Cait James

Cheat Sheet / Updated 11-30-2023

When you have diabetes, you need to monitor your health closely — including what you eat, how much you eat, and how much you should eat. Managing diabetes means knowing your ideal weight, body mass index (BMI), and kilocalorie intake; maintaining healthy eating habits; and recognizing food terms that indicate fat content.

Step by Step / Updated 04-24-2017

Following a nutritional plan sometimes seems so complicated. But really, if you follow the few simple rules outlined here, you can make the process much easier. None of them cost anything other than time. Doing them one at a time makes a big difference in your calorie and fat intake. Adding one after another makes the results huge. Your weight, blood pressure, and blood glucose all fall. Who could ask for anything more?

Step by Step / Updated 03-09-2017

Children don’t hate vegetables any more than they hate ice cream. It is what you teach them that determines their feelings about food. If you show them that you love vegetables and consider them delicious, that’s how they will feel about vegetables. They love to follow your example. The best time to do this is at family meals. Following are ten of the numerous things you can do to encourage your child to eat vegetables.

Step by Step / Updated 06-24-2016

You may think that giving up the diet you’ve followed all your life in favor of the Mediterranean diet requires a major upheaval in your lifestyle. The process may not be simple, but you aren’t giving up good taste. You’ll enjoy the diet — and your blood glucose, blood pressure, cholesterol, and weight will all take a turn for the better. Here are ten ways to go from your current diet to the Mediterranean diet.

Article / Updated 03-26-2016

As you go through life with diabetes, you'll be exposed to many "experts" and different ideas about the best way to manage your disease. Before you make a major change in your diabetes program, run the new ideas by your doctor or diabetes educator to make sure it will help and not hurt you. Here are a few of the more common myths about diabetes — save yourself some grief and ignore them. People with diabetes shouldn't exercise. This myth probably arose from the rare person with diabetes who has severe eye disease and probably shouldn't jar his or her eyes. For the vast majority of people with diabetes, the truth is the opposite. Exercise is one of the best ways to help bring your diabetes under control. People with diabetes can only engage in moderate exercise, like walking. The large number of people with diabetes who are professional athletes should be all the proof you need that, with proper precautions, including checking with your doctor before you begin high-intensity exercise, you can do any level of exercise you desire (and it will further improve your diabetes). If in doubt about whether a form of exercise is safe for you, as always, talk with your doctor. People with diabetes can't get life insurance. This myth can easily be proven false by checking with a few insurance companies. They'll be more than happy to accept your premium for insurance. Needing insulin shots means you're at the end of your disease. In fact, insulin is often used early in diabetes to get control of blood glucose. Many patients on insulin can come off it with just lifestyle changes. Insulin is just another tool for good diabetes care. Low blood glucose kills brain cells. Studies have shown that adults who have low blood glucose have no loss of mental functioning. Children whose brains are still developing need to be protected from low blood glucose, however. Eating a piece of cake is dangerous. Sure, your blood glucose may go a little higher, but you can easily bring it down with exercise or medication. An occasional slip is not irreversible. If you take your medicine, follow a healthy diet, and get enough exercise, your glucose will be perfect every time. So many things go into determining your blood glucose, including your mental state and menses (for menstruating women), that you shouldn't be surprised if an occasional blood glucose measurement is out of the acceptable range. There are simple cures for diabetes like acupuncture, yoga, or chromium. Unfortunately, to date there are no simple cures for diabetes. If one is found, you'll hear about it. Until then, it's diet, exercise, and medication. You can't be spontaneous when you have diabetes. The fact is, you can live your life much like the person without diabetes, but the addition of a better diet and plenty of exercise will probably make you healthier than your friend who doesn't have diabetes. Diabetes is inherited. Type 1 diabetes is rarely found in two members of the same family. Type 2 diabetes does run in families but that has more to do with family dietary habits and lack of exercise than heredity. You are not to blame if your child develops diabetes, and you can't pin your diabetes on your parents.

