Diabetes Cookbook For Canadians For Dummies. Cynthia Payne

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      Considering the complications of high blood glucose

      Having high blood glucose can do two main things: It can cause symptoms like those we discuss in the previous section, and, if severe or if longstanding, it can damage the body.

      

If you have very high blood glucose levels (more than 15 to 20mmol/L or so) and you are feeling very unwell, then this may be an emergency and you should seek immediate medical attention.

      If your blood glucose levels exceed target year after year, you will be at risk of a number of different types of complications. But if you keep most of your blood glucose levels within target you can dramatically reduce your risk of running into problems. In other words, diabetes complications are not inevitable!

      Chronically elevated blood glucose levels can lead to complications like these:

      ✔ Eye damage (retinopathy), which, if severe, can lead to blindness

      ✔ Kidney damage (nephropathy), which, if severe, can lead to kidney failure and the need for dialysis

      ✔ Nerve damage (neuropathy), including abnormal or loss of sensation in the feet, which can be a factor leading to amputation

      The role of high blood glucose in causing heart attacks and strokes is more complicated, but it likely plays an important role. Your risk of a heart attack or stroke is much higher if you are overweight, sedentary, smoke, have inadequately controlled high blood pressure, or if you have elevated LDL cholesterol. See a common denominator? We do. These are all things that, working with your diabetes team, you can control! In Chapter 4, we look at the ways healthy eating can help you control your blood pressure and your cholesterol.

Low blood glucose

      Low blood glucose (hypoglycemia) is defined as a blood glucose level below 4.0mmol/L. As we mention earlier in this chapter, diabetes, per se, does not cause low blood glucose; rather, it is certain drugs – such as insulin or glyburide – used to treat diabetes that can lead to this condition.

      Looking at the symptoms of low blood glucose

      These are the common symptoms of low blood glucose:

      ✔ Anxiety

      ✔ Hunger

      ✔ Sweating

      ✔ Palpitations (noticing a rapid or excessively forceful heartbeat)

      ✔ Trembling of the hands

      If hypoglycemia is severe, it can lead to other symptoms, including confusion, difficulty concentrating, difficulty speaking, and even loss of consciousness. Fortunately, the great majority of the time when people with diabetes experience hypoglycemia they will quickly recognize its symptoms and ingest some sugar-containing food, which will quickly bring their blood glucose level back to normal.

      Treating low blood glucose

      If ever you have low blood glucose, you need to treat it quickly in order to return your blood glucose to a safe level.

      As recommended by the Canadian Diabetes Association, these are the steps you should take if you have low blood glucose:

      1. Eat or drink 15 grams of a fast-acting carbohydrate such as

      ● Four 4-gram glucose tablets (for example, Dex4 tablets; this totals 16 grams)

      ● ³/₄ cup (175ml) of juice or regular (not diet or sugar-free) pop (but see the warning following this list)

      ● 3 tsp (15ml) honey or maple syrup; or 3 tsp (15ml) of table sugar dissolved in water

      ● Seven jelly beans

      2. Wait 15 minutes, and then retest your blood.

      If your blood glucose level is still less than 4mmol/L, ingest another 15 grams of fast-acting carbohydrate (as listed in the previous step).

      3. If your next meal is more than one hour away, or you are going to be physically active, eat a snack, such as half a sandwich or cheese and crackers.

      The snack should contain 15 grams of carbohydrate and a source of protein.

      

If you have low blood glucose and you’re about to eat a meal, you must instead first treat your hypoglycemia with the measures we just described. Only when your blood glucose is back to normal (above 4mmol/L) should you then eat your meal.

      Controlling Your Blood Glucose through Nutrition

      Not a day goes by when we aren’t totally blown away by the tremendous power that healthy eating has on helping improve blood glucose control. Indeed, nutrition therapy can reduce your A1C up to 2 percent (which is far greater than most drugs ever achieve). Nutrition is so vital in the management of diabetes that we felt it deserved an entire cookbook devoted to the topic. That would be this book.

      When coupled with regular exercise and weight control, the impact of healthy eating is all the greater.

      

Achieving better health – and needing fewer pills – through the magic of lifestyle therapy

      Martha was a very overweight, sedentary 55-year-old woman who had been living with type 2 diabetes for five years. She was taking three different types of medicine per day – totalling more than ten pills – to control her blood glucose. One day, after witnessing her grandson’s look of alarm as he saw her swallowing a fistful of pills, she decided there had to be a better way of managing her health. Working with a dietitian and her local YMCA, she adopted healthy eating strategies, began regularly exercising, and progressively shed weight. With each passing day her health improved, and within a year she was able, under Ian’s guidance, to reduce the number of her pills from ten down to two.

      “I’m going to soon not need these last two,” she said as she left her doctor’s appointment. “I bet you’re right,” Ian said to her as she left.

      As we discuss in detail in Chapter 2, there are three basic types of nutrients: carbohydrates (“sugars”), proteins, and fats. Each of these has important roles in healthy eating, but when it comes to blood glucose control it is carbohydrates that have the key role. We look at carbohydrates next.

Watching your carbohydrate intake

      Carbohydrates are found primarily in those foods that are grown in the ground (such as rice, potatoes, grains, and fruits), and in dairy products. They provide energy for your body; when consumed in excess of your needs, this extra energy is stored as fat. Also, the carbohydrates you eat are responsible for raising your blood glucose levels. For these reasons, you need to make sure you’re eating the appropriate amount of carbohydrate; consuming too much or too little is unhealthy.

      

The Canadian Diabetes Association recommends that between 45 to 60 percent of the calories you consume come from carbohydrates, СКАЧАТЬ