Handle your diabetes with healthy living

By Neil Bartlett

Managing type 2 diabetes

Diabetes is the seventh leading cause of death in the U.S., affecting about 29 million people. Another 86 million are at risk of developing the disease in the next five years, according to the Centers for Disease Control and Prevention. By far, Type 2 is the most common form of the disease, as only 5 percent of people with diabetes have Type 1.

 NetQuote.com asked Jill Weisenberger, who's worked with individuals with Type 2 diabetes for more than 20 years, to help readers better understand and manage diabetes. She's an internationally recognized nutrition and diabetes expert, author of three books and graduate of the University of Florida. Weisenberger is a member of the Academy of Nutrition and Dietetics, the American Association of Diabetes Educators and the American Diabetes Association. 

Q. Some Type 2 diabetes experts say cutting out carbohydrates is unwise, while other diabetes experts advocate a high-protein, high-fat diet with few carbs. Which approach do you prefer, and why?

A. There are many ways to a healthy plate and good diabetes control. There's no "one size fits all" eating plan for diabetes. So I don't advocate one particular diet over another. There are good arguments for many diet plans. I've had people do very well controlling their Type 2 diabetes on a high-carb vegan diet. Then I've had people do better on a low-carb omnivorous diet, and every single thing in between. I wouldn't advocate that someone with Type 2 do something against common sense, such as follow a diet that severely restricts calories.

Individuals with Type 2 diabetes are at higher risk than others for several cancers and heart disease. So when looking at food choices, what you eat is important for several reasons. It's a mistake to focus on your blood sugar readings alone. Look at the bigger picture. The quality of the food you eat is more important than just looking at the fat, carbohydrate and protein amounts. Choose foods in moderation that you enjoy and give the most health protection.

So if you have Type 2 diabetes, eat a piece of fruit, not a bowl of fruit. Enjoy starchy vegetables and grains, not a giant plate of spaghetti. With each type of food, there are smart choices and poor choices. It's the difference between drinking a large glass of sweetened iced tea versus a small apple, glass of low-fat milk and half-cup of black beans. That's a big difference in the quality of food.

There's usually something that works for everybody. It may be spreading out when you eat food better, cutting back on portions and calories, and redistributing the carbohydrates.

Jill Weisenberger

Q. Many experts advocate a high-fiber diet to help people with Type 2 manage their condition better. Why?

A. Generally, if you're eating a high-fiber diet, you're eating high-quality food. That's a plus. But fibers aren't all the same, so we can't say all fibers will lower blood sugar. If you eat a variety of fiber-rich foods like vegetables, whole grains and fruit, it can help you maintain or lose weight. Fiber is an excellent topic to bring up with a registered dietitian.

Q. Is there any one thing that's easiest for people with Type 2 to lower their A1c readings?

A. For most individuals with Type 2, controlling calories and carbs is vitally important. And many individuals with Type 2 are overweight. For them, reducing calories is even more important.

If you have extra pounds and you start restricting calories, you should see improvement in your blood sugar readings even if you don't lose weight. If you lose weight and then plateau, don't give up and return to your old habits. Continue to eat as you are to maintain your new weight and blood sugar control. Or see a registered dietitian to help. 

Another good strategy is to exercise regularly -- daily is best. The American Diabetes Association and the American College of Sports Medicine recommend 150 minutes a week of brisk walking. Exercising after a meal helps lower post-meal blood sugar numbers. But exercising anytime is a lot better than not doing it. 

Q. Why is sleep so vital to people with Type 2 diabetes?

A. Research shows that people who are sleep-deprived are at higher risk for Type 2 diabetes, heart disease and obesity. The reasons aren't clear, though hormones may play a role.

Look at it this way: If you're sleep deprived, studies show you're a lot more likely to choose foods that are higher in calories and lower in nutrients. If you're tired from lack of sleep, how motivated will you be to prepare a healthy meal or take a walk? Diabetes is a condition that requires almost constant work. It's easy to lose your motivation when you're sleep-deprived. Stress and sleep deprivation will distract you from doing other things that will help you control your diabetes.

Q. Why is it so important to rest each day while managing of Type 2 diabetes?

A. Diabetes is a time-intensive disease -- you can't take a vacation from it -- and it can drain your energy. Everyone needs to have a little time to relax and recharge. If you have Type 2, it's even more important.