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Portions and moderation
Diabetics can thankfully enjoy a feast
YOUNGSTOWN
Diabetics, don’t despair.
You, too, can enjoy today’s Thanksgiving Day feast and the upcoming Christmas gorging if you just follow a few rules.
It’s even OK to have an alcoholic beverage toast providing you trade the calories in the wine, beer or liquor by eliminating something with equal calories, such as butter on your rolls or gravy on your mashed potatoes, say diabetes experts at Northside Medical Center.
If it’s a mixed drink, use a diet mixer, said Janine Petko, licensed registered dietician.
Portion size is one of the major keys for diabetics to control their sugar level.
It isn’t so much what diabetics eat as how much they eat, assuming desserts are eliminated from the equation, Petko said.
A diabetic can have the same foods as everybody else, minus the sweets. And even a reasonable portion of pie is possible if Splenda or other sugar substitute is used in the recipe, always keeping in mind that carbohydrates, such as pie crust, turn to sugar and can also cause diabetics’ sugar levels to spike to potentially harmful levels.
Symptoms of high sugar levels are increased urination, which causes dehydration and can lead to increased thirst or so-called “dry mouth,” said Petko, of Boardman.
One way to avoid over-indulging in foods during the holidays with too many calories and carbs is to eat extra vegetables or salads before the main courses, said Patricia Crawford, a registered nurse and certified diabetes educator at Northside.
Also, she said, diabetics can take food items to the family feast that are better for them, such as angel food cake or sugar-free gelatin, for dessert.
The reality is, when you learn you have diabetes it forces you to take a look at how you are living and what you need to change, said Crawford, of Champion.
The good news is, Crawford said, if diabetics alter their lifestyle to control their disease, they can live longer and happier lives than if they were nondiabetic but do not change the way they eat and exercise.
The bonus side effects of losing weight and exercising are there will be less strain on joints and back and they will generally feel better, she said.
“Everybody should be eating like a diabetic. Then the looming epidemic might not happen,” said Petko.
The epidemic to which Petko referred is quantified by the U.S. Centers for Disease Control and Prevention.
According to the CDC, in 2005 to 2008, based on fasting glucose or hemoglobin A1c levels, 35 percent of U.S. adults 20 and over and 50 percent of those 65 and over are prediabetic. Applying these percentages to the U.S. population in 2010, the CDC estimates that 79 million American adults 20 and over are pre-diabetic.
Before people develop Type 2 diabetes, they almost always have pre-diabetes, a condition when blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. Even then some long-term damage to the heart and circulatory system may already be occurring, according to the American Diabetes Association.
“We have put too little emphasis on pre-diabetes. Not that we should ignore diabetics, but we have a host of people out there with prediabetes,” said Dr. Paul A. Rich, director of the Family Practice Residency Program at Northside Medical Center.
There is a recently developed test, PreDx Diabetes Risk Score (DRS), that not only diagnoses pre-diabetes but gives patients the percentage likelihood of their becoming full-blown diabetics within the next five years. The test is being used at Northside, Dr. Rich said.
“We have used other tests in the past, but none have been proven to identify likelihood of risk of diabetes as does this test. We need to identify those who are pre-diabetic and then identify the 10 percent at high risk of developing diabetes and use aggressive management consisting of diet, weight loss and exercise to try and prevent diabetes,” he said.
He said studies have shown that some medications, such as Metformin, help prevent diabetes, but that not all patients are candidates for medication initially. “We prefer to try lifestyle changes first.”
Northside has a pre-diabetic education program, “Diabetes HELP” [health education lifestyle program], to help with lifestyle changes, Dr. Rich said.
The bottom line, he said, is that, without ignoring the diabetic population, it is necessary to start focusing on the people who are not diabetic but are at high risk for developing the disease within the next several years.
“If we don’t focus on those people, we will be swimming an uphill battle,” Dr. Rich said.