Healthy Living & Eating with Diabetes

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.

It can be easy to get stuck in a rut of eating the same vegetables over and over again. ​The health-promoting compounds in vegetables are not evenly distributed across different types, thus we need to consume variety of vegetables to ensure optimal nutritional intake and gain the full benefit of adequate veg intake . In this blog post, we'll explore why variety is as important as quantity when it comes to vegetable intake and how you can incorporate more variety into your diet.

Why is Variety Important?

First and foremost, it's important to note that not all vegetables are created equal. Different types of vegetables contain different health-promoting compounds such as vitamins, minerals, fiber, and phytochemicals. For example, dark leafy greens like spinach and kale are high in iron and vitamin K, while colorful veggies like carrots and bell peppers are packed with vitamin C and beta-carotene.

In order to ensure that you're getting a wide range of these beneficial nutrients, it's important to include a variety of different types of vegetables in your diet. This can also help prevent nutrient deficiencies and promote optimal health.
Additionally, including a variety of vegetables in your diet can help prevent boredom and increase enjoyment of healthy foods. Research shows that individuals who eat a wider variety of vegetables in a single meal tend to enjoy vegetables more and are more likely to eat them again in the future.

How to Incorporate More Variety

So how can you incorporate more variety into your diet? Here are some tips:

1. Mix it up: Rather than sticking to the same vegetables week after week, try to mix things up by trying new veggies or preparing your old favorites in a different way. For example, roast your Brussels sprouts instead of steaming them, or try spiralizing your zucchini into "noodles" for a fun and different way to enjoy this veggie.
2. Shop the rainbow: When you're at the grocery store or farmers market, try to choose a variety of different colored veggies. This will not only add variety to your diet but also ensure that you're getting a range of beneficial phytochemicals.
3. Try new recipes: Don't be afraid to experiment with new recipes that include vegetables you may not be familiar with. This can be a great way to discover new flavors and textures, and you may just find a new favorite veggie in the process.
4. Incorporate veggies into meals and snacks: Rather than viewing vegetables as a side dish, try to incorporate them into your meals and snacks in a variety of ways. For example, add spinach to your morning smoothie or snack on raw veggies with hummus or guacamole.

It's important to remember that incorporating a variety of vegetables into your diet is just one piece of the puzzle when it comes to managing diabetes. It's also important to pay attention to portion sizes when it comes to starchy vegetables, choose whole, unprocessed foods as much as possible, and work with a registered dietitian to create a personalized nutrition plan that meets your unique needs and preferences.
​
In conclusion, variety is as important as quantity when it comes to vegetable intake for individuals with diabetes. By incorporating a range of different types of veggies into your diet and trying new recipes and preparations, you can ensure that you're getting a wide range of beneficial nutrients and preventing boredom with your meals.

Label reading can be an overwhelming task, especially if you're trying to make healthier food choices. But fear not, with a few tips and tricks, you can easily navigate food labels and make informed decisions about what you eat. By understanding what to look for on a food label, you can make informed choices that support your health goals.

Here are the TOP 3 label reading tips to keep in mind:

1. Check the sugar content per 100g: When looking at the nutrition label, start by checking the 100g column for sugar content. Make sure that the sugar content is below 15g per 100g. Even better if it's below 10g! This will give you an idea of the percentage of sugar in the product. The lower the sugar, the less likely it is to cause a spike in blood sugar levels.
2. Look for the fiber content per serving: Next, move over to the serving size column and choose foods with 5g or more of fiber per serving. High fiber content helps to slow down the absorption of sugar into the bloodstream and can prevent blood sugar spikes. Plus, fiber is great for digestive and heart health.
3. Limit the carbs per serving: Finally, make sure that the carbs per serving are not excessive. It's recommended to limit carb intake to 30g per serving, but this can vary depending on individual needs and goals. ​If the carb content is higher than this, consider reducing the serving size or choosing a lower carb option. Remember, the amount of carbs you consume is just as important as the quality of carbs (low sugar, high fiber) you consume.

It's important to note that these guidelines are a starting point and that a registered dietitian can help to personalize them for your individual needs. Everyone's body responds differently to different foods and nutrient intake, so working with a professional can help you optimize your blood glucose control and overall health.

By following these three tips, you can make healthier choices and keep your blood sugar levels in check. Don't be afraid to ask questions or seek help if you need it. With a little bit of practice, label reading can become a valuable tool in maintaining a healthy diet.

Diabetes is a chronic condition that affects millions of people worldwide. Sadly, the dangers of uncontrolled diabetes become notable when it is too late, and severe damage has been done to almost every body system. The good news is that managing diabetes is possible with the right information, tools, and support.

One of the most critical aspects of diabetes management is monitoring blood sugar levels. Regular monitoring allows you to see how well you are managing your blood sugar levels and make adjustments to your diet, exercise routine, and medication as needed.

