A good example of what leads me to wonder about fruit, and this my fellow diabetics will understand, is the case of a couple of blood sugar tests I took this morning and yesterday morning after having almost the same breakfast both days but with the addition of a serving of fruit in today’s breakfast. Starting with my overnight fasting reading in the morning on both days of under 121 mg/dL (6.7 mmol/L), followed by a healthy serving of cooked oatmeal with soymilk added, my reading yesterday two hours later was 146 mg/dL (8.1 mmol/L), not bad for me, but today after adding fresh fruit to my oatmeal the reading two hours later was 221 mg/dL (12.3 mmol/L), far too high.

So what should I do?  It is often said that we are all different, so for myself it may just be a case of me being more sensitive than some others – or is it just my imagination, in spite of the conflicting readings? And I will have to repeat those breakfast comparisons for the next few days to get a better idea. But what do the diabetes “authorities” say about fruit and the diabetic?

The benefits of fruit as part of the diabetic menu
The American Diabetes Association in their published material, clearly approves of the inclusion of fruits in the diabetic menu and emphasizes the benefits they bring because they are loaded with vitamins, minerals, and fiber, in the same way as are the vegetables that we are also urged to eat more of.

Fruit and the Glycemic Index
Most fruits are rated as being low glycemic index foods because of their fiber content, and most diabetics are aware of the need to avoid high glycemic foods as much as possible, the sugary pies, cakes, biscuits, chocolates, candies, and such. A glycemic index rating of 55 and less is considered as being low and most fruits are in that range. Check this link for more about the Glycemic Index and Glycemic Load.

Of 25 individual fruits I checked on, some of them listed below, 14 have an index value of less than 54 and 9 of them have a moderate rating  between 55 to 70.  Watermelon rates slightly higher at 72 and dried dates are high glycemic at 103.

But even though low index foods are a large part of the diabetic diet, moderation in the amount of food being eaten is important, and there are other factors to consider in devising a healthy and nutritious diabetic menu plan.

Carbohydrates and fruit

A “serving” of carbohydrate foods is usually considered to be about 15 grams and as a rough estimate, there are about 15 grams of carbohydrates in a small piece of fruit, such as a half of a medium sized apple, or in a half cup of canned or frozen fruit or in three-quarters to one cup of berries.

Checking the blood sugar levels

The best way to know how fruits, or any foods for that matter, affect a person’s blood sugar levels is to check by taking a meter reading before eating and then again in one or two hours after eating. For me, and for many diabetics, a meter reading will still show higher than normal blood sugar levels existing after two hours, so to really know the affects of fruits or other foods it is necessary to take further periodic tests until it can be seen that the elevated blood sugar levels have, in the main, dissipated.

Some examples of low glycemic index fruits
The following short list of fruits are rated as being medium on the glycemic index with a ranking of 54 or less, sizes and quantities may differ from one reference fruit to another.

They are listed here, with their GI ratings, only to show some of the fruits, out of the many commonly available, that could be made part of a healthy diabetic diet, perhaps as snacks or dessert items after the main meals. Advice from a dietitian or other health care provider can provide guidance in the choice of fruits and all other food items that are appropriate to include in a diabetic menu. Check this link for a general discussion on Diabetic Menu Planning.

Apple 38 ♦ Apricots (dried) 30 ♦ Banana 52 ♦ Cherries 22 ♦ Grapefruit 25 ♦ Grapes 46 ♦ Kiwi, 52 ♦ Mango 51 ♦ Navel Orange 42 ♦ Peach (large) 42 ♦ Pear 38 ♦ Plum 39 ♦ Prunes 29 ♦ Strawberries 40

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Fruit and vegetable juices
There have been a variety of studies conducted over the past decade that have discovered that some fruit and vegetable juices can help manage the symptoms of diabetes. Especially diabetes type-2.

One of the most recent discoveries is bitter melon juice. Researchers in India experimented with 100 sufferers of diabetes in a 2 day trial. On the first day and after a period of fasting the diabetic participants were given a drink containing pure glucose and the subsequent rise in blood sugar levels was recorded. The second day after an equivalent period of fasting the participants were given a drink with the same amount of glucose as the previous day, but this time they were also given bitter melon juice too. Amazingly, the bitter melon juice helped to lower the spike in blood sugar levels by 14% on average across all 100 participants! For those of you who manage their diabetes every day know just how significant 14% can be!

