Monday, May 23, 2011
So many people with diabetes have trouble knowing how many carbs to eat, which food categories to choose them from and how to keep track of them. Why is this important? Because carbohydrates have the greatest impact on raising or stabilizing our blood sugars. Too much (or too little) sugar in the blood creates huge risks for diabetics.
I was pretty excited when I found an online guide for a Type 2 Diabetes Meal Planner* (click here). This 2 page* planner shows 1,200 - 2,500 calorie plans with a defined number of exchanges for starches, fruits, milk, vegetables, meat (substitutes), and fats. It also has an extended food list for substitutions. Since I have followed a Weight Watcher plan in the past, food exchanges and substitutions make sense to me. Using the 1500 calorie diet*, I copied the basic guideline into an Excel document and added space for my own choices. (Sorry for the misalignment of the lines - it just won't format correctly in the posting section.)
1500 CALORIE DIABETIC MEAL PLANNER
1200 Calorie 1500 Calorie
Exchanges SAMPLE MENU Adjustments Write Down Your Food Choices
(Per Page 1*) (Use Page 2* for Food Substitutions)
1 Starch 1/2 English Muffin Add 1 Starch _____________________________
1 Fruit 1/2 (med) Banana _____________________________
1 Milk 1 pkg Hot Cocoa _____________________________
1 Starch 1 oz Tortilla (6") Add 1 Starch _____________________________
2 Meat 1 oz Chicken _____________________________
1 oz Cheese _____________________________
1 Vegetable 1/2 cup Green Beans _____________________________
1 Fruit 2" raw Apple _____________________________
1 Fat 2 Tbsp Lite Ranch Dressing _____________________________
Nothing (Unless you save an item from lunch)
2 Starches 1/3 cup Rice Add 1 Fat _____________________________
1 oz Corn Chips _____________________________
2 Meat 2 oz Ground Chicken _____________________________
1 Vegetable Chopped Onion _____________________________
1 Fruit 1/2 cup Canned Fruit _____________________________
2 Fat 2 tsp olive oil or butter _____________________________
1 Starch 3 cups Lite Popcorn _____________________________
1 Milk 8 oz Low-Fat Rice Milk _____________________________
GOAL: Starches: 7 Fruits: 3 Milk: 2 Meats: 4 Vegetables: 2 Fats: 4
DAILY Starches: ___ Fruits: ___ Milk: ___ Meats: ___ Vegetables: ___ Fats: ___
Nutrition is such a complex science. Carbohydrates are found in grains, nuts, fruits, milks and even vegetables. Simple and complex carbohydrates along with fiber play a key role in the management of diabetes. Understanding how to break down the carb count into the various food categories is one thing. Deciphering endless nutrititional information along with controversial food theories of researchers and physicians is quite another. Diabetics must coordinate their food choices along with their insulin dosage or glucose-lowering medications to best stabilize their blood sugars. It's a confusing mess that can leave one with glucose readings which are either too high or too low, and thereby we end up feeling like a failure for getting results which are less than what we strived for. Sometimes we just want to throw up our hands in defeat and hopelessness.
My online research proved difficult in finding a diabetic meal planner with nutritional exchanges. I found this online guide at the Huntsville Pediatric & Adult Medicine Associates webpage. The reviews for this clinic were favorable to outstanding, so I was hopeful this would become a valued guide and useful tool.
The American Diabetes Association website offers no meal planners or breakdown of food exchanges for carbohydrates. It does define a carbohydrate exchange as 15 grams. The ADA recommends each meal contain 3-4 carb exchanges in the range of 45-60 grams but also says this varies from person to person. The conversion of grams to calories is 1 gram equals 4 calories*. By this general recommendation we would consume somewhere around 180 to 240 calories of carbohydrate per meal. Snacks are suggested to be 4 exchanges or 60 grams of carbohydrate equaling 240 calories. Taking into account the 1500 calorie diet would provide 13-16 carbohydrate exchanges equaling 195-240 grams or 780-960 calories. The carbohydrate servings would make up 52.0-64.0% of the total diet.
My calculation of the "online planner" shows that the 1500 calorie diet includes 12 exchanges of carbohydrate (at 15 grams per exchange) which totals 180 grams or 720 calories, resulting in a percentage of 40.8% of the overall diet. I will check with my nutritionist to see whether I should increase the number of carb exchanges in this planner, and if so, in which of the food exchange categories would this addition be the most beneficial to my health and well-being.
It took a lot of research to get to this point. I'm tired - and perhaps you are too. But if you are a diabetic, I hope this provides some valuable information to you! Thanks for checking in today. Take good care of yourself and keep track of your eating habits and log them in a journal to share with your healthcare provider. Tracking your exchanges gives insight and opportunity to make educated changes.
Sunday, May 15, 2011
I am so fortunate. For the 35 years I've been dealing with complicated health issues, I've had my good share of what I consider to be great medical practitioners. I'm not going to say all of them have been good. But when I come across a physician with whom I do not 'connect', I don't hesitate - I look for another. I value my health too much to waste time, energy and money on someone who could care less about who I am and all the health issues I deal with on a daily basis.
