Whether you are being treated with insulin or pills, understanding how to eat properly is important for keeping your blood glucose in good control.

Helpful Clues to Eating Right

· Try to find healthy foods that you enjoy eating. You are an individual
and your meal plan should fit your lifestyle.

· Eat your meals at about the same time every day- do not skip meals.

· Eating about the same amount of food at the same meal and at
snack-times can help you to avoid short-term problems such as a
low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia).

· Your meal choices should not be very different from those eaten
by other family members. Everyone should be concerned about eating
a healthy diet that includes a greater variety of fresh fruits and vegetables,
foods high in fiber, less animal type fats (saturated fats) and limiting foods
with added sugar.

· Achieving and maintaining a healthy weight should be a primary goal.
Even a 10% weight loss in overweight patients has been shown to make
a big difference in controlling blood glucose levels.

What should be stressed:
· There is no single diabetic diet for improving glucose control for all
patients with diabetes
· Eating properly may also delay or prevent complications associated
with diabetes such as kidney disease, high blood pressure, and heart disease.

Do patients with type 1 diabetes have special food needs?

If you have type 1 diabetes, your meal plan should help you keep your blood glucose as close to normal as is safely possible. Eat your meals when your insulin is working the hardest. Test your blood glucose levels and write them down so you can match the dose of insulin you are taking with your carbohydrate intake and physical activity. Your health care provider will provide you with instructions on how to adjust your insulin.

Guide to good control:
· Know how to adjust your food intake (meals and snacks) and your insulin dose when you exercise.
· You should know how to treat and avoid a low blood sugar.
· Know what may be causing a high blood sugar
· Understand how to eat when you're ill, can't eat normally
("sick- days") and when you should contact your doctor.

Children and teens with type 1 diabetes need a special meal plan that provides them with enough calories and other nutrients for normal growth and development. The increasing number of children and teens who have obesity-related type 2 diabetes should be on a weight-reducing diet, but this diet needs to be adequate in calories, protein, vitamins, and minerals for their special needs.

If you are planning to get pregnant, it is vital that you speak with your doctor prior to becoming pregnant to develop a meal plan that will keep your blood sugar under stricter control during the critical and early period of the pregnancy.

Does the patient with type 2 diabetes have special concerns?

If you have been told that you have type 2 diabetes, your health goals should be:
· normal levels of blood cholesterol, HDL (good cholesterol), LDL (bad cholesterol), and triglycerides (fats)
· a normal blood pressure
· weight loss and exercise
· Exercise such as walking 30 minutes per day for a minimum of 4 days per week can make a major difference in controlling type 2 diabetes. Eating right and exercising will help make your medications work better.
· Focus on reducing the fats in your diet. Limit or avoid fried foods. If you are having difficulty in losing weight, it may not be what you are eating. Eat less!. Losing 10 -20 pounds can improve both your blood glucose and blood pressure.

What is a nutritious diet for someone with diabetes?

NUTRITION refers to getting NUTRIENTS such as protein, carbohydrates, fats, vitamins and minerals- from your food to keep you healthy. Carbohydrates, protein and fats provide your body with energy needed for your basic needs.

The amount of each that you need varies, but in general a diabetic diet will include:
· 10- 20 % of total calories from protein. Sources of protein include: fish, lean meats, poultry, eggs, low fat dairy products, beans, grains, ands vegetables.

· Less than 30% fat. Americans eat too much and the wrong type of fat. Patients with diabetes are at increased risk for heart disease - more reason to change the amount and types of fat eaten. Less than 10% of the fat should come from SATURATED FATS found in whole milk, butter, high fat meats, high fat cheese, etc. This type of fat has been associated with raising cholesterol and increased risk for heart disease. The primary sources of fat in your diet should come from monounsaturated fats such as plant oils like olive or canola oil, and polyunsaturated fats found in fish and other seafood.

· Most of the calories should come from COMPLEX CARBOHYDRATES. Carbohydrates are found in fruits, vegetables, dairy products, and starchy foods such as breads, beans, rice, and pasta. Try to limit foods with added sugars such as candies, cakes, pastries, and sugar sweetened beverages. They can lead to rapid increases in blood sugar levels.

· Fiber. Foods containing fiber include: vegetables, fresh fruits, whole grains, and brown rice. Fiber may help to regulate your blood glucose levels.

· Sodium. Limit your foods high in sodium. It has been shown that even if you do not have high blood pressure, people who have diabetes tend to be more sensitive to a high salt diet. Foods high in sodium include: processed foods, hot dogs, bologna, salami, frozen prepared meals, regular canned foods, soy sauce, and seasoning salts.

· Supplements, herbs, vitamins. Keep your doctor informed about any vitamins, herbs or supplements you may be taking without your doctor's knowledge. Make certain that what you are taking does not interfere with your prescribed medications.

Can people who have diabetes eat sugar?

Sugar is one type of CARBOHYDRATE. For about 100 years, people with diabetes were told to avoid sugar. It was thought that table sugar would raise your blood glucose levels more rapidly that any other carbohydrate. The American Diabetes Association (ADA) provides us with basic nutrition guidelines. In 1994, ADA lifted the ban on sugar from its dietary guidelines. This change was based on scientific studies showing that carbohydrate in the form of sugar does not raise blood glucose levels more rapidly than other types of carbohydrate containing foods.

However, there are still good reasons why sugar is not considered to be a smart food choice. Sugary foods are often considered to be "EMPTY" calories. They provide few vitamins and minerals. Your dietitian can help you work sugar into your diet, but these foods should not be used to replace the healthier food choices. There is no reason to avoid foods that contain sugar. What is more important is the amount that you are taking and knowing how it may affect your blood glucose. Testing your blood glucose before and after eating will help you to determine this information. The glucose value two hours after the first bite of food is called a "post-prandial glucose" and is helpful in evaluating your treatment plan.

If you feel you need assistance in learning how to eat properly speak with your doctor or health care provider. You should look for a person who is properly trained and who has specialized knowledge of diabetes. She or he will usually be a Registered Dietitian, preferably one who is a Certified Diabetes Educator. A Certified Diabetes Educator (CDE) must pass a national credentialing examination and can be identified by the initials following their names (RD, CDE). If you wish to find a Certified Diabetes Educator in your area, you can contact the American Association of Diabetes Educators (AADE) at: 1-800- 338-3633 or www.aadenet.org