It is important to note here, that as a rule it is a good idea to stay clear of fresh fruit juices because of the high sugar content and lack of fiber. If we eat a piece of fruit then we are also getting the fiber, which significantly slows down the digestion and absorption of the natural fruit sugars into the bloodstream. Juicing strips away this fiber and the sugar is consequently absorbed rapidly into the blood stream. We also need to take into account that one serving of fruit juice is a couple of pieces of fruit at least and therefore more sugar.

Vegetables are a lot less sugary than fruits and are generally safer for blood sugar levels. However, vegetables that grow in the ground like carrots, yams and beets are the most sugary of the vegetables and should be juiced infrequently. Vegetables that are very very low in sugar and are fair game include, kale, lettuce, spinach, collard greens, cabbage and broccoli.

Vegetable juice from green beans and brussell sprouts are the best to use for your diabetic juicer recipes because they have natural plant compounds that have an insulin like effect in the blood, similar to bitter melon juice.

A new quick weight loss program is out and that is the weight loss boot camp. It is a fun way of losing weight and builds a slimmer and leaner body. It is fun because it is done outdoors and in groups. This gives individual much fun and it gets rid of any boredom that indoor exercise brings. It does motivate each one to maintain and finish its training.

A weight loss boot camp works as a total body workout. It is a combination of different kinds of exercise which includes cardio exercise, endurance training, strength training, weight loss and fat loss exercise which will improve your agility and balance.

Exercise or workouts are done outdoors which makes it more exciting and refreshing. Being close to nature makes it more interesting activity than the usual indoor exercise you do in gyms or at home.

Workouts are done with other people or group which can help you work more to get fast results. As you see others work hard, it makes you work hard too to achieve your goal. Plus it is kind of fun to do it with the group.

What is more convenient is that you can do this workouts anywhere without the use of any machines or any equipment at all. This kind of workout certainly burns a lot of calories in a short period of time. This activity can be challenging and you certainly achieve a higher level of fitness by doing it with a group.

A word of caution though, it is best if you consult your doctor before involving yourself in this kind of weight loss program especially if you have any injuries or any medical conditions. It is also best that you choose your boot camp right, one that has a good instructor. For more general comments on the diabetic and weight loss check here.

It appears that a common spice, cinnamon, in use for thousands of years, may help diabetics in their daily efforts to control and manage higher than normal blood sugar levels. Elevated blood sugar levels in the body create serious health problems and if left untreated and allowed to occur for extended periods of time can lead to life threatening complications. Unfortunately many Americans suffer from this condition and are unaware of that fact.

Some studies carried out in recent years indicate that cinnamon appears to act somewhat akin to insulin, perhaps boosting the body’s own impaired insulin production to better allow the uptake of glucose. Or perhaps the properties of cinnamon help the cells become more responsive to insulin, whatever the effect, the use of cinnamon may lead to an improved glucose control.

In 2003, the journal “Diabetes Care” reported on a 40-day study involving 60 participants with type-2 diabetes, divided into 4 groups, who were given capsules of either, 1, 3, or 6 grams of cinnamon or a placebo. After 40 days it was shown that blood sugar levels had been lowered by 18 to 29 percent in all the groups given cinnamon but not the placebo group.

It is interesting to note that only the group taking the smallest amount of cinnamon, 1 gram, continued to experience improved blood sugar levels for at least 20 days after having stopped taking the cinnamon. Researchers were unable to determine the reason for that fact.

An added benefit for those who received cinnamon was that Triglycerides and LDL cholesterol levels were also lowered.

But not all health care authorities agree
Other studies on the effectiveness of cinnamon for use in lowering blood sugars have shown no such beneficial results and some have been inconclusive. Many scientists believe that cinnamon should not be used.

A Mayo Clinic’s newsletter, described cinnamon as a “topic of debate”, that most researchers suggest that cinnamon is not effective in treatment of type-1 or type-2 diabetes and said further that “At this point, it seems unlikely that cinnamon could play any role in diabetes treatment”.

