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Diabetes Type 1 & Type 2




  1. Where can I find a dietitian who works with diabetes? Answer
  2. I am a diabetic and weigh 130 pounds. I would like to go down to 115 - 120 pounds. Any tips or suggestions? Answer
  3. I constantly crave sugar. I know that some of these are symptoms of diabetes, but could something else be the cause? Answer
  4. I need to find what kinds of cultural foods / diet that Lakota Sioux Indians eat for a patient who is a new diagnosed diabetic. Answer
  5. My husband followed his diabetes and cholesterol diet, but now that his doctor took him off pills he is going back to his old ways of eating and drinking. Answer
  6. I was tested when I had all the blood work done. My sugar level was a little high. Answer
  7. Since insulin turns carbohydrates into fat, is there a medication to take that will slow down insulin production? Answer
  8. My father has diabetes and his doctor says frozen packaged food is not good for diabetics. Is there anything to that? Answer
  9. My mom has type 2 diabetes, but is confused on how to count sugar grams in foods and how carbohydrates map to sugar grams if they do. Answer


  10. My father has borderline diabetes for which he is taking pills. He would like to know what kind of doctor he should be seeing to get the best dietary advice. Answer
  11. I am a diabetic. What are the benefits of taking this vanadyl sulfate supplement? Answer
  12. What are the signs and symptoms of diabetes? Answer
  13. Is there a similar set up for a diabetic that's on, let's say, 2000 calories a day? Answer
  14. I am very shaky and just do not feel well. I was wondering if the Weight Watchers diet would work for me as I have diabetes and high blood pressure. Answer
  15. Sometimes in the morning after I eat breakfast by an hour or so I become sleepy even though I do not overeat. While if I overeat during dinner I do not feel the same effect. Answer
  16. I have a friend who has diabetes and is obese. She makes no effort to curb her fat intake and her tests are in the good to excellent range. Answer
  17. I was wondering how to tell when blood glucose readings are just "low" and when they are "deadly" low? Answer
  18. What is the best way to find a registered dietitian in my area that specializes in diets for type 2 diabetics? Answer
  19. I thought that fructose raises your LDL. Is this in fact the case? Answer


  20. I'm a diabetic who eats 4 - 5 servings of nuts per day and 5 - 6 sodas. Is this consumption OK? Answer
  21. My husband is a diabetic. Could you give me some help in filling lunch pails for him? Answer
  22. My doctor told me I have "borderline diabetes". He told me to lay off sugar and candy. Is that all I should not eat? Answer
  23. Does NutraSweet stimulate my food wants? Would I be better off going back to the saccharin sweeteners? Answer
  24. I am a diabetic and I've read that I can use fructose as a sweetener. Is that true? Am I limited in how much I use? Answer
  25. I need some help with my dad who is a diabetic. I would like some cookie recipes if you have some available or could you tell me where some could be found. Answer
  26. Can I rinse the syrup off regular canned fruit? I'm a diabetic and the dietetic canned fruit is so expensive? Answer
  27. Why do diabetics have to cut out all sweets yet when they feel weak or light-headed they put a piece of hard candy in their mouths? Answer
  28. My son is a diabetic. What should I serve at his birthday party? Answer


Where can I find a dietitian who works with diabetes?

The Diabetes Care & Education dietetic practice group of the Academy of Nutrition and Dietetics specializes in working with patients with diabetes. You can find a dietitian at the Academy of Nutrition and Dietetics. Include your zip code or city / state and the type of service you want (individual consultation) and area of expertise in diabetes.


I am a diabetic and weigh 130 pounds. I am 5 foot 6 inches and would like to start dieting. I currently eat 900 calories a day (approximately) and exercise lightly three times a week. I would like to go down to 115 - 120 pounds. Any tips or suggestions?

You are at a healthy weight for your height. I would not recommend you lose any additional weight, but do continue your exercise program.

Considering you have diabetes, I would recommend you eat much more than 900 calories per day. A food intake this low is deficient in vitamins and minerals which over the long run is unhealthy for you. You may want to read my chromium topic as this mineral is essential to insulin. Depending on your overall activity level in addition to exercising, you may need almost double the 900 calories you are currently eating. Try the Healthy Body Calculator to find out how many calories you need to maintain your weight.


I don't know what is wrong with me. I constantly crave sugar. So bad sometimes that I will go in the kitchen and eat tablespoons of raw sugar at a time. I am really moody. One minute I will be happy and then 10 minutes later want to cry. I get so sleepy after I eat, especially lunch. But after an hour nap, I feel OK again. I am constantly thirsty and urinate a lot. I am scared because diabetes runs in our family. I am 20 years old, weigh 115 pounds and my height is 5 feet 5 inches. I know that some of these are symptoms of diabetes, but could something else be the cause?

I would suggest you contact your doctor. You do have some symptoms of diabetes with excessive thirst and urination. If you do have diabetes, it can be controlled with a diabetic nutrition therapy, exercise and perhaps medication (either oral or injected insulin).

There is no explanation for why you are craving sugar. Are you eating enough protein (meat, poultry, fish, eggs, cheese, milk and dried beans)? High carbohydrate foods induce sleep as well as elevate your mood. Do you eat several high carbohydrate foods at lunch i.e. starches or sweets? Do you feel happy after eating sweets like sugar?

Your mood swings though should be evaluated by psychologist. But first, I would suggest you see your medical doctor who can evaluate your physical symptoms.


Hi, I am a registered nursing (RN) student who is looking for some information to do with a case study we are working on. I need to find what kinds of cultural foods / diet that Lakota Sioux Indians eat. This particular patient is also a new diagnosed diabetic so we need to help her plan a diet that is involved with her own cultural foods. If you have any information that can help us I would deeply appreciate it. Thank-you for your time.