Article / Updated 03-26-2016

Exercise is a key part of the foundation for the management of diabetes (the other parts of the foundation are diet and medication). Everyone with diabetes should exercise, but be sure to check with your doctor if any of the following apply to you: You have complications of diabetes like eye disease, kidney disease, nerve disease, or heart disease. You're obese. You have a physical limitation of some kind. You have high blood pressure. You're on medication. To make exercise safe and healthful, follow these tips: Wear an ID bracelet stating that you have type 1 or type 2 diabetes. Test your blood glucose often — before, during, and after exercise. Choose proper socks and proper-fitting shoes. Drink plenty of water before, during, and after exercise. Carry treatment for low blood glucose with you at all times. Exercise with a buddy. Reduce your insulin dose and/or eat some carbs before you exercise. If you're wondering when you should exercise, the answer is: any time you'll do it faithfully. Some people are morning exercisers, and other people prefer exercising in the evening. The time of day you exercise doesn't matter — the key is to do it! The American Diabetes Association recommends 150 minutes of moderate-intensity aerobic exercise spread out over at least three days per week, with no more than two consecutive days passing without exercise. Whether you should do more than that depends on your goals — maybe you want to lose weight, become a champion racer or swimmer, or just maintain a healthy mental state. As you exercise more, you'll become better conditioned, but if your exercise is somewhat hard for you to do, you're working out at the right intensity. Resistance exercise (like weight lifting) is just as good as aerobic exercise for your diabetes. Just be careful not to do so much that you injure yourself and have to stop.

Article / Updated 03-26-2016

Although diet is an essential part of the Mediterranean lifestyle, there is much more to it than just the diet. Most of the way that people live their lives is consistent with prevention or amelioration of diabetes. Many other behaviors that make up the Mediterranean lifestyle contribute to the long, healthy lives of people who live in the Mediterranean region. Taking a run on the beach in the morning, a stroll around town, or a brisk walk in the evening is typical. People in the Mediterranean also use their bicycles to get around a lot more than Americans typically do. Exercise is a key part of the prevention and management of diabetes. The mild winters and the long hot summers of the Mediterranean make the outdoor lifestyle a lot easier, too. In the Mediterranean, the "eat and run" concept is unheard of. Stores close in the middle of the hot day, and people return home for a long lunch, during which they chew their food slowly and don't watch TV or check their email. They may have a glass of red wine with their lunch. Often there are guests and conversations ensue, which everyone enjoys. Conversation also slows down the pace of eating. Their bodies are given time to feel full so people tend to eat less. Eating less leads to more normal weight, another key part of the prevention and management of diabetes. And, of course, they cook their own food. Relaxing with friends also reduces stress and increases longevity. It's part of what makes life worth living. Stress reduction is another essential part of the prevention and treatment of diabetes. When you relax, you don't secrete the hormones like cortisol that tend to raise your blood glucose. Another important aspect of the Mediterranean lifestyle is the tendency to take a nap. The long lunch and the glass of wine lead to a calm feeling that makes you tired even though, typically, people in the Mediterranean area don't set clocks to wake themselves early in the morning. Rest is not only good for diabetes but for your blood pressure and your heart. Although the benefits of the Mediterranean diet are greatest when eaten as a part of a total lifestyle, you don't need to move to Greece or Italy to profit from it. You can adopt the diet and follow these tips to immerse yourself in the lifestyle: Take a walk after dinner every night. Tell yourself you're going for a passeggiata (an evening stroll), and maybe you'll feel like an Italian! Walk or ride your bike instead of driving, at least for errands closer to home. Make an effort to eat slowly, at a table, free of distractions. Invite friends to join you in conversation, or if you're dining alone, listen to some relaxing music. Cap off your meal with a glass of red wine. Take an afternoon nap to stay rested. And make sure to get enough sleep every night. Aim for eight hours. Plan a two-week trip to the Mediterranean coast of Greece if you can. If that's not in your budget, rent Mamma Mia! and imagine yourself dancing the night away with Meryl Streep.

