Diabetes Treatment Information

What should I know about Eating and Diabetes?

How Food Affects Your Blood Glucose

Whether you have type 1 or type 2 diabetes, what, when, and how much you eat all affect your blood glucose. Blood glucose is the main sugar found in the blood and the body's main source of energy.

If you have diabetes (or impaired glucose tolerance), your blood glucose can go too high if you eat too much. If your blood glucose goes too high, you can get sick.

Your blood glucose can also go too high or drop too low if you don't take the right amount of diabetes medicine.

If your blood glucose stays high too much of the time, you can get heart, eye, foot, kidney, and other problems. You can also have problems if your blood glucose gets too low (hypoglycemia).

Keeping your blood glucose at a healthy level will prevent or slow down diabetes problems. Ask your doctor or diabetes teacher what a healthy blood glucose level is for you.

What should my blood glucose levels be?

For most people, target blood glucose levels are

Before meals	90 to 130
1 to 2 hours after the start of a meal	less than 180

Ask your doctor how often you should check your blood glucose. The results from your blood glucose checks will tell you if your diabetes care plan is working. Also ask your doctor for an A1C test at least twice a year. Your A1C number gives your average blood glucose for the past 3 months.

How can I keep my blood glucose at a healthy level?

- Eat about the same amount of food each day.
- Eat your meals and snacks at about the same times each day.
- Do not skip meals or snacks.
- Take your medicines at the same times each day.
- Exercise at about the same times each day.

Why should I eat about the same amount at the same times each day?

Your blood glucose goes up after you eat. If you eat a big lunch one day and a small lunch the next day, your blood glucose levels will change too much.

Keep your blood glucose at a healthy level by eating about the same amount of carbohydrate foods at about the same times each day. Carbohydrate foods, also called carbs, provide glucose for energy. Starches, fruits, milk, starchy vegetables such as corn, and sweets are all carbohydrate foods.

Talk with your doctor or diabetes teacher about how many meals and snacks to eat each day. Print out these clock faces and draw hands on the clocks to show when to have your meals and, if necessary, snacks.

Your Diabetes Medicines

What you eat and when affects how your diabetes medicines work. Talk with your doctor or diabetes teacher about the best times to take your diabetes medicines based on your meal plan.

Your Exercise Plan

What you eat and when also depend on how much you exercise. Exercise is an important part of staying healthy and controlling your blood glucose. Physical activity should be safe and enjoyable, so talk with your doctor about what types of exercise are right for you. Whatever kind of exercise you do, here are some special things that people with diabetes need to remember:

- Take care of your feet. Make sure your shoes fit properly and your socks stay clean and dry. Check your feet for redness or sores after exercising. Call your doctor if you have sores that do not heal.

- Drink about 2 cups of water before you exercise, about every 20 minutes during exercise, and after you finish, even if you don't feel thirsty.

- Warm up and cool down for 5 to 10 minutes before and after exercising. For example, walk slowly at first, then walk faster. Finish up by walking slowly again.

- Test your blood glucose before and after exercising. Do not exercise if your fasting blood glucose level is above 300. Eat a small snack if your blood glucose is below 100.

- Know the signs of low blood glucose (hypoglycemia) and how to treat it.

Hypoglycemia

You should know the signs of hypoglycemia (low blood sugar) such as feeling weak or dizzy, sweating more, noticing sudden changes in your heartbeat, or feeling hungry. If you experience these symptoms, stop exercising and test your blood glucose. If it is 70 or less, eat one of the following right away:

- 2 or 3 glucose tablets
- 1/2 cup (4 ounces) of any fruit juice
- 1/2 cup (4 ounces) of a regular (not diet) soft drink
- 1 cup (8 ounces) of milk
- 5 or 6 pieces of hard candy
- 1 or 2 teaspoons of sugar or honey

After 15 minutes, test your blood glucose again to find out whether it has returned to a healthier level. Once blood glucose is stable, if it will be at least an hour before your next meal, it's a good idea to eat a snack.

To be safe when you exercise, carry something to treat hypoglycemia, such as glucose tablets or hard candy. Another good idea is to wear a medical identification bracelet or necklace (in case of emergency). Teach your exercise partners the signs of hypoglycemia and what to do about it.