I would suggest look at the Academy of Nutrition and Dietetics's publication Navajo Food Practices, Customs and Holidays. That is about as close to Native American eating practices as I have seen in print.

In Minnesota and South Dakota Native Americans' food choices consisted of wild game (deer, duck and goose), fresh water lake fish (walleye, Northern pike and trout), wild rice and berries (blueberries, raspberries and strawberries). Unfortunately, we Americanized their lean healthy eating habits by introducing fats and fried foods. There is a high incidence of diabetes, especially among some South West Native American tribes.


I am so worried about my husband, in January he was diagnosed with type 2 diabetes. His cholesterol was 441 and his triglycerides were 2395 the highest his doctor has ever seen. His glucose was 347. He was put on a diet and pills.

Well we followed the diet strictly and seriously in a week his cholesterol was at 391, his triglycerides were 1171 and his glucose was down to 294. He quit drinking and smoking all together by May, his cholesterol was 160, triglycerides were 147 and glucose was down to 89. The doctors could not believe we did this. She told him that in September, she would probably take him off pills.

Well now the problems started. He figured then if he was going off pills that he could drink again. So he started again. In July I was downsized to 2nd shift, he works 1st. Almost 2-4 times a week, I would come home and he would not be there. Later he would come home drunk. I know this is not good. He does not eat right and is drinking heavily and smoking again. I tell him he is hurting himself and all he says is the doctor says I will be off pills so this is OK. He says there is nothing at the house for him now so he goes to a bar.

I mean for 7 months we watched everything, made charts of meals and everything. Now he thinks it's all OK. He has an appointment today to get blood checked. I know it has to be bad. If not, I don't know what he's doing. Is it OK for a diabetic to drink and smoke like this? I don't think so.

I know he will not tell doctor today what he's been up to. He thinks it's all right. He also takes blood pressure pills. Since we have been on this diet the doctor told him he would not need to take them anymore, but still takes them because they are good for his heart. The thing is that for the last 4 months he's has not followed his diet. If his test comes back normal today, he will never slow down. I can't see how they can, but it seems like he has something on his side. He is 42 and 6 feet 1 inch and about 260 pounds. He is a big man. In the beginning he was so scared of losing now all he feels like is a winner of this. In the last 3 months, he has had a caring wife.

You can lead a horse to water, but you can't make him drink also applies to people's health care. While your husband's doctor cannot tell you your husband's blood results without his permission due to HIPPA privacy laws, you can share your concerns with his doctor before your husband's appointment.

When you husband gets his blood work done, the doctor will not only check his blood glucose, cholesterol and triglycerides, he can also check his A1c (glycosylated hemoglobin). When red blood cells are forming, glucose molecules attach. Since a red blood cell lives 120 days, a doctor can tell what the patient's blood glucose has been over the last 4 months.

Drinking is not advised for persons with diabetes when blood glucose is out of control (A1c >7) and even if their blood glucose is in control (A1c <7 American Diabetes Association or A1c <6.5 American Association of Clinical Endocrinologists) alcoholic beverages should be limited. Your husband needs to lose weight and exercise, which will improve his blood glucose along with following a diabetic nutrition therapy. Your husband may benefit from an appointment with a registered dietitian, but he first needs to deal with his dependence on alcohol.

Smoking is not good for anyone's health and increases hardening of the arteries which is also accelerated in persons with diabetes even if they don't smoke. Your husband should stop smoking, but he should first get his alcohol dependency and blood glucose under control because it is very difficult to change more than one behavior at a time.


In response to your asking if I had been tested for diabetes, I was tested when I had all the blood work done. My sugar level was a little high. But it goes up and down. Sometimes it is low. I do not remember the number. But I do remember my doctor telling me by the time I am 30, I will be a full-blown diabetic. It's genetic on my dad's side. I can't name a person on his side that does not have diabetes. I am now 27 years old. Is there anything I can do to prevent this? Being genetic, I am going to assume there isn't. And the last blood work I had was a year ago. Should I go back and have it redone?

I would suggest you talk to your doctor and specifically tell him / her about your dad's family history if your doctor is unaware of your family history. Depending on when your blood glucose is taken at the doctor's office (i.e. either fasting or 2 hours after a meal) will affect the test results. Your blood glucose should be 70 - 105 milligrams per deciliter fasting and it is normal for your fasting blood glucose to double within 2 hours after a meal. However, it should be below 140 milligrams per deciliter two hours after eating. Anything higher should be tested further. Ask your doctor. You should have your blood glucose tested at least once a year as a screening for diabetes considering your family history.

You can't prevent diabetes completely and research points to causes other than what you eat, but overweight is a risk factor for developing diabetes sooner rather than later. Until more is learned, lose weight and exercise to manage your blood glucose. Control carbohydrates and alcohol to lower your triglycerides.


Since insulin turns carbohydrates into fat, is there a medication to take that will slow down insulin production?

No and it would not be wise. Your pancreas produces insulin to move glucose into cells where it is metabolized into energy which fuels the body. When your blood glucose returns to a normal range 70 - 105 milligrams per deciliter, your pancreas produces a hormone called glucagon that stimulates the release of glycogen (stored glucose) from liver and from muscles if you are exercising. Glycogen is broken down and replenishes the glucose in your blood. This keeps your blood glucose within normal ranges between meals while you go about your activities and exercise.

People with diabetes who do not take insulin have higher than normal levels of insulin in their blood. Their insulin receptor sites on cells seem to be less responsive to insulin and higher levels of insulin are needed to move glucose into a cell. Also, because the body cannot turn off the injected insulin, it continues to be available to move glucose into cells. Once glucose is inside cells, the energy is released for use by the body or converted into fat for storage.


