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Diabetes and Nutrition

AMBULATORY CARE:

Nutrition plans

help with healthy eating patterns that improve health. Nutrition plans and regular exercise help keep your blood sugar levels steady. They also help delay or prevent complications of diabetes, such as diabetic kidney disease.

Call your local emergency number (911 in the US) if:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat

Seek care immediately if:

  • You have a low blood sugar level and it does not improve with treatment. Symptoms are trouble thinking, a pounding heartbeat, and sweating.
  • Your blood sugar level is above 240 mg/dL and does not come down within 15 minutes of treatment.
  • You have ketones in your blood or urine.
  • You have nausea or are vomiting and cannot keep any food or liquid down.
  • You have blurred or double vision.
  • Your breath has a fruity, sweet smell, or your breathing is shallow.

Call your doctor or diabetes care team if:

  • Your blood sugar levels are higher than your target goals.
  • You often have low blood sugar levels.
  • You have trouble coping with diabetes, or you feel anxious or depressed.
  • You have questions or concerns about your condition or care.

A dietitian will help you create a nutrition plan

to meet your needs and your family's needs. The goal is for you to reach or maintain healthy weight, blood sugar, blood pressure, and lipid levels. You should meet with the dietitian at least 1 time each year. You will learn the following:

  • How food affects your blood sugar levels
  • How to create healthy eating habits
  • How to make food choices based on your activity level, weight, and glucose levels
  • How your favorite foods may fit into your plan
  • How to keep track of carbohydrates
  • Correct portion sizes for each food
  • Changes you can make to your plan if you get pregnant or are breastfeeding

What you can do before you meet with the dietitian:

  • Do not skip meals. The goal is to keep your blood sugar level steady. Blood sugar levels may drop too low if you have received insulin and do not eat.
  • Eat more high-fiber foods, such as fresh or frozen fruits and vegetables, whole-grain breads, and beans. Fiber helps control or lower blood sugar and cholesterol levels. Choose whole fruits instead of fruit juice as much as possible. Sugar may be added to juice, and fiber may be removed.

  • Choose heart-healthy fats. Foods high in heart-healthy fats include olive oil, nuts, avocados, and fatty fish, such as salmon and tuna. Foods high in unhealthy fats include red meat, full-fat dairy products, and soft margarine. Unhealthy fats can increase your risk for heart disease, increase bad cholesterol, and lower good cholesterol.
  • Choose complex carbohydrates. Foods with complex carbohydrates include brown rice, whole-grain breads and cereals, and cooked beans. Foods with simple carbohydrates include white bread, white rice, most cold cereals, and snack foods. Your plan will include the amount of carbohydrate to have at one time or in a day. Your blood sugar level can get too high if you eat too much carbohydrate at one time. Blood sugar levels do not spike as high or drop as quickly with complex carbohydrates as with simple carbohydrates. Choose complex carbohydrates whenever possible.
  • Have less sodium (salt). The risk for high blood pressure (BP) increases with high-sodium foods. Limit high-sodium foods, such as soy sauce, potato chips, and canned soup. Do not add salt to food you cook. Limit your use of table salt. Read labels to have no more than 2,300 milligrams of sodium in one day.

  • Limit artificial sweeteners. These may be found in food or drinks, such as diet soft drinks or other low-calorie beverages. Artificial sweeteners are low in calories. They may help you lower your overall calories and carbohydrates. It is important not to have more calories from other foods to make up for the calories saved. Artificial sweeteners do not have any nutrition. Eat whole foods and drink water as much as possible. Your plan may include beverages with artificial sweeteners for a short time. These can help you transition from high-sugar beverages to water.
  • Use the plate method for each meal. This method can help you eat the right amount of carbohydrates and keep your blood sugar levels under control.
    • Draw an imaginary line down the middle of a 9-inch dinner plate. On one side, draw another line to divide that section in half. Your plate will have one large section and 2 small sections.
    • Fill the largest section with non-starchy vegetables. These include broccoli, spinach, cucumbers, peppers, cauliflower, and tomatoes.
    • Add a starch to one of the small sections. Starches include pasta, rice, whole-grain bread, tortillas, corn, potatoes, and beans.
    • Add meat or another source of protein to the other small section. Examples include chicken or turkey without skin, fish, lean beef or pork, low-fat cheese, tofu, and eggs.
    • Add dairy products or fruit next to your plate if your meal plan allows. Examples of dairy include skim or 1% milk and low-fat yogurt. If you do not drink milk or eat dairy products, you may be able to add another serving of starchy food instead.
    • Have a low-calorie or calorie-free drink with your meal. Examples include water or unsweetened tea or coffee.
    Plate Method

Know the risks if you choose to drink alcohol:

Alcohol can cause hypoglycemia (low blood sugar level), especially if you use insulin. Alcohol can cause high blood sugar and BP levels, and weight gain if you drink too much. Women 21 years or older and men 65 years or older should limit alcohol to 1 drink a day. Men aged 21 to 64 years should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor. Hypoglycemia can happen hours after you drink alcohol. Check your blood sugar level for several hours after you drink alcohol. Have a source of fast-acting carbohydrates with you in case your level goes too low. You need immediate care if you have signs or symptoms of hypoglycemia, such as sweating, confusion, or fainting.

Maintain a healthy weight:

A healthy weight can help you control your diabetes. You can maintain a healthy weight with a nutrition plan and exercise. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight. Together you can set weight loss and maintenance goals.

Follow up with your diabetes team as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

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