The Many Facets of Diabetes Care

Whether you are newly diagnosed with diabetes or have been diagnosed for many years, there is no denying the complexity of diabetes treatment. Additionally, once someone finds out you have diabetes, it can lead to a lot of (well-meaning) unsolicited advice.

Due to the prevalence of diabetes, most people know someone with diabetes or prediabetes, which leads to a lot of discussion on how to best manage one's blood sugar.

Often when l first meet with patients, they express to me that they are just overwhelmed and confused about the variety of information they have heard and do not know what to eat or how to manage their blood sugar successfully.

They share that they have been told to eliminate certain food groups and certain foods, that they have been told to stop eating at a certain time, or that they have been choosing products with five ingredients or less.

While these tidbits of advice are meant to help the patient, generally the patient reports they are just confused about how to proceed. This sense of confusion is only compounded with the fact that people with diabetes have a higher rate of disordered eating and body dissatisfaction than people not diagnosed with diabetes, which can lead to willingness to try anything and everything to see one's desired results.

Thankfully, despite this general sense of public confusion, we do have a sizable body of scientific evidence that can inform practitioners how to best treat their patients.

As a dietitian, I’ve reviewed evidence that shows instead of eliminating foods and food groups to instead promote variety and multifaceted care, as well as to modify each patient's medical nutrition therapy specifically to fit their lifestyle.

There is no one-size-fits-all dietary pattern that has been shown to improve blood sugar control in ALL individuals.

If you or a loved one have been diagnosed with diabetes or prediabetes, consider the multifaceted care tips below.

Sleep

• Improve sleep hygiene and sleeping a healthy amount - doing so decreases the amount of stress hormone produced and improves blood sugar.
• Sleep deprivation also decreases insulin sensitivity (insulin is the hormone that allows the sugar in your blood to enter your cells where it is used as energy, and insulin sensitivity is your body's ability to recognize this insulin).
• Tip: Improve sleep hygiene by sticking to a regular bedtime and setting a time to start winding down at night.

Stress

• Increased stress levels lead to increased stress hormone levels, which increases blood sugar
• Inversely, stress management leads to improved blood sugar
• Tip: Create a list of ways to cope with stress like calling a friend, going for a walk, or enjoying a favorite hobby

Physical activity

• Weightlifting or weight bearing exercises are great for bone mass maintenance (preventing osteopenia
• or osteoporosis!) and also promotes long term
• improvements in blood sugar.
• Cardiovascular exercise like swimming, water aerobics or walking promote immediate improvements in blood sugar by utilizing the blood sugar for immediate energy

Nutrition

• Eating protein and fat with carbohydrates promotes slower digestion of the carbohydrate food and prevents blood sugar spikes (think about pairing some cheese with those crackers!).
• Increasing your intake of non-starchy vegetables like asparagus, mushrooms, cucumber, and sugar snap peas increases the amount of fiber, vitamins and minerals in your diet and promotes improved blood sugar.
• Reduced intake of added sugars means you are reducing the chance of blood sugar spikes and generally choosing healthier food options.
• Decreased intake of refined grains and increased intake of whole grains leads to increased intake of vitamins, minerals, and fiber, and it improves blood sugar.
• Food swaps like switching brown rice for white rice or chickpea pasta for refined flour pasta can increase the amount of fiber or protein in a meal, and thus improved blood sugar.
• increased hydration: Staying hydrated improves blood sugar concentration.

Navigating the world of diabetes treatment can be confusing and overwhelming, but there are plenty of successful ways to manage blood sugar. Reach out to your physician and registered dietitian for a treatment plan that is customized to you.

Sarah Montgomery, MS, RD, LD, is a Registered Dietitian at Carson Valley Health, which offers nutrition education and counseling services for one-on-one dietary guidance. Go to cvmchospital.org or call 775-783-3084 to learn more. Sources of information for portions of this article include the American Diabetes Association, HAES Health Sheets and Society for Biomedical Diabetes Research.