My father, who lives in Israel, is 86 years old and has non-insulin-dependent diabetes. He just told me that one of his doctors says that frozen packaged food (or perhaps any food that is frozen) is not good for diabetics. Is there anything to that? Please let me know.

Some frozen packaged foods (frozen vegetables and fruits) are OK for a person with diabetes; some are high in sugar, fat and salt and are not OK. Perhaps his doctor was trying to steer your dad away from dessert type frozen foods or perhaps his doctor also want your father to reduce fats or salt. Otherwise his diabetic nutrition therapy can include fresh, frozen or canned foods as long as it follows his diabetic nutrition therapy. I think he should talk to a registered dietitian or if he has access to the Internet, suggest he read this diabetes topic. Abnormal blood glucose occurs in 90% of persons over the age of 70 so it is not surprising that your father has diabetes.

The nutrition therapy for non-insulin dependent diabetes (type 2) is a low fat meal plan and exercise. Weight loss may be recommended as body fat increases a person's resistance to insulin. He may or may not be taking pills that stimulate his pancreas to produce more insulin or taking insulin shots daily if his blood glucose is no longer normalized by oral medication.

A diabetic nutrition therapy includes 3 average sized meals per day and if your father is taking pills or injecting insulin, will need a snack at night. A Kosher eating plan is very good as food is usually cooked from scratch, but he needs to lower the fat content in the foods he eats to around 30% of calories from fat. One simple method is to choose foods low in fat, nothing fried, then add 1 teaspoon of trans fat free margarine, mayonnaise, oil or 1 tablespoon salad dressing to one food at each meal. He can choose which food to add fat.

Exercise improves a person's blood glucose response, increases the rate at which the body burns calories and helps to reduce appetite. Any activity like walking that he can do for 30 to 60 minutes daily would be beneficial. People lose muscle mass as they age so moderate weight lifting would help maintain muscle mass for your dad.

An Israeli registered dietitian could find out what he eats on a usual basis, read his medical chart and give him a meal plan that would take his likes and dislikes into consideration.


I have a question for you. My mom has diabetes type 2, but is confused on how to count sugar grams in foods and how carbohydrates map to sugar grams if they do. Can you point me to some reference material that I could pass along to her?

Sugar is a carbohydrate and 1 level teaspoon has 4 grams of carbohydrate. There is not a specific way to predict how many grams of sugar is in a food with x amount of carbohydrate as it depends on whether the sugar is naturally occurring or added to a packaged food. The Nutrition Facts on a food label will list sugar grams from all sources (natural occurring or added sugar) as part of the carbohydrate in a food. But counting sugar grams is not necessary for a person with diabetes.

Starch, fruit and milk diabetic exchanges have approximately the same number of grams of carbohydrate and each are counted as 1 carbohydrate choice (serving size varies with the food). Diabetic nutrition therapy is designed to count carbohydrate choices (1 carbohydrate choice has 15 grams carbohydrate). So a person on a carbohydrate counting eating plan counts the number of starch, fruit and milk exchange servings eaten each meal each day using a plan that keeps their blood glucose within normal ranges which is 70 to 105 milligrams per deciliter. Usually 2 to 4 carbohydrate choices (depending on calorie and weight goals) are eaten per meal and 1 carbohydrate choice as a snack between meals to spread out the carbohydrate intake over a day which helps to even out highs and lows of blood glucose levels.

I would suggest your mom make an appointment to see a registered dietitian to help plan her meals and determine the number of carbohydrate choices per day based on her weight and blood glucose goals. The dietitian can provide her with a booklet on carbohydrate counting from the Academy of Nutrition and Dietetics. The booklets Basic or Advanced Carbohydrate Counting) explains how carbohydrate counting works.


My father has borderline diabetes for which he is taking pills. He also has high cholesterol and high triglycerides. He would like to know what kind of doctor he should be seeing to get the best dietary advice. His general doctor has not been supportive in putting him on a well-defined diet - at best he is vague. My father would especially like specific foods to avoid and a list of recommended foods he can have. Please advise!!! Thank you.

An internist or endocrinologist would be appropriate doctors for diabetes care, but it sounds like your father needs to see a registered dietitian who would be the most appropriate to provide diabetes nutrition therapy. Dietitians have the education and experience to provide nutrition therapy using a person's medical history. It would probably be very helpful to have a eating plan to follow with recommended foods. Your father needs a diabetic, low fat and carbohydrate controlled, no alcohol meal plan.

By the way, there is no such thing as borderline diabetes. It's like saying a woman is borderline pregnant. Either your father can eat all the carbohydrates he wants and his blood glucose will return to normal levels within 4 hours or he has to limit carbohydrates and possibly take medication. Just because a person with elevated blood glucose doesn't have to take medication to control diabetes, they still have diabetes.


In the health food store the salesman recommended that I take vanadyl sulfate. I am a diabetic, what are the benefits of taking this supplement? Are there any side effects?

I checked the National Institute of Health's Office of Dietary Supplements, several drug references and cannot find any information about vanadyl sulfate. Beware of persons without degrees or a state license in nutrition who offer nutritional advice. This can be illegal in some states that license persons who can give nutritional advice or call themselves a dietitian or a nutritionist.




What are the signs and symptoms of diabetes? For a long time now when I get up in the morning I have a strong need / desire for something sweet. I never eat sweets any other time. Usually, one bite of something or anything with sugar is enough to satisfy this desire. I have tried substituting with things like bagels or toast but this does not work. Could this be a symptom of something other than a craving?

