Diabetes Diet Help

    • Gold Top Dog

    Diabetes Diet Help

    My husband was diagnosed with type 2 diabetes yesterday.  The doctor says he needs to lose about 20 lbs., change his diet and start testing his glucose.  He has an appointment to speak with a nutritionist and to learn how to use the meter, but that's not until March 19th.
     
    In the meantime, I want to get started on changing his diet now, but I don't really know what he should/should not be eating.  I've started doing research on the internet and I see we've got a lot to learn, but I really need to get some grocery shopping done soon.  Anyone have a short list of things to avoid, at least until we see the nutritionist? Any info at all would be appreciated.
    • Gold Top Dog

    I am really no help but wanted to send you my support.  My mother was just diagnosed with diabetes 2 and given the same info as your husband.  She loves sweets and the few things I do know is that she is trying to limit her carbs as well as sugar and is buying sugar free when she can.  My mother had such a better understanding of what to do once she went to the doctor and the nutritionist.  I found a cookbook that I really like that has a lot of great recipes in it.  Trim & Terrific Diabetic Cooking by Holly Cleg.  I have found some new favorites in it and the recipes are all really quick and easy as well as very low calories so it meets all my needs. 

    I was given a few cookbook recomendations from a friend who also has type 2 diabetes.  Here is what she wrote to me:

    the one i showed y'all was better homes diabetic
    living cookbook.  there is also a cook book i like
    called "you can eat that!" awesome food for kids with
    diabetes...because even though it is for kids, it has
    great recipes in it!  there is also a book called
    "instead of this, eat that" that was featured on
    ellen's show the other day that i can't wait to get.
    it tells you about certain foods at restaurants and
    what the calorie, fat, carb, etc. intake is so you can
    make better choices.  it looks really good.  hope that
    helps!

    Edit: I want to say that on things like bread, past and rice that if she is going to have them I think she is supposed to stay with the more natural grains like brown rice, whole wheat pasta etc.  I could be wrong.  It might be easier to find some info by going to the local bookstore and picking up a book about it.  There is so much info on the internet that it can be hard to tread through it all and a little overwhelming.

    • Gold Top Dog

    http://www.diabetes.org/nutrition-and-recipes/nutrition/overview.jsp

     I use the website above when cooking for my friend with diabetes.  They have some good recipes that do not require exotic ingredients. 

    The main idea is to try to keep the blood sugar as even as possible without too many highs/lows.  I know she eats smaller and more frequent meals and tried to keep her carbohydrates to 50 grams a day.  She did really well and lost a lot of weight. 

     It's a change but doable - don't be scared.  Kathy tells me she feels better now then she ever has. 

    • Gold Top Dog

    If I'm remembering right,  I think it's white carbs that turn to sugar faster, so a switch to brown rice, whole wheat bread and pasta, sweet potatoes instead of white etc. would help.

    Joyce

    • Gold Top Dog

    Depending on the severity, the doc and the nutritionalist you'll find different allowable numbers of carb servings per meal.  DH can have 3/3/4 (brfst, lunch, dinner).  A carb serving is 15 grams.  Off the top of my head, 4 oz of OJ is 1 serving, 8 oz milk (2%) is one serving.  DH very often has a 'breakfast sandwich' which is pretty tasty.....1/2 toasted english muffin (1 carb serving) with a slice of canadian bacon and cheese....just stick in the microwave after its assembled for a few seconds.

    The idea is to balance everything he eats so that he gets protein to keep the blood sugar stable and the carbs.  As I recall, carbs trigger the release of insulin, while protein slows it down.  DH eats his 3 meals a day, and typically a couple snacks, balancing the carbs and protein.  So, instead of eating pretzels, he'll eat crackers with cheese.  With him I have to watch his cholestrol too so I have a bit more juggling to do.

    You'll need to start reading labels and measuring.  I don't know of a single veggie that has NO carbs, but typically the winter squashes, peas, carrots and corn will be HIGHER.    Those of course are the ones that DH likes BEST.  Naturally.

