Transcription:Melanie Cole (Host): Diabetes is the seventh leading cause of death in the United States, and it’s estimated that 79 million Americans have diabetes. After hearing this diagnosis of diabetes or prediabetes, you might have several questions. Here to answer them today is Jessica Crandall. She is a registered dietitian and certified diabetes educator. Welcome to the show, Jessica. Let’s talk about blood sugar. Everybody hears this. It’s very confusing. They don’t understand what is a good normal blood sugar, what would indicate prediabetes or all-out diabetes. Tell us a little bit about blood sugar.
Jessica Crandall (Guest): When you’re looking at your blood sugar, you want to make sure that you’re checking -- in the morning, fasting is a great time to check, and your blood sugar should be between 70 to 120. If you’ve eaten a meal, then your blood sugar should be between 70 to 140 mg/dL two hours after a meal. If your blood sugar number is trending higher, that is an indication of diabetes or prediabetes, and that’s something we really want to get under control.
Melanie: Should we be checking our blood sugars on a regular basis or only if we’ve been told that we are prediabetic or diabetic?
Jessica: I strongly encourage my clients to check their blood sugars on a yearly basis with their physician if they’re not diagnosed with diabetes, but if they have the genetic tendency to have diabetes or if there is strong family history, then I encourage they might check a little bit more frequently, especially as we age. Because we know that as we age, we tend to develop diabetes a little bit more prevalent in the population of the elderly. Something that might be a little bit more concerning for you and that you might want to check more frequently as you get older. Once you become diagnosed with diabetes, it is encouraged that you check it several times throughout the day, and your doctor or dietitian or diabetes educator can give you guidelines on how frequently they want you to check.
Melanie: If you are diagnosed with prediabetes or diabetes, what are the most important foods to stay away from, and then what are the best foods that you really want to load up on?
Jessica: The nice thing about the diabetes diet is that it really can encompass any food. The one thing that you want to make sure of though is carbohydrates. If you’re consuming them in excess, that can cause your blood sugar to rise. It’s not that we have to restrict carbohydrates and cut them out completely, but we really want to make sure we’re getting adequate amounts and not excessive amounts. Once again, no restriction, but just the appropriate amount of carbohydrates. One of the best ways for us to focus on getting carbohydrates and in the right amount is by looking at our vegetables and making sure that half of our plate is full of vegetables and a quarter of our plate is full of protein, because neither one of those foods, vegetables and protein, cause an elevation in blood sugar significantly. Then the remainder of the quarter should be carbohydrates. Once again, half of your plate, vegetables; quarter of it, protein; and a quarter of it, fruit or carbohydrate sources.
Melanie: Carbohydrates. again, a confusing word for people because while rice and potatoes are carbohydrates, so are the vegetables that you mentioned, and so are the white flour, white sugar products that people see in a box on the shelf.
Jessica: Yes, you’re right.
Melanie: When you say that a quarter, let’s clear that up a little bit. When you say a good carbohydrate, obviously our vegetable’s half the plate. The proteins, good lean meats and fishes on quarter of the plate. When that other quarter of the plate, what are those carbohydrates you want us to be eating?
Jessica: The carbohydrates really encompass five different food groups. Those five different food groups are fruits, your grains, your starchy vegetables, your sweets, and then your dairy. Once again, we don’t encourage the sweets be consumed, but if they are consumed, do so in very small amounts. Those carbohydrates encompass five different food groups, and really making sure you know the appropriate range. If you’re looking at a food label, most women should be consuming no more than 30 to 45 grams of carbohydrates per meal and around 15 grams of carbohydrates for snacks. Males, on the other hand, are around 45 to 60 grams of carbs per meal and 15 grams of carbs per snack. Looking at that food label and trying to find out how many grams of carbohydrates you are consuming will be helpful.
Melanie: How does activity impact blood sugar? Because if someone is a diabetic and they are an exerciser, then that has an effect, an insulin-like effect. So explain how they should be sort of titrating their exercise with their blood sugar monitoring.
