Blood Glucose and the Glycemic Index

December 16th, 2010

Proper diet is crucial for diabetics, as food can have both short and long term effects on blood glucose control. For reasons researchers have yet to uncover, blood sugar levels soar after eating, and many diabetics need to time their insulin injections around meal times to aid in controlling blood sugar. One thing researchers do know - the higher the glycemic index of a food, the more impact it has on blood glucose.

The glycemic index (GI) is a measure of the influence that a particular food has on blood sugar levels. It takes into account the fact that different types of carbohydrates perform differently in our bodies. The GI ranks carbohydrates on a scale of 1 to 100 based on how quickly they raise blood sugar.

Low GI foods are in the range of 0 to 55, medium are ranked 56 to 69, and high are scored 70 and above. Foods with a high GI are rapidly digested and absorbed, resulting in a rapid spike in blood sugar and insulin demand. Foods with a low GI are digested and absorbed more slowly, resulting in a more gradual increase in blood sugar and insulin. Because they're digested more gradually, low GI foods reduce hunger and keep you feeling full longer.

In general, the more fiber a food has, the lower its GI. Whole grains like oats, barley and bran, nuts, eggs, milk, meat, legumes, fructose, most fruits and vegetables, and low carbohydrate foods are low on the GI. Whole wheat products, basmati rice sweet potatoes and sucrose rank medium on the GI. Most high carbohydrate foods like potatoes, watermelon, white bread, white rice, candy, pastries, most baked goods, low fiber breakfast cereals and glucose are all high on the glycemic index. The resourceful Australians have developed a low GI potato called "Carisma", but sadly, it's not yet available in North America.

A low GI diet reduces the body's insulin levels and insulin resistance, and improves overall blood glucose control in both type 1 and type 1 diabetics. As a rule, diabetics are advised to eat foods that are low to medium on the GI, but a diabetic who is experiencing a period of low blood sugar may want to eat a high GI food to quickly raise their blood sugar. You can use a glycemic index chart to search for low glycemic food choices, and to check the glycemic index of your favorite foods. Bear in mind that other factors will affect the impact a food has on blood sugar, such as fat and protein content, ripeness, cooking method, the combination of foods eaten, the time of day, and your insulin and activity levels.

Recent studies indicate that the risk of diabetes and other diseases is closely related to the overall GI of our diets. A US study of national data spanning almost 90 years found that the rising consumption of high GI corn syrup (widely used to sweeten soft drinks and processed foods) and decreasing intake of dietary fiber parallels the explosion of type 2 diabetes in America. The World Health Organization recommends a low GI diet to prevent and combat the "diseases of affluence" that are rampant in North America - diabetes, obesity and heart disease.

Ten Superfoods for an Insulin Resistance Diet

January 24th, 2011

salmon steak

The key to diabetes treatment is controlling blood sugar (glucose) levels, and diet plays a vital role in that complicated process. The main dietary goals in diabetes are balancing blood sugar and cholesterol levels, and achieving and/or maintaining a healthy weight.

Traditionally, theemphasis in a diabetic diet was on avoiding sugar. Modern guidelines place more emphasis on total carbohydrate intake and the type of carbohydrates eaten - sometimes referred to as an insulin resistance diet. Often, type 2 diabetics can control their disease with diet and exercise alone, avoiding the need for diabetes medications.

The American Diabetes Association has released a list of the top ten "diabetes superfoods". All of the foods on the list have a low glycemic index (a scale of how quickly a carbohydrate raises blood sugar), but rank high in essential nutrients like vitamins, calcium, magnesium, potassium and fiber. The ten diabetic superfoods on the American Diabetes Association's list are:

1) Beans - Kidney, pinto, navy, black and other beans are nutritional powerhouses that are low fat and very high in fiber. One-half cup provides as much protein as an ounce of meat. Rinse canned beans before you serve them to reduce the amount of sodium.

2) Dark green leafy vegetables - As a general rule, the darker in color a vegetable is, the more nutritional value it has. Spinach, chard, kale, collards and other dark leafy greens are low in both calories and carbohydrates.

3) Citrus fruit - Oranges, grapefruit, lemons and limes all offer a dose of vitamin C and a helping of soluble fiber. But remember that grapefruit juice can interferes with the action of some medications, including pain relievers and prescription drugs used to treat high blood pressure, cholesterol and abnormal heart rhythms.

4) Sweet potatoes - Sweet potatoes are lower on the glycemic index than regular potatoes, and full of vitamin A and fiber.

5) Berries - Berries are low calorie, low carb, and high in antioxidants and fiber. And several studies have shown that blueberries lessen insulin resistance.

6) Tomatoes - Tomatoes are a versatile superfood containing vitamin C, vitamin E, iron and other nutrients. Cooked tomatoes are even better for you than raw, as cooking makes tomatoes' healthy antioxidant compounds like lycopenes easier for your body to absorb.

