Given the statistic, reported by the American Diabetes Association (ADA), currently 9.3 percent of the population has diabetes, and 37 percent of adults over 20 years old have prediabetes, you very likely fall into one of those categories right now.
Diabetes mellitus is defined by the ADA as “a condition characterized by hyperglycemia resulting from the body’s inability to use blood glucose for energy. In Type 1 diabetes, the pancreas no longer makes insulin and therefore blood glucose cannot enter the cells to be used for energy. In Type 2 diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly.”
For individuals with Type 1 diabetes, medication is critical for life since the pancreas does not make insulin; diet plays a big factor and blood glucose levels must be closely monitored. For individuals with Type 2 diabetes, prediabetes, and insulin resistance, diet and activity level are the biggest factors.
Diabetes, and complications from diabetes, is the seventh largest cause of death in Americans. Complications of diabetes include heart disease, stroke, kidney failure, eye disorders and blindness, nerve damage, and amputation.
To help you understand this disease, let’s discover what is happening in your body, and why the foods you eat make such a big difference. Your cells use glucose for fuel. So, no matter what you eat, it has to be turned into glucose before your cells can use it; that takes place in your intestines. Insulin is produced by the pancreas and serves several purposes. When you cells need fuel, it is insulin that takes the glucose through the cell walls. That very action should lower blood glucose levels. However, if there is more glucose in the blood than your cells can use, the liver converts it to triglycerides to be stored as fat. Insulin is required for fat storage, too. When blood glucose levels are too high for the insulin to bring down to normal, the condition is known as hyperglycemia.
When insulin levels remain high due to excess blood glucose and triglycerides, the cells can begin to ignore the insulin’s attempts to deliver glucose; this is known as insulin resistance. Insulin resistance causes problems when cells actually need fuel because it takes more insulin than normal to deliver the glucose. The pancreas ends up working extra hard to keep up. Plus, all the extra insulin insures that fat will stay stored in your cells instead of being burned for fuel. That is why someone with insulin resistance can exercise intensely only to feel exhausted and no fat is lost. Hence, if your blood glucose, triglycerides, or insulin levels stay too high, fat will not be burned.
In the absence of diabetes and insulin resistance, when blood sugar/glucose levels fall too low, the pancreas releases an amino acid peptide called glucagon that releases fat stored in your body. It is converted into glucose by the liver for your cells to use as fuel. Of course, insulin will then be required to take the glucose into the cells. When the pancreas does not release enough glucagon to raise blood glucose levels to normal, the condition is called hypoglycemia. So you can see that the pancreas is very important to cell function and your overall health.
Now let’s look at how what you eat affects how well your body maintains the proper blood glucose level. Protein is used by your body to build and maintain muscles; it does not affect blood glucose levels. Fats, both animal and vegetable, are broken down in the intestines and are used for a variety of functions in the body. Glucose converted from fat is the normal choice for fueling the body, but carbohydrates are converted to glucose faster than fats. Fruits and vegetables are sources of carbohydrates. The fiber in them causes the glucose to be released slowly, minimizing blood sugar spikes.
Refined sugars like table sugar, fruit juice, corn syrup (especially high fructose corn syrup), and other sweeteners cause blood sugar levels to spike because they need very little processing in the body before they enter the blood stream. The same goes for refined grains (pretty much any form of bread, pasta or pastry) and vegetables with very little fiber (like white potatoes). Even when wheat and other grains are ground with the fibrous outer husk included (called whole grain flour), it is processed too much for the fiber to be effective in slowing the rise of glucose in the blood.
Artificial sweeteners may not raise your blood sugar level, but they raise your insulin level, worsen insulin resistance, and intensify cravings.
And let’s not forget alcohol. The process for your body to completely deal with alcohol is complicated, but always results in raising triglyceride levels; especially in the case of beer. Sorry.
If your head is swimming with all this talk about fats, proteins, fiber and carbohydrates, stay with me; I’m going to make it simple to understand here in a little bit. We have a few more things to cover.
Since nearly 28 percent of people with full blown diabetes don’t even know they have it, and only 11 percent of people who have prediabetes are informed by their physicians that their blood sugar is too high, you need to know what your blood glucose level is and what is healthy.
If you get an annual physical from your doctor, a basic blood panel is usually done that will indicate your blood glucose level. The most accurate blood test is done after you have fasted for 8-12 hours; this is your fasting blood glucose level. You can check your blood glucose level yourself with a personal blood glucose test meter that you can buy at any pharmacy. They are inexpensive to buy and can give you an accurate picture of what affects your levels.
To track your blood sugar, there are two times that you test it. First thing in the morning upon waking (that’s the fasting glucose level), and two hours after you have eaten a meal (called the oral glucose tolerance test).
The ADA has set these guidelines for blood glucose levels:
| FASTING PLASMA GLUCOSE |
RANGE |
| Diabetes | 126 + mg/dl |
| Prediabetes | 100-125 mg/dl |
| Normal | < 100 mg/dl |
| ORAL GLUCOSE TOLERANCE TEST | RANGE |
| Diabetes | 200 + mg/dl |
| Prediabetes | 140-199 mg/dl |
| Normal | < 140 mg/dl |
A few years ago, the ADA’s guidelines set these levels higher, but due to the increase in cases of Type 2 diabetes (especially among children), they have lowered them to what they are currently. In all honesty, these levels are still a bit high, based on studies that show an increased risk of developing diabetes or complications of diabetes with blood glucose levels lower than the ADA’s guidelines.
