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Glycemic Targets
Dr. Maisara Rahman shares the glycemic targets for type 1 and type 2 diabetes, how often you should check your blood sugar, and how with proper diet you can help to control your Type II Diabetes.
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Learn more about Maisara Rahman, MD
Maisara Rahman, MD
Maisara Rahman, MD graduated from the American University of the Caribbean School of Medicine. She completed her Family Medicine Residency Training at Riverside County Regional Medical Center and became the Chief Resident. She is board certified with the American Academy of Family Physicians and is president of the California Academy of Family Physicians for the San Bernardino-Riverside Chapter.Learn more about Maisara Rahman, MD
Transcription:
Melanie Cole (Host): If you have diabetes, glycemic targets are so important. And in this series on diabetes today, we’re talking with Dr. Maisara Rahman. She’s a Family Medicine Physician and a member of the medical staff at Temecula Valley Hospital. Dr. Rahman, what is glycemic control for adults with diabetes? What does that mean?
Maisara Rahman, MD (Guest): So, glycemic control just means that our patients have to have – we try to get out patients to goal in terms of their A1c and getting them to goal means that we are trying to prevent many of the complications of diabetes. So, normally, according to the ADA, they are recommending that the A1c is below 7, but if we can get our patients to below 6.5, that will prevent many of the diabetes complications down the line.
Host: When we get our blood checked, we hear the words A1c. What does that mean and why is it important that we know these numbers?
Dr. Rahman: So, it is very important for patients who have type 2 diabetes to know what their A1c number is. It is important because just controlling your A1c alone and getting to goal and different patients will have different goals in terms of A1c goal. So, there are patients who are healthy, and they don’t have too many other comorbid conditions like heart failure or coronary artery disease. Those patients we try to control their blood sugars better so their A1c we like to see below 7 or below 6.5 if we can get them there without causing low blood sugar events.
Host: So, people hear that you say we need to know our numbers, our A1c we need to know about glycemic index. Are there some barriers to self-monitored blood glucose? What do you want us to know Dr. Rahman about keeping track of blood sugar which is very important for people with diabetes.
Dr. Rahman: Yeah. I think it’s important for patients to do self-monitoring of their blood sugars at home. But there are some patients who have type 2 diabetes that are oral hypoglycemic agents, they are pretty well-controlled, they don’t need to check their blood sugars every day, but somebody who is more on an intensive kind of insulin regimen, who is taking both basal insulin and bolus insulin; those patients need to monitor their blood sugars more. And so we do recommend that they check their blood sugar fasting and before meals.
Host: And are the kits that they get at the pharmacy, are those accurate?
Dr. Rahman: Absolutely. Yeah. Most of the kits that are available at the pharmacies are pretty accurate.
Host: Tell us about the low glycemic index diet, because again, there’s that word glycemic and people are trying to figure out what that means as far as their blood sugar and then the food that they eat. What is a low glycemic index diet?
Dr. Rahman: So, the glycemic index, it measures how a carbohydrate containing food raises their blood sugar. So, the higher the carbohydrate – the glycemic index, that means the higher the blood sugar is going to be after that patient ingests that food. So, usually, you want patients to have low GI foods, low glycemic index foods, anything that has say wheat flour, oatmeal, sweet potato, corn, legumes, lentils, those are low glycemic index types of foods so the higher the glycemic index just think about the white starch. Anything that has like white bread or cake or maybe any kind of – anything that has just carbohydrates that’s more like white bread and all that stuff is going to be at a higher glycemic index. So, that means if a patient ingests say just a piece of white bread; their blood sugar if they check it after a while is going to be really high. But somebody who ingests say something like a non-starchy vegetable which is low glycemic index, their blood sugar isn’t going to be as elevated.
Host: So, it really sounds to me like you’re saying processed foods, white flour foods, what about things like potatoes or sweet potatoes, a white potato versus a sweet potato or legumes and beans. Are all of these things acceptable?
Dr. Rahman: So, legumes, sweet potato, corn, yams, beans are considered actually low glycemic index. They are less than 55 in terms of the scoring. Anything that has a glycemic index of 70 or more is considered high. Those foods include the Russet potato, rice cakes, crackers, white bagels, white bread, instant oatmeal, rice, pasta.
Host: How do we know? Is it written on the package Dr. Rahman? Do we know what the glycemic index of a food is? Is it on the label now or no?
Dr. Rahman: So, some foods do have the glycemic index on there, but the majority, all you can see is sugars and carbohydrates. You can always look it up online and see what the glycemic index of the foods that you are buying or eating and that would be I would suggest that for all patients who are diabetic and for all who are trying to lose weight as well.
Host: I think that’s a good idea. You can download something online, print it out, for the glycemic index of the foods while you are shopping so that you can take it with you while you are shopping in case that stuff isn’t on the labels. And maybe best to buy food without labels so give us your best advice about glycemic targets and why that’s important for diabetics.
Dr. Rahman: So, it’s important for our patients to monitor their blood sugars at home. Normally and of course every diabetic, you are going to see that they are going to have this discussion with their physician because every diabetic, their treatment plan has to be individualized in terms of their A1c target, their fasting blood sugars or their postprandial blood sugars which means this is a blood sugar after they eat. So, usually, we’d like to see our patients’ fasting blood sugars be between 80 and 130 fasting and after meals, our goal for our patients their blood sugar should be less than 180.