Jessica: Of course, it’s important to monitor your blood sugars before you’re active. One of the things that I encourage my clients to do is to be active on a daily basis. Because it kind of cleans out the stored form of glucose that’s actually in your cells, and it takes it away so that you have more room to put sugar that you’re consuming or carbohydrates you’re consuming in a stored form. Long story short, exercise helps us to keep our blood sugars in a healthy range. We want to make sure that we’re making sure we’re monitoring our blood sugars, because sometimes they can dip a little bit low if we’re being really intense with our exercise. But also, we want to make sure we encourage exercise so that we keep that blood sugar in a healthy range.
Melanie: What foods do you recommend if you’re an exerciser and you want to keep this nice, neat level of blood sugar going? We are 70 to 120 right in and around there. When you’re exercising and it’s going to bring those levels down a little bit, what do you recommend to bring it back up?
Jessica: A good balance of keeping your blood sugars stable is going to combine carbohydrates and protein and a fiber together. Think carbohydrate being that fruit, for example, with the protein and fiber such as nuts. If you have that combination, you’re going to get a better, slower release of carbohydrates, giving you more sustained energy as well as a better release of carbohydrates or sugar so that your body doesn’t have that spike in blood sugar or that drop. Really the combo of that carbohydrates, fiber, and protein before exercise or as a snack would be a great thing for you to be focusing on.
Melanie: What about weight? Obesity, we know, is a major risk factor for diabetes, but how does that impact blood sugars?
Jessica: As we gain weight, our body has to secrete more insulin to keep up with the carbohydrates we’re consuming. It’s more taxing on our bodies the more weight we gain. Really important that we maintain an ideal body weight or even lose a percentage of our body weight. Even up to seven percent can significantly help out with keeping those blood sugars, and that’ll help your blood sugar range.
Melanie: Can the progression of diabetes be prevented, Jessica?
Jessica: Absolutely. I think one of the great things about being a dietitian is focusing on diet and exercise to help encourage my clients to slow the progression to a halt of that diabetes progression, really preventing the disease state from getting worse, because it is a progressive disease. You can either be the driver or you can be in the back seat. So encouraging my clients to stay motivated to check their blood sugars, eat the right food, and be active are three critical elements in controlling their diabetes and the prevention of the disease progression.
Melanie: Now, tell us about the really bad stuff. If people are junk food junkies and they’re eating even something like McDonald’s or fast food. Which of these foods, if you had to pick a few foods, Jessica, would you say, “I need you to really stay away from those foods because those foods are going to really exacerbate your diabetes or take prediabetes and turn it into all-out diabetes.”
Jessica: I think any excessive sugar form is something we definitely want to stay away from, so that white sugar, things like honey, but liquid calories are probably the most prevalent thing that I see my clients consuming, as well as white, refined grains. Liquid calories come from sodas, juices, lattes that have a lot of extra sugar in them. Those are things that we really want to cut out of our diet just because they’re not contributing healthy calories or good carbohydrates. The other thing is though the white sugars or those white carbohydrates that are going to be like your white refined breads, white rice. The more fiber we have in our diet, the better. So avoiding those white grains is going to be a better way for us to control our blood sugars. If you were eating in a restaurant that had fast food, maybe taking off the bun or swapping it up for a healthier substitution.
Melanie: In just the last minute, kind of wrap it up for us about your best advice for diabetes, prediabetes, and the best foods, the way to keep track, in just about 30 or 40 seconds here.
Jessica: I think the best thing is making sure you’re doing it on a continuous basis. Find foods that you enjoy and that you can gravitate towards that you like, such as your lean proteins, a variety of vegetables, and incorporating fresh fruit as well on a continuous basis, breakfast, lunch, dinner, as well as snacks. Be active every single day. It will help to slow the disease as well as prevent the progression of the disease.
Melanie: That’s absolutely great information, and you’re listening to Eat Right Radio with our good friends from the Academy of Nutrition and Dietetics. For more information, you can go to eatright.org. That’s eatright.org. This is Melanie Cole. Thanks so much for listening and stay well.