Anecdotal reports by many individuals with diabetes claim that it has been of help, others report less success. Every diabetic must be under the care of a doctor and follow the prescribed course of treatment without fail. However, the daily management of glucose is the responsibility of the individual diabetic and many may wish to consider the use of cinnamon, at least on a trial basis for a month or two, to see whether in their own situation it can provide a benefit.

The most frequently recommended amount to consume is one-quarter to one-half spoonful each day. But larger amount are sometimes suggested especially when used in the preparation of cooked foods and low-fat, low-sugar-desserts.

For instance, an apple-bran muffin recipe in a book targeted at controlling blood sugars, in its list of ingredients specifies the use of two teaspoons of cinnamon.

The product is inexpensive and readily available in a powdered form from grocery stores where it is sold as a spice for use in the kitchen. An easy way to take the finely powdered cinnamon is to sprinkle it onto a breakfast cereal or cooked oatmeal porridge. Or perhaps there are some beverages that may help distribute it sufficiently well to consume, one suggestion being to add it to ground coffee.

In Conclusion
As a long time type-2 diabetic I will give cinnamon a try while continuing my other blood sugar control efforts in accordance with my doctor’s instructions.

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We hear opposing views on whether to include eggs in our daily diet because they are high in cholesterol and for some that’s a problem since high cholesterol is associated with a higher risk of heart disease people with diabetes are already at a higher risk of heart disease.

The American Diabetes Association says “Yes”

The ADA’s publication 101 tips on Nutrition for People with Diabetes, tells us that we don’t need to eliminate eggs from our diet but at the same time we should follow the American Heart Association’s guidelines for diabetics and heart patients saying that it is better to eat a small or medium egg rather than a large one. A medium egg has about 185 milligrams of cholesterol and a large egg has about 215 milligrams of cholesterol.

A Mayo Clinic newsletter mentions that you should limit your total dietary cholesterol intake to less than 200 mg daily if you have diabetes, cardiovascular disease or existing high levels of LDL, often called the bad form of cholesterol. For non-diabetics and otherwise healthy adults the recommended maximum daily amount is 300 mg.

But eggs are a good source of high quality protein and are rich in nutrients. One egg provides over 10% of the recommended daily protein intake at less than 70 calories and comes with many vitamins and minerals, including vitamins A, B2, B5, B12, folate, D, choline, phosphorus and selenium, in fact, eggs contain most of the minerals that the human body requires for health.

Some eggs, from chickens fed with flax seeds, contain goodly amounts of omega-3 fatty acids that, it is claimed, may have specific health benefits related to heart disease prevention. In a study from Canada, reported in the journal Food Research International (Vol. 39, pp. 910-916), the author wrote, in part, that: “Egg products can serve as ideal functional foods for the dietary delivery of the cardio-protective omega-3 fatty acids (EPA/DHA).

The product label on the carton of eggs in my refrigerator specifies that a large omega egg contains 195 mg of cholesterol, which is within the Mayo Clinic recommendation.

And for healthy adults

In a newspaper column of March 2008, under the headline: “Unscrambling the Myths of Eggs and Cholesterol” by Samara Felesky-Hunt, for Canwest News Sevices, part of a Canadian news network, it was stated that:

“Research conducted by the Harvard School of Public Health, showed the dietary cholesterol in eggs does not have a negative effect on blood cholesterol levels of healthy people. This and numerous other studies have shown there is no link between eating eggs and a higher risk of heart disease or stroke for healthy adults. Some recent studies have even shown that HDL (good) cholesterol increased when people ate an egg-supplemented diet.”

I believe the Harvard study followed 100,000 men and women.

From a different source, I also read that a 2007 study, published in the Medical Science Monitor, had looked at 10,000 people and produced the same results. And in a publication of the British Nutrition Foundation it was stated that dietary cholesterol in foods such as eggs had only a minor effect on cholesterol levels.

Regarding Eggs and Cholesterol

It is important to note that saturated fat has more significant negative effects on your blood cholesterol levels than does the cholesterol content of eggs.

