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Diabetes is a disease characterized by an inability to store and use glucose. Glucose is a simple sugar and is the main source of cellular energy in the body. There are different types of diabetes: type 1 diabetes, formerly referred to as juvenile-onset or insulin-dependent diabetes; type 2 diabetes, formerly referred to as adult-onset diabetes; gestational diabetes, which comes about during pregnancy; and pre-diabetes, in which blood sugar levels are higher than normal but are lower than those needed for a type 2 diabetes diagnosis. Pre-diabetes and type 2 diabetes are the most prevalent forms of the disease and are increasingly common in Westernized societies.
Diabetes should be managed with a combination of diet and regular exercise and, when necessary, medication. Each of these components plays a major role in a person’s overall health and well-being.
Type 1 diabetes—People with type 1 diabetes must take insulin every day in order to process the food they eat and use it for energy. You will work closely with your doctor to determine the right doses and timing for your insulin. The most important things to remember are:
Type 2 diabetes—People with type 2 diabetes may not need to take insulin to manage their disease, but often will take other medication to help control their blood sugar. Your main dietary goals are:
Gestational diabetes—Gestational diabetes increases the risk of other health problems during pregnancy as well as the mother's risk of developing type 2 diabetes after pregnancy. Pregnant women have the added responsibility of eating for two—what you eat and how well you control your blood sugar will impact the growth and development of your fetus. With this in mind, the most important goals for your diet are:
Pre-diabetes—Although this is not true diabetes, having pre-diabetes puts you at high risk for developing type 2 diabetes. The dietary goals for people with pre-diabetes are similar to those for people with type 2 diabetes:
If adults with diabetes choose to drink alcohol, they should be advised to do so in moderation (one drink per day or less for adult women and two drinks per day or less for adult men). Some people, such as those with high blood pressure, should in many cases avoid alcohol. But always follow your doctor's advice about how much alcohol you may drink if you have pre-diabetes or any other type of diabetes.
Carbohydrates are the sugars and starches found naturally in grains and cereals, fruits and fruit juices, dairy products, legumes, and in small quantities in vegetables. In addition, carbohydrates such as sucrose (table sugar) and fructose (usually as high fructose corn syrup) are commonly added to many processed foods. Diabetes is a disease that makes the body unable to process carbohydrates due to problems with the hormone insulin. In people with type 1 diabetes, the problem is a lack of insulin due to autoimmune destruction of the pancreatic cells that makes insulin, but in people with type 2 diabetes, the problem is the body’s cells’ decreasing sensitivity to insulin. This reduced insulin sensitivity, also called insulin resistance, is widely believed to be caused by cellular damage resulting from chronic low-level inflammation throughout the body. Adding to the problem, insulin resistance increases inflammatory activity in the body and so is part of a self-perpetuating cycle.
Multiple meal planning approaches and eating patterns can be effective for achieving blood sugar control. The meal planning approach or eating pattern should be selected based on the individual's personal and cultural preferences. For example, for people who manage their diabetes with medications, one important strategy is to match the amount of carbohydrates they eat at each meal or snack with their prescribed insulin or other medications to prevent their blood sugar levels from dropping too low (hypoglycemia). This is known as carbohydrate counting. Carbohydrate counters don’t necessarily have to restrict the amounts of starches, legumes, and fruits they eat, but they do need to be consistent about how much and when they eat them. If your health care provider recommends carbohydrate counting, they will guide you in how to analyze labels on processed foods, make the best choices when you eat out, and prepare healthy foods at home.
Having type 2 diabetes puts you at higher risk of developing cardiovascular disease, kidney disease, non-alcoholic fatty liver disease, and obesity. Because of the relationship between diabetes and these conditions, improving your overall health with smart diet and exercise choices is very important. Eating lots of fruits and vegetables, plenty of fiber-rich foods like whole grains and beans, and mono- and polyunsaturated fats like those in nuts, seeds, and fish can help you keep your blood pressure, cholesterol levels, and triglyceride levels down, reduce your risk of other chronic health problems, and improve your general health.
Most people with diabetes take medications to help control their blood sugar levels. Whether you are taking insulin several times a day or an oral glucose-lowering medication such as metformin, be sure to carefully follow the instructions your prescribing physician provides. Consult with your physician before changing your medications or making big changes in your diet or exercise routine.
Like everyone else, people with all types of diabetes need to exercise regularly. Exercise improves insulin sensitivity, helps control weight, reduces risks of cardiovascular and other chronic diseases, and increases your sense of well-being. Everyone needs to make an exercise plan that works for them, and everyone’s plan will be different, but the general recommendation for people with diabetes is a minimum of 150 minutes (2.5 hours) of moderate intensity exercise per week. A consultation with a fitness expert may be helpful as you develop an exercise plan that works for your age, ability, interest, and schedule. Exercise increases the rate at which glucose is metabolized to produce energy, and hypoglycemia (low blood sugar) can occur during or after exercise in people taking blood sugar-lowering drugs. If you use medications to manage your diabetes, check with your prescribing doctor before adding or changing an exercise routine.
Having diabetes can be overwhelming, especially at first. Enlisting the help of nutritionists or dieticians, nurses, doctors, and other healthcare professionals can help build your confidence as you learn to live with diabetes and become adept at the self-care strategies that ensure your best possible long-term health.
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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2016.