures must be taken to control blood sugar levels.
Gestational diabetes occurs when a woman is pregnant and has elevated blood sugar levels. This type of diabetes typically resolves after the baby is delivered. However, gestational diabetes can put both the mother and baby at higher risk of developing diabetes later in life.
The biggest diet focus for diabetics is carbohydrates because they completely break down to sugar. Carbohydrates include fruits, milk products, starchy vegetables and starches. One serving of carbohydrates has 15 grams of carbohydrates.
A serving size of fruit is typically around one-half of a cup of canned fruit (in their own juice or sweetener, avoid syrup) or a fresh fruit about the size of a baseball.
A serving of milk is eight fluid ounces or six ounces of yogurt. Starchy vegetables include potatoes, peas, corn, and beans, and the average serving size is one half of a cup.
For starches, including grains, cereals, breads and pastas, one serving is typically one-third to three -fourths of a cup. Examples of serving sizes of starches include one-third of a cup of rice and pasta, one-half of a cup of cooked cereals or one ounce of bread.
Protein does not have a large effect on blood sugar levels, but people with diabetes are at higher risk for heart disease and stroke, so extra precaution should be taken to avoid fried and high fat meats (look for the words "round" or "loin," which indicate lean protein sources).
Fat also does not have much effect on blood sugar levels, but because of the increased heart disease risk, the lower fat options should be pursued. So avoid frying foods, added oils or butter and choose lower fat options, such as fat free or 1 percent milk products.
While there is no cure for diabetes, there are many ways you can improve your diabetes control. There has been some research which has shown an improvement in diabetes for people following a vegetarian or vegan diet.
Also, there has also been a significant amount of research on the improvement of diabetes after bariatric surgery. In most cases patients are able to decrease their medications and in some cases completely stop taking diabetes medications.
Research is showing that result is caused by a change in hormones, which improve insulin sensitivity and secretion.
There are many resources in our community for diabetes education. I encourage you to reach out to the local hospitals and find out when their next diabetes class is offered.
Most of these classes will include a registered dietitian and a nurse - one or both may even be a certified diabetes educator.
Also, from 8 a.m. to noon on Nov. 17 there will be a Stop Diabetes Day at the Pine Street Community center where local diabetes experts will provide advice and education free of charge.
Elizabeth Sommerfeld is the clinical nutrition manager/bariatric coordinator at DeTar Healthcare Systems. She is a registered and licensed dietitian and has a master of science degree. Send questions or comments to firstname.lastname@example.org.