Article / Updated 03-26-2016

Vegetarian eating is an excellent way to prevent diabetes or to manage it if it occurs. Although a vegetarian diet remains an excellent diet for diabetes, most people prefer to have some animal protein in their diets — for taste, variety, and convenience. The Mediterranean diet fulfills all these criteria and more. The first big study confirming the benefits of the Mediterranean diet was published in the Archives of Internal Medicine in December 2007. It showed a significant reduction in deaths from all causes. More recently, in a study published in the Annals of Internal Medicine in January 2014, patients who followed a Mediterranean diet supplemented with extra-virgin olive oil had a significant reduction in the onset of diabetes compared to a control group who were just given advice on a low-fat diet. Another study, published in Diabetologica in December 2013, confirmed the advantages of the Mediterranean diet. These are just a few of the many studies pointing to the effectiveness of the Mediterranean diet in preventing or managing diabetes. What are the major features of the Mediterranean diet? The diet emphasizes the following: Plant-based foods such as fruits and vegetables, whole grains, legumes, and nuts Olive oil in place of butter or margarine Herbs and spices to flavor foods instead of salt Red meat no more often than twice a month Fish and/or poultry twice a week Alcohol in moderation (5 ounces of red wine daily for all women and men over 65 years and 10 ounces for men younger than 65) People with a family history of alcohol abuse or heart or liver disease should not drink any alcohol. How can you get started without moving to Greece? Here are some suggestions: Make sure that most of your meal and snacks are made up of fruits and vegetables, preferably unprocessed and whole. If you eat bread or cereal, make sure it’s whole grain. The same is true for rice and pasta. Skip butter and use olive oil on bread or pasta instead. Tahini (blended sesame seeds) is another great alternative to butter. Eat a handful of almonds, cashews, pistachios, and walnuts for a delicious snack. Add herbs and spices to flavor your foods. Grill or bake fish instead of frying or breading it. Especially good for you are tuna, salmon, trout, mackerel, and herring, fresh or in cans. If you eat dairy, opt for low-fat options like skim milk, fat-free yogurt, and low-fat cheese. The food that you find in Italian chain restaurants across the United States is not Mediterranean food. They use a lot of butter, full-fat cheese, cream sauce, meat, and white-flour pasta among other non-Mediterranean foods. So, don’t think you’re eating Mediterranean just because the restaurant serves pasta.

Article / Updated 03-26-2016

Thai food is a good choice for people with diabetes. It is cooked with little fat because stir-frying is the method of choice. Thai cooking keeps the meat, fish, and poultry to small quantities, thus providing taste rather than bulk, as in a Western diet. The dipping sauces have strong tastes, so they’re used in very small quantities, minimizing the salt and sugar in the diet. Vegetables are eaten in larger quantities. At the end of the meal, Thais enjoy fruits like mango, pineapple, guava, and papaya, which provide fiber, vitamins, and minerals. Thai food, like Italian food, is also the product of many influences. Westerners introduced milk into Thai cooking, and because coconut milk is so readily available, this became a staple of Thai dishes. The Chinese coming down from the north brought stir-frying with them, as well as noodles. Thanks to the Chinese, the five basic flavors of Asian cuisine — bitter, salt, sour, hot, and sweet — were established, and Thai meals use them as their basis for a balance of flavors. Dishes made with soy and ginger are a good example. India brought curry dishes to Thailand, with coconut milk serving as an antidote to the hot spices in some of those curry dishes. The Thais have put their own delicious stamp on these curries, using a lot of green chile pepper, also given to them originally by Westerners. Southern Thai food is usually hot and spicy, and fish is a major ingredient because the area is so close to the sea. However, you can always get dishes that aren’t so spicy, and the subtle tastes of good Thai cooking have made it tremendously popular in the United States and throughout the world wherever Thais are found. Rice generally is part of the meal. Most Thai dishes have garlic, a condiment that grows all over Thailand. Coconut milk, actually a combination of the coconut flesh and the liquid inside the coconut, is added to Thai curries and soups. Use the low-fat coconut milk if possible. Fish sauce, made by fermenting shrimp, salt, and water together, takes the place of soy sauce in Thai cooking. In American Thai restaurants, a dish called pad thai has become a favorite entree. It means “Thai-style stir-fried noodles” and was brought to Thailand by the Chinese. When employment was low in Thailand after World War II, the government promoted noodle shops and stalls as a way of getting people back to work, and pad thai noodles became popular throughout the country. Thai immigrants brought the dish to the United States. It’s not exactly representative of the finest Thai cuisine, but it’s eaten so frequently in the United States that it must be considered when the diabetic has Thai food, particularly because the sauce often contains a lot of sugar and salt. A small portion of pad thai is fine for the person with diabetes, but leave at least half the serving for another day. Thai food is so nutritious that there is little about it to warn the person with diabetes. As always, avoid large portions and too much rice. And be careful of the hot spices.