Knowing your blood sugar targets is also crucial for effective diabetes management. As we discussed in a previous post, for individuals with type 2 diabetes, the general recommended fasting/pre-prandial blood glucose target is 4.0 to 7.0 mmol/L, and the post-meal/post-prandial blood glucose target is 5.0 to 10 mmol/L.

In addition to monitoring blood sugar levels and knowing your targets, it is also essential to understand what foods contain carbohydrates and how much you can eat. Carbohydrates have the most significant impact on blood sugar levels, so it is crucial to manage your carbohydrate intake to maintain healthy blood sugar levels. Knowing how much is an appropriate portion for carbohydrates is also vital. Your registered dietitian can provide guidance on these matters and help you develop a meal plan that is tailored to your individual needs and preferences.

It is essential to work with your healthcare team to manage your diabetes effectively. If your blood sugar levels are not optimal, do not wait for your next scheduled appointment. Contact your healthcare team as soon as possible to discuss adjustments to your treatment plan.

Uncontrolled hyperglycemia can cause damage to many of the body's organs, leading to disabling and life-threatening health complications such as cardiovascular diseases, nerve damage, kidney damage, and eye disease. However, appropriate management of diabetes can delay or prevent these serious complications altogether.
​
Managing diabetes can be challenging, but it is essential to take responsibility for your health and work with your healthcare team to achieve optimal blood sugar control. Regular monitoring, understanding your targets and carbohydrate intake, and working with your healthcare team can help you manage your diabetes effectively and reduce the risk of developing diabetes-related complications.

If you have recently been diagnosed with diabetes, it is understandable to feel a range of emotions, including confusion, fear, and uncertainty. However, as a registered dietitian, whose practice focuses on diabetes management, I want you to know that you are not alone, and there are steps you can take to manage your condition effectively.

As your dietitian, here is what I WANT for you:

1. Optimal and Confident Diabetes Management: I want you to feel confident in managing your diabetes, knowing that you have the knowledge, skills, and tools necessary to keep your blood sugar levels under control.
2. Active Involvement in Your Management: Diabetes management is a team effort, and I want you to be an active participant in your own care. Together, we can work to establish a personalized plan that meets your unique needs and lifestyle.
3. Fearless Living: I want you to live your life without fear of the future or unknown. With the right guidance, you can manage your diabetes and live a healthy, fulfilling life.
4. A Support System: Managing diabetes can be challenging, but it is important to have a support system in place. As your dietitian, I am here to support you every step of the way.

Here is what I DON’T WANT for you:

1. Feeling Powerlessness: I don't want you to feel powerless or overwhelmed, causing you to give up on managing your diabetes. It may seem daunting at first, but with the right guidance and support, you can manage your condition effectively.
2. Feeling Alone: I don't want you to feel isolated or alone in managing your diabetes. It is important to have a team of healthcare professionals, friends, and family members who can support you through this journey.

​Together, we can optimize your diabetes management with scientifically sound and evidence-based advice. Please do not hesitate to reach out to me with any questions or concerns you may have. Remember, there is light at the end of the tunnel, and with the right care, you can successfully manage your diabetes and live a healthy, fulfilling life.

Do you test your fasting blood glucose?  Do you know your target? Comment below. No judgement here! 

Fasting blood glucose levels can give us an idea of blood sugar control in individuals with type 2 diabetes. A fasting blood glucose test measures the level of glucose in the blood after a period of fasting, usually eight hours or overnight. The test provides an indication of how well the body is able to regulate blood sugar levels during periods of fasting.

For individuals with type 2 diabetes, the recommended fasting blood glucose target is between 4.0 to 7.0 mmol/L. This target may be adjusted based on an individual's age, health status, and other factors. The post-meal or post-prandial blood glucose target is between 5.0 to 10 mmol/L.

It is important to discuss your fasting blood glucose targets with your doctor and work together to determine what is appropriate for you. Your fasting blood glucose targets may be adjusted based on your HbA1c target, which provides an indication of how well blood sugar levels have been controlled over time.

Regular monitoring of fasting blood glucose levels is important for individuals with diabetes to ensure that blood sugar levels are well controlled. Monitoring can help identify trends and patterns in blood sugar levels and enable adjustments in diet, exercise, and medication as needed.

If you do not know your fasting blood glucose target, it is essential to discuss this with your doctor. Understanding your targets and working to achieve them can help reduce the risk of developing diabetes-related complications, such as nerve damage, kidney damage, and eye damage.
​
Remember that achieving your fasting blood glucose target can be challenging and may require lifestyle changes and medication adjustments. It is essential to work with your healthcare team, which includes a registered dietitian, to develop a plan that is tailored to your individual needs and circumstances. Regular monitoring, open communication with your health care team and a commitment to self-care can help you achieve your fasting blood glucose target and improve your overall health.