It is always interesting to hear questions from my patients concerning their diabetes care plans. Although many of these questions are quite specific and tackle their own needs, I still get general questions asked by plenty of people. I would like to share them with you.
- Why can’t my physician just give me a tear off sheet with a diabetic diet so I know exactly what to eat at each meal, everyday? Luckily, there is no such thing as the diabetic diet since you are allowed to eat what everyone else eats in moderation. The good news is that we should all be eating a healthful meal plan whether we have diabetes or not! Everyone should try to increase their fiber intake to 20-35 grams a day by including whole grains, fruits, vegetables and beans. Everyone should practice portion size control and use a smaller 9-inch plate or salad plate. We should all try to drink calorie free beverages to keep down our sugar intake as well as wasted calories (except for low fat, fat free milk or plain soy milk). Everyone should maintain a reduced amount of sodium in their meal plan and limit saturated fats. Finally, if factored into your daily food allowance you can include a sweet treat, now and again.
- It is my birthday next week and I already have anxiety and frustration. My spouse or significant other will give me attitude if I want to order a piece of chocolate cake with ice cream to celebrate. It just makes me feel worse and I want to cheat more. How should I handle this? As stated above, you can still enjoy your special treats certain times without feeling guilty. You need to explain to them that sugar is sugar and you could eat a piece of bread, a bowl of cereal, a potato or cake and ice cream and your body can’t tell the difference. They are still all carbohydrates and eventually become 100% sugar. If you watch the amounts and eat lean protein and vegetables as your main meal, you can celebrate in style. The sweets have no nutritional value but are fun to eat on occasion. Again, watch portion sizes. The ice cream may even keep the blood sugar from spiking quickly due to the fat content.
- Can I save my 9-12 servings of carbohydrates for dinner if I skip all my carbohydrates at breakfast and lunch? That way, I can enjoy my huge plate of pasta, the bread basket and a cannoli without feeling guilty when I am out to dinner. No! It does not work that way. To keep your blood sugar in reasonable range you need to eat your carbohydrates 2-4 servings per meal, whatever is recommended to you depending on your weight, blood sugars and medications. Skipping carbohydrates during the day will lead to low blood sugar and saving them for a later meal will make blood sugars climb sky high.
- I am still not clear on alcoholic beverages. Does it make my sugar go up or down? How much can I really drink? Can I save up all my drinks for the weekend? It is confusing but alcohol makes the blood sugar go down if you do not combine it with fruit juice, regular soda or sweet mixer (the liver stops producing sugar and is busy metabolizing the alcohol). 4 ounces of dry wine, a 12 ounce light beer or 1 ½ ounces of hard alcohol are considered a daily portion for all women and for men over 65. Men under 65 are allowed 2 servings a day. You can’t save up alcohol just as you can’t save up carbohydrates. You must always check with your physician regarding your other health conditions as well as medications before drinking alcohol. Use sparkling water with a lemon or lime on weekends to feel included after one alcoholic drink.
- I never sleep more than 4-6 hours a night. I have no time to myself during the day and I like to hang out and relax with no one around. Does this have an effect on my health or diabetes? Yes! Sleep is extremely important in over-all health and especially diabetes control. Increased cortisol, a hormone, is secreted and too much in our system causes insulin resistance; it can also cause weight gain, raise your blood sugar as well as blood pressure. Sleep deprivation can lower your immune system, which diabetes already does. Lack of sleep changes the way your body metabolizes carbohydrates and causes memory loss. Remember, your body recovers while you’re asleep so we must allow it that time. Universal recommendations still remain at 8 hours per night.
I hope these often asked questions helped you understand some more diabetes basics. Keep reading, keep learning and keep asking!
NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.