August 27, 2009

Diagnosis - Type 2 Diabetes

Are you newly diagnosed?  Remember the doctor pronouncing the diagnosis and muttering something about changing your diet, and sending you on your way? Does this sound familiar? Or did the doctor say that you will be scheduled for classes with a dietitian and diabetes educator?

Now what do you do in the meantime? Many stress out as they have been told about people, relatives maybe, that had an amputation, gone blind, and other scary tidbits of "more than you wanted to know information", and panic sets in.

I do not have all the answers, but my advice is to relax. Go home and take an inventory. Look at the cookbooks already on the shelf or in a pile somewhere. Most can be adapted for your needs. In addition, you now have a lifestyle that must be changed.

Going out and purchasing new cookbooks like I did is not the answer. I thought they would help me and I have regretted it since. Most had the word DIABETIC in the title. Bad, bad mistake and money poorly spent. They were generally written by people without diabetes and the recipes were high in carbohydrates.  They might be okay for type 1 diabetes, but not for type 2.

If you happen the have a "diabetic cookbook", and have no other information, use it for starters until you are comfortable with adjusting regular recipes. Then donate it somewhere.

The classes may or may not be of value. It will depend on the dietitian/nutritionist and what they know about diabetes. There are some good people doing this, and I hope yours is one of these like mine was. If they start talking about the exchange system or eating over 160 grams of carbohydrates daily (three meals and two snacks), then you may want to consider another method of learning.  Do finish the classes, as you will be able to adapt what you learn.

Certified Diabetes Educators in the US are required to pass an exam and are being required to have continuing education to retain their certification. So generally you will be in good hands with these people.  This is often when you will get a glucose meter.  Learn how to use it!  It will become a good friend!  If you do not and are without insurance check out this.

When you are ready, take an inventory of the food you have in the house. If is is white - potatoes, rice, and pasta - keep it for other family members or give it away, depending on your finances. You do not want these foods on your plate. If it is highly processed foods, you may want to do the same. The local food box is always looking for donations.

Examples of labels on different foods:
Looking at the label on a can of cut green beans, I see serving size is 1/2 cup (120grams). There are 3 1/2 servings in this can. The rest of the label in based on one serving. Fat is 0g (all categories), Sodium is 400 mg, total carbohydrates is 4g and protein is 1g. Under carbohydrates it lists dietary fiber as 1g and sugars as 2 g. For counting carbs, I would normally eat two servings and would count 6g of carbohydrates. Yes, the 1g of dietary fiber is subtracted times two servings.

Now of some pasta (not white, but whole grain) - the label on a box of elbow macaroni. Serving size is 2 oz (56g - 1/8 box), eight servings per box. Total fat is 1g, sodium is 0g, total carbohydrates is 46g (high), and protein is 7g. Under carbohydrates the dietary fiber is 2g and sugars is 1g.

So if I would have this for an evening meal, I would count 46g of carbs (not including anything added to this meal which needs counting), which is higher than I like. I strive to stay under 100g (80 if possible) of carbohydrates for three meals and two snacks.  You have to determine what will work best for your own control of diabetes.

When looking at your cookbooks, make use of them. With Calorie King, Nutrition Analysis, and other tools available on the internet, the nutrition and carbohydrate count can be reasonably calculated.

If you are not comfortable with this, then next time you are in the book store, look at the recently published cookbooks.  While I am not promoting any, the most recent editions of Betty Crocker, Better Homes & Gardens, and The Taste of Home cookbooks all have the nutritional information with each recipe.  There are others as well that have the nutritional data.

I also recommend Alan Shanley for some excellent basics in getting started.

For vegetarians, I hope the following will provide a start to further investigation.  There may be vegetarian cookbooks at the local library or find them at Amazon.com.

If you are ambitious and want to start with low-carb. you may want to consider 500 Low-Carb Recipes by Dana Carpender.

Have some fun with the cookbooks already on your shelf.  If you have a food scale, use it.  You can eat regular foods, just smaller servings.  Learn which recipes work the best for you.  Cook, taste, and test, test, test with your meter to find out serving size of what you can eat, or need to eliminate.  Stay away from HFCS (high fructose corn syrup).  This is not always easy to determine on some labels.  It will get easier!

When you are comfortable, learn about the Glycemic Index, Glycemic Load, and lower glycemic index foods.  These work to level the absorption rate and make your medications more effective.

Learn how to use condiments and spices.  Do not settle for bland food.  Good eating!