A craving for sweets is not a symptom of diabetes. The fact that you crave sweets at breakfast may not be that unusual. Breakfast means you are breaking a fast from your last meal which was probably the evening before. If you are within your healthy body weight range and do not have diabetes or hypoglycemia then go ahead and eat something sweet for breakfast, but also include some whole grains and protein to keep you satisfied until your next meal. Glucose from sweets can get into your blood within 15 minutes, but doesn't have the lasting power of protein and fat to keep you satisfied to the next meal. Remember to brush your teeth after eating sweets.

Common symptoms of diabetes are excessive thirst and urination, weight loss (in spite of eating enough food) and blurred vision. To further define these symptoms consider the following examples. The excessive thirst is usually described by patients as feeling like feeling dry cotton balls in their mouth. Unless a person is pregnant, on diuretics (pills to reduce water retention) or has prostate enlargement, it is unusual for a person to wake up during the night to urinate. Blurred vision that continues even after a change in eyeglass prescription is highly suggestive of diabetes. If you think you have one or all of these, I would highly recommend you see your doctor who can test your blood glucose, examine you and determine if you have diabetes.

With the exception of pica, food cravings (even those pregnant women experience), are not easily substantiated and often cannot be linked with a nutrient imbalance in your body. There are neuro chemicals like serotonin, epinephrine and norepinephrine that strongly influence our appetite.


I am familiar with Weight Watchers and I like the way they have little boxes to check off. I know this sounds simplistic, but it actually works. Is there a similar set up for a diabetic that's on, let's say, 2000 calories a day? I have asked our dietitian. We have been to two classes (my husband is diabetic). Something visual would be very helpful.

The carbohydrate counting booklets have an eating plan that your dietitian will customize for you based on your calorie and weight goals. Why not just photocopy the meal plan that your dietitian created for you? You can then check off each carbohydrate choice at each meal.

You are right, self-monitoring with food records works. It helps you keep track as you eat food rather than relying on memory.




I was diagnosed with NIDDM (non-insulin dependent Diabetes Mellitus) about a month ago because of a glucose reading of 146 over a period of more than a year. I was told to quit eating sweets, exercise and lose weight and take 1/2 of a glucotrol tablet daily. I am 61 years old and have high cholesterol and high blood pressure. I am in limbo sometimes, I am very shaky and just do not feel well. I was wondering if the Weight Watchers diet would work for me. I lost weight this way once before, but after the initial weight loss I found 1 or 1/2 pound difficult to lose. Any suggestions would be appreciated.

Weight Watchers diet uses a points system based on the calorie, fat and fiber content of foods or calorie density with low calorie foods emphasized. The concept is similar to carbohydrate counting which is based on carbohydrate content in foods in the diabetic exchange list. Weight Watchers diet does not include a specific cholesterol or salt restrictions which the exchange list does identify.

I recommend you see a registered dietitian to create an eating plan that incorporates all three health issues, diabetes, high cholesterol and high blood pressure based on your food preferences. When you hit a plateau where weight loss is difficult, a dietitian could evaluate your food diary and exercise program to get you losing weight again.

The pill you take is not insulin, but stimulates your body to produce more insulin. When you feel weak and shaky, like you are going to faint, your blood glucose may be too low. Another symptom is sweating. When you feel like that, you should drink a 4 to 6 ounce glass of juice or milk or regular soda, 1 tablespoon honey or syrup or 6 saltines. If you don't feel better in 15 minutes, drink another glass of juice, milk, soda, etc. If you still don't feel good, your blood glucose probably isn't low. If your feeling shaky happens more than once a month, contact your doctor to regulate your medication.

Weight loss, combined with exercise, lower fat and salt intake can lower your blood glucose, cholesterol and blood pressure.


I have type 2 diabetes. I have been monitoring my diabetes through a more or less strict diet and daily exercise. My A1c test for the last three years has been within normal range. Sometimes in the morning after I eat breakfast by an hour or so I become sleepy even though I do not overeat. While if I overeat during dinner I do not feel the same effect. Could you explain the difference to me?


Congratulations on good control.

Have you tested your blood glucose 2 hours after meals (postprandial)? This may provide you an answer to feeling sleepy after breakfast, but not after dinner. Sleepiness is not usually a symptom of low blood glucose, a fainting feeling is. Have you discussed this with your doctor? If not bring it up your next visit.

Generally, a meal high in carbohydrates tends to make one sleepy and a meal high in protein tends to keep one awake. Breakfast meals tend to be higher in carbohydrates. Do you include meat or a meat substitute like an egg or peanut butter at breakfast? Does your dinner meal include more meat (3 ounces) than your breakfast (1 ounce)?

Overeating will also make one sleepy. After a meal, blood pools in the gastrointestinal area (stomach and intestines) to pick up nutrients from the food. This decrease in blood flow to the brain and extremities (legs and arms) can make you feel less alert mentally.

You did not mention whether or not you drink a caffeine containing beverage at breakfast. Two cups of coffee (8 ounces of coffee has 95 milligrams of caffeine and 8 ounces of tea made from 1 tea bag, not herbal, has 47 milligrams of caffeine). Less than 200 milligrams per day is considered safe. Caffeine usually works within 20 minutes and the effects last 6 hours with the greatest effect within the first 3 hours. Drinking caffeinated beverages with breakfast may only mask the symptoms and not address the real reason you feel sleepy after breakfast.

Exercise will increase your level of alertness after a meal. Consider going for a walk after breakfast.

