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Living Your Best Life with Diabetes

Good Nutrition & its Effects on Blood Glucose
By: Molly Boll
Published June 17, 2008

Food is the fuel and energy source for our bodies. Food cannot be used for energy until the body changes it into a simple sugar called "glucose." Our blood carries glucose (blood sugar) to every cell throughout the body. Without glucose, cells do not have the energy to work.

Glucose needs help to get inside each of the cells in our body. The helper that carries glucose inside the cells is called insulin, which is made by the pancreas. For a person with diabetes, food is changed into glucose just as it is in those without diabetes. For those with Type I Diabetes, however, the body does not generate a sufficient amount of insulin to control the glucose level. For those with Type II Diabetes, the body does not respond correctly to insulin (insulin resistance), and does not allow it to carry glucose into the cells. In both cases, the glucose that is not able to get into the cells builds up in the blood. This causes high blood sugar, which can lead to diabetic complications.

What is Good Nutrition?

Good nutrition entails eating a variety of different foods in combinations that provide both necessary nutrients and good blood sugar control. Good nutrition also means limiting your fat and cholesterol intake.

Food contains nutrients and energy. The nutrients in our food supply form the building blocks of the body. Food also contains energy, which is measured in calories. Calories come from carbohydrates, proteins, fats, and alcohol. The following is a quick summary of the different types of food and how they affect the blood glucose in our bodies.


Carbohydrates are the body's main source of energy, and can be found in the starches in breads, cereals, and most vegetables, and in the sugars found in fruits and milk. Complex carbohydrates should be a big part of your meals and snacks. Vegetables, lentils and legumes, beans and peas, whole grain unprocessed breads, cereals, rice and pasta are all examples of complex carbohydrates. These tend to slowly raise blood glucose, and contain a variety of vitamins and minerals as well as fiber. The sugar that is found in candy, cake, pie, jam, jelly and honey is also a carbohydrate. One hundred percent of the carbohydrates that we digest are broken down into the energy packet glucose. This happens quickly, from five minutes to three hours.

Fiber is a type of carbohydrate that is not used for energy. It does not raise blood sugar because the body cannot digest it and break it down into glucose. Insoluble fiber is useful for promoting regularity and feeding the good bacteria in the gut; it may decrease your risk of colon cancer. Examples of insoluble fiber are whole-wheat products, vegetables such as broccoli, Brussels sprouts, carrots, corn, and spinach. It is interesting to note that soluble fiber sources form gels and slow down absorption of sugars into the blood. Good sources of soluble fiber are oats, beans, fruits, and vegetables such as asparagus, green beans, cabbage, and celery.

The American Diabetes Association suggests that diabetics eat 20 - 35 grams of fiber per day. The average American adult, however, eats only 10 - 15 grams daily. To help you determine where and how much fiber is in your food choices, please note the following average amounts of fiber per serving:

Whole grain breads, cereals and crackers = 2 grams
Starch vegetables (potatoes, corn, yams) = 3 to 4 grams
Legumes (beans, peas) = 3 to 4 grams
Raw vegetables = 3 grams per cup
Cooked or canned vegetables = 2 grams per cup
One cup of fresh fruit = 2 grams
Frozen or canned fruit = 3 grams per half-cup


Proteins are used to build and repair the body. Proteins are found in meats, fish, poultry, cheese, milk, eggs, and nuts. Proteins also break down into energy. Fifty to sixty percent of the protein we consume breaks down into glucose. This process happens slowly, over three to six hours.


Fats pack a large number of calories, and therefore energy, in a small bundle. Foods that contain fats are oils, margarine, butter, meat, and salad dressings. Use fats sparingly if you are trying to lose weight or if your blood fats are high. The body will store the majority of fat and will only break it down to smaller energy packets for use in emergencies. Only ten percent of the fat we consume raises our blood sugar directly, over a period of eight to ten hours. Fat is a form of stored energy that is broken down at a later time; it is the preferred source of fuel for muscles at rest. Which fats are healthier for you? Margarine is preferable to butter, but olive oil is the healthiest choice of the three.


