Treating Diabetes with Good Nutrition: Questions and Answers

The American Diabetes Association maintains that sugar (sucrose) can be substituted for other carbohydrates, and eaten in moderation as part of a healthy meal plan. All forms of carbohydrate are digested to produce sugar (glucose) in the blood, which is then used to fuel the body. Obviously, sugar does not contain the same vitamins and minerals that are provided by other carbohydrate-rich foods like starches, fruits and milk.

Carbohydrate is the part of the food that has the biggest effect on the blood sugar. Carbohydrate is found primarily in breads, grains, legumes, starches, fruits, sugars, milk and yogurt. Carbohydrate counting requires keeping track of the number of grams of carbohydrate that you eat. A registered dietitian can assess the amount of carbohydrate that you need at meals and snacks. Eating a specific amount of carbohydrate at appropriate times can help keep the blood sugars in a healthy range. For people who use insulin, or certain diabetes pills, it is especially important to balance the amount and timing of carbohydrate with the medication.

It's probably most helpful to look at the total carbohydrate since digestion turns all carbohydrates (except fiber) into sugar in the blood. The total carbohydrate includes all of the forms of carbohydrate found in the product, such as the starch, the fiber, and the sugars. The subset listed below the total carbohydrate tells you the grams of sugar in the product. The grams of sugar are already included in the total carbohydrate, so don't add these two numbers together! Natural sugars like lactose (from milk) and fructose (from fruit), as well as the added sugars like sucrose (table sugar), honey and syrups, all get lumped together under the sugar category.

That depends on the other ingredients in the product. Something can be free of added sugars but still have other ingredients that supply carbohydrate which will ultimately digest and turn to sugar in the blood. Look at the label for the grams of total carbohydrate.

Sugar alcohol is a class of carbohydrates that includes mannitol, xylitol, isomalt and sorbitol. These carbohydrates tend to impact the blood sugar to a lesser extent than does sugar. However they are still a form of carbohydrate and digestion will still produce some glucose for the blood. Products that contain sugar alcohol often claim they are sugar-free, but that does not mean the same thing as carbohydrate free. Note: sugar alcohol may cause diarrhea, gas and bloating.

To treat low blood sugar you will want to eat a form of carbohydrate that is easily digested and absorbed so that the sugar will enter the bloodstream quickly. Examples are glucose or dextrose tablets or glucose gel, fruit juice, regular soda (not diet), fruit, or a type of candy that is primarily sugar (and doesn't contain protein or fat). Do not use chocolate bars, ice cream or cookies, all of which contain significant amounts of fat, which slows down the digestion of the sugar.

Type 2 diabetes is associated with insulin resistance. Insulin resistance menas the body does not properly use the insulin that it makes, thus causing blood sugar to go too high. Weight loss can improve insulin resistance, and therefore improve blood sugar control. Exercise has a similar benefit in improving insulin resistance. Weight loss and exercise are the cornerstone to treating type 2 diabetes.

Exercise does burn glucose from the blood and can lower the blood sugar. If you don't take medication for diabetes control, you are not at risk for hypoglycemia (very low blood sugar) and do not need to eat an extra snack. Many people exercise to help with weight loss. If extra snacks are eaten, fuel from the snack will fuel the exercise. As a result, the effort to lower blood sugar and burn fat for fuel will be less effective.

A study showed that blood pressure control and blood sugar control were both very important in preventing complications associated with diabetes. If you have high blood pressure you may need medication to control it. (See your physician). Other things you can do to control better blood pressure are: lose weight, if you are overweight; reduce salt (sodium) intake; exercise regularly; quit smoking; and minimize alcohol consumption.