Living with diabetes is a daily challenge, but tweaking these behaviours improves control over your blood sugar. Say goodbye to the behaviours derailing your quality of life, and wave hello to these tips to take charge of your diabetes.
Portion sizes
Surprise: We eat more than we should—even when we're focusing on healthy foods. (Yeah, you already knew that one.) For people controlling diabetes, portion sizes of carbohydrate foods determine how much medication they need or how their blood glucose responds. Try this rule of thumb for the carb portion of your plate—it should take up about a quarter of the typical, nine-inch dinner plate. Optimal servings of peas, potatoes, or whole wheat pasta is one cup per meal. Compare that to a usual Mexican restaurant plate, where high-carb foods cover the entire plate: rice, beans, tortillas, chips. Too much carbohydrate sabotages glucose control for diabetics.
Beverages
Why drink your calories? Drinks high in sugar and calories add up quicker than anything else. That giant fountain soda easily boasts over 500 calories, all from sugar, skyrocketing your glucose out of control. Sports drinks, fruit juices, smoothies, energy-boost drinks, sweet teas, and fancy coffee drinks contain significant amounts of simple carbohydrate (re: sugar). Even the healthy seeming stuff: Consider that 12 ounces of orange juice has 45 grams of carbohydrate—about the same as 12-ounce can of soda. Sure, the juice includes healthy vitamins, but the glucose load is the same as a cola. For those controlling diabetes, skip these sugary beverages and opt for water to rehydrate. Your blood glucose will thank you!
Skipping meals
Timing your meals throughout the day is key for controlling diabetes. Skipping a meal puts you at risk for hypoglycemia because your medications won't have carbohydrates to work with. Worse, we commonly overeat at the next meal when we miss one. Eating breakfast within 90 minutes of waking is ideal. Optimally, three meals per day, spaced 4-5 hours apart, will keep your blood glucose steady and constant. If your sleep pattern includes more than 10 hours of shut-eye, eat a snack with 15 to 30 grams of carbohydrate before retiring.
Highly processed carbs
While all carbohydrates affect blood glucose, some carbs (the complex kind) are the best choices. Why? Complex carbs such as whole grains, vegetables, and beans contain fibre—long molecular chains of carbohydrate that take longer to digest (or, in some cases are indigestible). Slowing down digestion will help prevent sharp spikes in blood glucose—something all of us should try to avoid, but especially people with diabetes. Simple carbs like those in refined flours and sugars are small, easily digested molecules. As the preferred quick energy for cells, these can cause rapid peaks and valleys in your blood sugar. For that reason, choose whole wheat pasta, beans, peas, sweet potatoes, brown rice, oats, fresh fruits and veggies.
Not enough veggies
Yeah, Mom was right: "Eat your vegetables!" Non-starchy vegetables like lettuce, broccoli, onions, peppers, spinach, and tomatoes are rich in vitamins (A, C and folate, especially), minerals (potassium, magnesium, phosphorous) and fibre! Yet, their carb content is fairly low. This makes them the optimal food group to load up on and enjoy. Make fajitas with bell peppers and onions, stir-fry broccoli, or mix up a cucumber-tomato chopped salads; these are delicious foundations for meals with a low-carb load. Try filling half of your plate with low-starch veggies.
Tricking out healthy foods
Oatmeal, smoothies, coffee, salads and sandwiches—straightforward healthy stuff, right? Sabotaging these seemingly good-for-you choices is easy when they're mixed with simple carbs. For example, adding fruit juice to smoothies pumps up the simple carb load in a hurry. Honey or syrup, and handfuls dried fruits easily triple the carb load of oatmeal. Jacking up your coffee with squirts of syrup, whole milk, whipped cream, and even crushed cookies turn it into a carb bomb! When counting carbohydrates for optimal glucose control, be sure to include all ingredients for accuracy.
Your snack is like a meal
Snacking can be good: You can take the edge off between meals and help steady blood sugar. But when your snacks drift upward to the size of a meal, weight gain and hyperglycemia is in the offing. The calories and carbohydrates of a snack should come in at less than a third of a healthy meal. Your general rule of thumb for diabetic snacks is to aim for 15 to 30 grams of total carbohydrate plus a protein source. Some examples: hummus and veggies, peanut butter and apple slices, almonds and dried cranberries.
Eating out too often
Fast food, drive-throughs, pizza delivery, chain restaurants: So tempting for a busy weeknight or when the cook isn't in the mood to slice and dice. Unfortunately, many favourite eats are loaded with more carbohydrate than a person with diabetes can handle. Searching the Internet for menus with nutritional analysis can help you choose the best meals for controlling carb intake. Aim for 45-60 grams of total carbohydrate per meal, or check with your registered dietitian for your individual carb goals. Other eating out tips include avoiding the bread basket or endless chip refills. If portions are too large, take half home for lunch tomorrow. Choose grilled, baked or broiled meats, rather than fried. Remember, when you cook at home, you have control over the ingredients, methods, and portion sizes.
Too much screen-time
When your face is glued to a screen, you're in suspended animation. Television, laptops, e-readers, phones, tablets and desktop computers suck time and rob your body of its need to be active. Exercise lowers blood glucose and provides health benefits to the heart, lungs, muscles and mind. The American Diabetes Association recommends 30 minutes of moderate intensity exercise for 5 days of the week, for a total of 150 minutes per week. Walking, biking, swimming, or aerobic activity are all options. Additionally, instead of sitting all day staring at a screen, the ADA suggests you break up your screen time at least once every hour. Stretch or do chair exercises at your work desk. Take a walk around the office at lunch. Park farther away from work. Wash your own car. Do your own housecleaning. Walk the dog. So many possibilities!
Avoiding all carbs
Extreme low-carb food plans aren't the answer. With so much attention given to very low-carb diets (think less than 50 grams per day), people with diabetes could go too low. Your body needs carbohydrate for energy, which is why nutritional advice recommends getting a minimum of 150 grams. Remember that your heart, other organs, muscles, and lungs all run on blood sugar. In fact, the brain uses glucose as a preferred fuel source. Also, switching to a very-low carb diet increases the risk of hypoglycemia—low blood sugar—especially if medications are a part of your care. Aim for a goal of moderate carbohydrate intake—not too low, not too high.
Medication mishaps
According to dietitian and certified diabetes educator Tamara Lutz, taking the wrong dosage of medications at the wrong time or skipping medications will wreak havoc on your blood glucose control. Both highs and lows occur with medication mistakes. Taking oral medications or insulin right after eating can result in hyperglycemia (high blood sugar) because the medication starts working long after the food raises your blood glucose. On the flip side, taking the medications too long before a meal may lead to low blood sugar. Lutz warns, "Skipping your medications completely causes high blood sugar as the body lacks adequate medication to work on your meal." Follow your prescription instructions carefully.
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