I am constantly reading and researching information to find interesting things to write about for you but I keep coming back to conversations that I have had with actual patients as a great resource. We can give you important advice, as well as accurate protocols as health professionals, but if you are living with diabetes, you may have concerns that we would never even think about. I want to share some thoughts and questions that were addressed during my week in the diabetes management setting.
- “I was in the hospital for knee surgery and I know that they documented on my chart that I have diabetes and a history of heart disease with multiple heart attacks. I am on 3 blood pressure pills, a blood thinner and on 2 diabetes pills at home. They continued to give me all the heart medications. They did tell me that I might be on insulin instead of diabetes pills during the hospital admission due to the fact that blood sugars can rise after stress from the surgery and I was fine with that. The first meal I had in the morning after my surgery was 3 pancakes with real butter and syrup, a large glass of orange juice, 2 strips of bacon and a side of fruit cocktail in gooey syrup. I demanded to see the dietitian who tried to explain that I never filled out a form for my menu and that was what made it up to my room. I just do not understand what they were thinking since my blood sugar was already elevated from the surgery. Then she started talking about exchanges and I did not understand. I know how to count carbohydrates not exchanges. I think there were 6-8 servings of carbohydrates and plenty of saturated fat on that tray. I know on a regular morning I have 3 servings of carbohydrates for breakfast. I finally got oatmeal, plain fruit and a boiled egg but I was starving by the time it came!”
I was so pleased with this patient’s response to what happened to him. He knew exactly what to do except wait “to be starving.” Unfortunately this scenario does occur frequently. Luckily he also knew not to accept the rapid acting insulin before he got the new tray (take within 15 minutes of the meal) and understood what that original meal could do to his blood sugars. He also realized that eating the saturated fat in the bacon was not the best choice for someone with heart disease. For the record, one exchange equals 15 grams which is a serving size of carbohydrate. The words are often used interchangeably.
- I have been hearing that some weight training or resistance training is helpful to diabetes, is that true?
Answer – A study in Diabetes Care showed that people who had type 2 diabetes who did weight training two times per week were able to have better control of their blood sugars. Increased strength means a better A1C. When adding a weight program to your routine you need to schedule days off with at least one day rest period of that body part to recover and restore your glycogen levels. Weight training can tear down muscle and the rest period gives it time to rebuild. Remember to always start under supervision so you do not get injuries and check with your physician before starting a weight program. Weight training can build muscle mass and increase your metabolic rate which will help you burn more calories. Consider keeping up your vitamin C levels from citrus, leafy greens or a supplement. Exercise can form free radicals which can account for part of the soreness after the session. Vitamin C decreases free radical damage and increases collagen formation. Collagen is a connective tissue that helps support bones and muscles. Get a partner to hold you accountable and then you can train together. Many insurance programs will now pay for gym memberships. Isolate the muscle group that you are working to prevent injury and get the most benefits.
- I know nuts can be a good snack but I know they are high in calories and fat? What should I choose if any?
Answer – Research has shown that adding a handful of unsalted dry almonds may help lower the blood sugars especially for after meal values. A handful of almonds are reasonable and even the skin of the almond has positive anti-oxidants. The fat is mono-unsaturated fat which is the healthy kind. A study on Metabolism in 2011 showed that 1 ounce prior to a heavy carbohydrate meal lowered blood sugars up to 30%. The nuts were eaten 30 minutes prior to the meal. Regular daily almond intake was also studied and results did show a lower A1C and less body mass. Eat plain or add to salads, fruit salad or meat loaf. Remember a serving of nuts is usually 6 nuts (45 calories) so portion size does matter!
These questions and concerns may not apply to you directly but you should always be consulting with your physician and searching for reliable answers to any of your specific ones. Knowledge today may help you tomorrow!
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.