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Diabetes and foot problems taken together can result in serious complications, so it is best to prevent them before they occur. When it comes to effective prevention of diabetic foot problems, one of the most important steps is preventing the feet from being damaged in the first place. The feet of diabetics have difficulty healing and can be injured quite easily, so a logical first step is to minimize rubbing and chafing against the shoes and socks. These need to be minimized because they can lead to not only wounds, but unhealing ulcers and worse. The best way to prevent chafing is to wear seamless socks beneath your shoes whenever you are wearing it.  The Jobst Sensifoot is an example of a line of Jobst compression socks, which are designed with this need in mind, as well as the need to improve circulation problems in the legs.

Another important component in preventing foot problems in diabetics is making sure that they are always clean. The feet are a natural magnet for infections, but the elevated blood sugar levels that are common to diabetics make those infections far more severe. The life and health of the patient is more important to a doctor than anything, and a very severe infection that could spread to the blood and potentially kill the patient can require the leg to be amputated in order to protect the patient. Though it is also important to make sure that the water is a comfortable temperature, frequent foot washing is one of the most important ways that you can prevent foot infections.

Diabetic neuropathy, or damage to the nerves of the feet that causes numbness, could very easily cause you to burn yourself without even knowing it. Great care must be taken when using any foot care devices that employ heat, from foot baths to hot water bottles.

Foot problems are very common among diabetics, especially those who have had the condition for a long time. Damage to the feet leads to a great many complications, so the best thing that a diabetic can do to prevent them is protect his feet. A lifetime of good foot health requires that a diabetic take special efforts to ensure proper foot care.

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Gestational diabetes is a temporary form of diabetes that affects a small percentage of pregnant women during their pregnancy, the actual numbers are uncertain with reports varying between three percent and eight percent, but its incidence is increasing, similar to all forms of diabetes.

With a special consideration of the diabetes condition, it is essential to follow good diabetic nutritional principles during pregnancy through a balanced dietary plan that caters to the needs of the mother and of the growing child, especially with the purpose of avoiding the harmful accumulation of sugars in the blood, the main characteristic of diabetes.

In the pregnant patient’s health care team, a registered dietitian should be available to create a gestational diabetes diet and meal that is plan tailored to the personal food preferences of the mother-to-be and that meets her calorie requirements based on her physical makeup, level of daily physical activity, and the needs of the growing baby. And continued consultation with the supervising doctor will enable modifications to be made if they should be required as the weeks go by.

With the appropriate care and attention and by following the guidelines established, a successful pregnancy will be realized and the gestational diabetes will end when the baby arrives.

A healthy gestational diabetes diet will provide the essential nutrients, vitamins, and minerals to maintain mother and baby but with special attention to the carbohydrate content, since carbohydrates are the nutrient category that most affects the sugar levels in the bloodstream.

Carbohydrates
Carbohydrates are very important nutrients for mother and baby and in order to minimize the spikes that can occur after eating them it is wise to spread the carbohydrate foods over 3 or 4 meals interspersed with snacks in between, a strategy adopted by many diabetics who suffer from other types of diabetes. It is partly a matter of establishing a routine and becoming accustomed and satisfied with it.

Carbohydrates can be simple or complex, a reference to their chemical structure. They are in fact, mainly molecules of sugar linked to form chains that are broken down to single molecules of glucose during the body’s digestive process after they have been eaten. The simple carbohydrates are to be avoided as much as possible because they deliver glucose into the bloodstream rather quickly causing the levels to become elevated above a desirable and healthy range. Complex carbohydrates take longer to break down to glucose and are therefore the preferred type of carbohydrate to consume.

A typical gestational diabetes diet will also regulate the other primary nutrients, the proteins and fats and will ensure the inclusion of the calcium and iron containing foods to meet the body’s increased demands for those substances during pregnancy.

The advice of the dietitian will probably be to avoid eating many of the sweet dessert type foods we sometimes enjoy, foods such as cookies and cakes, ice cream and apple pie. But for all diabetics those foods are normally banned except as rare treats, however, once weaned off sweet foods, to avoid them is no longer a sacrifice.