    The key is to remember that there is basically nothing that he CAN'T have, but the amounts need to be adjusted.  Ice cream you can only have a 1/4 cup, so if I know he's going to want some, I "save" a serving from dinner so he can have HALF a cup.  Still an awfully little amount, but better than 1/2 of that!

    If you need some ideas, shoot me an email and I'll help all I can!

    • Gold Top Dog

    I was diagnosed a couple of years ago with type 2.  Glenda gave a lot of the information I thought of, like a carb serving is 15grams.  My nutritionist gave me three servings per meal and 1 serving per snack.  Also, my nutritionist told me that if the serving has more than 5g of fiber, I can subract the fiber grams from the carb grams, therefore, a food with a lower carb serving. 

    Reading labels is going to be important.  Also, find a book/guide that will give you nutritional information about all kinds of foods.  I have The Doctor's Pocket Calorie, Fat and Carbohydrate Counter by Allen Borushek, Dietician, "The Calorie King".  There is also a web site: www. calorieking .com.  I have the 2004 edition, but I know that there is an updated edition.  My book has a diabetes diet guide. 

    Has your husband started any meds or are they letting him manage it with diet and exercise? 

    Sue

    • Gold Top Dog

    And then there is the whole issue of good carbs, not so good carbs, the fiber content, as Sue mentioned.....that's the part that gets really confusing.  So even thought a dried bean might have what looks like a lot of carbs, because of the fiber it doesn't "count" as much.  Or a whole wheat bread, pasta, etc, doesn't count quite as much as it's white counterpart.  And then we get into the whole complex vs simple starches.  It's enough to make a person pull their hair out.

    My very best advice is to MAKE HIM RESPONSIBLE FOR WHAT HE EATS.  Don't turn into the food cops.  My DH thought that I should be the one to go to the nutritionalist, not him.....after all, I do all the cooking.  Nope.  HE does all the eating and it has never been my job to monitor his food intake.  Yes, I prepare meals that are balanced for him, but, when it comes to his taking seconds of something, HE has to decide that on his own.  When it comes to the sides he orders with his meal out, HE has to use some common sense.  I'm happy to share what I've learned, that yes, the green beans would be better than the corn, but HE is the one who has to make the ultimate choice.  And yep, if you order mashed potatoes AND corn, you're blood sugar is going through the roof!

    I will NOT be the ogre that ruins the mans food enjoyment.  For us, it has to be that it is MY job to provide healthy meals and snacks, but it is HIS job to make responsible choices.  There is nothing he CAN'T have, so long as he uses some common sense about it, and everyone else in the house shouldn't be made to do without the snacks that THEY like because he won't say no to something.  In the very beginning I would portion the junk snacks so that he knew exactly what ONE carb serving was because it has always been his habit to sit with the bag, and not take out a single serving.  Breaking life long eating habits is tough, but it's not solely YOUR job, so please make sure that he is involved every step of the way and that HE does as much research as you do.

    Type 2 can be managed with diet and exercise, but it's HIS job to do his part.  You might have to encourage taking the walk, or joining the gym, but you can't do the situps for him.

    Just like weight lose, this involves a life style change, and HE is the one that has to embrace that.  With your help, but ultimately it's HIS job.

    • Gold Top Dog
    Thank you so much for all the info ladies.  Your posts sure added clarity to what I've been reading on the net.  
     
    The Dr. prescribed Metformin, at least for the time being.  His numbers were: 135 after fasting, 190 two hours after eating.  I don't know how high those numbers are on the scale.  I wish that I'd been able to go to the Doctor's office with him, as I would have asked a lot more questions than he did.  I hope that eventually it can be managed without the medication.  After reading up on the drug, we are thinking that he shouldn't start taking it until after he's seen the nutritionist.  He's going to call the Doctor's office today to see if it's ok to delay the start of the medication. 
     
    One of our biggest hurdles is going to be getting into the habit of eating regular meals to begin with.  We both are pretty much one-meal-a-day eaters.  Breakfast is going to be especially difficult.  My husband doesn't have much of an appetite in the mornings.  So, yep it's definitely going to be a complete life style change for us.
     