7) Omega-3 rich fish - Omega-3's are essential fatty acids found in fish (especially salmon), some nuts, and some plants. Omega-3 oils are credited with reducing inflammation, lowering bad cholesterol and raising good cholesterol, reducing blood clots and playing a crucial role in brain function. Be warned: some type 2 diabetics may have a slight rise in fasting blood sugar when taking fish oils.

8) Whole grains - Avoid processed grains with the fiber-rich bran and germ removed from them. Barley, bran and oats are good grain choices that rate lower on the glycemic index. The fermentation process used for sourdough bread lowers its glycemic index, making it another good choice, especially sourdough rye bread.

9) Nuts - Filling nuts provide protein, magnesium and fiber. Some nuts and seeds, such as walnuts and flax seed, are also a source of omega-3 fatty acids. But they're high in fat and calories, so eat them in moderation.

10) Low fat or fat-free milk and yogurt - Dairy products provide much-needed calcium, and many are fortified with vitamin D.

The bottom line is that a healthy diabetes diet is not much different from that recommended for the general public - high fiber, high protein, and low in fat. Diabetics need to limit their sugar and simple carbohydrate intake more than non-diabetics, and should avoid drinking alcohol. Weight control is especially important for diabetics, as insulin resistance is often associated with excess fatty tissue. Diabetes occurs more frequently in people who eat a lot of fat, and it's recommended that diabetics eat both less overall and less saturated fat, restricting fat to under 30% of their daily calories.

If you are insulin dependent and making changes to your diet or eating patterns, remember that it may have an effect on your blood sugar and insulin levels, and you may need to adjust your insulin therapy accordingly.

Asthma Inhalers Increase Risk of Diabetes and Insulin Resistance

January 25th, 2011

inhaler

Use of asthma inhalers containing corticosteroids has been linked to a 34% increase of developing type 2 diabetes, and to accelerated diabetes progression in those already diagnosed with the condition. Higher dose inhalers were linked to even higher risks - a 64% increase in type 2 diabetes diagnoses, and a 34% increase in existing diabetes progressing to the point of requiring insulin therapy.

Theses figures came out of a large Canadian study of the records of more than 380,000 asthma and chronic obstructive pulmonary disease (COPD) patients treated with inhaled corticosteroids. "Patients instituting therapy with high doses of inhaled corticosteroids should be assessed for possible hyperglycemia, and treatment with high doses of inhaled corticosteroids limited to situations where the benefit is clear," warn the researchers, from the Jewish General Hospital and McGill University in Montreal.

More than 30,000 of the asthma/COPD patients included in the study were diagnosed with diabetes over a span of five and a half years -over 14 patients per 1000 inhalers. Nearly 2100 patients who had been previously diagnosed with diabetes experienced a deterioration in their condition, going from controlling blood sugar with oral diabetes medication torelying on insulin injections.

Dr. Stuart Weiss, an endocrinologist at the New York Medical Center makes the point that the issue may be a common underlying cause of both diabetes and asthma/COPD, rather than corticosteroids. "We know that steroids increase insulin resistance, and that people treated with steroids require more aggressive diabetes management," he says, "What may be at the root of this problem is the fact that those who are most at risk for diabetes are the same people who have the worst asthma and COPD that requires steroid treatment in the first place." Weiss believes that "the overconsumption of processed foods and the lack of consumption of green vegetables" lead to pre-inflammatory conditions that raise the risk of both diabetes and asthma/COPD. He warns that if Americans don't improve their diets "the incidence of both these diseases will continue to go up at a dramatic rate."

DR. Rohit Katial, a professor of medicine at National Jewish Health, is concerned that the study contained no information about obesity, a significant risk factor for both diabetes and respiratory problems. "For the people on higher doses of medications, was their BMI (body mass index) higher? We don't know."

What the medical experts do agree upon is the need for doctors to prescribe the lowest possible dose of corticosteroids to asthma and COPD patients, and to educate patients about the risks of insulin resistance, becoming insulin dependent, and the possible need for more intensive insulin therapy.

Type 2 Diabetes Slideshow

April 26th, 2011

WebMD has put together a slideshow with a wealth of information for type 2 diabetes patients, including symptoms, diagnosis, treatment and complications. The overview will be of value to newly diagnosed and veteran diabetics, from those managing their diabetes with diet and exercise, through those using oral diabetes medications, to those relying on insulin injections to control their blood sugar.

To see the slideshow on WebMD, >CLICK HERE.<

Six Ways to Wreck Your Blood Sugar Levels

May 5th, 2011

WebMD has put together a list of Six Ways to Wreck Your Blood Sugar Level, subtitled What Not to Do If You Have Diabetes. The featured post on the online Diabetes Health Centre reminds diabetics that it requires constant vigilance to keep their blood sugar under control, warns against common mistakes and bad habits, and offers advice on how to avoid or deal with these pitfalls.

To read the post on WebMD, >CLICK HERE<.

What's the Best Exercise to Control Blood Sugar in Diabetics?