Fats
Essential as they are for good health, fats should be limited in order not to cause a gain in weight, and with the emphasis in choosing the healthier polyunsaturated and monounsaturated fats while avoiding transfats, and saturated fats as much as possible.

Polyunsaturated fats are found in vegetable oils such sunflower, safflower, and soybean, the type of fats that remain liquid at room temperature. Monounsaturated fats are considered ideal, they are found in olive oil, canola oil, and in nuts such as hazel nuts, brazil nuts, and almonds among others.

Protein
Suitable protein foods include fish, lean meat and skinless poultry, eggs, and low fat cheeses, milk, yogurt, and legumes, all very good protein sources that do contain some carbohydrate, but not normally sufficient to be of concern, but good to be aware of.

Other nutritious foods include fresh fruits and vegetables (with some exceptions, potatoes for instance), which can be eaten in fairly generous amounts, two cups of vegetables per day is often recommended, but the dietitian who establishes the special meal plan would make specific suggestions and recommendations.

Beverages
A usual recommendation is to drink 8 glasses, about 64 ounces, of liquids per day. Water, of course, is the major liquid to drink. There are conflicting opinions about caffeinated drinks such as teas and coffees, most experts say to all right to drink them in moderation but no more than two caffeinated beverages a day. Avoid soft drinks, pops, colas and the like that are sweetened heavily with sugar. Sweeteners such as Aspartame as in Nutrasweet and Equal or the Sucralose in Splenda are usually considered as acceptable, but again, the dietitian has the last word on such matters.

A good diet and daily exercise in moderation, if approved by the doctor, should lead to a happy outcome for mother and newborn.

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One of the first symptoms of diabetes is frequent urination.  If you find that you are going to the bathroom way more often than normal it could be caused by excess glucose being released in your urine.  This can cause you to be dehydrated and more thirsty than normal even after drinking many liquids throughout the day.

Another type 2 diabetes symptom is hunger even after you have eaten.  Your body needs glucose (sugar) to perform properly.  The energy provided to your muscles and organs run more efficiently with proper glucose levels.  If you have high blood sugar and your insulin is not transporting the glucose properly your body will need energy and will make you hungry.

Itchy skin is another symptom to watch out for.  Itchy skin is caused by dehydration and is also caused by a nerve damage (neuropathy).  Your brain will not get the message from your outer extremities such as your feet and hands to sweat.  This will cause dry skin and cause your skin to itch.

Fatigue is yet another symptom.  Our body’s cells need glucose to survive.  It is necessary to provide energy for our body to work properly.  When insulin does not transport the glucose then the body becomes deprived of the necessary cellular energy provided from the glucose resulting in extreme fatigue and tiredness.

If you have any of these symptoms is would be a great idea to talk to your doctor and consider getting a diabetes test done.  If you catch diabetes early it is much easier to manage and is treatable.

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Food and Exercise in the Control of Blood Sugar Levels

The primary objective of this website, Diabetic Menu Guide, is to discuss the various factors involved in constructing a diabetic menu that will help control the diabetic condition but can also meet the personal tastes and preferences of an individual. Inevitably some foods may have to be avoided and some may need to be limited in portion size.

Most diabetics, like most Americans, are overweight, do not exercise enough and eat foods that contribute to adding even more weight. And when we say weight we really mean body fat. When this is the situation, the diabetic is likely to have high cholesterol levels and face increased risks of developing high blood pressure and cardiovascular complications as well as other complications that are often associated with uncontrolled diabetes.

The articles on this website are mainly about the food factors that make up the various types of diabetic menus and dietary approaches that can help manage blood sugar levels. But we cannot ignore the other two main factors in the fight to control diabetes, namely the need to lose weight and to include increased physical activity into our lives. I say “we”, because I am a diabetic too and I recognize the difficulties faced by fellow diabetics who encounter problems in dealing with the condition.

The two factors, weight and activity are connected, so how can activity help us lose weight?

Being overweight is probably due to the consumption of more food calories than the body needs to stay healthy, so eat less or increase physical activity, or both, to shed some weight. Also, eat the right types of food, and avoid the fats and sugary food items, your diabetic menu should specify that.