    Glenda, I'm sure it's going to be my natural instinct to micro-manage this thing to death.  But I know he'll be very proactive and will do a good job of doing what he needs to do, once we figure out what that is.  I just can't wait to get to the dietician to get his meal plan.
    • Moderators
    • Gold Top Dog

     my dh was diagnosed last spring and by early summer they said he was 'no longer a diabetic' but he has to watch diet, weight gain and monitor his blood sugar.  His numbers were very similar to your dh slightly higher if I recall correctly.

    From our experience - do not start the drug - get exercising, lose weight and change diet.  If that doesn't work then down the road you can look at drugs.  The numbers aren't terribly high.

    I will say off the bat that I don't really believe in famous diets but our physician recommended the South Beach Diet and good golly it worked and worked fast in reducing blood sugar.  DH followed the first bit for more than the proscribed 2 weeks (despite my railing against it) because he was into the instant weight loss (argh).  The first two weeks are difficult but then it gets easier and the recipes in the book are easy and good.  The basic premise is that because of the sugar overload (simple carbs) some people's body becomes insulin resistant.  By removing carbs (I believe it is completely) for the first two weeks and then gradually introducing the more complex ones the body becomes more responsive to insulin again.  Go somewhere and read the first 100 pages.  As I said I believe much more in eating right, exercising more as a lifestyle than formatted diets but this really worked.  he lost about 30lbs and he has been off the SB diet since July or August and kept the weight off and his blood sugar is still in the mid-high normal range.  I don't think he's been outside normal since May or so.

    Another friend that was diagnosed about the same time did SB too and also has dropped out of the 'diabetic' tag.

    Another friend was diagnosed last summer and decided to just eat better and exercise more.  She is doing really well and has also dropped to normal range.

    My DH really panicked and did lots of research and was really against starting the meds because that is more likely than not a decision that stays with you for life.  Manage the eating and weight loss first there are way less chance of complications.  When DH went to the nutritionist she also said oh great the SB is fantastic for diabetics.

    worst part is I have low blood sugar and need carbs to keep it up, we had some strange meals together during those first two weeks.  DH generally eats normally now.  he has a very protein dense breakfast and limits his carbs in general but sometimes lets himself go.

    good luck and remember catching it early is fantastic! 

     

    • Gold Top Dog

    kpwlee

    From our experience - do not start the drug - get exercising, lose weight and change diet.  If that doesn't work then down the road you can look at drugs.  The numbers aren't terribly high.

    Thanks!  That really was my gut instinct as well. 

     

    • Gold Top Dog

    *raises hand*, yep I am type 2 as well.

    White anything flings me over the edge in terms of sugar. I now eat whole grain everything. So far over the past year I have lost 30lbs, but I have more to go, when I was diagnoised my numbers were in the same range as your husbands. I am still borderline, with my AC1 being exactly a 7.0.

    I have just switched diets to a more mediterranean style diet.

    I also use this site to guage glycemic load in foods:

    http://www.nutritiondata.com/facts-C00001-01c20Tm.html

    • Gold Top Dog

    Wow, thanks Truley, that website is great. 

    • Gold Top Dog

    I'm going to disagree about not starting the meds.  It's not necessarily an always and forever thing, but PLEASE FOLLOW THE DOCS INSTRUCTIONS.  Diabetes can lead to all sorts of problems, including heart disease.  DH is the owner of FIVE stents in his heart, one for a 98% blockage.  This is not something you even want to think about having to have done.

    It is a myth that once a med is started it's forever.  Both Mom and DH were given insulin when hospitalized because the BS was over 100.  Normal used to be considered 60-120, but that might have changed now, but the hospital rationalized that anyone with the potential of issues would get insulin.  I don't understand the why, but........Mom is not and never has been diabetic.  DH is not insulin dependent.  Mom was given insulin for 2 weeks in the hospital and not a drop since.

