America is facing an epidemic of diabetes, a serious disease that damages bodies and shortens lives. In the next four decades, the number of U.S. adults with diabetes is estimated to double or triple, according to CDC scientists. That means anywhere from 20 to 33 percent of adults could have the disease. About 1 in 9 adults have diabetes now.
If you already have diabetes, managing the disease can lower your risk of complications such as kidney failure, heart disease and stroke, blindness, and amputations of legs and feet
Diabetes is a disease that touches many lives. Nearly all of us can say that we know someone who is affected by diabetes, whether it’s a close family member, co-worker, or even simply a friend of a friend. Each year, National Diabetes Awareness Month, which takes place in November, offers people a chance to communicate the seriousness of diabetes and the importance of managing the disease.
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
There are 23.6 million children and adults in the United States, or 7.8% of the population, who have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, unfortunately, 5.7 million people (or nearly one quarter) are unaware that they have the disease.
In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.
With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.
In the OGTT test, a person’s blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.
Major Types of Diabetes
Type 1 diabetes
Results from the body’s failure to produce insulin, the hormone that “unlocks” the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.
Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.
Immediately after pregnancy, 5% to 10% of women with gestational diabetes are found to have diabetes, usually, type 2.
Pre-diabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.
Signs and Symptoms of Diabetes:
Type 1 Diabetes
- Frequent urination
- Unusual thirst
- Extreme hunger
- Unusual weight loss
- Extreme fatigue and Irritability
Type 2 Diabetes*
- Any of the type 1 symptoms
- Frequent infections
- Blurred vision
- Cuts/bruises that are slow to heal
- Tingling/numbness in the hands/feet
- Recurring skin, gum, or bladder infections
*Often people with type 2 diabetes have no symptoms
Note: You may not have any of these symptoms. Many people have diabetes for 5 to seven years or more before noticing these symptoms.
Family and friends should be aware of the diabetic emergency symptoms and be prepared:
If the patient is helpless (but not unconscious), family or friends should administer three to five pieces of hard candy, two to three packets of sugar, half a cup (four ounces) of fruit juice, or a commercially available glucose solution (A Glucose tube can be found in all the disaster first aid kits supplied to safety committee members and all Plateau stores).
If there is inadequate response within 15 minutes, additional oral sugar should be provided or the patient should receive emergency medical treatment, including intravenous administration of glucose.
Family members and friends can learn to inject glucagon, a hormone, which, in contrast to insulin, raises blood glucose
Some Risk Factors beyond your control:
When to Seek Medical Care
The following situations can become 911 medical emergencies and warrant an immediate visit to a hospital emergency department.
- The person with a severe diabetic complication may travel to the emergency department by car or ambulance.
- A companion should go along to speak for the person if the person is not able to speak for himself or herself with the emergency care provider.
- Bring a list of medical problems, medications, allergies to medications, and the blood sugar diary to the emergency department. This information will help the emergency care provider diagnose the problem and treat it appropriately.
The following are signs and symptoms of diabetic complications that warrant emergency care.
Altered mental status: Lethargy, agitation, forgetfulness, or just strange behavior can be a sign of very low or very high blood sugar levels.
- If the person is a known diabetic, try giving him or her some fruit juice (about 6 ounces) or cake icing if the person is awake enough to swallow normally without choking. Avoid giving things such as hard candy that can lodge in the throat. The healthcare provider can prescribe glucose wafers or gels that melt under the tongue.
- If the person does not wake up and behave normally within about 15 minutes, call 911.
- If the person is not a known diabetic, these symptoms can be signs of stroke, drug intoxication, alcohol intoxication, oxygen starvation, and other serious medical conditions. Call 911 immediately.
Nausea or vomiting: If the patient is known to have diabetes and cannot keep food, medications, or fluids down at all, they may have diabetic ketoacidosis, hyperosmolar hyperglycemic nonketotic syndrome, or another complication of diabetes.