A good exercise program can bring other benefits in addition to weight loss. Exercise can improve circulation and many diabetics suffer from circulation and nerve problems, referred to as neuropathies. It can also help lower blood pressure and reduce the cardio and stroke risks, relieve stress, improve sleep, and generally gain a sense of being well compared with that of being overweight.

An exercise routine needs to follow a fairly regular schedule that fits in exercise each day or every other day, but a minimum of five 30 to 40 minute sessions each week. It is not a casual activity, to get the benefits takes exertion, but not to the degree that you become exhausted although you may be breathing harder and beginning to perspire a little, just don’t overdo it, what I am conveying here are the generalities, when you become involved in exercising you should be speaking to someone who can provide professional guidance and perhaps you could also check the local library for information or instruction manuals.

Important caution:
Before beginning an exercise program, consult your doctor to obtain approval of what you intend to do. The doctor may specify guidelines to be followed. Everyone with diabetes must be under the care of a doctor.

Beginning an exercise program:

1.    Start off gradually and build slowly to a sustainable level of exertion, weight lost in doing so is more likely to stay off whereas weight lost too quickly will probably soon return. The body has to have time to adjust and it will do so when given sufficient time. This is where professional advice can be helpful, it is not just what you do but how you do it.

2.    The purpose is to burn off excess calories – but don’t then go and eat too much and add the calories back. Exercise can vary and may include the traditional simple forms of walking, bicycling, or swimming, or they can be the types of exercise that require special equipment that require membership in a health club or exercise gym. There are many of those available and they often have qualified trainers on staff to supervise your weight loss program. Very beneficial.

There is also special equipment that can be used in your own home. Items such as individual weights for basic weight exercising and building muscle strength, highly recommended. There are special exercise balls, often used by physiotherapists to help strengthen the back and other muscles. Exercise balls are available in several sizes and if needed, burst resistant balls can be obtained.

There are also the old favorites, the stationary exercise bike and the treadmill, both very good especially for building stamina. Check here for information on the electric treadmill. There are several advantages to having a mini-gym with such equipment at home, it can be used any time you are ready and when your personal workout is over your shower and fresh clothing is close by, and your favorite comfortable chair or sofa – if needed!

You can also get used to walking up a few flights of stairs, or walking a block or two instead of driving to the door of your destination. And if the opportunity presents itself, take a walk in the park, recent announcements on research from several universities claim that studies show that there are mental health benefits from walking in the park.

In summary
The objective is to achieve acceptable blood sugar levels that minimize the risks of developing any of the more serious diabetic complications for which the disease is the leading cause in America today. Complications such as kidney disease, eye diseases that lead to blindness, circulatory disorders that require lower limb amputations, a shortened lifespan, and death from cardiovascular disease.

Diet, weight, and exercise, the solution to blood sugar control
It is essential to follow a good dietary approach, construct a diabetic menu that incorporates the right type of foods in the right ratios of proteins, carbohydrates, and fats. There is also a need to shed excess pounds to get down to a healthy weight and to do so will probably require an exercise component that is appropriate for your general health conditions and age. The possible results are worth the effort.

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My name is Jim Robinson, I was diagnosed more than 20 years ago as being a  Type 2 Diabetic. The experience and insight I have gained over that period of time as a patient, and my efforts to keep informed and up to date may be of value to those  who have to travel the same path as I have done, and still  continue to do with my continual battle to control my blood sugars.

I am not a health-care professional or nutritionist, I do diligently seek out and read with a questioning eye whatever I see published in matters related to diabetes.

This is such a frustrating disease to get control of.  We have learned that much of the care of the diabetes condition is left to each individual patient, and while we understand and accept the need to follow the doctor’s instructions for the treatment of our diabetes, so much of the management and control of our condition is in our own hands, the actions that we take each day can affect the outcome.

If you are a diabetic you must be under the care of a physician
Your physician will diagnose and monitor your progress and will prescribe the appropriate medications if required. The doctor may also advise you on how you should direct your own personal efforts to help minimize and combat the diabetes — and that may involve some life style changes. It is important to follow your physician’s advice. Optimally, your diabetes health care team would include a diabetes educator and a dietitian.

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