    This is the laymens terms explanation our doc gave us about insulin resistance.  When you eat carbs the body converts them to sugar, which triggers the body to produce insulin.  So the little dump trucks full of insulin (THIS IS THE WAY THE DOC DESCRIBED IT, HONEST) back up to the loading doc of the cells and the doors don't open as quickly as they should, so the insulin doesn't get in in a timely manner to do the job it's supposed to do of disarming the sugar.  The metformin is basically the lubricant that makes the doors open more easily.

    The reason that a diabetic typically looses weight once the diet changes is that the body is getting what it actually needs instead of what the owner thinks that it wants.  DH lost 30 or 40 lbs as well, and so long as he is good about his diet, he stays at a good weight.  All of us have slightly different dietary NEEDS, not wants, but needs, and if we give our bodies what they actually need they tend to function better all around.

    Loosing weight is a secondary benefit of eating properly.  Your DH doesn't have to start a drastic weight loss diet.  What he does need to do is to start a proper diabetic diet and the pounds will melt off.  I didn't believe that my always slightly chubby husband would actually drop pounds as quickly as he did, but, by golly, the right diet made all the difference in the world for him.  And I use diet not as in a loosing weight term, but in a "fueling the body properly: term.

    Use the meds to start.  Let them grease those loading doc doors.  Six months from now he might be at a place that the doc is willing to let him do a trial without the meds to see if he can maintain a proper BS level without them.  But please don't run the risk of prolonging the negative affects of diabetes by not using the meds.

    I do think its just human nature for us wives to want to micro manage everything.  Nothing wrong with that, but.  THEY have to learn and understand as much as we do because ultimately, they are the ones that lift the fork to the mouth.  I let my DH be too dependent on me for guidance and I learned the hard way!

    • Gold Top Dog
    Glenda, thanks so much for your informative post.  I promise that we won't go against Dr.'s orders on the drugs.  He's going to call the office in the morning and ask if it's alright to delay taking them until he sees the nutritionist, which is in two weeks.  It would be nice to see what affect diet alone might make in the next couple of weeks, but if the doctor insists that he start right away, then he will.
     
    I've been reading and researching until my head is swimming, but I think I've got a pretty good handle on what and how he needs to start eating.  My sister gave me a copy of the south beach diet yesterday and it really does seem to correspond with a good diabetic diet.  At the very least, I think using the recipes in there will be a good food buying guide until we get in to see the nutritionist.  My husband read it and he's all gunho about starting it from the beginning, but I'm going to try to convince him to just go to Phase 2 as it's much less restrictive on carbs and seems to be very close to the diabetic diets I've seen recommended. 
     
    Anyway, thanks for all the help everyone.  This has come as quite a surprise to us.  He's been getting annual physicals for 30 years and this is the first time anything like this has come up on the radar. I've gone into information overload since then and hearing your personal experiences has helped a lot.   
    • Gold Top Dog

    minimom

    kpwlee

    From our experience - do not start the drug - get exercising, lose weight and change diet.  If that doesn't work then down the road you can look at drugs.  The numbers aren't terribly high.

    Thanks!  That really was my gut instinct as well. 

     

     

     

    Sorry, but this is BAD advice.  IMPO, He should start the drug and get the sugars under control IMMEDIATELY.  Diet modification and exercise are not something that works overnite and pretty much NEVER is able to adequately control diabetes.  If your husband is able/willing to loose weight and start an exercise program, he can go down on the medications as his sugars become better controlled.  Prolonged elevations of sugar will kill you by causing irreversable damage to many organ systems (heart, kidneys, etc.).  The treatment of both diabetes and hypertension have changed over the last 10 years and although we used to advocate trying diet and exercise first, it has been shown that these modifications are almost never successful and you do your patients harm by allowing them to persist with high sugars/blood pressure when you can be controlling it.  Please follow the advice of your doctor and not people on the internet.   I think it is a great idea as stated above to see a diabetes educator/nutritionist.  They are very experienced on diet modification.  My dad has type II, he had a Hgb A1c of 17% at diagnosis.  He was started immediately on medications and over about three months was weaned off almost all his medications.  Now he is well controlled on only one agent at a small dose.  I actually manage patients simmilarly to his endocrinologist.