Alcohol has calories, but little nutritional value. It is interesting to note that alcohol actually lowers blood sugar levels. It is suggested that people with diabetes snack while drinking to ensure that their blood sugars do not go too low. They should also limit their intake to one drink.

Since nutrition is a key component to managing one's blood sugar, it is important to learn to put together healthy meals from the various food groups. The food pyramid offers an easy approach to healthy eating. This guide shows that healthy meals and snacks should contain lots of carbohydrates that are also rich in vitamins, minerals, and fiber (lentils, legumes, vegetables, and yogurt, for example). All carbohydrates become glucose in blood within five minutes to three hours after they are eaten. These foods have a significant effect on blood glucose. The best ones to choose are those that are full of nutrients instead of those that just offer empty calories (soda, cakes, and candy, for example). You should eat antioxidant-rich vegetables that are high on the glycemic index scale, such as spinach, broccoli, yellow squash, and tomatoes.

Healthy eating also means avoiding foods that are high in fat and cholesterol. These foods have been linked to atherosclerosis, the fatty build-up inside blood vessel walls. This can lead to heart disease or stroke. People with diabetes have a two to three times greater risk of getting atherosclerosis. Therefore, when choosing proteins and fats in your diet, opt for lean cuts of meat, and eat more fish, chicken, and turkey (without the skin). Use nonfat milk or low fat milk products. Limit fried foods, gravies, cream sauces, butter, and margarine.

How much should I eat?

Logically, the key to maintaining your weight is watching the amount of food you eat. For good diabetes control, you must be consistent from day to day. Plan your day to be sure that you eat the right foods, in the right portions, at about the same times every day. Here are several examples of what constitutes a serving size:

1 slice of bread
1 cup of ready-to-eat cereal
1/2 cup cooked rice or pasta
1 cup of raw, leafy vegetables
1/2 cup of non-leafy vegetables
1 medium apple
1/2 cup of cooked/canned fruit
1/2 cup of fruit juice
1 cup of milk or yogurt
1.5 ounces of natural cheese
2 ounces of processed cheese
2-3 ounces of cooked meat, poultry, or fish

In addition to eating healthily, it is crucial to stay hydrated by drinking plenty of water. Start your day out with an eight-ounce glass of water, and continue to drink water throughout the day. Water dilutes the blood and therefore has some degree of influence on lowering your blood sugars.

Planning Your Meals

As with all things in life, use the concept of BALANCE in choosing your meal plans. Eat a variety of foods that give a balance of carbohydrates and protein. One easy approach is to take your dinner plate and have one-fourth of it filled with proteins, one-fourth filled with a starch such as brown rice or a small potato, and one-half of the plate filled with vegetables (preferably the colorful ones as discussed above).

Here are a few recipes that could be part of a healthy diet for good diabetes control.

Spiced Chickpea Salad

A high-fiber summer salad from Mayo Clinic Health Solutions

2 - 15 oz. cans garbanzos drained and rinsed
1 red sweet pepper, chopped
4 green onions with tops chopped
1/4 cup chopped fresh cilantro
2 tsp. fresh lemon juice
2 tbs. white vinegar
1 glove garlic, minced
2 tbs. peeled and minced fresh ginger root
1/2 tsp. ground cumin
1/8 tsp. salt if desired
1/4 tsp. dried red pepper flakes
2 tbs. olive oil

Mix garbanzos, pepper, green onions, and cilantro in a large bowl. In a small bowl, combine the lemon juice, vinegar, garlic, ginger, cumin, salt, pepper flakes, and olive oil. Pour the liquid dressing over the vegetables and toss to coat. Cover the salad and refrigerate overnight.

(Serves 8; 130 calories; 5 g fat; 0 g saturated fat; 0 g trans fat; 17 g carbs; 250 mg sodium; 5 g fiber)

Stir-Fried Peanut Chicken

From a nutrition student at Bastyr University

2 tsps olive oil
1 small carrot, diced
A few dashes of soy sauce
2 tsps of peanut butter chunk style
A few tsps of water
1 small head of broccoli, chopped
4 oz. of cooked chicken, cut into chunks

Heat oil in a pan over medium heat. Add the carrot, and let it cook for one minute. Add the soy sauce, peanut butter, and water, followed by the broccoli and chicken. Stir-fry for about four minutes until the colors are bright and the aroma is nice. Make sure the bottom does not brown while cooking; add a bit more water as the pan dries. (Serves one; approximately 400 calories; 16 g carbs; 43 g protein, 19 g fat)

Since nutrition is such a vast subject, we will be continuing this healthy diet discussion in the next 'Living with Diabetes' article, where we will discuss the glycemic index, carb counting, sweeteners, and controlling your eating habits, to name a few topics.

