When it comes to diet and food and managing your type 2 diabetes, you're probably like most of our members and subscribers – you have LOTS of questions.
So today's discussion is all about answering some of the questions we've received.
If you have your own questions, please join the discussion and leave your comments, thoughts and questions at the bottom. We'll do our best to answer them. 🙂
Can you explain the effects of eating carbs while mixed with protein and fats? Why is it different?
Carbohydrate is the nutrient that affects blood glucose most significantly. All carbs except fiber, break down into simpler sugars before they are absorbed into the bloodstream.
Protein and fat can both raise your blood sugar as well, but to a much lesser degree. And because they are quite complex and break down very slowly, they do not tend to cause rapid spikes as carbs do.
Both protein and fat also provide higher levels of satiety (feelings of fullness). Protein breaks down into aminos acids, which are taken to the liver, whereas triglycerides (the form of fat we eat in the diet) are broken down into individual fatty acids and a glycerol (carb) backbone.
Essentially when you balance your carbs with some healthy fat and protein, you can minimize your blood sugar elevation after meal times.
What is the effect of protein on blood sugar? I was put on a 1200 calorie per day plan and was told I can only have 4 oz of lean protein per day. The diet is based on American Diabetes Association Guidelines. I have lost 25 lbs. in 3 months but I am craving protein foods. Why has the protein level been kept so low?
As to the effect of protein on blood sugar, please see above. You will note, that while it does influence blood sugar, it's effects are much less than carbs. Carbs are the single biggest nutrient of influence on your blood sugar and A1C levels.
The American Diabetes Association (ADA) has not endorsed specified calorie meal plans restricting carbs, protein or fat for decades.
Even so, the outdated 1200, 1400 and 1800 calorie meal plans are being used, despite the fact that the ADA specifically made public statements renouncing their endorsement.
Instead ADA encourages general healthful eating patterns, which say nothing about protein limitations. Also, in low carb studies (which show diabetics get better results than any other diets), there is often no calorie restriction. And people get results regardless – lower blood sugar, A1C, cholesterol and weight.
Without seeing your specific meal plan or conversing with whomever ‘put’ you on this, I cannot comment more clearly than to say that, I don't know of any good reason why such a low protein intake would be recommended.
Kidney problems can sometimes necessitate low protein intake. However, even then, research has shown that a higher protein intake has no effect on kidney function.
I find I am very sensitive to coffee and caffeine and don’t understand why it raises my blood sugar?
While caffeine doesn’t have any sugar or calories in it per se, it does alter hormones in a way that can raise blood glucose.
Because it raises adrenaline and other stimulatory hormones, this can result in elevated glucose as you described.
However, research seems to suggest that while this is how it plays out in the short run, after 4 weeks, coffee can actually start having a beneficial effect by improving insulin sensitivity once a tolerance is built.
Of course this will be on an individual case-by-case basis, so the only way to know is to check your sugars over time. Another option is to drink decaffeinated or half-caf coffee, which will be far less potent.
There is a much more detailed article I’ve written about coffee and diabetes available here.
How do I stop the late night sugar cravings?
Jedha wrote a great article about that here.
In addition to her suggestions, I would advise working toward an earlier bedtime.
Our circadian rhythms (24 hour body clock) work best when we go to bed when the sun does and wake up when the sun does.
When we’re very tired or exhausted we tend to produce more ghrelin (appetite hormone) and less leptin (satiety/ fullness hormone), which means avoiding staying up late at night can dream away your cravings!
I have started testing to gain control of diet, blood sugar levels and diabetes, do you agree that I should do this? NHS (diabetes organization) do not recommend type 2 diabetics do testing, is this simply a cost effective issue?
Research shows that home glucose monitoring is a very effective tool for managing diabetes. Really, it's one of the key components of diabetes self-management and we absolutely recommend all type 2 diabetics test their levels regularly.
Similar to checking your weight, examining your feet, or even balancing your checkbook, the purpose of monitoring at home is to give yourself data to help guide you as to how effective treatment (diet, lifestyle and medication) are working.
I’m not very familiar with NHS, but per their site:
“If you have type 2 diabetes, as well as having your blood glucose level checked by a healthcare professional every two to six months, you may be advised to monitor your own blood glucose levels at home.A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be useful for detecting high blood sugar (hyperglycaemia) or low blood sugar (hypoglycaemia).
If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low.
Blood glucose meters aren't currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if you're unsure.
Diabetes UK also provides further information about the availability of blood glucose test strips (PDF, 195kb).
Regularly monitoring your blood glucose levels will ensure your blood glucose is as normal and stable as possible.”
Based on this I glean that the agency both supports and encourages use of home glucose monitoring, but defers to the clinician(your doctor) which is appropriate because people are treated on a case-by-case basis.
