Diabetes: Nutrition

Diabetes Nutrition

There are nearly 14 million people in America with diabetes. One very important part of the management of diabetes is proper nutrition. For the diabetic patient who requires daily insulin, a proper diet helps keep blood glucose levels under control and reduces the risk of diabetic complications. For the non-insulin-dependent diabetic, the correct nutrition can help lower blood glucose, reduce cholesterol and triglycerides and moderate weight loss.

Proper nutrition will help people with diabetes control their blood glucose levels.

Planning an Exchange Diet

Diabetes is a disease in which the body does not produce or respond properly to insulin. Insulin is a hormone that helps blood sugar (also known as blood glucose) enter the cells of the body for use as energy. Although there is no cure for diabetes, it has been shown that if blood glucose levels are well controlled, there is less risk of developing the debilitating effects of diabetes, including eye disease, nerve damage and kidney disease. Proper nutrition is a key part of good blood glucose control.

Proper Nutrition: Nutritional planning was first simplified into a uniform system in 1950, when the American Diabetes Association created Exchange Lists to assist people with diabetes in meal planning and food choices. These lists contain groups of foods with similar nutritional value in terms of their calories, carbohydrates, protein and fat content. Foods are listed in their portion size equal to one “exchange,” so that they can be interchanged for flexibility in meal planning. For example, the starch diet includes beans, grains, pasta, breads, crackers and cereal. The amount of each item equal to one “exchange” is shown so foods equal in grams of carbohydrate can be traded for other foods on that list. Since the last revision of the guidelines was issued in 1986, much has been learned about nutrition and diabetes and the foods available have changed considerably. The new 1995 version of the Exchange Lists for Meal Planning is now available. It includes many important additions to the previous lists, with expanded food groups, more flexibility in interchanging food exchange and the addition of sucrose and foods with sugar as a part of a healthy diet. Fast foods, vegetarian foods, and reduced-fat or fat-free foods now commonly available are included in the Exchange Lists, along with tips for buying and preparing foods.

Exchange Lists: The 1995 Exchange Lists for Meal Planning now includes:

• Foods regrouped by major nutrients in three categories: carbohydrate, protein and fat.
• An expanded list of carbohydrates (a new list with sweets and potato chips), and the vegetable list. This expanded list allows for interchange of a starch, fruit or milk exchange to increase variety and make meals easier to plan.
• Fats are now divided into monounsaturated, polyunsaturatecl and saturated fats, so the intake of saturated fats is easier to limit.
• A “very lean meat” list developed since the advent of lower fat meats and meat substitutes.
• A list of reduced-fat or fat-free foods, such as snack chips, waffles, salad dressings, etc.
• Many fast foods have been added to the combination food list.
• Vegetarian foods have been added to all of the lists with their growing popularity.
• Tips on how to buy and prepare foods are also included.

The 1995 (or newer) Exchange Lists booklet may be purchased through the American Diabetes Association. If you have diabetes and have questions about blood glucose control, your medications or proper nutrition, ask your doctor, dietitian or pharmacist.

**Note: The newest exchange list is available at the American Diabetes Association site.