Fruit & Pre-Diabetes

Here is a question I recently received from FOODPICKER.org:

I was diagnosed as having pre-diabetes earlier this year.  Since then I have completely changed my eating habits and become a vegetarian.  I’ve lost weight but want to lose more.  Can you tell me which fruits have a high sugar content?  I am wondering about apples, raisins, bananas, and strawberries.  I already know I need to avoid orange juice. Thanks for your help!

Answer:   Congratulations!  It seems like the changes you have made are a step in the right direction!  Fruit is in essential part of your diet and can be a great addition to meals and snacks.  Below are some tips to help you with your daily fruit selection :

• Choose whole pieces of fruit first to maximize the vitamin, mineral and fiber content – 1 whole piece of fruit (i.e. apple, banana, pear, peach, orange) is equivalent to 15 grams carbohydrate
• Watch your portion size of dried fruit –  1/4 cup of raisins, cran-raisins or other dried fruit contain roughly 30 grams of carbohydrate
• Limit fruit juices to no more than 1x/day – 1/2 cup apple, grapefruit, orange, pineapple juice or 1/3 cup cranberry, grape, prune juice is equivalent to 15 grams carbohydrate

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Pre-Diabetes vs. Type 2 Diabetes

Here is a question I recently received from FOODPICKER.org:

What is the difference between Pre-Diabetes and Type 2 Diabetes?  Could you tell me the diagnostic criteria for both as well as the treatment?

Answer:  Type 2 diabetes is the most common form of diabetes and can develop at any age.  Essentially, the pancreas loses its ability to secrete enough insulin in response to meals.   Type 2 diabetes is diagnosed with one of the following tests:

• Fasting blood glucose level higher than 126mg/dL on two occasions
• Oral glucose tolerance test higher than 200mg/dL 2 hours after the test
• Random blood glucose level higher than 200mg/dL with some of the common symptoms (increased thirst, urination or fatigue)

Treatment options may include dietary changes, physical activity, weight loss, medications to help control blood sugar levels and self monitoring of blood sugar levels.

Pre-diabetes, meaning “before diabetes” essentially means blood glucose levels are higher than normal, but not yet high enough to be diagnosed as diabetes.  Pre-diabetes is diagnosed with one of the following tests:

• Fasting blood glucose level between 100-125mg/dL on two occasions
• Oral glucose tolerance test between 140-199mg/dL 2 hours after the test

Research shows those with pre-diabetes can prevent or delay the onset of type 2 diabetes by making lifestyle changes including a healthy diet, physical activity, and weight loss (if indicated).

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Pre-Diabetes & Weight Loss

Here is a questions I recently received from FOODPICKER.org:

I was recently diagnosed with pre-diabetes and was prescribed medication.  I have been following a diet to lose weight but unfortunately in the past few weeks, I have actually gained a few pounds.  When I was eating whatever I wanted without the medication, I stayed the same weight.  In the past, I have exercised at least 3 days a week but after a year of doing this I only lost about 10 pounds.  Do you have any suggestions?

Answer:  Some medications used to control blood sugar levels can result in weight gain.  At your next appointment with your physician, I would recommend discussing your blood sugar control, the weight gain and any other concerns you may have. Your physician may choose to change the dosage or medication prescribed.   Here are some other tips to help you achieve your weight loss goals:

• Physical activity – Try to engage in at least 30 minutes of physical activity 5 days a week. Remember that physical activity does not need to be ‘planned’ – the goal is to get active and stay active by doing things you enjoy such as swimming, walking, dancing, running, team sports, etc. 
• Meal frequency and portion size – Try to eat 5-6 small meals/day.  Make sure to watch the portion sizes and read labels.
• Try keeping a food diary with all foods and beverages you eat and drink throughout the day.  When you look back on your days intakes, ask yourself what you could have done differently to promote weight loss and better eating habits.  i.e. smaller portion sizes, fewer calorie dense beverages, less condiments, more fresh fruits, etc.
• Balance intake and expenditure – one pound is equivalent to 3500 calories.  To lose 1 lb in a week, you would need to either consume 500 fewer calories/day, burn an additional 500 calories/day or a combination of the two.
• Make dietary changes to incorporate more fresh fruits and vegetables, whole grains, low fat dairy products and limit fat.

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A1c and Pre-Diabetes

Here is a question I recently received from FOODPICKER.org

I was recently told by my doctor I have pre-diabetes and that I need to lose weight, eat right, and get my sugar levels down.  On a 12 hour fast, my glucose level was 73 yet my A1c was 6.1%.  If my glucose is low, why is my A1c still high?  What can I do?