Over the last 5 years I have been so blessed to receive excellent care from wonderful healthcare professionals. After a devastating 4th hip replacement revision surgery which resulted in paralysis of my right leg from femoral nerve damage, my PCP stepped up to the plate when my orthopedic surgeon denied any assistance.
My PCP referred me to a neurological physical therapist trained in rehabilitative medicine. We worked together on gaining mobility of my paralyzed leg over a 16 month period. Her devotion, knowledge and willingness to 'think outside the box' in treatment options were invaluable. My PCP offered care for my whole person, including mental, physical and emotional support. She worked with me on diet, supplements, medications, mental health options, and developing a good support system. She taught me how to be proactive in defining my choices in healthcare options. I will be eternally grateful for all of her care and wisdom. I also had excellent alternative care providers, the best of which was the intuitive and trusted hands of my shiatsu masseuse.
I have since switched insurance companies and am currently under the services of a large HMO provider system. I expected to be disappointed in their care and lost in their system. Thankfully I've been proven wrong in my basic assumption. I have one of the best PCP's I've ever had. She is easy to talk to, understands the many complications of my health, and offers me shared decision-making in determining my care. She trusts me to make wise choices about how I care for my body every day, and that's RARE for a healthcare physician in this day and age! I trust her to advise me in the best treatments available to me. I have not had the same experience with all of the specialists I have been referred to in this system. However the availability of electronic medical records in an HMO system does offer other providers a chance to look into the history and results of a patient's medical record which can be a useful tool for further investigations.
Selfishly I miss the integrated team approach of the physicians and healthcare professionals I had with my previous PPO insurance. I had my PCP, a pharmacist, a physical therapist, multiple specialists (for diabetes, fibromyalgia, neurology, orthopedics, etc.) that comprised my healthcare team. I would meet together with several of them once a year to address options and concerns for integrating my care. I realize this was in a teaching university environment where they look to teach medical students the effects of integrated medicine. However it was invaluable to me as a patient knowing that all areas of my health were being looked at and addressed as a complete being.
Now the decision-making responsibility sits wholly upon the shoulders of my PCP in the HMO system. My care is only as good as my PCP, and as I've said, I have a great doctor that I trust. I choose to be responsible for following up with her and my other specialists, knowing that things do and will fall through the cracks without my proactive approach and education.
I hope you too take your health seriously enough to be accountable for finding the best physician and healthcare providers to give you the services you need. Another concern for me is to reach out to multiple social network arenas to share information and support with people who have similar health concerns to mine. This is a time of vast expansion on the internet and discernment is really critical. I value my research skills and the multiple reviews available online to help me question and learn more about health issues. Especially when patient's don't feel well or are overwhelmed by multiple issues, it can be difficult to think clearly. Sometimes "miracle" cures look pretty tempting. It's good to have a reality check with others who understand the "nature of the beast"(the illness) and can offer another perspective.
Thanks for visiting today. If you have any comments or insights, I'd sure love to hear them. Have the best day you can. Blessings to you and your loved ones.
Monday, May 9, 2011
I have a previous post about the effects of potatoes on inflammation in the body. I'd like to continue to explore the remaining nightshade vegetables. The Solanaceae family, or nightshade vegetables, are used for food, spice and medicine. They are often high in alkaloid chemicals which can be either desirable or toxic to humans and animals. Atropine has a stimulant effect on the central nervous system and heart, whereas Scopolamine has a sedative effect. In very small controlled pharmaceutical doses they can halt many types of allergic reactions, control motion sickness, dilate pupils to examine the inner eye and subdue the effects of chemotherapy. In other circumstances ingested toxicity from this family of nightshade vegetables may produce a rash, itching, inflammation, increased pain, bloating, dry mouth, respiratory difficulty, gastrointestinal problems, urinary retention, convulsions, and various other central nervous system conditions.
Nicotine is another alkaloid found in the nightshade plant, tobacco. It is highly toxic and addictive to the human body. Glycoalkaloids are present in 'greening' potatoes and some rare species of berries and can be lethal at high levels. Capsaicin can be found in hot peppers and omits a strong burning sensation when sprayed or eaten.
If you suffer from chronic illness, the nightshade vegetables most recommended to avoid are:
- tomatillo (or ground cherries)
- chile peppers
- sweet bell peppers
I can tell you from first hand experience, eliminating these vegetables (minus the tobacco because I'm not a smoker) takes a concentrated effort. From ketchup to salsa, baked potatoes to french fries, and even ratatouille, I miss many of my favorite foods. But the suffering I endure when I eat them is so horrible, I now envision them as "poisonous foods". When looked at in this manner, it's no longer difficult to pass them up.
Some of you who have life threatening food allergies (i.e., peanuts, wheat, eggs, etc.) know the danger involved in ingesting poisonous foods. I encourage all who have inflammation in your joints and muscles, consider eliminating these foods from your diet. I believe you will see a noticeable difference in your pain levels. Another option in addition to eliminating nighshade vegetables, would be to follow the anti-inflammatory diet. Click on this link for further details about this healthy lifestyle choice.
It's made a huge difference in my life. Let me know your findings! Thanks for checking in on my blog. Hope you'll come back again soon to visit.