and others will influence how you and your health care provider will treat your diabetes.
Keep in mind that the care of type 2 diabetes has changed a great deal over the past few years. That’s because more has been learned about the progressive changes noted above. Recent research indicates that you can slow down the progression of type 2 diabetes—and reduce the chances of heart and blood vessel complications—by keeping your glucose levels on target day to day and year to year. For this reason current ADA recommendations suggest that you start taking one of several blood glucose-lowering medications as soon as you are diagnosed with type 2 diabetes. This doesn’t negate the importance of losing some weight and becoming more physically active. These actions can help increase your insulin sensitivity and, along with the medication, improve your ABCs.
If your health care provider suggests blood glucose-lowering medication, don’t fight it. Normal or near-normal blood glucose levels will help keep you healthy. As time goes on, don’t fight taking more medication or adding a new one to keep your blood glucose under control (see Know Your ABCs). If your health care provider suggests taking insulin to achieve glucose control, try not to fight this or put it off for too long. With thinner, sharper needles, convenient pens or pumps, and newer insulins, taking insulin is easier than ever before.
Key Features of a Diabetes Treatment Plan
Regardless of the medications you use over the years to manage your glucose levels, blood lipids, and blood pressure, research shows that there are three other key features for a solid treatment plan for diabetes. These are:
• healthy eating
• achieving and maintaining a healthy weight
• being physically active.
You can start to take charge of your plan by reading this book and deciding which changes you can make to live a healthier life with diabetes.
What You’ll Learn:
• a definition of calories and how your body uses them
• what the big nutrients are—carbohydrate, protein, and fats
• what the small nutrients are—vitamins, minerals, and water
As you set out to learn about healthy eating with diabetes and the ins and outs of meal planning, you’ll need to learn a few nutrition basics. Familiarity with these basic nutrition terms will help you understand your diabetes nutrition goals as well as how this book breaks foods into food groups.
Calories
Food supplies energy in the form of calories (units of energy), and the body uses calories to function and to move. Your body’s need for calories, or energy, never stops, even when you sleep. The number of calories you need each day depends on many factors. For starters, these factors include your sex, your size, what you do during the day, and how physically active you are outside of your daily activities.
The calories in foods come from one of three macro—or big-nutrients. These are carbohydrate, protein, and fat. A fourth source of calories is alcohol.
Your body needs insulin to be able to put the calories you eat to work. Insulin is a hormone that is made in and secreted from the beta cells of the pancreas. If you have diabetes, your body has trouble supplying insulin to your cells. With type 1 diabetes, your body is no longer able to make any insulin. In type 2 diabetes, your body may not make enough insulin to manage your blood glucose (insulin deficiency) and/or may not effectively use the insulin made in the pancreas (insulin resistance). Both situations make it harder to manage blood glucose levels.
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Think of foods as “packages” of varying amounts of carbohydrate, protein, and fat. For example, a slice of bread contains mostly carbohydrate with a small amount of protein. A piece of turkey contains mainly protein with a small amount of fat.
The Big Nutrients
Carbohydrates
Carbohydrates are the main source of calories that provide your body with energy They are your body’s preferred source of energy because they provide energy in a form that’s easy for your body to break down and use. After you eat, your body breaks down carbohydrate into glucose that travels to your blood stream. To help the cells use this glucose, the body normally releases insulin from the pancreas.
Carbohydrates fall into three general categories: sugars, starches, and fibers. Carbohydrates contain 4 calories of energy per gram. They are the main source of energy that raises your blood glucose levels.
Carbohydrate Sources
These foods contain most of their calories from carbohydrate:
• starches, such as breads, cereals, pasta, and starchy vegetables
• sugars, such as regular soda, gum drops, and syrups
• sweets, such as desserts, ice cream, and candy
• vegetables (nonstarchy), such as lettuce, broccoli, and carrots
• fruits, such as apples, oranges, fruit juices, and raisins
• dairy foods, such as milk and yogurt (cheese contains just a small amount of carbohydrate)
Proteins
Proteins are a source of calories from foods that provide energy, but unlike carbohydrates, they aren’t your body’s preferred source of energy. Proteins are made up of chains of amino acids—the building blocks of protein. Different sequences of amino acids create different proteins. Once you eat protein, the body breaks it down into amino acids, which are used to build, repair, and maintain the body’s tissues. Protein contains 4 calories of energy per gram.
Protein Sources
These foods contain most of their calories from protein:
• red meats (beef, lamb, pork, and veal)
• poultry (chicken, turkey), seafood, fish, and shellfish
• cheese
• eggs
These foods contain moderate amounts of their calories from protein:
• dairy foods, milk, and yogurt
• legumes, beans, and peas
• nuts
These foods contain small amounts of their calories from protein:
• starches, such as breads, cereals, pasta, and starchy vegetables
• vegetables (nonstarchy), such as lettuce, broccoli, and carrots
• fruits, such
