World Diabetes Day: Tips for Managing Diabetes

Within the time that you finish reading this post, someone in Canada will be diagnosed with Diabetes. That’s right, according to the Canadian Diabetes Association, every three minutes, a Canadian is diagnosed. Rates of Type 2 Diabetes and prediabetes have gone up significantly over the past decade, so much so that the World Health Organization has recognized Diabetes a global threat. So how do we combat this apparent epidemic? Well, to begin with – we need to understand it.

What is Diabetes? Well, it depends on the type. Type I Diabetes and Type II Diabetes are quite different, as are the protocols to treat them. Type I Diabetes, previously referred to as Juvenile Diabetes, occurs when the immune system essentially attacks itself, specifically certain cells in the pancreas. The cells being attacked are those that release insulin, the main hormone responsible for lowering blood sugar. As a result, those with Type I Diabetes can no longer regulate their blood sugar level and it continues to build within the bloodstream. Type I diabetics need to be treated with insulin, as this is the only way their bodies can properly control blood sugar levels. On the other hand, Type II diabetics can produce insulin; however, their bodies just don’t recognize that it’s there. As a result, blood sugar levels rise, insulin is released, but the blood cells don’t hear the insulin knocking at the door, so the insulin is left without a job to do and the blood sugar levels continue to rise. There are lifestyle factors that can help with Type II Diabetes – diet and physical activity are the first line of defense, as these factors may help increase the blood cells’ sensitivity to insulin (aka improve their hearing so they hear it knocking!), and they can help to prevent the rollercoaster effect of blood sugar all together. If Type II Diabetes goes unmanaged long enough, medication and eventually insulin may be used to treat it.

A rose by any other name… – Before we dive in, it’s important to recognize that in the world of diabetes, the terms carbohydrates, starches and sugars are used very much interchangeably. Whether we are talking about carbohydrates or sugars, the end result is that these foods are broken down into their simplest form of glucose in the body – and that is where the cycle of absorption and storage begins. For the sake of this article, we will refer to these foods strictly as carbohydrates.

Tips to Help Manage Prediabetes/Diabetes

Not all carbs are created equal – It is only recently that people are beginning to realize the difference between complex and simple carbohydrates. However, for those who live with diabetes, this is one of the first lessons learned, and one that is critical to understand when working to manage diabetes. Carbohydrates have many functions in the body, one of which is to provide immediate energy. Carbohydrates are broken down into their simplest form – glucose – which is then absorbed into the bloodstream, or stored for later use. In response to glucose entering the bloodstream and increasing your blood sugar, the pancreas kicks into gear and releases insulin. Depending on how complex the carbohydrate is, and how insulin resistant the individual is, the speed at which it is broken down and absorbed into the blood differs. The more complex, the slower it is absorbed. The slower it’s absorbed, the less insulin required to do damage control.

Examples of different carbohydrates

Another important way to determine which carbohydrates are to be eaten is The Glycemic Index. This scale ranks how much certain carbohydrate-containing foods raise blood sugar compared to glucose (the simplest form of sugar). The higher the glycemic index of a food, the faster it will raise the blood sugar. Foods with a high glycemic index should be avoided or eaten in small quantities for those with prediabetes or diabetes to avoid spiking the blood sugar. For more information on the glycemic index visit Diabetes Canada.

It’s all about FIBRE – The main difference between complex and simple carbohydrates is their fibre content. Most fibre is indigestible and therefore does not affect blood sugar levels. The more fibre there is in a carbohydrate source, the better. Why? Because that means there is less of the remaining carbohydrate to potentially elevate the blood sugar. Fibre can be found in abundance in most vegetables, fruit, whole grains, legumes, nuts and seeds. Ensuring that women are meeting their recommendation of 25 grams of fibre per day, and men are meeting their recommendation of 38 grams per day is one step in the right direction to managing blood sugar levels and Diabetes. Including a high fibre food in every meal and snack can not only help control blood sugar levels, but it can aid with regular digestion, and keep you feeling full longer. Talk about a superfood!

Balance – For those recently diagnosed with Type II Diabetes, balanced meals and snacks have never been as important as they are now. Keeping the blood sugar stable requires extra effort for those who are insulin resistant. Therefore, regularly timed, balanced meals are more important than ever. Skipping meals can result in fluctuating blood sugar levels – and for those who have never experienced low blood sugar – it is not pleasant. Dizziness, confusion, weakness, nausea, headaches, mood changes, and potentially loss of consciousness may occur if the blood sugar drops too low. To ensure that meals are regular and balanced, it’s advised that those at risk of diabetes or those who are diabetic schedule their meal times, as though they were appointments. Eating should be a priority. All meals should consist of the proper serving of a high-fibre food, high quality protein, and a healthy fat. Snacks should include at least 2 of the aforementioned macronutrients to ensure proper blood sugar balance.

What is a proper portion size? Ahh, the portion question. Portion control is definitely one of the biggest challenges for those trying to improve or change their diet and lifestyle. We are faced with larger portion sizes on a daily basis, starting with the larger-than-necessary coffee we pick up at the drive-thru. Did you know that a standard dinner plate should be eight inches in diameter, compared to the 10 to 12 inch plates most of us use at home? No wonder we can’t quite get a handle on portions! Portion sizes are different for everyone, depending on their metabolism, their weight, their age, their activity level, and many other factors. However, there are a few great ways to begin managing portions:

1. The Hand Method – your hand can be an excellent guide to help you measure portions without buying a food scale.
2. The Ideal Plate – focusing on having a plate with 50% non-starchy vegetables, 25% protein, and 25% high-fibre carbohydrates is a great way to control portions.

Hand Portion Guide

The Ideal Plate (resource: Mylan Health Coach)

Managing diabetes can be overwhelming, to say the least. There are many different factors that come into play – all of which can be easier to understand and apply with the help of a Registered Dietitian. It is important to take your medications, physical activity level, and blood sugar level into consideration prior to making major adjustments to your diet, therefore it is highly recommended that you speak with your healthcare team to help guide you in the right direction. Managing Type II Diabetes with diet and lifestyle changes may be possible, so be sure to speak with your healthcare provider about your options, and start by following a few of the steps discussed to get your diet on track!