Article / Updated 03-26-2016

Although people with diabetes are allowed to have some sugar in their diet, sugar is more appropriate for a diabetic who is at normal weight than an obese diabetic. Preventing obesity may be a matter of avoiding as little as 50 extra calories a day. If this can be accomplished by using artificial sweeteners, which provide sweetening power but no calories, so much the better. There is no good evidence that using sugar substitutes results in significant weight loss. Recipes calling for 1/4 cup or more of sugar are perfect opportunities to use a sugar substitute and significantly lower the calories from sugar. Kilocalorie-containing sweeteners Several sugars besides sucrose (table sugar) are present in food. These sugars have different properties than glucose, are taken up differently from the intestine, and raise the blood level at a slower rate or not at all if they’re not ultimately converted into glucose. They sometimes cause diarrhea. Although these kilocalorie-containing sweeteners are sweeter than sugar, and you use them in smaller amounts, they do have calories that you must count in your daily intake. The following sweeteners contain kilocalories but act differently in the body than sucrose: Fructose, found in fruits and berries: Fructose is sweeter than table sugar and is absorbed more slowly than glucose, so it raises the glucose level more slowly. When it enters the bloodstream, it is taken up by the liver, where it is converted to glucose. Xylitol, found in strawberries and raspberries: Xylitol is also sweeter than table sugar and has fewer kilocalories per gram. It is absorbed more slowly than sugar. When used in gum, for example, it reduces the occurrence of dental caries (tooth decay). Sorbitol and mannitol, sugar alcohols occurring in plants: Sorbitol and mannitol are half as sweet as table sugar and have little effect on blood glucose. They change to fructose in the body. Sweeteners without calories This group of non-nutritive or artificial sweeteners (with the exception of Stevia, which comes from a plant) is much sweeter than table sugar and contains no calories at all. Much less of these sweeteners will provide the same level of sweetness as a larger amount of sugar. However, the taste of some of them may seem a little “off” compared to sugar or honey. They include the following: Saccharin: This has 300 to 400 times the sweetening power of sugar, and it is heat stable so it can be used in baking and cooking. Brand names for saccharin are Sucaryl, SugarTwin, and Sweet’N Low. Aspartame: This is more expensive than saccharin, but people often prefer its taste. It is 150 to 200 times as sweet as sugar. Equal and Sweet Mate are two of the brands. It loses its sweetening power when heated, so it can’t be used if food has to be cooked for longer than 20 minutes. Acesulfame-K: This is 200 times sweeter than sugar and is heat stable, so it is used in baking and cooking. Stevia: This is 250 to 300 times sweeter than sugar. It was approved by the FDA in 2008 and marketed as Rebiana in Coca-Cola. Sucralose: This sweetener, which is made from sugar, is 600 times sweeter than its parent, sucrose. The brand name is Splenda. It remains stable when heated and has become a favorite sweetener in the food industry. Because foods don’t bake the same when made with Splenda, a combination of Splenda and sugar called “Pure Magic” is sold to reduce calories while providing the baking characteristics of sugar. Feel free to substitute calorie-free sweeteners whenever sugar is called for. The calories you save could make a big difference in your diabetes. Contrary to opinions that you may hear or read, there is no scientific evidence that these sweeteners are associated with a higher incidence of cancer.