9) CONTROLLING BLOOD SUGAR WITH DIET
a) Blood Sugar Control
Several large studies have established that frequent measurement of blood sugar (glucose) and close regulation of blood sugar can considerably extend the life expectancy of anyone with diabetes. Blood sugar is controlled and kept low by eating only small amounts of complex slowly digested carbohydrates at any one time. Low blood sugar translates into low "protein poisoning" (glycation), which is very important in over-all health. Low blood sugar also tends to result in lower weight, which is probably equally important in over-all health. Lower blood sugar levels also translate into better control of triglycerides, a known risk factor for large blood vessel "heart" disease. So maintaining low blood sugar levels is very beneficial for an individual with type 2 diabetes from many different standpoints. Control of blood sugar (blood glucose level) in diabetes is not as complex as it might seem. There are many levels of control that are used:
1. no control, eat what you want (believe it or not it is estimated that 50 to 60% of person with diabetes follow this "plan")
2. keep total carbohydrates to a "reasonable" amount at each meal
3. keep total carbohydrates to less than 50 grams (200 calories) every meal spaced out evenly over the day
4. keep total carbohydrates to less than 50 grams (200 calories) every meal and eat few "refined carbohydrates" (synonyms are "empty calories", "the white stuff", "high glycemic index", "wheat, rice, bread, corn, sugar", etc.)
5. keep total carbohydrates to less than 50 grams (200 calories) every 4 hours
6. use any one of the carbohydrate "exchange", "servings" or "point" programs that can be found in books on the American Diabetes Association Website (or read the systems described in the books section of Google under "diabetes". Make sure to only read books written after 2000, note that most of the books only have a portion of their contents on the Google website).
7. use an exchange program to match insulin injection amounts with carbohydrate intake
8. keep total carbohydrates to less than 25 grams (100 calories) every meal
9. keep total carbohydrates to less than 25 grams (100 calories) every 4 hours
10. keep the glycemic index load (grams carbohydrate multiplied by the glycemic index) to less than 1,500 for each 4 hour period.
11. eat no carbohydrates with a glycemic index above 50 and keep total carbohydrates to less than 20 grams per 100 lbs of body weight as a maximum every 4 hours, with a fast of 12 hours.
12. eat no carbohydrates with a glycemic index above 50 and a fiber content of less than 10% and keep total carbohydrates to less than 20 grams per 100 lbs of body weight as a maximum every 4 hours with a twelve hour fast per day.
13. a very low carbohydrate diet, 10 grams low glycemic carbs for breakfast, 10 grams low glycemic carbs for lunch, 15 grams low glycemic carbs for dinner; 7 grams each for two snack, less than 50 grams carbohydrate per day with a twelve hour fast per day.
14. 30 grams carbohydrate per day (Doctor Bernsteins diet plan)
15. An ultra low Atkins diet of less than 20 grams of carbohydrates per dayOur recommendation is to go with choices 11,12,13 or 14. Note that 15 to 30 grams of digestible carbohydrates (which equals "net carbohydrates" minus "fiber") is not a lot. Read labels and use the calculator, it is important. A small apple has about 12 grams of slowly digested carbohydrates while a large well ripened banana has about 26 grams of rapidly digested carbohydrates. Obviously a person with diabetes interested in ultra-close blood sugar control probably shouldn't eat a lot of bananas! Also note that there are huge variations in the amount of carbohydrates listed for different natural products such as fruit in different lists, for an apple it can vary from 6 grams to 24 grams, for a banana it can vary from 15 to 35 grams! It depends largely on the degree of ripeness of the fruit tested; the riper the fruit, the higher the sugar content.
Current Chapter: 9) CONTROLLING BLOOD SUGAR WITH DIET
a) Blood Sugar Control
b) Individualized Reactions
c) What a Diary Tells a Person with Diabetes
d) Protein Poisoning by Fruit Sugar
e) What are "Acceptable Fruits
f) Other Sugars
g) Best Mix of Protein, Carbohydrates, and Fats
h) Low Carbohydrate Diets
i) Fitting the Diet to the Individual
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