Eating Guidelines for Diabetes

General Goals
The major nutrition goals for diabetes are to control blood glucose, blood cholesterol and blood pressure. This can help prevent the long-term complications associated with diabetes.

Carbohydrates
Carbohydrates includes sugar and starch. Since both have a similar effect on blood glucose levels, foods containing sugar can be used occasionally without affecting blood glucose control. The total amount of carbohydrate eaten at a meal directly affects the rise in blood glucose after the meal.
· Eat high fiber foods like whole grain breads and cereals, dried beans and peas, vegetables and fruits
· Eat about the same amount of carbohydrate at meals from day to day unless you adjust your insulin before each meal
· Substitute foods containing sugar for equal amounts of other carbohydrate-containing foods at the meal
· Check your blood glucose 1 hour after a meal to observe the effect of types and amounts of foods.

Sweeteners
· Sweeteners made from aspartame, saccharin, acesulfame-K, and sucralose have been determined to be safe for use in people with diabetes and during pregnancy. These sweeteners do not affect blood glucose levels.
· Sugar alcohols like sorbitol and mannitol have less effect on blood glucose than sugar, but may need to be limited due to their laxative effects.

Protein
Protein has little effect on blood glucose levels.
· Protein does not need to be restricted unless kidney disease is present; however, large amounts may contribute to the development of kidney disease.
· Protein is not necessary to include in snacks; it provides extra calories and does not prevent hypoglycemia to a greater extent than a carbohydrate snack.

Fat
People with diabetes have 2-4 times the risk of heart disease. Although fat does not raise blood glucose levels, it affects the risk of heart disease.
· Reduce your LDL cholesterol by eating less saturated fat and cholesterol like meats, meat fats and regular dairy products. Choose non-fat and reduced fat products.
· Eat fewer foods that contain trans fats like stick margarine, fried fast foods, commercially prepared bakery goods, crackers, and snack foods. Choose soft or liquid margarine or oil in place of stick margarine.
· Eat 2-3 servings of fish per week due to the protective effect against heart disease.
· Choose more monounsaturated fats like olive oil, canola oil, olives, avocado, and nuts in place of saturated fats.
· Eat less total fat to improve blood cholesterol and assist with weight loss. Choose more whole grains, vegetables and fruits. Prepare foods with minimal or no fat.

Weight Loss
A small amount of weight loss is very beneficial in type 2 diabetes. It can improve insulin resistance, lower blood glucose, improve cholesterol, and reduce blood pressure.
· People are more likely to lose weight and maintain the weight loss with a structured weight loss program that includes education, regular exercise, less fat and calories, and frequent contact or follow-up.
· The safety of high protein, low carbohydrate diets is unknown and maintenance of long-term weight loss has not been shown.

Vitamins and Minerals
There is no clear benefit from vitamin and mineral supplements in people with diabetes who do not have deficiencies. Vitamins and minerals should ideally be obtained from foods.
· High doses of vitamin and mineral supplements can be toxic.
· Routine use of antioxidants (vitamin C, E, selenium, beta-carotene) may be ineffective and unsafe.
· Calcium supplements, especially for older people and folate supplements for women of childbearing age are recommended.

Alcohol
If you choose to drink:
· Limit use of alcohol to one drink/day for women and two drinks/day for men.
· Avoid hypoglycemia by eating food while drinking alcohol.

High Blood Pressure
Blood pressure can be reduced in many people by easting less salt and losing a modest amount of weight. Drinking more than 3 alcoholic drinks/day can increase blood pressure.

Diabetes Prevention
People at high risk of diabetes can reduce the risk by losing weight if overweight and being physically active every day.

Debbie Wilburn is County Agent/Family and Consumer Science Agent with the Hall (770)535-8290 and the Forsyth (770)887-2418 County Extension Service.