- If the patient has not already taken the latest insulin dose or oral diabetes medicine, do not take it without talking to a medical professional.
- If the patient already has low blood sugar levels, taking additional insulin or medication will drive the blood sugar level down even further, possibly to dangerous levels.
- Fever of more than 101.5°F: If the primary healthcare provider cannot see the patient right away, seek emergency care for a high fever if they are diabetic. Note any other symptoms such as cough, painful urination, abdominal pain, or chest pain.
- High blood sugar level: If the patient’s blood sugar level is more than 400 mg/dL, and the primary healthcare provider cannot see them right away. Very high blood sugar levels can be a sign of diabetic ketoacidosis or hyperosmolar hyperglycemic nonketotic syndrome, depending on the type of diabetes you have. Both of these conditions can be fatal if not treated promptly.
Large sores or ulcers on the feet or legs: If the patient has diabetes, a non-healing sore larger than 1 inch in diameter can be a sign of a potentially limb-threatening infection.
- Other signs and symptoms that merit immediate care are exposed bone or deep tissue in the wound, large areas of surrounding redness and warmth, swelling, and severe pain in the foot or leg.
- If left untreated, such a sore may ultimately require amputation of the limb.
- Cuts or lacerations: Any cut penetrating all the layers of skin, especially on the legs, is a potential danger to a person with diabetes. Proper wound care, although important to anyone’s recovery, is especially important in diabetics to assure good wound healing.
Chest pain: If the patient is diabetic, take very seriously any pain in the chest, particularly in the middle or on the left side, and seek medical attention immediately.
- People with diabetes are more likely than non-diabetic people to have a heart attack, with or without experiencing chest pain.
- Irregular heartbeats and unexplained shortness of breath may also be signs of heart attack.
Severe abdominal pain: Depending on the location, this can be a sign of heart attack, abdominal aortic aneurysm (widening of the large artery in the abdomen), diabetic ketoacidosis, or interrupted blood flow to the bowels.
- All of these are more common in people with diabetes than in the general population and are potentially life-threatening.
- Those with diabetes also get other common causes of severe abdominal pain such as appendicitis, perforated ulcer, inflammation and infection of the gallbladder, kidney stones, and bowel obstruction.
- Severe pain anywhere in the body is a signal for timely medical attention.
Diabetic Food Pyramid
The Diabetic Food Pyramid will help guide you with group of foods based on their carbohydrate and protein content because these foods affect blood glucose levels, which is indeed the primary concern to people with diabetes. You may find differences like potatoes and other starchy vegetables in the grains, beans and starchy vegetables group instead of the vegetables group, cheese is in the meat group instead of the milk group.
A serving of pasta or rice is 1/3 cup in the Diabetes Food Pyramid and ½ cup in the USDA pyramid. Fruit juice is ½ cup in the Diabetes Food Pyramid and ¾ cup in the USDA pyramid. This difference is to make the carbohydrate about the same in all the servings listed.
Grains and Starches
Situated at the base of the pyramid, these are foods contain mostly carbohydrates. Bread, cereal, rice, and pasta are food in this group mostly made of grains, such as wheat, rye, and oats. Starchy vegetables like potatoes, corn, and peas also belong to this group, along with dry beans such as black eyed peas and pinto beans. Starchy vegetables and beans are in this group because they have about as much carbohydrate in one serving as a slice of bread. As for beans and starches, they are group together because they affect blood glucose in the same way.
Recommended serving: 6 -11 servings per day.
Vegetables are full of vitamins, minerals, fiber, and naturally all of them are low in fat. Vegetables that should be at the top of your food list should be dark green and deep yellow vegetables,
such as spinach, kale, broccoli, romaine lettuce, carrots, cucumbers, chilies and peppers. Try to get fresh or frozen vegetables rather than canned vegetables because they have less sauces, fats and salt added.
Recommended serving: 3 – 5 servings per day.
