I had a request from one of my favorite people to talk about how to provide a quick educational lesson to patients with type 2 diabetes. This is a great question! Patients with newly (or not) diagnosed diabetes are often confused about what and how to eat.
The great thing is patients with diabetes with Medicare can get unlimited nutrition visits with a Registered Dietitian to provide one-on-one, individualized recommendations and counseling. Many RDs are also CDEs – certified diabetes educators in order to provide the best recommendations. If you have type 2 diabetes or know someone with it, let me know about this awesome benefit.
This quick nutrition lesson to educate patients with type 2 diabetes is focused towards patients with type 2 diabetes who are not on insulin. It’s a good lesson for anyone, though, especially since 90% of people with pre-diabetes don’t know it!
The goal for diabetes is to regulate your blood sugar in order to delay or prevent long term health effects, such as loss of feeling in the extremities (feet), eye damage and blindness, kidney disease, heart disease, and more. High blood sugar damages anyone’s body, regardless if they have diabetes or not. Often the test used is hemoglobin A1c (Hgb A1c), which measures the average blood glucose level over the past 3 months, and the goal is for patients with diabetes to be <7%. Ask your doctor for this test at your annual physical in order to catch pre-diabetes early before it progresses.
The goal is to maintain a blood sugar close to a normal level and prevent blood sugar swings. Your average blood sugar could be 150 mg/dL, but you could be going as high as 240 mg/dL then dropping down to 60 mg/dL a few hours later. These sharp swings will damage your cells, and you’re not going to feel very great either!
Before getting into very detailed nutrition lessons, such as carbohydrate counting, I would focus on creating balanced meals with patients.
Patients should aim to eat 3 balanced and nutrient-dense meals per day and an additional snack based on hunger levels. At each meal, there should always be:
- A small amount of carbohydrate
- Some fat
- Fiber (non-starchy vegetables)
If you have all 4, you’re on the right step. Then, you have to choose the right portions to balance your plate and control your blood sugars. Eating protein and fiber with your carbohydrates slows down the release of sugar into your blood stream and prevents the sharp blood sugar spikes.
Let’s take an example and choose:
- Protein – Salmon
- Carbohydrate – Sweet potato
- Fat – Avocado
- Fiber – Spinach salad
Your protein should be about the size of your palm and the thickness of a deck of cards. It should take up about a quarter of your plate. This controls your portion for your size – if you’re petite, you don’t need the same portion as a 6 foot tall man. Aim for high quality, anti-inflammatory proteins, such as salmon and other omega-3 rich fish, pasture raised eggs, or grass fed meats.
Next, add the fibrous, non-starchy vegetables and cover at least half your plate. These include all those vitamin-packed leafy green veggies, cancer-protective cruciferous veggies (broccoli, Brussels sprouts, cauliflower, cabbage), carrots, beautiful beets, and any other non-starchy veggies. Aim for a wide variety of colors and at least 1-2 different veggies at each meal (yes, even breakfast!). All the vitamins, minerals, and antioxidants will help protect and repair your cells from damage.
Now, in your last quarter of your plate, add a nutrient-dense source of carbohydrates. It’s these foods that raise your blood sugar, but controlling the portion and the type of carbohydrate you eat will balance your blood sugars. Choose a portion about the size of your fist, and aim to choose the most nutritious bang-for-your-buck carb to eat. Carbs that contain more fiber and nutrients are much better than nutrient-poor white pasta, for example. Some great sources are starchy veggies, such as the super sweet potato, winter squashes (butternut, acorn, spaghetti squash), peas, because they contain a moderate amount of carbs and are also packed with vitamins, minerals, and fiber. For breakfast, the carb may be a piece of fruit, for example.
Lastly, include a heart-healthy source of fat. Heart disease is very common in diabetes, and you can protect your cardiovascular system with anti-inflammatory fats. These include omega 3 fatty acids found in fatty fish like salmon and sardines, as well as monounsaturated fats. Chop up some avocado for your salad, or make your own salad dressings with olive oil to avoid high amounts of pro-inflammatory omega 6 fats. Choose raw nuts or seeds as a snack, or try out chia seeds with breakfast. Healthy fats not only decrease inflammation but increase your absorption of fat-soluble vitamins – vitamins A, D, E, and K.
If you’re hungry after this meal, choose the fiber-rich veggies or a little more protein rather than the carbohydrate to prevent a big rise in blood sugars.
Finally, create a list of meals that fit these guidelines for patients to put on their fridge or use as a meal planning guide for the week. Encourage patients to look up quick & easy meals or create their own – cooking dinner doesn’t have to take hours. Finding a few go-to meals motivates patients and helps them avoid throwing together a plate of white pasta with sugar-filled tomato sauce for dinner.
Some examples include:
- Roasted salmon, spinach salad with avocado and olive oil, small sweet potato
- Baked chicken with garlic, wilted swiss chard and mushrooms, roasted butternut squash with butter
- Omelette with bell peppers, onions, and tomatoes topped with avocado with an orange on the side
Creating balanced meals is great goal for someone with diabetes to control their blood sugar levels and to provide a steady stream of vitamins, minerals, and other nutrients. Balancing meals also helps control weight and may support weight loss. Losing even 5% of your weight helps improve diabetes control!
What’s an easy, quick, and healthy balanced meal you rely on?