Eat a variety of food to get the vitamins and minerals you need. Eat more from the groups at the bottom of the pyramid, and less from the groups at the top.

How much should I eat each day?

Have about 1,200 to 1,600 calories a day if you are

a small woman who exercises
a small or medium woman who wants to lose weight
a medium woman who does not exercise much

Choose this many servings from these food groups to have 1,200 to 1,600 calories a day:

6 starches	2 milk and yogurt
3 vegetables	2 meat or meat substitute
2 fruit	up to 3 fats

Talk with your diabetes teacher to make a meal plan that fits the way you usually eat, your daily routine, and your diabetes medicines. Then make your own plan.

Have about 1,600 to 2,000 calories a day if you are

a large woman who wants to lose weight
a small man at a healthy weight
a medium man who does not exercise much
a medium to large man who wants to lose weight

Choose this many servings from these food groups to have 1,600 to 2,000 calories a day:

8 starches	2 milk and yogurt
4 vegetables	2 meat or meat substitute
3 fruit	up to 4 fats

Talk with your diabetes teacher to make a meal plan that fits the way you usually eat, your daily routine, and your diabetes medicines. Then make your own plan.

Have about 2,000 to 2,400 calories a day if you are

a medium to large man who does a lot of exercise or has a physically active job
a large man at a healthy weight
a large woman who exercises a lot or has a physically active job

Choose this many servings from these food groups to have 2,000 to 2,400 calories a day:

11 starches	2 milk and yogurt
4 vegetables	2 meat or meat substitute
3 fruit	up to 5 fats

Talk with your diabetes teacher to make a meal plan that fits the way you usually eat, your daily routine, and your diabetes medicines. Then make your own plan.

Measuring Your Food

To make sure your food servings are the right size, use

- measuring cups - measuring spoons - a food scale

Also, the Nutrition Facts label on food packages tells you how much of that food is in one serving.

Weigh or measure foods to make sure you eat the right amounts.

These tips will help you choose the right serving sizes.

- Measure a serving size of dry cereal or hot cereal, pasta, or rice and pour it into a bowl or plate. The next time you eat that food, use the same bowl or plate and fill it to the same level. - For one serving of milk, measure 1 cup and pour it into a glass. See how high it fills the glass. Always drink milk out of that size glass. - Meat weighs more before it's cooked. For example, 4 ounces of raw meat will weigh about 3 ounces after cooking. For meat with a bone, like a pork chop or chicken leg, cook 5 ounces raw to get 3 ounces cooked. - One serving of meat or meat substitute is about the size and thickness of the palm of your hand or a deck of cards. - A small fist is equal to about 1/2 cup of fruit, vegetables, or starches like rice. - A small fist is equal to 1 small piece of fresh fruit. - A thumb is equal to about 1 ounce of meat or cheese. - The tip of a thumb is equal to about 1 teaspoon.

When You Are Sick

It's important to take care of your diabetes even when you're ill. Here are some tips on what to do:

- Even if you can't keep food down, keep taking your diabetes medicine. - Drink at least one cup (8 ounces) of water or other calorie-free, caffeine-free liquid every hour while you're awake. - If you can't eat your usual food, try drinking juice or eating crackers, popsicles, or soup. - If you can't eat at all, drink clear liquids such as ginger ale. Eat or drink something with sugar in it if you have trouble keeping food down, because you still need calories. If you don't have enough calories, you increase your risk of hypoglycemia (low blood sugar). - Make sure that you check your blood glucose. Your blood glucose level may be high even if you're not eating. - Call your doctor right away if you throw up more than once or have diarrhea for more than 6 hours.

Points to Remember

- What, when, and how much you eat all affect your blood glucose level.
- You can keep your blood glucose at a healthy level if you
* Eat about the same amount of food each day. Eat at about the same times
* each day. Take your medicines at the same times each day. Exercise at the
* same times each day. Every day, choose foods from these food groups:
* starches, vegetables, fruit, meat and meat substitutes, and milk and
* yogurt. How much of each depends on how many calories you need a day.
* Limit the amounts of fats and sweets you eat each day.