An A1c blood test (glycosylated hemoglobin) will tell what your blood glucose has been over the last 4 months. As red blood cells (RBC) are forming, glucose from the blood attaches to the cell wall. If your blood glucose is high when the red blood cells are forming, more glucose will attach. Red blood cells live 4 months and so glycosylated hemoglobin will reflect blood glucose over a longer period than a single fasting blood glucose that measures what glucose is in the blood at that specific moment. You should aim for an A1c <6.5.


I have a close personal friend who was diagnosed as having non-insulin dependent diabetes several years ago. She is very obese and since that time has been very faithful in watching her sugar intake. However, she makes no effort what so ever to curb her fat intake. At her last physical, all her tests came back in the good to excellent range. With those results, she has almost gone overboard eating although she still watches her sugar intake. Do you have any thoughts on what she is doing to herself? She is about 160 pounds overweight and I'm worried she won't live long enough to have fun with me in retirement!

Overweight people are more resistant to their own insulin and actually need to produce more insulin to effectively metabolize glucose in body cells. If your friend were to lose weight, her insulin resistance would improve. Even if a person limits their sugar intake though, excess calories can contribute to an above normal blood glucose levels.

Usually a low fat eating plan is recommended as part of a diabetic nutrition therapy with around 25% to 30% of your calories from fat, 50% to 60% carbohydrate and 10% to 20% protein. I am wondering if her doctor has measured her blood fats (cholesterol and triglycerides) and whether they are within normal ranges?

Excess weight and foods high in fat intake are risk factors for heart disease and many types of cancer. It is up to your friend to choose to lose weight and control her fat intake. Even a 10% loss of body weight can make big improvements in blood glucose levels. You can be supportive of her positive efforts. Nagging her about her food habits will produce negative results. Why not create opportunities for you both to get some exercise together?



I was wondering how to tell when blood glucose readings are just "low" and when they are "deadly" low? Sometimes I have readings of 40-50 even though I had feelings that I had "high" blood glucose (headache, stomach bloating and feeling funny, nauseated) and other times when my blood glucose is 40-50. I've had low blood glucoses bad enough to call an ambulance. How do you know how the low reading will actually affect you?

Each person is different. Typical low blood glucose symptoms are difficulty concentrating, weakness, feeling shaky or trembling, sweating (usually across the brow or under the bust), lack of coordination and lightheadedness or faintness.

Your brain and internal organs use your blood glucose for fuel. If there is insufficient fuel (glucose), your organs cannot function normally. That is why some persons who have low blood glucose pass out because there is not enough energy for the brain to function. The brain uses more glucose than any other organ in the body.

If you are not sure, use a blood glucose meter to quickly determine what your blood glucose is with a finger stick drop of blood. Otherwise, how would you know whether you need to eat 15 grams of carbohydrate (4 to 6 ounces of orange juice, milk or regular carbonated soda, 1 tablespoon honey or syrup or 6 saltine crackers) or take more medication (pills or insulin)? Eat 20 to 30 grams of carbohydrate if your blood glucose is less than 50 milligrams per deciliter, but only if you are conscious. This should raise your blood glucose 45 to 50 milligrams per deciliter. Test your blood glucose in 15 minutes and 60 minutes. If your blood glucose is still low, repeat with 15 grams carbohydrate. Use blood glucose readings to reinforce the physical symptoms that you are feeling. You should keep a record with the date, time and how you feel when your blood glucose is low. Have you discussed this with your doctor or dietitian?

Most persons will experience low blood glucose below 70 milligrams per deciliter. I know some people with type 1 diabetes though who find it difficult to tell if their blood glucose is high or low without testing with a blood glucose meter. You need to have a plan that defines when you need to take carbohydrate for low blood glucose and you should wear a bracelet that identifies you as having diabetes. Do you also know about glucagon shots or glucose tablets that you can take when your blood glucose is low? Ask your doctor about these.

After low blood glucose, you may feel sluggish for a while or no different. It just depends on the individual.


What is the best way to find a registered dietitian in my area that specializes in diets for type 2 (?) diabetics? What questions or qualifications should one ask or be on the lookout for? What, if any, additional training should such a person have and is there any "certification" standards associated with this training?

Overweight persons are more resistant to their own insulin and actually need to produce more insulin to effectively metabolize glucose in body cells. If your friend were to lose weight, her tolerance of glucose would improve. Even if a person limits their sugar intake though, excess calories can contribute to an above normal blood glucose levels.

Usually a low fat diet is recommended as part Look in your yellow or white pages of the phone book under dietitian. Your state or city dietetic association should be listed. Call them. Or you can call the clinic or hospital where your physician practices and ask to talk to a registered dietitian (RD). You can find a dietitian at the Academy of Nutrition and Dietetics's Find a Registered Dietitian and search for dietitians who have expertise in diabetes. Dietitians are trained in medical nutrition therapy and your health insurance company (including Medicare) probably covers seeing a dietitian for diabetes education.

Dietitians who specialize in diabetes education will have a CDE (Certified Diabetes Educator) after their name. These certified dietitians should be very capable at working with people who have either type1 (insulin dependent) or type 2 (non-insulin dependent) diabetes. Diabetes educators take continuing education credits to stay certified.

A great source of diabetes educational materials is the Academy of Nutrition and Dietetics, the American Diabetes Association or International Diabetes Center in Minneapolis Minnesota.


Over the course of a year I managed to bring my total cholesterol down from a high of 305 to 220. I am still working on bringing it down even lower. A month or so ago, I had a fasting blood test, prior to a small surgical procedure and my blood glucose was 170, which is apparently high for fasting. However, I did suck on a hard candy before the test. The point of my question is that, now that I am trying to watch my sugar as well, I have switched to fructose (don't use artificial sweeteners anymore, since about a year ago--too controversial). I thought that fructose raises your LDL. Is this in fact the case? Any insight would be most helpful.