Please email me at mollyboll@verizon.net with any and all questions about your diabetes and I will attempt to get back to you. If I do not know the answer to your question, I will obtain an answer from a healthcare provider.


Looking Ahead at Your Health

You've Been Diagnosed with Diabetes - What's Next?
By: Molly Boll
Published April 8, 2008

Diabetes is a serious, lifelong condition that touches every part of your life. If you've recently been diagnosed with diabetes, you should know that living with this disease is not easy. It's going to take hard work and discipline to manage your diabetes.

But, the good news is that it can be done! You can enjoy a good life while having diabetes. There are a lot of things you can do to protect your health from this disease. By taking charge of your diabetes today, you can live a more healthy life in the years to come.

My Life with Diabetes

I would like to start by giving you a quick glance at my struggles with diabetes. As I look back to when I was first diagnosed some 27 years ago, I realize today the extent of my denial at that time. I did not even take my diabetes medications for the first two years after diagnosis. I thought I was invincible, and I felt fantastic! I had a college education and a very interesting and demanding career in the Alaskan seafood industry. Now, how could I have this disease called DIABETES? People who have diseases are sick, and I was not sick!

Little did I know at that time that my blood glucose levels were working hard on my internal organs to eventually cause many health complications. Fortunately, my mother steered me to one of the top endocrinologists in the United States, Dr. Irl Hirsch of the University of Washington Medical Center-Diabetes Clinic.

Over the years, and with Dr. Hirsch's help, I have slowly learned how to manage this disease. It has been an ongoing process, and one in which I sometimes succeed and other times fail. But the important thing is that when I do fail, I pick myself up and start all over again in this process of managing my diabetes.

Yes, approximately 60% of people living with diabetes have denied having this disease at one time or another. Yet, diabetes is a disease that seldom goes away. It is always with us. We have to consistently monitor our blood glucose levels, take our medications, and watch our diets. You are certainly not alone if you find yourself denying that you have this disease. But it is vitally important for you to acknowledge that you have diabetes, and to be willing to pick yourself up and continue on your self-management program for good diabetes control.

You have diabetes. So what's next?

It is paramount to understand that YOU, AND ONLY YOU, are in control of your diabetes; but you can manage this disease with the help of a strong team. I like to explain this by way of a triangle and a ship. You are the captain of your ship at the top of the triangle; your doctor is the chief engineer at the lower left point; and your nutritionist is the first mate at the lower right point of the triangle.

You ultimately run the ship, while your doctor is your chief advisor and your nutritionist gives you the fuel to run your ship. It takes a TEAM effort to manage your diabetes. So, the first thing to do is to find a well-qualified internal medicine doctor who is familiar with diabetes, or an endocrinologist, as well as a diabetic nutritionist.

Sailing towards a full and healthy life.

Now that you have this concept of a ship to help you with your diabetes control, your ship must have a destination. Ultimately, this destination is a full and healthy life where your diabetes is well under control. Here are some suggestions to get you started on your journey to your "diabetes destination."

Assemble your diabetes medical team. It is important to find the right physician for your diabetes visits, whether that is an endocrinologist or an internal medicine doctor. After you find the doctor that's the right fit for you, be sure to ask him or her for the names of recommended diabetic nutritionists, eye doctors, and foot doctors.

Enroll in a diabetes class. It is highly suggested that you enroll in a diabetes class to learn more about your disease. Knowledge is a powerful tool in diabetes self-management. You will also meet a supportive network of people who are facing the same challenges that you are.