Answer:  An A1c test is a test that measures your average blood glucose level over the past 2 – 3 months. An A1c of 6.1% equates to an average blood glucose level of about 135.   Since it is an average, you are likely to have some above and below this average blood glucose level.

Having an A1c test is important as it can verify the results of self-testing, help to assess whether a treatment plan is working and can show you if your lifestyle changes are making a difference in your diabetes control over a period of time.  Typically, it is recommended to have this test done 2x/year, but can vary on an individual basis.

Speak to your MD or CDE about when to be testing your blood sugar – i.e. before or after meals.  Testing after meals can be more beneficial to help you understand the immediate affect foods have on your blood sugar.

 

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Newly Diagnosed with Pre-Diabetes

Here is a question I recently received from FOODPICKER.org

I found out I have pre-diabetes.  I’m very confused and don’t know what I should do to treat it.  My friend told me to avoid all fruits.  Could you help me with how to treat my new diagnosis and if it’s ok to eat fruit?

Answer:  Pre-diabetes is when blood sugar levels are elevated, but not quite high enough to be diagnosed as type 2 diabetes.  Individuals diagnosed with pre-diabetes are more likely to be diagnosed with type 2 diabetes in the future if  lifestyle modifications are not made.  These changes usually include dietary changes to consume consistent amount of carbohydrates, reduce the amount of fat and calories, increase physical  activity and weight loss (if overweight).

Before you become too confused or stressed  with how to treat this new diagnosis,  speak with your healthcare provider to determine which treatment method would be best for you.

In terms of avoiding fruit, this is NOT necessary!!!!!  Fruit is an important component of a well balanced diet as they are a rich source of many vitamins, minerals, antioxidants and fiber.  However, fruits are considered a carbohydrate source which means they will raise your blood sugar. You will want to watch your portion size and plan accordingly.  Try to choose whole fruits instead of canned or fruit juices to maximize the health benefits.

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Sweet Potatoes and Pre-Diabetes

Here is a question I recently received from FOODPICKER.org

I was recently diagnosed with Pre-Diabetes and I’m trying to follow a low fat diet.  I have a question I hope that you can answer.  Are sweet potatoes considered a vegetable and are they ok to eat in my diet?

Answer: There are two different types of vegetables – starchy and non starchy vegetables.  Sweet potatoes are a type of starchy vegetable and contain more carbohydrate compared to non-starchy vegetables such as broccoli, carrots or cauliflower.  Typically, 1/2 cup of sweet potatoes equates to one carb choice or 15 grams carbohydrate.

Sweet potatoes are ok to eat in your diet as they are a good source of Fiber, Vitamin A, Vitamin C, Calcium and Potassium.  Like other carbohydrate sources, it is important to monitor your portion size.  Also, since you are trying to follow a low fat diet, try baking or steaming your vegetables and limiting the amount of excess fat you add.

 

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Diabetes & New Year’s Celebration

Here is a question I recently received from FOODPICKER.org

I have recently been diagnosed with diabetes and my wife has pre-diabetes.  New Year’s Eve we always have a large celebration with cocktails and lots of food.  We are growing weary of the party this year given my new diagnosis.  Any tips on how we can still enjoy the party?

Answer:  Holiday celebrations can be a challenge, especially when there is an abundance of food and alcohol involved.  Here are some tips to how you can still enjoy the party without over indulging:

• Mingle away from the food where you wont be as tempted to constantly graze.  Focus on catching up with old friends and not the food.
• Remain active earlier in the day to burn additional calories that may be consumed at the celebration.
• Eat a healthy, balanced meal/snack before the celebration – showing up hungry could lead to over eating.  If you snack, choose raw vegetables, pretzels or popcorn.  Avoid the cakes, cookies, and crackers.
• Make sure to eat food while you drink alcohol.  Drinking alcohol without eating can  cause low blood sugar, or hypoglycemia, anywhere from 6-12 hours after consumption. If you are going to drink, do so in moderation. The American Heart Association describes moderation as men drinking no more than 2 drinks/day and women 1 drink/day.   One drink equates to 12 oz beer, 4 oz wine, and 1-1.5 oz spirits.
• Monitor your portion sizes.
• If you over-indulge, don’t be too hard on yourself!  Ask yourself what you change next time and go back to your usual healthy way of eating.

 

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