Eating For Type 2?
If you have diabetes, here’s how to find mealtime satisfaction

By Sharon Palmer, RD

Discovering that you are one of the 17 million Americans with diabetes may seem like depressing news, as images of ice cream and tiramisu are replaced by those of dry toast and sugar-free gelatin. But the days of absolute denial for diabetics are over. Today we know that diabetics can live healthy, satisfying lives and eat well without feeling deprived.

“People newly diagnosed with type 2 diabetes need to know that they don’t have to give up all of their favorite foods. Almost any food can fit into a sensible meal plan if the portion size is reasonable,” says Carrie Swift, MS, RD, a certified diabetes educator.

Diabetes facts of life
As the sixth-leading cause of death in the United States, diabetes carries an annual price tag of $98 billion in health costs. Type 2 (formerly called adult-onset) diabetes is closely linked to obesity and physical inactivity; in fact, more than 80 percent of type 2 diabetics are overweight or obese. People with diabetes cannot make or properly utilize insulin, a hormone produced by the pancreas that helps convert food into blood glucose, the fuel that helps our bodies run. Insulin is essential in this process, unlocking cells to allow glucose to enter and supply energy. When you have diabetes, your insulin is either insufficient or malfunctioning. The cells are not unlocked to receive glucose, so blood glucose levels continue to rise and cells are deprived of food.

Controlling glucose levels is the primary treatment goal for diabetics because it dramatically reduces the risk of diabetes complications, such as kidney, eye, nerve, and heart disease; amputations; and stroke. Diabetics can manage their glucose levels through a balanced diet, weight loss, home blood-glucose testing, increased exercise, and, in some cases, medication.

Carbohydrates count
Type 2 diabetics may be pleasantly surprised to learn that they can still be content at mealtime. “The diabetic should eat no differently than anyone else who wants to eat healthfully,” says Wahida Karmally, DrPH, RD, an American Dietetic Association spokesperson. “Don’t give up on your favorite foods; just look at the recipes and make them more healthful.”

Great cookbooks for diabetics
Cooking with the Diabetic Chef by Chris Smith (McGraw-Hill, 2000)

The Diabetes Snack, Munch, Nibble, Nosh Book, 2d ed., by Ruth Glick (American Diabetes Association, 2003)

Diabetic Meals in Minutes—Or Less! by Robyn Webb, MS (McGraw-Hill, 1996)

The New Family Cookbook for People with Diabetes by The American Diabetes Association (Simon & Schuster, 1999) Prior to the mid-1990s, health experts told diabetic patients to eliminate refined sugar, believing it made glucose levels rise more quickly than other foods did. Now scientists say starchy foods, such as white bread, white rice, or potatoes, affect glucose levels in ways similar to sugar. The new wisdom holds that the total amount of carbohydrates taken in is what matters most for glucose control, not whether the carbohydrates come from sugars or starches. Consequently, carbohydrate counting, a method of tracking carbohydrate grams within a meal plan, has become a popular, effective, and simple glucose-control strategy.

Does this mean sugar is OK for diabetics? Yes and no. Before you break out the jellybeans, consider that most desserts are high in carbohydrates and fat without providing much in the way of nutrients. The American Dietetic Association advises diabetics to choose whole grains, low-fat dairy products, and fruits and vegetables as their primary carb sources and to save the sweet stuff for an occasional treat.

Eat well, eat smart
When diagnosed with diabetes, your first step should be to schedule an appointment with a registered dietitian or nutritionist who can help you create a personal meal plan that meets your specific needs, depending on blood lipid levels, diabetes medication, weight goals, and other factors.

Still, some diabetes-management steps remain constant. Food labels are required reading to help track carbohydrate and fat levels. According to Walter Willett, MD, DrPH, head of the Harvard School of Public Health’s nutrition department, diabetics should avoid all trans fats (serious culprits in raising cholesterol), minimize intake of refined carbohydrates and sugar, and emphasize olive oil and other healthy oils in cooking.

An emphasis on heart-healthy eating should prompt diabetics to make careful protein and dairy choices. By selecting legumes; lean meats, poultry, and fish; and low-fat dairy products, and watching for saturated fats in snack foods, you can easily eat well while maintaining healthy blood sugar levels. “Include lots of fruits and vegetables—all of the colors in a crayon box—which are rich in antioxidants,” adds Karmally. Willett also advises eating fish at least twice a week.

Diabetes also carries an increased risk for high blood pressure, so it’s a good idea to put a cork on the salt shaker. Be wary of salted meats, salty snacks, processed foods, canned soups, and condiments, all typically laden with sodium.

If you’re diabetic, you’ll find support by enlisting a registered dietitian or nutritionist to help you create an individualized, satisfying meal plan. Visit www.eat right.org (800.877.1600, ext. 5000) or www.findanutritionist.com to find a reputable professional in your community.