Test your blood sugar. I've found this to be the absolute most important tool. How can you possibly manage this disease if you do not know the levels of your blood glucose? Your diabetes educator can teach you how to use one of the many blood glucose meters available, and your doctor can tell you how often to test. You might be instructed to take a fasting test before your breakfast and then one or two more tests before lunch or dinner. Bring your blood glucose machine with you to your doctor's visits so that he or she can see trends in your readings.

Lose weight. Diabetes and heart disease go hand in hand with excess weight. Obesity strains your heart, raises your blood pressure, and raises your LDL (bad) cholesterol and triglyceride (blood fat) levels. It lowers HDL (good) cholesterol. Even losing ten pounds can help to decrease your heart disease risks by lowering blood pressure, insulin resistance, and body fat.

Be physically active. Regular exercise helps to lower blood glucose levels and lower insulin resistance. This means your body can use its own insulin more effectively. Walking, swimming, and biking are excellent forms of exercise.

Eat a healthy and balanced diet. Have your diabetic nutritionist assist you in putting together a good meal plan for your particular diabetes. One essential component of this plan is that you eat all of the food groups daily. We will be discussing healthy eating for those with diabetes in our next article, with recipes included.

Take your medications as prescribed by your doctor. You must follow your doctor's recommendations about your diabetic medications. It is essential to blood glucose management that your medications are taken daily as per the instructions of your doctor.

Know about the ABC's of diabetes.

The (A) stands for a Glycosylated hemoglobin test (A1C). The A1C test measures the amount of sugar that attaches to protein in your red blood cells. Your red blood cells live for about two to three months, so this test shows your average blood sugar levels during that time. The greater the amount of sugar in your blood and the longer it remains high, the more sugar that will attach to those red blood cells. It is suggested you have this test done at least every three to six months. The American College of Endocrinology (ACE) recommends a target A1C of less than 6.5%. To give you an example of what the A1C indicates in terms of blood sugar, if your A1C is 6, then your average blood sugar would be 135 mg/dl; if your A1C is 7, then your average blood sugar would be 170 mg/dl; and if your A1C is 9, then your average blood sugar would be 240 mg/dl. The ACE recommends the following goals:

Blood sugar before meals=less than 110 mg/dl.
Blood sugar 2 hrs after meals=less than 140 mg/dl.

A word of caution here: these levels apply to most people, but your individual levels may be higher or lower. Your healthcare team will help you set the blood sugar target range that is best for you. It is also suggested that you try to keep your blood sugar levels similar on a daily basis. Research has shown that "variable" blood sugar levels can cause diabetic complications.

The (B) stands for blood pressure. It is said that people with diabetes are as much as three times more likely to have high blood pressure than people without diabetes. For this reason, people with diabetes are at a greater risk for heart disease. High blood pressure increases your risk for heart disease and stroke, and is also a factor in diabetic kidney disease, and eye and nerve problems. About 71% of people with diabetes have high blood pressure/hypertension. There are two numbers associated with blood pressure levels: the systolic (the bigger number) which measures the pressure as your heart beats and pushes blood into the blood vessels; and the diastolic (the smaller number), which measures the pressure when your heart rests between beats. The American Diabetes Association recommends that your blood pressure be no more than 130 for systolic and 80 for diastolic. If you have high blood pressure, you can make a number of lifestyle changes to lower your numbers. Quitting smoking, exercising at least four times per week, lowering your sodium intake, and adopting a weight-loss program if you are overweight can help to lower your blood pressure. Many people also need medication to get their blood pressure into the target range. These could include ACE inhibitors, angiotension receptor blockers (ARBs), beta-blockers, or diuretics.

The (C) stands for Cholesterol. If your LDL (bad) cholesterol is higher than 100 mg/dl., your HDL (good) cholesterol is lower than 40 mg/dl., and your triglycerides (blood fat) are higher than 200 mg/dl., then you are at greater risk for cardiovascular disease, diabetes, and insulin resistance. To keep cholesterol within healthy limits, eat a diet low in saturated fat and low in cholesterol.

In summary, whether you have been recently diagnosed or you have had diabetes for years, but do not feel in control of the disease, it is highly suggested that you: get your diabetes health team together; register for a diabetes education class; test your blood sugars daily; begin a weight loss program if needed; stop smoking; exercise consistently; eat a healthy and balanced diet, take your medications as prescribed; and know the ABC's of diabetes.