Fruits are fabulous because they provide important vitamins, minerals, and fiber. Fruits also contain carbohydrates. Most dietitians recommend consuming whole fruits rather than juices because of the fiber contained. Avoid fruits and fruit juices that contain sweeteners or syrups added. This group includes blackberries, grapefruit and tangerines, cantaloupe, strawberries, oranges, apples, bananas, peaches, pears, and apricots.
Recommended serving: 2 – 4 servings per day.
Milk products contain a lot of protein and calcium as well as many other vitamins. When looking at milk or yogurt, try to choose low-fat or nonfat milk products for the great taste and nutrition without the saturated fat.
Recommended serving: 2 – 3 servings per day.
Meat and Meat Substitutes
Includes in these group are beef, chicken, turkey, fish, eggs, tofu, dried beans, cheese, cottage cheese and peanut butter. Meat and meat substitutes are great sources of protein and many vitamins and minerals. Nutritionists usually recommend fish and poultry over red meat, because it’s less fatty. Keep your portion sizes small and trim away all the visible fat off meat. Baking, roasting or grilling is preferable to frying.
Recommended serving: 2 – 3 servings per day.
Sweets, Fats and Alcohol
Sitting at the very top of the pyramid simply means that your body should have smaller amounts of them. Your body needs fat for some things, but it’s smart to avoid eating too much of it. And although sugary foods like candy and cookies are simple carbohydrates that can give you quick energy, they are usually loaded with calories and don’t offer much in the way of nutrients. In the right amount, though, fats, alcohol and sweets can spike up the flavor in meals and snacks.
Recommended serving: Use them sparingly. In other words, eat only a little bit and don’t eat them very often.
Top 20 Power Foods for Diabetes
Are you constantly asking yourself, “What can I eat?” It’s time to stop worrying! Living with diabetes doesn’t have to mean feeling deprived or restricted. We’ll help you learn what you can eat (which is just about anything), how much of it you can consume, and how often you can enjoy it. Once you get the hang of eating a healthy diet, you can relax and dig in to a wide variety of delicious meals and snacks.
If you love asparagus, you’ll really love that it’s a nonstarchy vegetable with only 5 grams of carb per serving and nearly 2 grams of dietary fiber. It is also high in the B vitamin folate, vitamin C, and a health-promoting antioxidant called glutathione, says Jeannette Jordan, MS, RD, CDE, a Charleston, South Carolina-based registered dietitian and advisory board member for Diabetic Living. Glutathione may help boost the immune system and promote lung health by protecting against viruses.
The cardiovascular benefits of folate and other B vitamins have been studied in relation to homocysteine, an amino acid in the blood that has been linked to a higher risk of coronary heart disease. The American Heart Association recommends including foods containing folate and other B vitamins in your diet to help lower homocysteine levels.
Enjoy the benefits of blueberries on their own or in a variety of foods, including smoothies and pancakes. Blueberries provide dietary fiber, vitamin C, and flavonoids, a type of phytonutrient that offers antioxidant protection, such as boosting your immune system and fighting inflammation. Flavonoids may also help decrease the LDL (bad cholesterol)-oxidation process that can lead to arterial plaque, according to the Cleveland Clinic.
Blueberries get their dark blue color from anthocyanins, another disease-fighting antioxidant that may benefit heart health. Blueberries have also been studied for their potential to protect and improve vision.
Sweet, juicy, and delicious, the ruby red grapefruit packs more antioxidant power and possibly more heart benefits than the white grapefruit. In a preliminary 30-day test of 57 people with heart disease, those eating one red grapefruit daily decreased their LDL (bad) cholesterol by 20 percent and decreased triglycerides by 17 percent. In contrast, those eating a white grapefruit reduced LDL by 10 percent with no significant change in triglycerides, compared with a group of people who didn’t eat the fruit.
Include the vitamin C-rich grapefruit as a juice, in salads, or by itself. The only way the body can get vitamin C is through food, such as citrus fruits, or supplements.