Why is it so hard to find a list of foods that are good for you. One list says this food is good for and that food is good for you but the next list says those same foods are bad for you. Where can I find a complete and accurate food list of good foods?
We have compiled just such as list here – so go ahead and check that out!
The great thing is, there are MANY very healthy foods people with diabetes can include in abundance in their diets.
Unfortunately, we are very much surrounded by a plethora of unhealthy foods and these not only abound in our culture but seem to be tempting us at every turn.
Then there are the confusing ones… the grey area foods. These include foods which are deemed “healthy” for the general population and may reduce risk of diabetes. But many of these supposedly healthy foods may still elevate blood glucose – more so in some than others.
One of the things we make a clear division about is diabetes PREVENTION and diabetes TREATMENT.
Take notice as you read many diabetes sites or information and you will find that much of the time they are talking about prevention.
Treatment is not the same as prevention because once you have diabetes, your body has undergone substantial metabolic changes and you have to accommodate those. Much information doesn't.
Another reason it’s difficult to find an exact list is that diets do have to be a bit personalized, to some degree.
We know soda is unhealthy for everyone and generally speaking broccoli and kale is healthy for everyone. But some people are sensitive to oxalates in which case a healthy food like kale may be off limits.
Some people love those little ‘cuties’ or ‘halos’ and they make a great sweets substitute for dessert, while for others they send blood sugars soaring.
We strive to provide education and resources so that each person can make their own health decisions. If you continue to have more trouble, we have a more detailed options for our VIP members here or you could consider scheduling an appointment with a Nutrition Professional to help develop an individualized meal plan.
What snacks can I eat at night when I go low?
It depends on what you mean by low and how often this is taking place.
If you are taking insulin or a glucose lowering medication, it may be wise to discuss with your physician whether it would be a good idea to consider decreasing your dose.
It seems silly to have to eat a snack to increase your blood sugar because you took a medication, which is dropping your blood sugar too low. Also, it’s important to make sure you have a good balanced dinner.
If your blood sugar is <70 mg/dL, that is considered hypoglycemia, which you can read in greater detail about here (including appropriate treatment options).
If blood sugar is above 70 and you tend to drop, a balanced snack of 15 grams high fiber carbs with some protein is a good option. A cup of blueberries with some almonds, veggies and hummus, plain yogurt, or small apple with peanut butter are good options.
Are you still allowed treats once in awhile?
That depends on how you define “treats” and “once in awhile.”
I suppose it also depends on what you mean by “allowed” because assuming you are writing in as an adult, you are “allowed” to eat any foods you want.
The goal with a diabetic diet is not to give you rules, but evidence-based guidelines to help control blood glucose.
The more you think of foods as “forbidden,” the more tempting they are likely to be. Therefore, we recommend you think about all the foods you can include in a healthy diabetic diet, and forget about the ones you can't.
The key here is that your “treats” aren't filled with sugar and crap and are within a reasonable carb range so they don’t have a drastic effect on glucose.
On the other hand, if your “treats” are ice cream blizzards (163 g carbs for a brownie batter), and your frequency is a few times per week, don’t expect your blood sugar or weight to cooperate.
How much is alcohol affecting my score? Is whisky OK? Is red wine OK?
There is an extensive article here on alcohol and type 2 diabetes.
In short, some alcoholic beverages contain carbs (wine and beer) while others do not (hard liquor).
Some mixers contain carbs as well. All of these should be accounted for.
Never drink on an empty stomach as alcohol can tie up the liver, making dangerously low blood sugars a possibility.
Remember alcohol is empty calories, meaning it’s not providing any significant nutritional benefits (though red wine does provide some polyphenols and antioxidants). And alcohol does kill brain cells.
Furthermore, it can lower inhibition causing some people to make poor food choices.
How do I stay motivated?
Motivation is a tricky thing, which everyone must discover for themselves.
Some people are motivated by very little, while others struggle a great deal with will power. Most of us are somewhere between the two.
As you consider motivation, being regularly reminded of WHY it’s important for you to manage your diabetes goes a long way.
Our WHY is why many of us are so strongly motivated initially, then it slowly fades. Whether it’s to be there for your family, see your kids or grand kids walk down the aisle, avoid dialysis or hospitalization, remain independent as long as possible, or something else – call this to your mind often.
Post sticky notes, pictures or reminders in a place where you see them frequently so that your WHY inspires the motivation.
Accountability and education are extremely powerful ongoing motivators as well.
Hopefully the community here at Diabetes Meal Plans and the information we share is helpful in providing some degree of both. You can leave your comments at the end of all of our blogs and we will answer. 🙂
And of course, identifying sources of support around you, to help keep you going day in and day out, is also a wise move to help boost motivation.
In the end though, it is up to you. Focus on the positives, because there are truly many to be had.
Please pin, tweet or share this discussion and get others involved in the conversation. Thanks!