With a type 2 diabetes diagnosis comes a wake-up call to change the way we eat. But when we listen to the experts, we hear so many different theories that it’s hard to separate the signal from all the noise.
Instead of throwing up our hands in despair and continuing our old ways, we have a way out of the diet morass. Each of us can rely on the inner wisdom that our body has when we listen to it.
The Five Principles
When we listen to our body, we can hear the five principles that guide us to good health:
1. Does what we eat help us to manage our blood sugar level? Only when we get it down to normal can we minimize the risk of complications from diabetes. A normal A1C level, which is our average over the previous two or three months, is certainly 6.0 percent or less. When we check our sugar using a fingerstick test with our meter that’s the equivalent of an average of 126 mg/dl.
2. Do we eat too much to keep our weight right? The body mass index or BMI is the standard way we calculate it. This ratio of our weight to our height shows that a normal weight is 18.5 to 24.9. The best BMI calculator is the one developed by the U.S. National Institutes of Health. The size of our waist also matters, and we reduce our risk of disease if it is less than 35 inches in women and less than 40 inches in men.
3. Do our meals help us keep our blood pressure normal? That cuts our risk of an heart disease, stroke, and more. Normal blood pressure is under 120/80. Losing weight is the most important step in reducing blood pressure. Cutting back on the amount of fructose we eat may help us to reduce our blood pressure. But some of us also need to cut back on the amount of salt that we eat.
4. Do our lipid levels look good? Our lipid tests measure our cholesterol and triglyceride levels, which help determine our risk of heart disease. The optimal LDL cholesterol level is less than 100 mg/dl, HDL cholesterol needs to be above 60 mg/dl, and a normal triglyceride level is below 150 mg/dl, according to the National Cholesterol Education Program. High blood pressure is a risk factor for high lipid levels. A recent study showed that a very low-carbohydrate diet improved these lipid levels."¨After we fine-tune our diets, we can also work to improve other levels. These include adequate vitamin D, how much fructose we eat, and the right ratio of omega 3 to omega 6 fats.
5. How do we feel when we finish a meal? If we are still hungry 15 minutes after finishing a meal, maybe we need more. More likely, however, is that we ate wheat or other grain, which is addicting. If we are bloated then, we ate too much.
It’s Our Call
Our diet is no exception to the fundamental advice about controlling our diabetes: it is a disease that, perhaps more than any other, depends much more on the patient than on the doctor. The ball is in our court.
All of us are different. If our diet fails any one of these tests, we have to stay alert to the need to make a course correction.
No one but you knows which diet is best for you. Nutrition is an emerging science, one that even now is coming out of the dark ages of opinion. Each of us has to decide for herself or himself what foods will help us to control our diabetes and indeed our health in general.
The best approach and the one I follow myself is to read and digest the recommendations of the experts. And then measure them against your individual experience.
See more of my articles about how to manage diabetes:
David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.