Our next diabetes article will focus entirely on exercise and good nutrition, and will include some delicious recipes that complement a healthy diabetic diet.

If you have any questions about diabetes, please feel free to email me at mollyboll@verizon.net and I will attempt to answer all of your questions.


The Silent Epidemic

The Basics of Diabetes
By: Molly Boll
Published February 7, 2008

Are you aware of an often-undiagnosed disease that is currently growing at an alarming rate? It is a disease that is making headlines around the world for the devastating health complications that it inflicts on our bodies. It is a disease of the young, the elderly, the rich, and the poor. It does not discriminate. It causes serious health complications, such as heart disease and stroke, blindness, kidney disease, and amputations, to name a few.

Diabetes is the silent epidemic hitting our worldwide population today. It is a disease that currently has no cure. In the United States, there are over 20.8 million children and adults - some 7% of the total population - living with diabetes. Only 14.6 million have been diagnosed, leaving over 6.2 million people undiagnosed and untreated. Per the American Diabetes Association (ADA), if present trends continue, one in three Americans, and one in two minorities, born in 2000 will develop diabetes at some point in their lifetime. Can you imagine the implications this will have on our medical systems? Our hospitals and clinics are already overflowing with people needing chronic and acute healthcare.

This will be the first in a series of articles on diabetes. Some of the topics that will be covered in this series include: what diabetes entails; its symptoms and complications; the myths surrounding diabetes; proper nutrition for those with diabetes; what to do during sick days; and monitoring your blood glucose levels. All of these articles are geared toward helping you to prevent diabetes, or to better live with the disease if you have already been diagnosed.

The ADA regularly reports statistics that paint a vivid picture of the prevalence of diabetes in the United States population.

Two million children between the ages of 12 and 19, or 1 in 6 overweight adolescents in this age group, have pre-diabetes. 20.6 million, or 9.6% of all people over the age of 20 have some form of diabetes. For those older than 60, there are 10.3 million, or 20.9% who have diabetes - typically Type II Diabetes. Men with diabetes account for approximately 10.9 million, or 10.5% of the male population over 20 years old. Women with diabetes account for approximately 9.7 million, or 8.8% of the female population over 20 years old.

This disease is more prevalent in Mexican Americans, American Indians and Alaska Natives; 12.8% of American Indians and Alaska Natives age 20 years or older who received medical care in 2003 had diabetes. More and more countries around the world are seeing increasing numbers of their populations having diabetes, diagnosed or undiagnosed. There is an alarming spike in the diagnosis of diabetes in China, Japan, and other Asian countries where fast foods, unhealthy food choices, and increased sedentary lifestyles are becoming more and more popular. These are the main reasons for an increase in diabetes worldwide today.

Another statistic from the American Diabetes Association reads:

"Diabetes is the fifth-deadliest disease in the United States. Since l987, the death rate due to diabetes has increased by 45 percent, while the death rates due to heart disease, stroke, and cancer have declined. Some 224,092 deaths were attributed to Diabetes. Diabetes as a cause of death is under reported."

What is Diabetes?

Simply put, diabetes is a disease in which the body does not properly control the amount of sugar in the blood. Diabetes can be categorized into four different types.

Type I was previously called insulin-dependent diabetes mellitus (DDM) or juvenile-onset diabetes. It occurs when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone "insulin" that regulates blood glucose. People with Type I Diabetes must inject insulin. Type I diabetes is usually found in children and young adults, although it can occur at any age. Some 5% - 10% of all people with diabetes have Type I. To date, there is no known way to prevent Type I diabetes.

Type II has been called adult-onset diabetes and accounts for about 90% - 95% of those diagnosed with diabetes. This type usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. The pancreas gradually loses its ability to produce insulin. Type II diabetes is usually associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, or race/ethnicity. Current clinical reports reflect that Type II diabetes is being increasingly diagnosed in children, particularly in American Indians, African Americans, and Hispanic/Latino Americans.

Gestational Diabetes is a form of glucose intolerance found in some women during pregnancy. Though it can affect any pregnant women, it occurs more often in those who are obese and have a family history of diabetes, and those having babies over 9 pounds. Women who have had gestational diabetes have a 20-50% chance of developing diabetes in the 5-10 years following their pregnancy.

Pre-Diabetes is a condition that raises the risk of developing Type II diabetes, heart disease, and stroke. Glucose levels in those with pre-diabetes are higher than normal, but not high enough to be classified as diabetes. If one's fasting glucose levels are 100 - 125 after an overnight fast, one is said to be "pre-diabetic" and has a condition that is called Impaired Fasting Glucose (IFG). Another way of looking at pre-diabetes is a measure of Impaired Glucose Tolerance (IGT), where two hours after an oral glucose tolerance test, the blood levels measure 140 - 199.

The ADA reports that 54 million American adults had IFG or Pre-Diabetes in 2002. Can you imagine 54 million people on the verge of getting diabetes? Read on, as there is HOPE!

Progression to full diabetes in people with the "pre-diabetes" condition is not inevitable. There are many studies that have shown that people with pre-diabetes who lose weight and increase their physical activity can delay and even prevent diabetes, as they return their blood glucose levels to normal. Our series of articles will give you tools on how to prevent diabetes.

Since the majority of the people who will be reading these articles are over the age of 55, we will concentrate on Type II diabetes, which is the type of diabetes usually found in people of this age group.

Who is at risk for Type II diabetes?

The following people are at the greatest risk for Type II diabetes: those with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG); those over the age of 45; those with a family history of diabetes; those who are overweight; those who do not exercise regularly; those with low HDL cholesterol or high triglycerides, and high blood pressure; certain racial/ethnic groups; and women who had gestational diabetes or those who had a baby over 9 pounds at birth.

The warning signs of Type II diabetes can include:

Frequent urination
Unusual thirst
Extreme hunger
Extreme fatigue
Frequent infections
Recurring skin/bladder infections
Tingling/numbness in hands/feet

Often, however, people with Type II diabetes have no symptoms.

Though not currently curable, Type II Diabetes is treatable. People can manage their blood glucose by following a healthy meal plan, implementing an exercise program into their daily lives, losing excess weight, and taking medications (oral and insulin). Self-management and diabetes education are imperative in achieving good control of diabetes. It is interesting to note, per the ADA, "that among adults with diagnosed diabetes, 16% take insulin only, 12% take both insulin and oral medications, 57% take oral medications only, and 15% do not take either insulin or oral medications," as they are able to control their diabetes through nutrition and exercise.

Our next article will discuss how to prevent diabetes; what to do when you are recently diagnosed with diabetes; and how to thrive with this disease. We will also be discussing some myths about diabetes.

Healthy Eating & Diabetes

Living Your Best Life with Diabetes, Part 4
By: Molly Boll
Published September 16, 2008

As people living with diabetes, we have to follow a three-step process in managing our diabetes. The three components that help us to control our diabetes are good nutrition, exercise, and taking our diabetes medications as prescribed. We cannot leave out any one of these components and expect to be healthy. This fourth article in the "Living Your Best Life with Diabetes" series will continue to concentrate on good nutrition.

As a person who has lived with Type 2 diabetes for 27 years, I have found that following a good diabetes nutrition program takes much focus. I am constantly battling what to eat, how much to eat, and when to eat it. This article will attempt to give you some of the lessons I have learned about good nutrition over the years. If nothing else, please learn from my successes and failures.

The most challenging problems I have had with eating have been:
Controlling portion sizes
Eating foods that are healthy/available at all times
Eating at about the same time every day and disciplining myself to take my blood sugars at least 30 minutes prior to eating
Including a variety of nutritious foods in my daily diet
Finding the energy to spend the time in the kitchen to cook healthy diabetic meals.

All of these situations need to be overcome in order to maintain a fairly even and normal blood glucose level throughout the day.

Control Portion Sizes

I believe most of us have problems with portion control. Have you noticed that the size of muffins, candy bars, soft drinks, and restaurant foods have all grown over the years? The movie Super Size Me addresses this issue. As portion sizes grow, people tend to eat more than they need to stay healthy. This is just one of the factors that contributes to the epidemic of obesity in our society.

