Type 2 Diabetes - Diet and Exercise for People with Type 2 Diabetes

Author:

Naomi Berrie Diabetes Center, Columbia University

Medically Reviewed On: November 05, 2003

When you eat a meal, that meal includes three things: fat, protein and carbohydrates. It turns out that the only part that makes your blood sugar go up is the carbohydrate part. In other words, if you ate an entire meal that had only fat and protein in it, your blood sugar would not go up. That doesn’t mean that the fat and protein don’t have calories—in fact, the fat has more calories by weight than the carbohydrate does. But it is only the carbohydrates that get turned into the glucose that goes into your bloodstream.

So if you want to predict how a meal will affect your blood sugar then all you need to account for is the amount of carbohydrate in the meal. If you want to get really good at assessing your meals, you can buy books or take lessons in “carbohydrate counting."

When you have diabetes, you need to try to balance how much carbohydrate you have at each meal. For example, if you had a breakfast that included a big glass of orange juice, sugared cereal with strawberries on top and a piece of toast, most likely your blood sugar after that meal would be way too high. That meal contains mostly carbohydrates—except for the little bit of fat and protein in the milk in your cereal. Instead, in order to better control your blood sugar, you should cut out some of the carbohydrates and substitute a little fat and protein.

A good nutritionist trained in diabetic teaching will help you review what you usually eat to find the meals that have too much carbohydrate in them. To figure this out for yourself, you could start checking your blood sugars two hours after a meal. If you keep track of what you are eating and then look at your blood sugar levels after meals, you can pick out which meals probably had too much carbohydrate in them.

Eating Foods That are Low in Calories if You are Overweight
The majority of people with Type 2 diabetes are overweight. If you are overweight and you really want to control your blood sugar without medicines, the only way you are going to be able to do that is by losing weight. For reasons that are not currently understood, being overweight makes it hard for your body’s insulin to work. It causes what we call insulin resistance. That’s the bad news. The good news is that if you lose some weight—often only about 10 pounds, even if you are more than 50 pounds overweight—you can usually get your blood sugars back down to normal.

We all know that losing weight is hard to do. But you can be successful if you make up your mind that it is important for your health. Here are some tips I’ve learned from treating my patients and from reading a lot of medical literature: