Healthy Living & Eating with Diabetes

As a registered dietitian, I cannot stress enough the importance of early detection of type 2 diabetes. Many of the early warning signs can easily be dismissed as normal everyday occurrences, but these seemingly minor symptoms should not be taken lightly.

The early warning signs of type 2 diabetes include fatigue, increased thirst, and the need to wake up at night to pass urine. These symptoms may seem insignificant, but they could be an indication of an underlying issue. If you or someone you know is experiencing any of these symptoms, it's essential to encourage them to get tested right away, even more so if you have a strong family history of diabetes! 

If left untreated, type 2 diabetes can lead to serious complications. It can cause hyperglycaemic coma, acute renal failure, blindness, high blood pressure, and even limb amputation. The good news is that a simple finger prick test can provide results within seconds. 

If you're wondering whether you should  get tested for type 2 diabetes, consider the following questions:

• Are you overweight or obese?
• Are you over the age of 45?
• Do you have a close family member with diabetes?
• Have you  previously been diagnosed with high blood pressure, high cholesterol, or polycystic ovarian syndrome?
• Have you  been feeling unusually tired lately?
• Have you been drinking a lot more water than usual?
• Do you need to pass urine more often, especially at night?
• Is your vision blurred?
• Have you gained or lost weight without any major change in lifestyle?

​If you answers yes to one or more of these questions, I would encourage you to completing a screening / finger prick test. Early detection of type 2 diabetes is key to managing the condition successfully. Diet and lifestyle changes can help prevent and manage type 2 diabetes, but it's essential to catch it early to avoid irreversible damage. 

Insulin resistance is when your cells and muscles become less responsive to insulin. This means that your body needs to produce more insulin to achieve blood glucose control. As you become more insulin resistant, your body will need to produce more and more insulin until your pancreas can't keep up. This can lead to high blood sugar levels, ultimately diabetes, which can cause a range of health issues.

So, what causes insulin resistance? A few factors can contribute to it, including excess body fat (especially around the waist), unhealthy diet, smoking, lack of exercise, and too much alcohol.

While there aren't many symptoms of insulin resistance, it's important to be aware of the risk factors. Age and ethnicity can increase your risk, as can having excess body fat.

But don't worry – there are things you can do to reduce your insulin resistance and improve your health. The most important step is to lose weight, especially around your stomach (visceral body fat). 

In addition to weight loss, making healthy food choices can also help. Strict, ridged & unsustainable diets that only focus on what you can't eat, is not the answer. Instead, your focus needs to shift to understanding what "healthy lifestyle" change really entails. Its about balance, including less processed foods most of the time, whilst enjoying the odd indulgence.  Consistency is key! What you eat 80% of the time is what is going to make a difference. Use an app to track your calories and macros, better yet consult with a registered dietitian to guide you step by step and formulate a plan specifically for you! 

Exercise is also crucial for reducing insulin resistance. Minimum recommendation are 150 minutes moderate intensity exercise per week (30 minutes 5 days a week or almost and hour, 3 days a week). Include a mix of aerobic and resistance training.

By making these lifestyle changes, you can reduce your risk of developing cardiovascular disease, type-2 diabetes, non-alcoholic fatty liver disease, and polycystic ovarian syndrome (PCOS). And yes, it is possible to reverse insulin resistance with these lifestyle changes.
​
Remember, taking care of your health is a journey, and I'm here to support you every step of the way. If you have any questions or concerns, don't hesitate to reach out.

I have seen many patients on insulin therapy who struggle with weight gain. Insulin therapy can be a lifesaver for individuals with diabetes, but it can also lead to weight gain if not managed properly. If you are on insulin therapy and want to avoid weight gain, here are some practical tips you can follow:

1. Track your calorie intake: Overeating can contribute to weight gain. Fear of hypoglycemia and regular hypoglycemic events are common culprits that lead to overeating. Remember, too much insulin can cause blood sugar levels to drop too low, leading to hunger and cravings for high-calorie foods. It is essential to track your calorie intake and ensure that you are consuming the right amount of calories to reach your goals with better diabetic control and fat loss. Your registered dietitian can help you calculate the amounts you require per day of not only calories but also protein, fat, and carbs.
2. Track your total carbohydrate intake: Your overall carbohydrate intake is just as important as managing your overall energy intake. Your risk of hypoglycemia will increase when you inject too much insulin for the amount of carbohydrates that you consumed. Your registered dietitian can assist with calculating an appropriate insulin-to-carbohydrate ratio for you, in addition to developing a personalized nutrition plan that is suitable for your health needs and goals. Regular monitoring of your blood sugar levels and keeping a food diary with the amount of insulin injected with each meal will help your health care providers greatly in making necessary adjustments to your treatment
3. Choose low-glycemic index foods: Foods with a low glycemic index (GI) should be an important part of your meal plan. Lower GI foods promote a slow, steady increase in blood glucose levels. This can contribute to more stable blood glucose control. Remember, the portion of your carbohydrate foods, even if low GI, needs to be controlled to match your recommended calorie intake for weight control, and your insulin dose needs to be matched with the amount of carbohydrates you consume for better glucose control as well.
4. Exercise regularly: Some individuals on insulin therapy may have insulin resistance, which means that their cells do not respond to insulin effectively. This can result in higher insulin doses being required to regulate blood sugar levels, which can contribute to weight gain over time. Regular exercise can help reduce insulin resistance and promote weight loss. Consult your doctor before engaging in any exercise program.
5. Prioritize good sleep: Poor sleep quality and duration are associated with increased levels of the stress hormone cortisol, which causes insulin resistance. Improving sleep quality and duration may have important implications for improving insulin sensitivity and glycemic control in individuals on insulin therapy.
6. Stress management: Chronic stress has also been linked to the development of insulin resistance. Take steps to manage stress effectively to promote better glycemic control and weight management.

In conclusion, it is essential to manage your insulin therapy carefully and work with your healthcare team to adjust your treatment to meet your needs. Proper management of insulin therapy, combined with a healthy diet, regular physical activity, good sleep, and appropriate stress management, can help prevent excessive weight gain in people with diabetes on insulin therapy. Remember to regularly test your blood glucose levels, keep a food diary, and follow the recommendations of your healthcare team. With these tips, you can successfully manage your weight and improve your overall health while on insulin therapy.

If you've been experiencing unwanted weight gain and struggling to find the root cause, you may be surprised to learn that your insulin levels could partially be to blame. This is because when a person takes insulin, their body begins absorbing glucose again, and any excess glucose that is not immediately used for energy is converted into fat. 

There are several factors that can influence how much weight a person may gain while on insulin therapy. These include age, sex, height, the amount of insulin used with each meal, the level of insulin resistance, genetic makeup, family history, ethnicity, and diet and exercise habits.

Additionally, a person who takes insulin for diabetes may be gaining weight if they eat more due to concerns about developing hypoglycemia, or low blood sugar. Hypoglycemia can occur if a person takes too much insulin or skips a meal, and can cause symptoms such as dizziness, confusion, and shakiness. To prevent hypoglycemia, some people may eat more food or consume more carbohydrates than they normally would, which can lead to weight gain.
​
It's important to note that weight gain is not a reason to stop taking insulin therapy. Insulin is a life-saving medication for people with diabetes, and stopping or adjusting insulin therapy without medical supervision can have serious consequences. Instead, it's important to work with a healthcare provider and a registered dietitian to develop a plan that manages blood sugar levels effectively while also addressing weight concerns. This may involve adjustments to insulin doses, changes in diet and exercise habits, and other strategies to support overall health and well-being.

Insulin is essential in managing elevated blood glucose levels, and it is a powerful treatment Type-1 diabetes and Type-2 diabetes to help control blood sugar. However, insulin therapy comes with side effects, and weight gain is one of the most commonly expressed concerns from individuals who use insulin. 

As a registered dietitian, I want to assure you that gaining weight while on insulin does not have to be inevitable. By taking a few steps, you can maintain a healthy weight while using insulin.

First, focus on consuming nutrient-dense foods with balanced macronutrients. Eating a variety of fruits, vegetables, whole grains, and lean protein sources can help keep you satisfied and nourished while managing blood sugar levels. Additionally, reducing portion sizes and avoiding calorie-dense foods can make a difference in managing weight.

Physical activity is also a crucial factor in managing weight while on insulin. Regular exercise helps improve insulin sensitivity and glucose uptake by muscles, which helps in blood sugar management. Aim to engage in moderate-intensity physical activity such as brisk walking, cycling, or swimming for at least 30 minutes a day.

Lastly, it's essential to work closely with your healthcare team to adjust your insulin doses and regimen as needed to manage your blood sugar levels effectively. Remember, weight management is not a one-size-fits-all approach, and working with a registered dietitian or diabetes educator can help tailor a plan to your unique needs.
​
By making simple changes in your diet, engaging in physical activity, and working with your healthcare team, you can manage your weight while on insulin therapy. Don't let the fear of weight gain deter you from the life-saving benefits of insulin therapy.

If you have diabetes, you've probably heard of hemoglobin A1C, glycosylated hemoglobin, HbA1c or just “A1C” before. A1C levels play a huge role in how diabetes is managed, and it's also used to diagnose diabetes and prediabetes. A1C is a blood test that provides information about your average blood sugar levels over the past three months. Your diabetes care team use this number to gauge how things are going and if and how to tweak your diabetes treatment plan. In most cases, an A1C of less than 7% is recommended. To lower A1C levels, you can take medication, but lifestyle measures are effective, too.

What you eat and how much of it you consume can have a significant impact on your blood sugar control, which, in turn, affects your A1C levels. But with so many conflicting opinions about the "best" diet for diabetes, it can be challenging to figure out what to eat. The truth is, there is no one-size-fits-all approach to nutrition when it comes to managing diabetes. Contrary to popular belief, the American Diabetes Association does not prescribe a specific eating plan for people with diabetes. Instead, they recognize that various eating patterns, including lower-carb, vegetarian, DASH, and Mediterranean diets, can all be beneficial.

To determine what approach will work best for you, it's essential to meet with a registered dietitian who has experience working with people who have diabetes. Your doctor can refer you to a qualified dietitian who can help you create a personalized nutrition plan that takes into account your unique health needs, lifestyle, and preferences.

In the meantime, there are several steps you can take to help lower your A1C levels. For example, consider reducing your intake of processed and high-sugar foods and increasing your consumption of whole, nutrient-dense foods like vegetables, fruits, whole grains, lean proteins, and healthy fats. Portion control is also critical, as consuming too much of any food can lead to elevated blood sugar levels.
​
While there is no one "perfect" diet for managing diabetes, following a balanced, nutrient-dense eating plan and working with a registered dietitian can help you achieve optimal blood sugar control and lower your A1C levels.

Here are seven practical pointers:

1. Come up with a plan: Getting into the habit of eating three meals a day, and possibly some snacks, is a great way to get started on controlling A1C levels. In addition, aiming to eat your meals at about the same times each day will make it easier to stabilize your blood sugars. Try not to skip meals or delay eating your meals as much as possible.
2. Be carb choosey: Eating refined and processed carbs has been linked to an increased risk of diabetes, heart disease, inflammation and obesity. The carbs to focus on are unrefined, meaning, they retain their fiber, vitamins, minerals, and other plant-based compounds that are beneficial to your health.
3. Focus on fiber: Eating plenty of fiber is key for helping manage blood sugars, as fiber helps slow down the absorption of glucose in your bloodstream. High-fiber foods include fruits, vegetables, whole grains, nuts, and seeds.
4. Mind your portions: Portion control is important because eating too much of anything can cause your blood sugars to rise. Try measuring your food with measuring cups or a food scale to make sure you're eating appropriate portion sizes.
5. Keep moving: Exercise is great for helping to manage blood sugars, as it helps your body use insulin more effectively. Walking, cycling, swimming, dancing, and strength training are all great options.
6. Take your meds: If your healthcare provider has prescribed medication for you, it's important to take it as prescribed. Missing doses or taking too much can cause your blood sugars to rise.
7. Test your blood sugars: Checking your blood sugars regularly can help you see how your A1C levels might be affected by certain foods or activities. Be sure to follow your healthcare provider's advice on when and how often to check.

Remember, it's important to work with your healthcare team, including your registered dietitian, to help you navigate the blurry lines and you with an individualized diabetes treatment plan that works for you and your lifestyle. 

As a dietitian, I highly recommend implementing these simple, yet effective, top 5 principles to help better control your blood glucose levels:
​

1. Dress your carbs: Pair carbohydrate-containing foods with protein and/or healthy fats to slow down the digestion and absorption process. This will help to slow the rate of glucose rise and keep blood glucose levels more stable. For example, you can try having a slice of low GI bread with some smashed avocado or peanut butter as a fat source, or scrambled eggs as a protein source.
2. Increase your intake of high fiber foods: Soluble fiber, in particular, is known to help lower the GI of foods. It works by thickening the stomach contents and slowing down the movement of food from the stomach to the intestines. Foods rich in soluble fiber include oat bran, minimally processed oats, legumes, citrus fruits, and deciduous fruits like apples, peaches, pears, and plums.
3. Avoid processed foods: The more processed a food is, the easier it is for your body to digest and absorb the carbohydrates, which can raise your blood glucose levels faster. To lower the GI of your foods, choose whole foods and avoid milling, liquidizing, grinding, mashing, and overcooking your carbohydrates.
4. Include acidic foods: Acids have been shown to slow down the movement of food from the stomach to the intestines, which can lower the GI of foods. Incorporate acidic foods like pickled beets, tart fruits such as citrus fruits, and sourdough breads into your diet.
5. Slow down while eating: Eating slowly has been shown to help lower blood glucose levels. This is because slower eating gives your body more time to digest and absorb the carbohydrates, which can help to prevent blood glucose spikes.