Larger food portions have more calories. Eating more calories than you need may lead to weight gain. Too much weight gain can put you at risk for Type 2 diabetes, heart disease, and some cancers. Managing your weight involves looking at how much you eat and how often you eat.

Remember that a "portion" is how much food you choose to eat, while a "serving" is a standard amount set the by the U.S. Government, or sometimes by others for recipes or diet plans. The portion size you are accustomed to eating may be equal to two or three standard servings. As an example, a nutrition label for cookies may show the serving size as two cookies. If you eat four cookies then you are eating two servings - which means double the calories and fat. So be sure to read the nutrition labels on food packages to see the suggested serving size.

Portion control is my very biggest problem with food intake. To get your portion control under control, I would suggest keeping a food diary. Take note of how much you eat, when you eat, what kinds of foods you eat, where you eat, and why you eat. Studies have found that people who write down everything they eat tend to eat far less and lose more weight than those who do not record their food intake. If you find that you want to eat when you are not really hungry, try taking a break to walk around the block or call a friend. Another way to track portions is to use measuring cups and spoons to measure your portions, and then put the correct portions onto your plate before you start to eat. This will help you to see what a standard serving of food looks like.

Here are some other ideas for controlling portions at home:

Take a box of crackers, for example, and divide it into single-serving sizes in small plastic bags as soon as you get it home from the grocery store. That way you can just grab a small bag of crackers, instead of being tempted to consume a much larger portion when eating directly from the box.

Avoid eating in front of the TV or while busy with other activities. Pay attention to what you are eating and enjoy the smell and taste of your foods. Eat slowly so that your brain gets the message that you are full.

Take seconds of vegetable or salads rather than higher calorie foods such as meats or desserts. There's nothing wrong with having an extra large portion of steamed veggies!

Have Healthy Food Available

Most of us have opened the refrigerator from time to time and said, "There sure isn't much in here to fix for dinner!" Having a variety of healthy foods readily available is an important part of maintaining a balanced diet. This requires meal planning in advance. Plan your shopping trips to the grocery store by making a list of what you'll need to cover your weekly menu. Shop one day per week and learn to cook a few things in large batches to freeze in single-size portions for future use. You'll want to have enough healthy food on hand to prepare three nutritious meals and two small snacks each day. Including snacks in your daily plan is important, as it will lessen your tendency to overeat at dinnertime due to excessive hunger.

Eat at the Same Time Daily & Take Blood Sugar 30 Minutes Before Meals

How difficult is it for you to eat at the same time daily? There are so many factors that go into managing your diabetes. Although it can be tempting to let some of these slide on occasion, there are certain things that MUST be done. One of these "musts" is eating at the same time each day to keep your blood sugar under control. The other "must" is taking your blood sugars 30 minutes prior to meals, especially if you are on insulin. As a cook, I always found it difficult to take my blood sugars while cooking dinner. Now when I take the sugars 30 minutes prior to my meals, usually before I start cooking, I can be more focused on taking the blood sugars. I must admit that, after all these years, though I am faithful in taking my insulin, I constantly have to remind myself to take the insulin about 30 minutes prior to mealtime.

Eat a Variety of Healthy Foods

Some people think that having diabetes means that you have to start eating special foods or following a complicated eating plan. In truth, a healthy diabetes diet simply translates into eating a variety of nutritious foods in moderate amounts at consistent times. This means eating a diet rich in vegetables, fruits, and whole grains. A healthy-eating plan that is naturally rich in nutrients and low in fat and calories isn't just best for diabetics, it's really the best eating plan for everyone.

Here are some tips to help you include a variety of nutritious foods in your diet.
Whole Grains: To eat more of this food group, choose whole grain versions of refined carbohydrates. Eat whole wheat bread instead of white bread, and brown rice instead of white rice. Use whole grains in mixed dishes, such as barley in soups or stews, or bulgur wheat in casseroles. Substitute whole wheat or oat flour for up to half of the flour in pancakes, waffles, or muffins. Use rolled oats as breading for baked chicken, fish, and veal cutlets. Use brown rice, bulgur, graham flour, oatmeal, whole-grain corn, whole oats, rye, whole wheat, and wild rice.