Congratulation on lowering your blood cholesterol. Your blood cholesterol goal should be less than 200 milligrams per deciliter. The best approach is to keep food sources of fat around 25% to 30% of total calories, 7% of total calories from saturated fat, 35 to 30 grams of fiber, 30 to 60 minutes of exercise daily and lose weight if recommended.

LDL (low density lipoproteins) cholesterol is the fat that sticks to the blood vessel walls and blood levels are increased by trans fat, saturated fat and cholesterol in the food you eat. Tree nuts such as pecans, walnuts and almonds are a good source of monounsaturated fats and omega 3 fatty acids. Simple sugars consumed as fruits won't increase your LDL.

VLDL (very low density lipoproteins) are mostly triglycerides, which are increased by alcohol and sweets (cakes, pies, cookies and frozen desserts like ice cream and sherbet). Fructose is a simple sugar, usually found in fruits. Fructose is also sold as a calorie containing powdered sweetener that can be added to beverages and foods. Initially, it was suggested that fructose could be used by people with diabetes because it did not stimulate insulin secretion. However, fructose does not stimulate leptin production either and together with insulin they regulate satiety (feeling satisfied after a meal), food intake and body weight. Metabolism of fructose by the liver favors the production of fat. As with other simple sugars, excessive use can increase blood triglycerides and VLDL levels. So the use of added fructose by persons with diabetes is not recommended.

One piece of hard candy will not in itself raise normal fasting blood glucose (70 - 105 milligrams per deciliter) to 170. You need additional blood tests to determine if you have diabetes. What did your doctor recommend?

I would recommend the following changes to lower your blood glucose. Control carbohydrate to 30 to 45 grams per meal. Eat 3 meals per day. Loose weight, which should decrease any insulin resistance you have because of overweight. You should see a registered dietitian to work out an eating plan that will address your elevated blood cholesterol and glucose.

Artificial sweeteners periodically come under attack by various people questioning their safety. Aspartame, Saccharin, acesulfame K, neotame and sucralose,are currently considered safe to use based on current research and by the Food and Drug Association. Here is a list of artificial sweeteners from the National Institute of Health. Sorbitol, manitol and xylitol are often used to sweeten candy or gum. Carbonated beverages and sugar-free gum usually contains aspartame (NutraSweet), acesulfame K (Sunett), sucralose (Splenda) or sorbitol and manitol. Saccharin is found in many artificial sweetened foods in the United States.


I'm a type I diabetic who eats an excess of nuts, 4 - 5 servings per day, (typical 2 tablespoons - 1/4 cup). I'm of normal weight (5 feet 10 inches, 165 pounds) and my latest cholesterol was 129 (eat very little animal fat). I enjoy nuts as a between meal snack when I don't want to raise my blood glucose. Is this consumption OK? Know of any other lab tests that would be of value here?

Regarding the use of NutraSweet, I consume 5 to 6, 12-ounce sodas per day. Should I be concerned?

Does your nut snacking habit boost the fat content of your eating plan above the recommended 30%? You can find out by analyzing the food you eat using nutrition analysis software. At least, peanuts and tree nuts contain good monounsaturated fats other than macadamia nuts which contains saturated fat.

You are at your healthy body weight of 129 to 173 pounds for your height. Your cholesterol is on the low end of normal.

Lab tests that would be helpful in addition to blood cholesterol are HDL, LDL and VLDL levels of cholesterol. HDL cholesterol is the good fat and LDL and VLDL are the bad fats found in blood. Ask your doctor about this.

NutraSweet has been found safe for use in foods and less than two 12 ounce cans a day are recommended for any type soda with sugar or artificially sweetened. In regards to your diet soda consumption, do you drink caffeine containing diet soda or non-caffeine? Usually 12 ounces of a cola type soda contains half the caffeine of eight ounces of coffee so two cans would be equal to one cup of coffee. If you are drinking six cans per day, then you are drinking the equivalent of three cups of coffee, which is above the maximum 200 milligrams recommended per day. Why don't you try water . It's great!


My husband is a diabetic, could you give me some help in filling lunch pails for him?

In making lunches for people with diabetes, remember that variety helps ensure that those on insulin eat enough of the healthiest foods. Plan to include contrasts in flavor, texture, temperature, shape and color. When the weather is cold, you could send a cup of soup in a thermos. Many businesses now provide a microwave for employee use. Casseroles and leftovers can be re-heated in microwave safe cookware.

A meal is more appetizing when it contains something moist to offset dry food, tart to offset the sweet and crisp to offset the soft. To add moisture, add mayonnaise, mustard, horseradish sauce or catsup on sandwiches, lemon juice on fruit or vinegar on raw vegetables. Try including six-ounce cans of either tart tomato or vegetable juice or unsweetened fruit juices in boxes. The juice boxes can be frozen in the summer and they will help keep the whole lunch cold as the juice thaws. Coffee or tea can be carried hot or iced in summer.

Raw vegetables and pickles add crispness. Include zucchini, green pepper strips, broccoli, cauliflower, cucumber, carrots, celery, radishes, sliced onion, cherry tomatoes or crisp lettuce. To save time, clean a pound of carrots or a whole head of cauliflower at one time. Store the rinsed vegetables wrapped in a paper towel in a plastic bag in the refrigerator.

Fresh fruits are easy to pack. To change from apples and oranges, try fresh fruit in season cut up in finger size pieces. Chilled canned fruits, sugar-free gelatin or pudding or a baked apple travel well in wide mouth thermos containers. Remember to pack a spoon.

A brown bag lunch does not need to be a slice of bologna between two slices of white bread.