Host: That’s great advice. Thank you so much Dr. Rahman for joining us today. That wraps up this episode in our diabetes series of TVH Health Chat with Temecula Valley Hospital. Head on over to our website at www.temeculavalleyhospital.com for more information and to get connected with one of our providers. Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. If you found this podcast informative as I did, please share on your social media and be sure to check out all the other interesting podcasts in our library. I’m Melanie Cole.
Melanie Cole (Host): If you have diabetes, glycemic targets are so important. And in this series on diabetes today, we’re talking with Dr. Maisara Rahman. She’s a Family Medicine Physician and a member of the medical staff at Temecula Valley Hospital. Dr. Rahman, what is glycemic control for adults with diabetes? What does that mean?
Maisara Rahman, MD (Guest): So, glycemic control just means that our patients have to have – we try to get out patients to goal in terms of their A1c and getting them to goal means that we are trying to prevent many of the complications of diabetes. So, normally, according to the ADA, they are recommending that the A1c is below 7, but if we can get our patients to below 6.5, that will prevent many of the diabetes complications down the line.
Host: When we get our blood checked, we hear the words A1c. What does that mean and why is it important that we know these numbers?
Dr. Rahman: So, it is very important for patients who have type 2 diabetes to know what their A1c number is. It is important because just controlling your A1c alone and getting to goal and different patients will have different goals in terms of A1c goal. So, there are patients who are healthy, and they don’t have too many other comorbid conditions like heart failure or coronary artery disease. Those patients we try to control their blood sugars better so their A1c we like to see below 7 or below 6.5 if we can get them there without causing low blood sugar events.
Host: So, people hear that you say we need to know our numbers, our A1c we need to know about glycemic index. Are there some barriers to self-monitored blood glucose? What do you want us to know Dr. Rahman about keeping track of blood sugar which is very important for people with diabetes.
Dr. Rahman: Yeah. I think it’s important for patients to do self-monitoring of their blood sugars at home. But there are some patients who have type 2 diabetes that are oral hypoglycemic agents, they are pretty well-controlled, they don’t need to check their blood sugars every day, but somebody who is more on an intensive kind of insulin regimen, who is taking both basal insulin and bolus insulin; those patients need to monitor their blood sugars more. And so we do recommend that they check their blood sugar fasting and before meals.
Host: And are the kits that they get at the pharmacy, are those accurate?
Dr. Rahman: Absolutely. Yeah. Most of the kits that are available at the pharmacies are pretty accurate.
Host: Tell us about the low glycemic index diet, because again, there’s that word glycemic and people are trying to figure out what that means as far as their blood sugar and then the food that they eat. What is a low glycemic index diet?
Dr. Rahman: So, the glycemic index, it measures how a carbohydrate containing food raises their blood sugar. So, the higher the carbohydrate – the glycemic index, that means the higher the blood sugar is going to be after that patient ingests that food. So, usually, you want patients to have low GI foods, low glycemic index foods, anything that has say wheat flour, oatmeal, sweet potato, corn, legumes, lentils, those are low glycemic index types of foods so the higher the glycemic index just think about the white starch. Anything that has like white bread or cake or maybe any kind of – anything that has just carbohydrates that’s more like white bread and all that stuff is going to be at a higher glycemic index. So, that means if a patient ingests say just a piece of white bread; their blood sugar if they check it after a while is going to be really high. But somebody who ingests say something like a non-starchy vegetable which is low glycemic index, their blood sugar isn’t going to be as elevated.
Host: So, it really sounds to me like you’re saying processed foods, white flour foods, what about things like potatoes or sweet potatoes, a white potato versus a sweet potato or legumes and beans. Are all of these things acceptable?
Dr. Rahman: So, legumes, sweet potato, corn, yams, beans are considered actually low glycemic index. They are less than 55 in terms of the scoring. Anything that has a glycemic index of 70 or more is considered high. Those foods include the Russet potato, rice cakes, crackers, white bagels, white bread, instant oatmeal, rice, pasta.
Host: How do we know? Is it written on the package Dr. Rahman? Do we know what the glycemic index of a food is? Is it on the label now or no?
Dr. Rahman: So, some foods do have the glycemic index on there, but the majority, all you can see is sugars and carbohydrates. You can always look it up online and see what the glycemic index of the foods that you are buying or eating and that would be I would suggest that for all patients who are diabetic and for all who are trying to lose weight as well.
Host: I think that’s a good idea. You can download something online, print it out, for the glycemic index of the foods while you are shopping so that you can take it with you while you are shopping in case that stuff isn’t on the labels. And maybe best to buy food without labels so give us your best advice about glycemic targets and why that’s important for diabetics.
Dr. Rahman: So, it’s important for our patients to monitor their blood sugars at home. Normally and of course every diabetic, you are going to see that they are going to have this discussion with their physician because every diabetic, their treatment plan has to be individualized in terms of their A1c target, their fasting blood sugars or their postprandial blood sugars which means this is a blood sugar after they eat. So, usually, we’d like to see our patients’ fasting blood sugars be between 80 and 130 fasting and after meals, our goal for our patients their blood sugar should be less than 180.
Host: That’s great advice. Thank you so much Dr. Rahman for joining us today. That wraps up this episode in our diabetes series of TVH Health Chat with Temecula Valley Hospital. Head on over to our website at www.temeculavalleyhospital.com for more information and to get connected with one of our providers. Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. If you found this podcast informative as I did, please share on your social media and be sure to check out all the other interesting podcasts in our library. I’m Melanie Cole.