For a truly healthy standard of fasting blood glucose level, use this guideline suggested by Dr. John Douillard:
| FASTING PLASMA GLUCOSE | RANGE |
| Diabetes | 126 + mg/dl |
| Prediabetes | 110-125 mg/dl |
| Early prediabetes | 100-110 mg/dl |
| Increased risk | 90-100 mg/dl |
| Best range | 80-85 mg/dl |
| Too low | < 70 mg/dl |
The best place to start managing your blood glucose levels is your diet. If you are being treated for diabetes or other blood sugar problem, always talk with your doctor about changes you are making not only with food, but exercise as well. Keep blood sugar levels monitored and let your doctor adjust your medications. Other conditions such as high cholesterol and high blood pressure may improve as your blood glucose levels improve. Below are some suggestions for where to begin modifying your diet.
Begin eating more whole fruits and vegetables, cooked or raw, whichever you prefer.
Limit portions of meat to 6 ounces or less per meal but do not avoid the fat that comes with it.
Avoid low fat or no fat dairy. The protein in meat and dairy should not be separated from the naturally occurring fat it has.
Avoid fast food. They contain too much fat and hidden sugars, and are highly processed.
Limit processed grains and sugars. Avoid as much as possible.
Eat each meal with a balance of protein (meat or eggs if you are not vegetarian), 2 servings of vegetables, and you may have one serving of a starch (white potatoes, rice, etc.) if you blood sugar is normal.
One serving of whole fruit a day is fine if your blood sugar is normal; berries are the best choice. Too much fruit raises uric acid, which can raise fasting blood sugar levels.
Read labels to be aware of hidden sugars in condiments, jellies, jams, and salad dressings.
Often, by making changes to your daily diet, a limited amount of sweets and processed foods will be well tolerated, with blood sugar levels staying in the acceptable range. Bring your blood glucose levels to normal first, then experiment with your favorite treats. This is when having your own blood glucose meter is very beneficial.
Some supplements that have proven to help normalize blood sugars include magnesium, ALA, vitamin C, vitamin D3, iodine from sea vegetables, GLA, fenugreek, and ginseng.
Increasing your activity level has also been shown to effectively reduce blood glucose levels. Simply put, exercise will cause your cells to use more glucose, thereby reducing the current level.
It is also important to get a good night’s sleep every night. Eight hours of uninterrupted sleep between 10pm and 6am is ideal.
Gestational diabetes can be effectively managed with the same guidelines as for Type 1 and Type 2 diabetes. Please make sure you are in close contact with your doctor before making any changes to your diet and activity level.
Finally, I want to briefly mention that for exceptionally difficult to manage diabetes, additional considerations of the glycemic index of foods, as well as their glycemic load may help in managing blood glucose levels. These two ratings are different but related. Glycemic index is a rating based on the quality of carbohydrate in the food (as in whether it is a simple carbohydrate or complex). Glycemic load is a rating that factors in how much of the food is consumed, as well as the glycemic rating. For example, a carrot has a high glycemic index of 92, but only has 6 carbohydrates so the glycemic load is 5.52, which is low, making it a safer choice than a baked potato which a high glycemic load of 26.
As we head into the holiday season, help stabilize your blood sugar levels by making sure breakfast has plenty of protein, you drink adequate amounts of water throughout the day, get a sufficient amount of sleep, and if you are going to indulge in a sugary treat, save it for after the meal.
References
Common Terms. (2014, April 07). Retrieved from American Diabetes Association: http://www.diabetes.org/diabetes-basics/common-terms/
Diagnosing Diabetes and Learning About Prediabetes. (2014, December 09). Retrieved from American Diabetes Association: http://www.diabetes.org/are-you-at-risk/prediabetes/?loc%20atrisk-slabnav
Douillard, D. J. (2012, February 16). Healthy Blood Sugar Part 1: Is Your “Healthy” Diet Really Healthy? Retrieved from LifeSpa: http://lifespa.com/healthy-blood-sugar-part-1-is-your-healthy-diet-really-healthy/
Douillard, D. J. (2012, March 01). Healthy Blood Sugar Part 2: Home Screening. Retrieved from LifeSpa: http://lifespa.com/healthy-blood-sugar-part-2-home-screening/
Douillard, D. J. (2015, August 11). 10 Experiments to Solve Your Blood Sugar Mystery. Retrieved from LifeSpa: http://lifespa.com/10-experiments-to-solve-your-blood-sugar-mystery/
Douillard, D. J. (2015, November 19). Why Your Uric Acid Levels Matter. Retrieved from LifeSpa: http://lifespa.com/why-your-uric-acid-levels-matter/
Fast Fact Data and Statistics About Diabetes. (2015, December). Retrieved from Diabetes.org: http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/Documents/Fast_Facts_12-2015a.pdf
Glycemic Index Chart. (n.d.). Retrieved from Glycemic Edge: http://www.glycemicedge.com/glycemic-index-chart/
Sircus, D. (2012, November 27). Diabetic Epidemic Rising Dramatically. Retrieved from Dr. Sircus: http://drsircus.com/medicine/diabetes/diabetic-epidemic-rising-dramatically
Sircus, D. (2015, July 21). How To Treat and Prevent Diabetes. Retrieved from Dr. Sircus: http://drsircus.com/medicine/diabetes/how-to-treat-and-prevent-diabetes-2
Triglycerides. (2015, October). Retrieved from Cleveland Clinic: http://my.clevelandclinic.org/services/heart/prevention/risk-factors/cholesterol/triglycerides
Virgin, J. (2014). Sugar Impact Diet. New York: Hachette Book Group.