Vegetables: Buy fresh vegetables when they're in season, as canned vegetables tend to be high in sodium. Stock up on frozen vegetables for quick and easy cooking. Buy easy-to-prepare vegetables, such as pre-washed bags of salad greens, and then add baby carrots and tomatoes for a quick salad. Packages of pre-cut veggies and carrots make convenient and healthy snacks. Make veggies taste better by using a low calorie dip or dressing. Keep a bowl of fresh cut up veggies in the refrigerator for use as snacks.

Fruits: Keep fresh fruit on the counter or in the refrigerator, so that you'll be more likely to pick up this healthy snack when you're hungry. Buy fresh fruits in season. For convenience, buy packages of pre-cut fruit, such as melon or pineapple, for a healthy snack.

Proteins: Include more fish in your diet. Look for fish rich in omega-3 fatty acids, such as salmon, trout, and herring. These can be prepared into salmon steaks or filets, salmon loaf, or grilled or baked trout. Include dry beans or peas in your main dishes, such as chili with kidney or pinto beans, stir-fried tofu, split pea or lentil soup, black bean enchiladas, or hummus spread on pita bread.

The Glycemic Index (GI) is a great tool to help you choose food types for the management of your diabetes. The GI is a ranking of carbohydrates on a scale from 0 - 100, according to the extent to which they raise blood sugar levels after eating. Foods with a high GI are those which are rapidly digested and absorbed, and result in marked fluctuations in blood sugar levels. Low GI foods, by virtue of their slow digestion and absorption, produce gradual rises in blood sugar and insulin levels and have been proven to benefit your health.

Low GI diets been shown to improve both glucose and lipid levels in people with Type 1 and Type 2 Diabetes. They have benefits for weight management because they help control appetite and delay hunger. Low GI diets also reduce insulin levels and insulin resistance. With this in mind, I would recommend learning more about the Glycemic Index by visiting the following websites, which are excellent resources for this subject:


Some additional resources for planning a nutritious diet include:



Find the Energy to Cook Healthy Meals

The final challenge that I've had in maintaining a nutritious diet has been mustering up the energy to cook healthy meals on a regular basis. To meet this challenge, I've found it helpful to make larger batches of recipes when I'm feeling motivated. I can then freeze single serving meals for future nights. On my off days, I just reach into the refrigerator, choose a frozen meal, and add a nice big salad to round out my dinner.

Healthy eating with diabetes can be challenging, but there are many tools to enhance your ability to become healthy. Eat balanced meals; use fresh fruits and vegetables; eat healthy grains; substitute beans and legumes for meat; limit dairy products where appropriate; keep portions controlled; and eat at the same times daily. Becoming familiar with the Glycemic Index and using it to choose a variety of healthy foods in your diet will help you lose weight and lower your blood glucose levels. People living with diabetes and do nothing about it make a very big mistake, as this disease can be controlled and you can go on to live a long life. Just remember that your success with your nutrition program starts with the first step!

If you are experiencing some of the warning signs of Type II diabetes, it is suggested that you mention these to your doctor as soon as possible. In the meantime, if you have any further questions about diabetes, or about the information contained in this first article, you are welcome to email me at: mollyboll@verizon.net and I will attempt to answer your questions. If I am unable to do so, please note that I have access to Dori Khakpour, RD, CDE, a nutritionist who has worked with people with diabetes for over 20 years, for further advise on diabetes. It is my goal to attempt to inform you about this deadly disease so that you can prevent it, or, if you already have diabetes, to help you control and manage it.

Molly Boll, MBA, is a member of the Trilogy at Redmond Ridge Community in Redmond, Washington. She has been a Type II diabetic for 27 years, and has developed the Diabetes Wellness Group, a community-based diabetes educational group that gives seminars throughout the Seattle area. Molly is currently on the Diabetes Educational Review Board at the UW Medical Center/Diabetes Clinic. Molly has spent over 35 years working in the Seattle business community as a VP of Marketing for a major seafood firm, and various other positions, including accountant and business manager.

We'd like to thank her for allowing us use of these excellent articles.