My doctor told me I have "borderline diabetes". He told me to lay off sugar and candy. Is that all I should not eat?

What your doctor is telling you is that you have diabetes and need to control your food intake to keep your blood glucose within normal ranges. Calling yourself a "borderline diabetic" would be like a woman calling herself "borderline pregnant". Either your body can handle eating all the carbohydrate you want or you can't.

Your eating habits, weight and blood tests should be reviewed by a registered dietitian for specific carbohydrate and calorie recommendations. In the meantime, you should also plan to eat three meals per day and possibly two light snacks during the day to spread out your calorie intake. Eat 2 to 4 carbohydrate choices at a meal. Each carbohydrate choice should have 15 grams of carbohydrate. Limit alcohol and fats until you see a dietitian.


I am an insulin dependent diabetic on 40 units of Lente per day. This last year, I have been using NutraSweet (Equal) for a sweetener on my cereal. Recently a friend told me that NutraSweet increased the flow of insulin in your body and as a result increased your food wants. I have gained considerable weight in the last year and my need for food has increased. Sometimes, I feel if I don't have food immediately, I will "pass out". I was blaming the weight gain on the fact I am not as active as I used to be. I have been retired for several years and have a woman do my heavy cleaning each week. I am also arthritic and would like to get my weight down.

My question is: Does NutraSweet stimulate my food wants? Would I be better off going back to the saccharin sweeteners?


NutraSweet (aspartame) does not increase the flow of insulin as NutraSweet contains two amino acids (aspartic acid and phenylalanine) that are the building blocks of protein, not sugar. Your body secretes insulin to help glucose in your blood to enter your body cells and produce energy. Most blood glucose comes from carbohydrates in the food you eat, but your body can make glucose from stored proteins and fat as well. The small amount of protein in NutraSweet does not stimulate your body to secrete insulin. However, maybe you are eating more foods sweetened with NutraSweet and the carbohydrates in those foods will need insulin to be metabolized by cells. Sugar-free does not mean carbohydrate free or calorie free.

A person with diabetes takes insulin to control his / her blood glucose within normal ranges because their body doesn't make enough insulin to meet their needs. The amount of insulin injected varies among individuals (10 to 80 units per day). If a person with diabetes overeats, he / she may need more insulin to interact with the excess glucose to maintain normal blood glucose. A person with diabetes may in fact have higher levels of insulin in his / her blood than a person who doesn't have diabetes. This additional insulin makes more glucose available for energy production. When energy is produced, but not needed, it is stored as body fat. Insulin favors the storage of fat.

First, choose an artificial sweetener that you prefer the taste of on your food. Currently, you can choose sucralose (Splenda) saccharin (Sweet-n-Low) or aspartame (Equal) in the United States. Cyclamate and aspartame are available in Canada.

Second, start a regular exercise program. Discuss this with your doctor as he / she would be the best person to suggest exercises that would not aggravate your arthritis or cause low blood glucose. Swimming and water exercise classes are good because the water relieves the weight bearing on sore arthritic joints. Also, pools for water exercises can be heated to a warm, comforting temperature.

Exercise burns some excess calories without needing insulin. A strenuous exercise program may even decrease a person with diabetes need for insulin. Exercise also helps increase your number of calories burned even when you are not exercising. Exercise gives you a feeling of well being and would help you slowly lose weight.

Do not make any changes in your diabetic eating plan or insulin dose without first discussing changes with your dietitian and doctor. If you have had diabetes a few years, you may have slowly increased your food intake over the years. It would also be wise to make an appointment with a dietitian to review your eating plan and assess the number of calories you eat.


I am a diabetic and I've read that I can use fructose as a sweetener. Is that true? Am I limited in how much I use?

Fructose as a sweetener doesn't stimulate insulin secretion though it will add calories because fructose contains two glucose molecules. By using fructose as a sweetener, your blood glucose may go up, but not as much as using sucrose as a sweetener.

The use of fructose by people with diabetes was the subject of research a few years ago. It had been suggested that use of fructose by people with diabetes would not increase insulin production. While fructose does not cause your blood glucose to go up as high as sucrose, fructose sweeteners causes triglycerides to go higher in men when compared to glucose. Fructose is not currently recommended for use by people with diabetes.

Also, there are some misinformed people who support the use of honey instead of white sugar because it is "natural". Sugar is a "natural" food since it comes from sugar cane or sugar beets, both natural foods. Chemically, honey contains fructose and sucrose which in the end, breaks down into glucose. (Unpasteurized honey should never be given to an infant or young child as it contains bacteria, which could cause a serious infection or death. Honey is usually not pasteurized or heated to kill the bacteria.)

Glucose is the sugar that is found in your blood and the sugar that your body uses for energy to do work. Your body produces insulin to carry glucose inside your cells to release energy for the cells. Insulin is necessary for energy in food to be released. The more glucose in your blood, the more insulin is required to process it.

Your body is a biochemical factory. Food enters your mouth, is structurally broken down by the acid in your stomach, is further reduced by digestive enzymes and hormones in your small intestines and absorbed. The only things your body recognizes are chemicals. All sugars, including starch, milk, vegetable, fruit, white sugar, brown sugar, honey, molasses and fructose are chemically reduced by your body to glucose. Some foods like starches and sugar cause a greater increase in blood glucose than fruits, milk and vegetables.


I need some help with my dad who is a diabetic. I would like some cookie recipes if you have some available or could you tell me where some could be found.

For diabetic cookie recipes, I would suggest buying the "The New Family Cookbook for People with Diabetes" published by the American Diabetes Association and the Academy of Nutrition and Dietetics. They are available from either association or bookstores. The cookbook has some cookie recipes and other dessert recipes. In addition, it provides the nutritional analysis and diabetic exchanges per serving of each recipe.