By implementing these simple principles, you can better control your blood glucose levels and prevent spikes. Remember, everyone's body is unique, and it's essential to monitor your blood glucose levels regularly and consult with a dietitian to develop a personalized plan that works best for you.

As a dietitian, I find the low GI diet principles to be a useful tool to help patients manage their blood glucose levels. The benefits of a low GI diet are numerous and significant.

Firstly, a low GI diet promotes slow and steady increases in blood glucose levels, which helps to prevent spikes and crashes. This means that people living with diabetes (PLWD) can experience sustained energy levels throughout the day, and improved concentration and performance. Additionally, a low GI diet can enhance mood regulation and promote better appetite control, which can be particularly important for those struggling with weight management.

It's important to remember that the GI is a guideline and not a one-size-fits-all solution. Each person's response to food is unique, and there are a variety of factors that can affect how the body processes glucose, such as activity levels, hormone levels, and other chronic diseases. Consulting with a dietitian is crucial to ensure that  you receive personalized guidelines and appropriate portions to optimize their individual blood glucose control.

Finally, it's important to note that while low GI foods can help you manage your blood glucose levels, it's still important to consider portion sizes. Low GI foods still contain carbohydrates, and overeating even low GI foods can lead to blood glucose spikes. As a general guideline, it's recommended to limit carbohydrate-containing food portions to about a cup size (250ml) portion or no more than two slices of bread or ½ cup muesli.
​
Overall, incorporating more low GI foods into your diet can be an effective way to manage blood glucose levels and improve overall health. By working with a dietitian and paying attention to portion sizes, PLWD can experience the numerous benefits of a low GI diet.

More on the importance of portion sizes: 

Managing portion sizes is a crucial part of managing blood glucose levels in people living with diabetes (PLWD). Although low GI foods have a slower and more steady effect on blood glucose levels compared to high GI foods, it is still important to limit the quantity of carbohydrates consumed in one sitting.

It's important to note that appropriate portion sizes for PLWD may vary from person to person depending on individual factors such as age, gender, weight, height, activity level, medication, and other health conditions. This is why it's crucial to work with a registered dietitian who can help tailor a meal plan that's appropriate for your unique needs.

Regular monitoring of blood glucose levels can also help in determining appropriate portion sizes. By keeping track of your blood glucose levels before and after meals, you can get a better understanding of how different foods affect your blood glucose levels and adjust portion sizes accordingly.

Remember, that portion sizes not only apply to carbohydrates, but also to other macronutrients such as protein and fat. A balanced meal with appropriate portions of carbohydrates, protein, and fat can help to regulate blood glucose levels and improve overall health.

In summary, managing portion sizes is an important part of managing blood glucose levels in PLWD. By working with a registered dietitian and regularly monitoring blood glucose levels, you can find the right portion sizes that work for you and optimize your blood glucose control.

The Glycemic Index (GI) is a measure of how fast a particular food raises blood glucose levels. The GI scale ranks carbohydrate rich foods on a scale of 1-100 according to their actual effect on blood glucose levels. Internationally, pure glucose is ranked at 100 since it causes the greatest and most rapid rise in blood glucose levels. All other foods are ranked on the GI list in comparison with glucose. Low GI foods will raise blood glucose levels much more slowly compared to glucose which can contribute to more stable blood glucose control. On the other hand, consuming high GI foods causes a rapid spike in blood glucose levels followed by a sharp drop, which can leave you feeling tired, irritable and hungry. 

TOP BENEFITS OF LOW GI MEALS: 

One of the primary benefits of consuming low GI foods is sustained energy levels throughout the day. This can result in better concentration levels and performance. Stable blood glucose levels can also lead to enhanced mood regulation because you don’t feel as sluggish or irritable. Additionally, feeling more satisfied throughout the day can help you better control your appetite. Consuming low GI foods may also help reduce insulin resistance, which is associated with healthier weight management.

Examples of low GI foods include rolled oats, seeded bread, legumes, corn on the cob, sweet potatoes, citrus fruits and low-carbohydrate vegetables. These foods promote a slow, steady increase in blood glucose levels. On the other hand, high GI foods such as cornflakes, regular brown, white and ordinary whole wheat bread (unless it states “low GI”), potato, mielie-meal porridge, and watermelon can cause a rapid increase in blood glucose levels, followed by a sharp drop.

In summary, opting for low GI foods can have numerous health benefits, including more stable blood glucose levels, sustained energy levels, enhanced mood regulation, better appetite control, and healthier weight management.