May 16th, 2011

jogger

Researchers analyzing the results of 24 separate clinical trials involving over 8400 participants have determined the best type of exercise program to control blood sugar in diabetics. It turns out that engaging in moderate exercise for longer periods of time is more effective at stabilizing blood glucose than shorter bursts of intensive physical activity.

As well, diabetes patients given a structured exercise routine by their health care provider do better than those simply told to get more physical activity. "We always tell patients, even those without diabetes, to get more exercise," says Dr. Joel Zonszein, the Director of the clinical diabetes centre at New York's Montefiore Medical Center, "It would be good if we were able to prescribe an exercise program for them to follow."

Current guidelines suggest type 2 diabetics get at least 2 hours of moderate to intense exercise every week, including aerobic activity and some sort of resistance training such as working out with weights. "Exercise improves insulin activity," stresses Zonszein, "it makes insulin work better."

Some diabetics discover regular work outs reduce their need for diabetes medication, so be sure to consult with your healthcare provider if you are beginning or revving up an exercise program. To read more about the study and the researchers' recommendations on HealthDay, >CLICK HERE.<

Diabetics Advised Against Lowering Their Blood Sugar Too Much

May 18th, 2011

Researchers in England are saying that diabetes patients not only receive no advantage, but could actually experience a disadvantage, from lowering their blood sugar below 7 or 7.5 percent hemoglobin A1c. Hemoglobin A1c is a form of hemoglobin used to identify the average plasma glucose concentration over a period of two to three months.

After reviewing the results of several studies, the researchers are advising type 2 diabetics and their healthcare providers to avoid overly aggressive treatment requiring a lot of intervention or diabetes medication. To view a WebMD video on the possible health risks of lowering your blood sugar too much on >CLICK HERE<.

Nutrition and Diabetes Control

May 25th, 2011

woman grocery shopping

Nutrition is vitally important in diabetes management and blood sugar control. About.com's Nutrition and Diabetes page editors have compiled a wealth of information on healthy eating for diabetics including facts on carbs, calories, fiber and the all-important glycemic index; advice on surviving restaurant meals and holiday dinners, and even diabetes-friendly recipes and meal plans.

For those with an interest in alternative approaches, the Nutrition and Diabetes page also provides information on less conventional diets such as vegetarian, raw food and vegan. Other articles give you the lowdown on foods believed to have a positive affect on blood sugar and insulin resistance, such as fenugreek, prickly pear cactus and omega 3 fatty acids.

There are articles on sugar substitutes and hidden sugars, and nutrition facts and carb and calorie counts for individual foods like avocados, pomegranates, eggplant and watermelon (warning - very high carb!). The page also links to articles with recommendations for losing weight, specific diet tips for those with kidney disease, and even advice on healthy eating on a budget.

When making any major changes to your diet and/or activity levels, bear in mind they may impact your blood sugar levels and need for diabetes medication. Consult your healthcare provider about possible changes to your insulin dosage or other diabetes medicine.

To view About.com's Nutrition and Diabetes page, >CLICK HERE.<

Software Allows Cars to Monitor Driver's Blood Sugar Levels

May 26th, 2011

The Ford Motor Company is working with Medtronic Inc, a leading manufacturer of blood glucose monitors, to expand Ford's onboard Sync communication system to provide blood sugar monitoring for diabetic drivers. The prototype software monitors blood sugar, displays readouts on the dashboard, and warns the driver if his or her blood glucose is approaching dangerously high or low levels.

The driver can also request blood sugar updates using voice commands. The system can also be used to monitor the blood sugar levels of the vehicle's passenger, such as a diabetic child.

The blood sugar monitoring software uses a Bluetooth connection on the driver's phone to transmit information to the dashboard from a continuous glucose monitor worn on the body. If the driver's blood glucose levels dip to the point where it could cause symptoms like lightheadedness, disorientation, loss of coordination and blurry vision, a robotic voice alerts the driver.

The driver can then take some glucose tablets or diabetes medication, and will be instructed to recheck their blood sugar in 30 minutes. Ultimately, says Medtronic spokesman Brian Henry, the company would like to develop technology that would enable an insulin pump to automatically adjust and administer the correct insulin dosage in response to a low blood sugar reading from the in-car glucose monitoring system.

Ford's voice-activated Sync communication system was developed in partnership with Microsoft Corporation, and has been available since 2008 on most models. Sync provides services like traffic and direction information, voice activated assistance with music and phone calls, and blind spot detection and warnings.

With diabetes at epidemic proportions and the number of American seniors expected to double in less than 50 years, both Ford and GM see in-car health monitoring as an important feature in future automobiles. Ford is also working on other features such as a car seat with sensors that detect electrical impulses from the driver's heart and can warn of a pending heart attack.

"The car is more than just a car," says Ford's chief technology officer Paul Mascarenas, "People spend almost an entire week a year on the road, and that's expected to increase. The car is a private space for conducting personal business. We see health and wellness as a core area."

Ford says the continuous glucose monitoring system is advancing quickly, and hopes to make the feature available to America's approximately 26 million diabetics in three to five years.