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Take 5: Diabetes

Our diabetes expert answers five questions about lifestyle and blood sugar control.
By Christina Boufis
WebMD Magazine - Feature

If you're one of the nearly 24 million Americans living with type 2 diabetes, you know your body has difficulty using or producing insulin. What can you do to manage the disease? We asked Jill Crandall, MD, professor of clinical medicine and director of the diabetes clinical trials unit at Albert Einstein College of Medicine in New York City, to debunk some myths and help you learn to live well.

1. Does having type 2 diabetes mean you have to give up sugar completely?

Not really. It's a misconception that people with diabetes can never have a dish of ice cream. The diet we recommend for people with diabetes really isn't very different from the diet we recommend for everybody.

For most people, eating balanced meals of protein, carbohydrates, and modest amounts of unsaturated fat is the best approach. Large carb meals (pasta, bread, potatoes, rice) and concentrated sweets (fruit, fruit juice, cake) raise blood sugar, so it's best to eat those foods in moderation.

The plate method is often helpful: Think of dividing your dinner plate into three sections. Half the plate should be vegetables or salad, a fourth should be protein (for instance, meat or fish), and a fourth should be starch (such as rice or pasta, preferably whole grain).

We all know junk food like candy and donuts is not good for anybody. Junk food is especially problematic for people with diabetes because it tends to be high in carbohydrates and excess calories. But we try to stay away from saying there are certain things you can never have, because sometimes the idea of deprivation just makes foods all the more appealing.

If you know you want to have that piece of cake at the end of dinner, then don't eat any bread with dinner, or have a very small portion of rice.

2. Is it better to eat frequently throughout the day?

Some people find frequent, small meals work for them -- they don't get too hungry, and their bodies can handle smaller amounts of carbs better. But others find they end up gaining weight this way -- the frequent meals may not be that small. However, skipping meals is probably not a good idea because people get hungry, then can't control their next meal very well.

Keeping a food diary, along with testing blood sugar before and after meals, is a good way to see the effect of particular foods on blood sugar level. The immediate feedback can be helpful.

And pay attention to portion sizes. Food labels are useful (they provide information about carbohydrate content as well as total calories), but the portion sizes they list are often unrealistically small (how many people eat half a muffin?). Although weighing food servings can be annoying, it might help train your eyes as to what a "6-ounce serving" of something really looks like.

Is This Normal? Get the Facts Fast!

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Normal
70-130
High
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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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