Diabetes Management

Managing your diabetes

• Once your diabetes has been diagnosed you will work as a team with your health care provider and nurses and, if one is available, a dietitian
• The goal of managing your diabetes is to keep your blood sugars close to the blood sugar levels of people who do not have diabetes
  • The more normal your blood sugar, the less likely for you to develop the complications of diabetes
• Management is a balance
  • The key factors are diet, physical activity and, if necessary, medication

Ways to manage your diabetes

• The goal of diabetes management is to keep your blood sugar and hemoglobin A1C in the recommended ranges
• You do this through:
  • Diet
  • Physical activity
  • Medications, if necessary
• Most diabetes can be managed if you can to keep your daily blood sugar levels within the following ranges:
  • Fasting blood sugar at 80-110 mg/dl
  • After meals at 180 mg/dl or less
  • Bedtime at 100-140 mg/dl
• Different factors will affect your blood sugar:
  • Diet (and weight)
  • Physical activity
  • Stress
  • Illness

Diet:  Why is diet important?

• Our diets must give us the needed nutrition to keep all of our tissues strong and healthy
• We must maintain a balance of food groups to have:
  • Healthy weight
  • Normal blood sugar
  • Normal cholesterol

What is a healthy diet?

• Eating well requires choosing healthy foods
  • Lean meats
  • Lots of fruits and vegetables - raw and cooked
  • Boiled beans are healthy!
  • Whole grains and nuts
  • Whole wheat breads and noodles
  • Unsalted nuts
  • Low fat dairy products - milk, cottage cheese, yogurt, low-fat sour cream
    • If you are lactose-intolerant - can't use milk products - you can use lactose-free foods and drinks, use soy milk, use tablets like Lact-aid to remove the milk sugar
• To get a good idea of what foods you should be eating go to www.choosemyplate.gov › resources › MyPlatePlan

• Click on "start"
  • Fill in your age, sex, height, weight and activity level to see how many of each food group you should be eating every day
• Using healthy cooking methods
  • Boil - beans
  • Steam- other vegetables
  • Bake - vegetables and meats
  • Broil - meats when possible
• These cooking methods keep most of the natural nutrition in the food without adding fats

Choosing healthy portion sizes

• About 4 ounces (roughly the size of a deck of cards)
• This is a normal portion of meat, vegetables or grains
  • If you can eat 1-2 portions of different fruits and vegetables and at least one grain each meal, that's good nutrition.
• Eliminating unhealthy foods, for example:
  • Potato chips
  • Sugared drinks (soda pop)
    • Two cans of soda pop per day (300 calories, nearly 3 ounces of sugar) can cause one pound of weight gain every two weeks with NO nutritional benefit from the pop.

Healthy Diets: Traditional Native American Foods

• The traditional diets used by our tribal ancestors have been found to be healthy and do not contribute to high blood sugar.
• Returning to a Native American diet would be ideal, but many of the foods or food sources are not available and/or are too expensive.
• Why is the traditional diet healthy?
  • Wild game meat eaten by the ancestors was low in fat
  • Food preparation did not include frying or adding sugar
  • Foods gathered like roots or berries were high in fiber and low in sugar
  • There was no refined sugar or white flour
  • Even cooking or gathering berries and nuts required physical exercise
• The food exchange
  • Because persons with diabetes often are taught how to exchange certain foods for another, this has become known as a special diabetes diet or exchange diet.
  • But there is no special diabetes diet; the diet recommended is one that is healthy.
  • Food exchanges can help you balance healthy combinations of carbohydrates (simple and complex), protein, and fats.
  • If you are interested in using food exchanges to help balance your diet, go to this website: www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/fd_exch.htm  
• Diabetes and alcohol
  • If your blood sugar is well-controlled and if you take proper precaution, it is possible to have alcohol once in a while.
  • No more than one drink per day for women.
  • No more than two drinks per day for men.
  • One drink is:
    • 12 ounces of regular beer (150 calories)
    • 5 ounces of wine (100 calories)
    • 1.5 ounces of 80-proof distilled spirits (100 calories)
  • Precautions when drinking alcohol
    • Always eat something when you drink
    • Check the alcohol level of your drink
    • Account for any extra sugars added to the drink like fruit juices, soda pop or mixes
  • Watch out for
    • Signs of hypoglycemia (low blood sugar)
    • Confusion, rapid heart beat, cold sweats
    • Check your blood sugar if you are having these symptoms. If your sugar is low (below 100), treat it by taking glucose tablets or a snack high in sugar
• Before you go to bed after having a drink, eat a snack
  • Your blood sugar level can drop in the middle of the night
  • To prevent this, you may want to set your alarm clock to wake you up so you can test your blood glucose and eat a snack if necessary
  • Why does this happen?
    • When you drink alcohol, your liver stops making glucose while it removes the alcohol from your blood
    • And it takes the body about 2 hours to remove one ounce of alcohol from your body
    • This is enough time for your sugar to drop to low levels

Physical Activity:  Why exercise is important 

• Helps lower blood sugar (glucose)
• Reduces blood pressure
• Lowers blood fats (lipids) - cholesterol and triglycerides
• Assists in weight loss
• Reduces stress
• Strengthens bones
• Helps body use insulin more efficiently (your natural insulin and injected insulin)
• Helps prevent or delay diabetes complications

Manage your diabetes well!

• Choose nutritious foods
• Maintain a healthy weight
• Be physically active
• Keep your sugars under control