Grapefruit interacts with certain drugs, including statins and antiarrhythmic medications, so check with your health-care professional.
You can’t go wrong with beans. Beans are high in fiber and protein and are a good source of vitamins and minerals, such as folate, iron, magnesium, and potassium, which is essential for the water balance between the cells and body fluids, such as electrolyte balance. The American Heart Association recommends eating a variety of foods to get the necessary soluble and insoluble fiber needed daily–about 25 to 30 grams a day, which is twice the amount the average American adult normally consumes. One serving of navy beans is 1/2 cup and has 5.8 grams of fiber per serving.
There are so many delicious varieties of beans to choose from, such as black, kidney, garbanzo, white, lima, and pinto, finding ways to incorporate beans in your diet is a breeze. Soak and cook dry beans or use canned beans. Try substituting beans as your main protein source for lunch or dinner a couple times a week. Protein is an important part of your daily nutrition, which helps the body repair and produces cells and build muscle and bones.
Don’t underestimate the nutritional power of broccoli. Truly a super food, this nonstarchy vegetable has more vitamin C per 100 grams than an orange and is considered a good source of fiber and the antioxidant beta-carotene, which the body uses to make vitamin A. This dark green vegetable’s vitamin A power promotes healthy vision, teeth, bones, and skin. Vitamin C is essential for healing wounds and is a disease-fighting antioxidant, according to the National Institutes of Health’s U.S. Library of Medicine.
Cooked or raw, carrots are a healthy addition to any meal plan. Have them for a snack with 2 tablespoons of light ranch dressing or include them in your main course or as a side dish.
Carrots provide vitamin A from the antioxidant beta-carotene. This powerful phytonutrient may help prevent cancer and heart disease, says Jeannette Jordan, RD, CDE, and member of the Diabetic Living editorial advisory board. Carotenoids found in yellow and orange produce may also help reduce insulin resistance.
Seafood lovers rejoice! Fish is a great addition to your meal plan, especially omega-3-rich fatty fish, such as salmon, trout, tuna, sardines, mackerel, and herring. Omega-3s, a type of polyunsaturated fat, which is healthful, can help lower triglycerides. It contains omega-3s can also help reduce inflammation, lower blood pressure, and reduce the risk of blood clots.
Flaxseed is the new “it” super food, noted for its alpha-linolenic acid (ALA), a fatty acid that can be converted into omega-3 fatty acids, which offer similar benefits as the omega-3 fatty acids EPA and DHA found in fish. ALA omega-3s are known for helping to lower triglycerides, reduce inflammation, and decrease the risk of heart disease.
Flaxseed has emerged as a must-eat power food for overall health. High in both soluble and insoluble fiber, flaxseed is also a good source of lignans, a phytoestrogen that is considered another type of antioxidant.
They’re not just for Thanksgiving dinner! Cranberries are a power fruit packed with the disease-fighting antioxidant vitamin C that can be eaten year-round. Although best known for helping to prevent urinary tract infections, cranberries and their abundant phytonutrients, including anthocyanins, may also help protect against cancer and cardiovascular disease, studies suggest.
Anthocyanins lend vibrant color and antioxidant power to red, blue, and purple foods, such as cranberries.
The soluble and insoluble fiber in apples can benefit people with diabetes. According to a 2003 study published in the Archives of Internal Medicine, a diet high in fiber can reduce the risk of cardiovascular disease-a leading diabetes complication, which is often caused by high cholesterol, lack of exercise, and obesity. The good news is one medium-sized apple packs 3 grams of fiber–12 percent of the recommended 25 grams per day.
Plus, the soluble fiber in an apple may help slow digestion. According to the Cleveland Clinic, some research has indicated this slowing-down process may help regulate cholesterol and stabilize blood glucose.
A dessert straight from nature, melons come in many varieties including watermelon, cantaloupe, muskmelon, honeydew, casaba, crenshaw, Persian, and pepino.
While all provide good nutrients, watermelon is high in vitamins C and B6 and is a good source of the antioxidant lycopene, which may help protect against cancer, says nutritionist Jeannette Jordan. Lycopene is commonly associated with tomatoes and tomato juice, but watermelon is another optimal source. Watermelon is also high in beta-carotene, which the body uses to make vitamin A.
Honeydew is high in vitamin C and a good source of potassium, which can help improve or maintain blood pressure, according to the Harvard Medical School Family Health Guide Online. Check with a health-care professional before increasing potassium intake if you have kidney complications or kidney disease.
Cantaloupe is also high in potassium and the antioxidant beta-carotene, and it’s a good source of fiber, vitamin C, and folate. The American Heart Association recommends getting enough folate and other B vitamins in your diet to help lower homocysteine levels, which may help decrease the risk of heart disease.
Nuts are a good source of protein, fiber, vitamin E, and flavonoids and are power-packed with monounsaturated fat. Plant sterols known to lower cholesterol also naturally occur in nuts.
According to the Mayo Clinic, about 80 percent of a nut is made of up fat. Although nuts contain healthy fats, they are also high in calories.
Walnuts, almonds, macadamia nuts, pecans, and hazelnuts are just some of the nuts that can help lower LDL (bad) cholesterol, making them heart-healthy choices.
Eat nuts in moderation and avoid salted, sugared, or chocolate-covered options that increase calories and decrease nuts’ natural health benefits.
If you fuel up with a bowl of oatmeal in the morning, then you know its fiber content will keep you full longer, getting you to your mid-morning snack or lunch. The soluble fiber in oats also can help lower cholesterol, improve blood pressure, and stabilize blood glucose by slowing digestion. Oats are also a source of antioxidants, says nutritionist Jeannette Jordan. Flavor oatmeal with cinnamon or artificial sweeteners to keep total calories low. Oats also provide vitamin E, B vitamins, magnesium, and potassium, which may help lower blood pressure.
There are several types of oatmeal to choose from. Steel-cut oatmeal has a dense, thick texture and can take up to 45 minutes to cook, while old-fashioned (or rolled) oats are thinner and take less time to cook. The less processed the oat, such as steel-cut oatmeal, the lower it is on the glycemic index, which may help control blood glucose. Quick cooking oatmeal and instant oatmeal are also available.
Red onions don’t just add great color to salads, sandwiches, and stews. They also score highest in antioxidant power, with yellow onions not far behind and white a distant third.
Onions are also a good source of fiber, potassium, and folate-all good for heart health. Onions’ high flavonoid content also puts them on the map for cancer and cardiovascular research and other chronic diseases, such as asthma. According to a 2002 study in The American Journal of Clinical Nutrition, having a high dietary intake of the flavonoid quercetin found in onions may lower the risk of these chronic illnesses.
Raspberries are packed with fiber (partly due to their tiny, edible seeds) and are high in vitamin C, a powerful antioxidant that the body can only get through food. Vitamin C is beneficial for bone and skin health as well as cancer and heart disease prevention. These delicate berries are also rich in anthocyanins, which give red raspberries their color and more antioxidant power.
There are red, black, and purple raspberries, which you can plant in your garden or buy at your local market or farmer’s market. Store fresh raspberries in your refrigerator up to seven days or use ripe berries to make jams and jellies or freeze for later. In the winter, check your grocery store for frozen, unsweetened raspberries.
Popeye ate spinach for a reason. This dark green leafy vegetable is loaded with vitamins and minerals, including vitamins B2 and B6, folate, copper, magnesium, potassium, zinc, and fiber, according to the Cleveland Clinic.
