Nutrition Goals for Patients with Diabetes

November is National Diabetes Awareness month! With that we want to ensure that all our patients with diabetes understand how their diet can impact their diabetes and how to structure their meals.


First and foremost it’s important to know what blood sugar goals to aim for. There are two ways to assess how much sugar is in the blood. The more common way is to use a lancing device and test strips. Patients can check their blood sugar at their own convenience this way and check it multiple times throughout the day to see how food they eat affects them.


There are a couple important numbers to remember when checking your blood sugar this way. Before meals blood sugar levels should be between 80 and 130 mg/dL. Two hours after eating a meal (called postprandial glucose or PPG) should be less than 140 mg/dL. Fasting blood sugar levels, meaning after more than 8 hours with no food, should be less than 110 mg/dL.


The second way to check blood sugar is through a lab test abbreviated as HbA1c or A1c. This abbreviation simply represents a 3 month snapshot of how your red blood cells regulate sugar. Most patients should aim for an A1c of less than 7 mg/dL.


You may see the term macronutrients thrown around. That simply means the large food groups that all people consume daily. The three main macronutrients most people refer to are carbohydrates (also called carbs, grains or starches), protein, and fat. While macronutrients are calculated on an individual basis, typically carbs make up ~45% of calories, fats make up ~36-40% of calories, and proteins make up ~16-18% of calories.


The American Diabetes Association has created MyPlate, which can help with meal planning and understanding how proportions of food may look for meals. Below is a picture of the MyPlate graphic.


The percentages mentioned above are equal to 3-4 servings of carbs, 4-5 servings of protein, 2-3 servings of fat, 4-6 servings of vegetables and 2-3 servings of fruit in a day. It’s important to know that serving size is dependent upon the specific food item.


Calories are based on weight management goals and our pharmacists or your physicians, dieticians, or other healthcare providers can help you determine this number.


With certain foods you may hear the term Glycemic Index, abbreviated as GI. Glycemic index is the fancy way to say how the food impacts your blood sugar. The higher the GI means the larger the impact (or increase) in blood sugar. High GI foods tend to keep you full for less amount of time as well. Think white bread, candy, or cupcakes. Low GI foods keep you feeling full for a longer amount of times. Think whole grain bread, brown rice, beans, or yogurt. To learn more about the glycemic index click here .


You may be thinking, “Are there other important things to consider in my diet?” The answer is yes!


Fiber is very important. Luckily, fiber is in other foods you are already choosing such as beans, peas, fruits and whole grains. It is recommended to consume 14 grams of fiber per 1,000 calories eaten. However, some patients may need to use dietary supplements. Fiber can help lower A1c levels. Keep in mind when reading nutrition labels, the percentages provided are based typically off of a 2,000 calorie diet.


Additionally, it’s important that patients with diabetes (and/or high blood pressure or high cholesterol) limit their salt intake. This can be done by buying less pre-made frozen or canned foods, choosing canned goods that say “No salt added” and by cooking at home. Typically most healthcare providers recommend less than 2 grams of salt a day for people with high blood pressure, high cholesterol and/or diabetes.


There are much more components to diet that we would love to discuss with you when you stop by the pharmacy. We have even created some handouts for you discussing diets recommended for patients with diabetes and examples of recipes.


If you still have questions or want further guidance on how to test your blood sugar, how to create meals, eat out or meal prep, stop by the pharmacy and talk to our staff!



Resources:

https://www.aace.com/disease-state-resources/diabetes/depth-information/type-2-diabetes-glucose-management-goals

https://care.diabetesjournals.org/content/42/5/731

https://care.diabetesjournals.org/content/43/Supplement_1/S66

https://clinical.diabetesjournals.org/content/38/1/10

https://www.cdc.gov/diabetes/managing/eat-well/meal-plan-method.html


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