What to Eat After a Diabetes Diagnosis

The latest statistics show that diabetes affects 25.8 million people in the United States alone, or about 8 percent of the population.
The latest statistics show that diabetes affects 25.8 million people in the United States alone, or about 8 percent of the population.

The Centers for Disease Control aren't painting a pretty picture these days.

The latest statistics show that diabetes affects 25.8 million people in the United States alone, or about 8 percent of the population. That's quite an alarming figure, especially when it seems like healthy eating is a huge focus for many people these days. But others may not realize just how serious a problem diabetes can be. Diabetes results in a number of other serious health conditions, including kidney failure, non-traumatic lower-limb amputations, and even blindness among adults - in fact, it is the number one cause of these conditions in the United States. It is also a contributing factor to heart disease and stroke.

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Diabetes is a disease of the pancreas, the organ responsible for insulin production. Without its proper functioning, glucose, the body's source of fuel, can't enter cells, and essentially results in a condition that can be characterized as starvation from the inside out. Instead, sugar begins to accumulate in the bloodstream, and side effects such as constant itching and thirst, frequent urination, fatigue, and even blurry vision begin to manifest.

There are two types of diabetes. Type 1 diabetes is an autoimmune disorder, meaning the body destroys the cells in the pancreas that produce insulin. People with type 1 diabetes make no insulin and need to take insulin injections about four times a day. They are usually diagnosed in childhood and continue to live with the disorder for the rest of their lives.

With type 2 diabetes, the onset occurs more often in middle age, and differs from type 1 diabetes in that insulin is still produced, but cells have become resistant to it and no longer respond properly. Furthermore, insulin resistance is also accompanied by insulin deficiency - people with type 2 diabetes make less insulin than healthy individuals.

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A genetic component figures more prominently into type 2 diabetes than type 1 diabetes, but the key takeaway is that type 2 diabetes can sometimes be prevented. We spoke with Donna Gebert, MPH, a certified diabetes educator affiliated with Novo Nordisk, a company that specializes in diabetes care, and whose history includes the first use of insulin as a diabetes treatment. Gebert helps physicians take care of their patients by offering nutrition and health advice related to diabetes, and has worked as a dietitian in outpatient care for more than 15 years.

She says it is now possible to diagnose "pre-diabetes" using some special blood tests that nip the problem in the bud just before anything goes seriously wrong. A pre-diabetes diagnosis is returned when tests reveal current and historic fasting blood sugar levels to be just below the threshold for a full-blown diabetes diagnosis.

In her experience, people who are overweight and have a pre-diabetes diagnosis can often prevent the onset of type 2 diabetes and see a significant reduction in their fasting blood sugar levels just by losing approximately 5 percent of their body weight over a period of three months. This is a result achieved by a change in lifestyle - namely, a switch to a high-fiber diet with emphasis on eating more vegetables, and exercise.

Not exactly stuff that anyone hasn't heard before. But, it's what really works. She estimates about 80 to 85 percent of the patients who have a pre-diabetes diagnosis and fail to do this go on to develop type 2 diabetes.

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That's staggering. But as always, the devil is in the details. What, exactly, is one to do after the diagnosis? Gebert offers some sound advice, as well as tips on specific substitutions for favorite foods. These guidelines are also useful for those who have already been diagnosed with diabetes and need to manage their condition.

Rice

Some patients have hard time giving up pasta, some have trouble with grits, and others, rice. Brown rice is the way to go since it contains more fiber than processed rice and slows the release of sugar into the bloodstream. Gebert says just to be careful of portion sizes. One cup of cooked rice contains 45 grams of carbs, or about three servings. Women should only have three to four servings of carbs in one meal, while men should only have about four to five servings - so that one cup of cooked rice might be it for the whole meal. No more carbs after that.

Milk, the Dark Horse in the Room

This one sometimes surprises patients. Milk contains lactose, a sugar that is found in dairy products. When broken down by the body, however, it all turns to glucose, which can mean a spike in blood sugar levels. Gebert says that milk is OK to drink, but make sure to limit it to just two 8-ounce servings per day. Since most cups these days are much larger than 8-ounces, she says that it's a good idea to purchase a measuring cup.

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And While We're Talking About Milk…

Yogurt is OK to eat, too. Gebert prefers Greek yogurt, which is creamier (and perhaps, more satisfying to some). But they also often contain fewer carbs per serving than regular yogurt. A 6-ounce container of Greek yogurt usually contains about 14 grams of carbohydrates - just shy of 15 grams, which is considered one serving of carbohydrates.

Resistant Starch and Eating Skins Are Good

Gebert suggests working more legumes such as black and red beans into one's diet since they contain a type of starch different from that found in most other foods - resistant starch. Resistant starch is released more slowly into the bloodstream. It still gets broken down into glucose eventually, but at a much slower rate. In addition, as a general rule of thumb, she says it's a good idea to leave the skin on fruits and vegetables (when edible) because also slow the release of glucose into the bloodstream.

The Biggest Question of All: Pizza


The days of chowing down on greasy slices are probably over, but she says it's still possible to have pizza occasionally. Look for pizza made with whole-wheat dough, and instead of piling on the meaty toppings, add more vegetables. Limit portion sizes (take one slice instead of three) and put more salad on the plate instead.

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-Will Budiaman, The Daily Meal