AboutCatherine Burns. RN. BS. Expertise I will endevour to answer questions re daily "Self Management of Diabetes Care" for people who are currently under the care of a physician.
My focus would be Diabetes health care education and not diagnosis.
Experience I have 15 years experience as a Diabetes Nurse Educator.
Education/Credentials I am an RN for many years.
I have a BS in Healthcare Management.
I was a Certified Diabetes Educator for many years.
Question My husband came home from the doctor yesterday and said he was very close to being diabetic. (He is very over weight at 270 lbs.) I have been reading about recommended diets (how many starches, fats, portion control, etc. to try and help him. What about alcholol? Should he eliminate all drinking? If he does have a drink, what is best (wine vs. bourbon?) Is it considered a starch?
Thank you for your help.
Answer
Cathy Pennington Asks in Category Endocrinology (including Diabetes) ...
Subject: Type 2 Diabetes
Private: no
Question: My husband came home from the doctor yesterday and said he was very close to being diabetic. (He is very over weight at 270 lbs.) I have been reading about recommended diets (how many starches, fats, portion control, etc. to try and help him. What about alcholol? Should he eliminate all drinking? If he does have a drink, what is best (wine vs. bourbon?) Is it considered a starch?
Thank you for your help.
Answer:
Dear Cathy,
The following is basic general information, and it is not intended to
be viewed as a replacement for the personal physician’s expert medical
evaluation, diagnosis, advise, or treatment.
“Very close to being diabetic” could mean either pre-diabetes, or type 2 diabetes. You did not provide the current fasting blood glucose level, so the following will help you determine which type of diabetes is involved.
..Fasting blood glucose levels over 100mg/dL to 126mg/dL range indicates pre-diabetes.
Fasting blood glucose levels over 126mg/dL indicates diabetes.
I shall address the pre-diabetes issue, as I feel that is what the physician was referring to.
Pre-diabetes is a serious medical condition that can be treated. The good news is that the recently completed Diabetes Prevention Program study conclusively showed that people with pre-diabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity. They may even be able to return their blood glucose levels to the normal range. The normal fasting blood glucose level is below 100mg/dL
Have the personal physician recommend a personal exercise program for your husband.. In the meantime, walking for 10 to 15minutes after meals can help improve the body’s insulin activity.
With pre-diabetes there is some insulin resistance.
Insulin is a hormone that is essential in helping glucose get inside the body’s cells so it can be converted to energy. Insulin is made in the pancreas, a vital organ that lies behind your stomach.
Insulin resistance is where existing insulin at the cell site fails to enter the cell because the cell membrane will not allow the insulin to drive the glucose into the cell to be “burned” for energy. The cell then “resists” the insulin and fails to lower blood sugar levels. As a result, the pancreas produces more insulin to help move glucose into the cells, and blood insulin levels rise. Eventually, the pancreas can no longer produce enough insulin to compensate for the insulin resistance, causing blood glucose levels to rise and diabetes to develop.
Until the fasting blood glucose level is below 100mg/dL (Normal range) your husband needs to eliminate foods high in sugar. .A weight reduction of as little as 10lbs or 5% to 7% of total weight can lower blood glucose if the blood glucose is higher than normal. I recommend a referral to a nutritionist who is a Certified Diabetes Educator and is highly qualified to educate on making the essential healthy food choices, with focus on weight reduction
In the meantime the following tips are very informative, from the The American Diabetes web site.
Making Healthy Food Choices
Here are a few tips on making healthful food choices for you and your entire family.
• Eat lots of vegetables and fruits. Try picking from the rainbow of colors available to maximize variety. Eat non-starchy vegetables such as spinach, carrots, broccoli or green beans with meals.
• Choose whole grain foods over processed grain products. Try brown rice with your stir fry or whole wheat spaghetti with your favorite pasta sauce.
• Include dried beans (like kidney or pinto beans) and lentils into your meals.
• Include fish in your meals 2-3 times a week.
• Choose lean meats like cuts of beef and pork that end in "loin" such as pork loin and sirloin. Remove the skin from chicken and turkey.
• Choose non-fat dairy such as skim milk, non-fat yogurt and non-fat cheese.
• Choose water and calorie-free "diet" drinks instead of regular soda, fruit punch, sweet tea and other sugar-sweetened drinks.
• Choose liquid oils for cooking instead of solid fats that can be high in saturated and trans fats. Remember that fats are high in calories. If you're trying to lose weight, watch your portion sizes of added fats.
• Cut back on high calorie snack foods and desserts like chips, cookies, cakes, and full-fat ice cream.
• Eating too much of even healthful foods can lead to weight gain. Watch your portion sizes.
Want more information on foods that are healthier, or how to establish a plan for eating healthy foods? Let the American Diabetes Association help point you in the right direction. Go to the following web site.
Nutrition & Recipes - http://www.diabetes.org/.../nutrition/overview.jsp
For more information on pre-diabetes and diabetes go to diabetes.org.
You can also take the risk test for diabetes at this site.
Excerpt from The American Diabetes Association re Alcohol
Although an occasional drink may not hurt your blood sugar control, it can harm your eating plan if your goal is weight loss. Two light beers equal about 200 extra calories. Alcohol is called empty calories because it does not give you any nutrients.
If you are on a low-calorie meal plan, think twice about adding alcohol. In general, alcohol counts as fat servings (1 drink equals 2 fat exchanges).
I recommend that your husband’s personal physician be the one to advise re use of alcohol. The physician knows the medical history, and the medications (if any) that are prescribed. There are some medical conditions and medications that do not permit alcohol consumption.
.I wish you and your husband good health,
Sincerely,