Some guidelines would be helpful in selecting diabetic dessert recipes. First, desserts can be added to a diabetic menu, but they must be exchanged for other foods in your eating plan or counted as part of your carbohydrate choices total for the day depending on whether you are using exchanges or carbohydrate counting. Allowances for including some desserts in meal plans of 1800 calories or more is fine and gives additional flexibility to the diabetic nutrition therapy.

Second, sugar-free, does not mean calorie free. Diabetic cookies and candy may contain more calories than the sugar containing ones.

Third, dietetic does not necessarily mean sugar-free. Dietetic means that one or more of the usually occurring ingredients has been changed. The product may be salt-free and not sugar-free. In the case of cookies, the sugar may have been removed and sugar substitute added. In canned vegetables or soups, the salt has been removed and nothing else is usually added to replace salt.

Lastly, diabetic researchers are experimenting with making cookies with reduced amounts of sugar and their effect on blood glucose. Splenda (sucralose) makes a baking sweetener that is half regular sugar and half Splenda. Substitute half the amount of sugar called for in a recipe with the Splenda baking sweetener. You cannot bake with aspartame (Equal).


Can I rinse the syrup off regular canned fruit? I'm a diabetic and the dietetic canned fruit is so expensive?

No, I would not recommend you rinse the syrup off regular canned fruit. When fruit is canned in syrup, the fruit absorbs sugar because the sugar concentration in the syrup is usually greater than the sugar concentration in the fruit. Rinsing the fruit will not remove any sugar that has been absorbed into the fruit. Look for ingredients on the food label like sugar, corn syrup solids, fructose, high fructose corn syrup, sucrose, dextrose, lactose, dextrin, honey, molasses, sorghum or invert sugar. Ingredients are listed in order of decreasing proportion. The ingredient listed first is the largest amount in that food.

You don't have to buy dietetic canned fruit because now you can buy juice packed, canned fruit. Dietetic canned fruit usually has no sugar added and canned in water, but you should read the ingredient label. Instead, I would recommend that you buy the fruit canned in fruit juice. Usually, a combination of pineapple, apple, pear or white grape juice is used. The cost of juice pack fruit is usually the same as syrup pack fruit.


Why do diabetics have to cut out all sweets, yet when they feel weak or light-headed, they put a piece of hard candy in their mouths? Is it supposed to be sugar-free candy?

No. People with diabetes can eat regular sugar containing hard candy when they feel low blood glucose symptoms. A quick dissolving and absorbing food with 15 grams of carbohydrate per serving is best. A better alternative is 4 to 6 ounces of fruit juice, milk or regular carbonated soda, 1 tablespoon honey or syrup or 6 saltine crackers. Glucose tablets are available in most pharmacies.

A person with diabetes takes insulin or pills prescribed by their doctor to control their blood glucose within a desirable range of approximately 70 to 105 milligrams per deciliter. These medications combined with a diabetic nutrition therapy and exercise keep blood glucose within that desirable range. However, when a person with diabetes either skips a meal, eats too little, drinks alcohol without eating, gets too much exercise or takes more than the prescribed does of medication, low blood glucose (hypoglycemia) is more likely to happen. Their blood glucose drops below the person's fasting range, usually below 70 milligrams per deciliter. Your body uses your blood glucose as its main fuel. When your blood glucose drops, your body will start sending you warnings in the form of symptoms.

The symptoms are shaky, sweaty, hungry, headache, dizzy, mood change, blurred vision or pale. If ever in doubt of whether a person with diabetes is having low blood glucose, test their blood glucose using a blood glucose meter. If you are not able to test their blood glucose, offer them one of the following foods rather than do nothing or wait: 4 to 6 ounces fruit juice or milk; one-half can regular carbonated soda; 1 tablespoon honey or syrup; 6 saltines. Within 15 minutes, the person with diabetes should feel better. If they are not better, repeat the same amount of food. If the diabetic still doesn't feel good, his / her blood glucose probably wasn't too low. He / she should then see a doctor. Never force food or liquids down a person who is groggy or unconscious. You may be pouring the food or liquids into their lungs rather than into their stomach. Get a person with diabetes that is groggy or unconscious to the nearest hospital immediately.

You can feel a person's skin if you suspect a reaction. Their skin will feel wet, cool and possible clammy. Feel your own skin now. Your hand should slip smoothly over your skin. It should feel warm and dry unless you have been out in hot weather or exercising heavily.

If a person with diabetes has frequent or regular occurring low blood glucose, he / she should see their doctor to change the dose of insulin or pills. Low blood glucose on a regular basis does not happen to most people with diabetes. People with diabetes and their family should know the symptoms and treatment for low blood glucose.


My son's birthday is next week. The problem is he is a diabetic. I've carefully watched his diet the last six months since we found out. What should I serve at his birthday party? He knows he can't have cake.

Start making plans for a traditional birthday party with cake for your son. A person with diabetes, young or old, can have a piece of regular birthday cake on his or her birthday.

Try angel food, yellow or chocolate cake frosted with non-dairy whipped topping. You can sprinkle the topping with a sugar-free beverage powder or sugar-free gelatin to add color to the top.

Your son can choose the rest of the meal. Favorites like hamburgers, pizza, tacos or hot dogs are fine for his birthday party. Sugar-free pop or unsweetened fruit juice to drink would be good.

The party celebration should start with the food because of the excitement and extra physical activity if games are planned. Active and sitting games after the meal would be great to help use up some of the extra carbohydrates in the birthday cake.

Remind your son ahead of time to watch for signs of an low blood glucose. Hope he has fun!






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