I was just diagnosed with type 2 diabetes.  I would like to know, should I avoid carbs all together or is there a minimum you must eat?

Answer:  Carbohydrate is actually your body’s favorite source of energy so you don’t want to avoid all carbs.  In addition to being an energy source, carbohydrates also offer a variety of vitamins and minerals as well as fiber to the diet.

It is important to select more “nutrient dense” carbohydrate sources such as whole grains, vegetables, fruits, and low-fat dairy products instead of “empty calorie” carbohydrates such as cakes, cookies, and other snack foods that do not offer much nutritional value.   Portion sizes should be noted when consuming carbohydrate as well.

The Recommended Dietary Allowance (RDA) for carbohydrate has been set at 130 grams per day.  The brain uses an average minimum of 130 grams carbohydrate daily.  This minimal amount is where the RDA is derived.  Consider that other parts of the body would like to use carbohydrate for energy as well.

Since you were just diagnosed with diabetes, it would be a good idea to ask your doctor for a referral to a registered dietitian and a diabetes education class to help you get started with the basics.

I have pre-diabetes and have been doing a pretty good job of exercising outdoors during the spring and summer months.  Now that the weather is starting to cool down, I am trying to determine what I can do for physical activity in the colder months.  Suggestions?

Answer:  It’s great that you have been exercising!  Research shows that those with Pre-Diabetes can make simple lifestyle changes (including regular physical activity) to reduce risk for diabetes later in life.  With regards to exercise in the colder months, here are a few suggestions:

• If you enjoy exercising outdoors, look into winter activities such as skiing (down hill or cross-country),  snow shoeing, or ice skating for example).
• Look into joining a gym or health club when the weather does allow for outdoor activity.
• Check with your local community center for group exercise classes.
• Consider purchasing a piece of exercise equipment for your home (such as a treadmill for example).

My husband has diabetes and this time of year we attend a lot of football games.  Before the game we often will meet up with friends for tailgating parties.  Can you give me some healthy ideas of what we can eat during the tailgate?

Answer:  Tailgating before a football game can be filled with food temptations from barbecuing high fat meats, salads, chips, and treats.  Try these tips for a healthier tailgate party:

• choose lean meats such as skinless chicken breast over high fat meats such as brats,
• select a whole grain bun for added fiber,
• add vegetables to your plate by including grilled vegetables on the bbq or a tossed garden salad,
• opt for salsa over high fat dips,
• drink water throughout the day.

Diabetes runs in my family and I think this puts me at risk.  Could you tell me what are the symptoms of type 2 diabetes?

Answer:  Having a family history can increase your risk for diabetes.  There are a number of lifestyle choices you can make to reduce your risk for type 2 diabetes.  These include maintaining a healthy weight, eating right, and regular exercise.

Here are some of the symptoms of type 2 diabetes:

• increased thirst
• increased urination
• increased hunger
• blurred vision
• weight loss
• fatigue

Regular check-ups with your doctor important.  Be sure to tell your doctor about your family history and any symptoms you are having.

I have type 2 diabetes and love to bake.  When cooking or baking, if I substitute Splenda or Stevia for regular sugar does this make the recipe sugar free?

Answer:  Generally, you will want to look at the total carbohydrate in a food or a recipe instead of sugar.   In the past, when someone was diagnosed with diabetes, they were told they should not eat sugar.  The thinking was that sugar affected blood sugar more than complex carbohydrates (table sugar compared to a slice of bread). That thinking has shifted.  Sugar has no greater effect on blood sugar than complex carbohydrates.  All carbohydrates are considered fairly equal as far as affecting blood sugar.

Using Splenda or Stevia or other non-nutritive sweeteners when baking would replace the sugar content in the regular sugar BUT it would not necessarily make the recipe sugar free or carbohydrate free.  Other ingredients such as flour, fruits, or oats contain carbohydrate and would add to the total carbohydrate of the recipe.

When baking try to use more nutrient dense foods that will offer fiber, vitamins, and minerals.  Experiment with the following tips:

• Opt for whole grain flour when possible.
• Use unsweetened fruits.
• Use egg whites instead of whole eggs to limit fat.
• Choose canola oil or olive oil for healthier monounsaturated fat.

Be sure to limit portion sizes of treats as well.

I have pre-diabetes and am struggling to eat healthy.  My brother and his family live with me and there are tons of junk food temptations in my kitchen.  I want the entire household to start eating healthy with me, they can all benefit, but they are resistant.  Any suggestions?

Answer:  It can definitely be helpful if the entire family is choosing to eat healthier.  Here are a few suggestions that may be of help:

• Sit down with your family and discuss your goals.  Explain why it is important for you to eat healthier and describe what you mean when you say “eat healthy”.  This will help them understand your point of view as well as give them a clear picture of how their eating would change.
• Get creative with your recipes and make them over into healthier options by reducing fat, choosing leaner protein sources, opting for whole grains, etc.
• Involve your family in preparing meals.  This can be a great opportunity for everyone to contribute to healthier eating.

We have a large salad bar at the work cafeteria that I would like to take advantage of for lunch (especially during the summer).  I’m trying to lose weight and control blood sugar.  Could you give me some tips on what to choose and what to steer clear on at the salad bar?

Answer:  A salad bar can be a great opportunity to load up on fresh vegetables and lean proteins.  You will want to use caution however since the salad bar can offer high calorie and fat salads, dressings, and proteins.  Here are some tips to help guide you:

• Start with lots of salad greens (romaine, mixed greens, spinach, etc.).
• Add a variety of non-starchy vegetables such as peppers, cucumbers, mushrooms, tomatoes, and broccoli.
• Look for garbonzo or kidney beans for additional fiber and protein.
• Opt for sliced turkey or chicken breast over bacon bits.
• Try vinaigrette salad dressing on the side so you can control your portion.

I was diagnosed as having pre-diabetes earlier this year.  Since then I have completely changed my eating habits and become a vegetarian.  I’ve lost weight but want to lose more.  Can you tell me which fruits have a high sugar content?  I am wondering about apples, raisins, bananas, and strawberries.  I already know I need to avoid orange juice. Thanks for your help!

Answer:  It sounds like your off to a good start making lifestyle changes and losing weight.  Fruit can be a great addition to your weight loss plan.  Here are some tips to help you with selecting fruit:

• choose whole fresh fruits when possible since these will contain fiber
• watch portion sizes on dried fruits since these are more dense (2 Tablespoons of raisins OR 1 small apple will contain the same 15 grams of carbohydrate)
• opt for a variety of fruits for vitamin, mineral, and phytochemical benefits,
• eat what is in season for the most fresh fruits.

What is the difference between Pre-Diabetes and Type 2 Diabetes?  Could you tell me the diagnostic criteria for both as well as the treatment?

Answer:  Pre-Diabetes and Type 2 Diabetes are similar.  Someone with Pre-Diabetes has elevated blood sugar (fasting blood sugar of 100-125 mg/dl).  A fasting blood sugar for someone with Type 2 diabetes is 126 mg/dl or above.

Eating right, exercising, and weight loss (if needed) are very helpful with both Pre-Diabetes and Type 2 Diabetes.   Medication to help control blood sugar can also be a part of treatment.  Pre-Diabetes is different in that you can actually reverse your elevated blood sugar.  With Type 2 Diabetes, you cannot reverse the diagnosis but you can take good care of yourself and limit complications by controlling blood sugar.

You can learn more by reading the FDA Proposed New Labeling Requirements