Studies of spinach have found it has potential to decrease the risk of cancer, cataracts, and heart disease. Spinach is high in beta-carotene, an antioxidant that the body uses to make vitamin A. Beta-carotene helps protect the body’s cells from free radicals, which contribute to chronic illness and aging. Plus, just 1/2 cup of cooked frozen spinach has 145 mg of calcium and 3.5 grams of fiber. Although many studies have concluded that more research is needed to declare that cartenoid-rich vegetables, such as spinach, prevent or decrease disease, spinach is still a great nonstarchy vegetable to include in any meal plan.
Often used as a substitute for animal products, soy is an excellent power food to incorporate in your diet, even if you aren’t a vegetarian. Soy can be eaten in whole bean form, such as baby green soybeans called edamame, which is the highest in protein. Other soy products include soy milk or cheese, tofu, soy nuts, or vegetarian meatless products.
Soy is also a source of niacin, folate, zinc, potassium, iron, and alpha-linolenic acid (ALA), a fatty acid that can be converted into omega-3 fatty acids, known to help lower cholesterol. All of these nutrients serve important functions in the body:
Niacin is a B vitamin that aids in converting food into energy.
Folate may help lower homocysteine levels linked to heart disease.
Zinc, found naturally in foods or supplemented in foods or vitamins, may be lower in people with diabetes and may help improve immune function and wound healing, according to the National Institutes of Health Office of Dietary Supplements.
Potassium may help lower blood pressure and is essential for the water balance between the cells and body fluids, such as electrolyte balance, according to the American Heart Association.
Iron oxygenates the blood and body and helps keep a healthy immune system.
Check with a health-care professional before increasing potassium intake if you have kidney complications or kidney disease.
The next time you pour yourself a cup of white, green, or black tea, you could be doing your health a favor. Tea contains antioxidant-rich flavonoids, called catechins, which have been studied for their effectiveness in preventing chronic illnesses such as cancer and heart disease, says nutritionist Jeannette Jordan.
There are various types of teas from all over the world, and many are sold ground in tea bags or as loose-leaf varieties.
Fun tea facts: White tea is the highest in antioxidants, with green coming in second, followed by oolong tea, then black tea, according to Mike Feller, co-owner of Gong Fu Tea in Des Moines. This is because of each tea’s degree of oxidation–the less it is oxidized, the higher the antioxidants and the lower the caffeine.
Tea can be enjoyed either hot or cold. If you prefer decaf, Feller suggests this technique: Steep regular tea for 30 seconds, then pour it out. Steep the tea leaves or tea bag again for 3 to 5 minutes, then drink. This natural, chemical-free decaffeinating process removes 80 percent of the caffeine, which is released in the first 30 seconds.
The tomato is an excellent source of vitamin C and potassium and is rich in lycopene, a powerful antioxidant that is easier for your body to absorb from cooked and processed tomatoes, such as tomato juice, than from fresh, whole tomatoes. According to Healing Gourmet: Eat to Beat Diabetes (McGraw-Hill, 2006), adding a little bit of oil while sauteing or cooking tomatoes can help aid in lycopene absorption.
Studies suggest lycopene-rich tomato products may help protect against certain types of cancer, including prostate cancer, and may offer cardiovascular and anti-inflammatory protection.
Yogurt is a sweet treat that is creamy, delicious, and good for you. An excellent source of calcium, which helps promote the health of bones and teeth as well as muscle and blood vessel function, yogurt, is also a good source of energy-boosting vitamin B2 (riboflavin) and protein. It also provides zinc, which can be deficient in some people with diabetes and aids in immune function and wound healing. Probiotic yogurt contains health-promoting bacteria that some research has proposed is beneficial for digestive health, including lactose intolerance and irritable bowel syndrome. Yogurt’s live cultures may also benefit immunity and improve cholesterol, according 101 Foods That Could Save Your Life (Bantam Books, 2008).
There are different yogurts to choose from on the market, including Greek yogurt, which is thicker than regular yogurt because it is strained before being packaged.
More information can be found at www.diabetes.org, Diabetic Living, CDC and ADAM.
Today’s blog post is brought to us courtesy of Ken Oswald
Safety and Security Manager for Plateau