If you read my last Blog, you know that I emphatically
believe the community of Registered Dietitians are having a positive impact on
Diabetes. Yes, it’s an enormous
challenge. The sea of patients with Type 2 Diabetes or pre-diabetes seems never
ending. But, just because there are a
lot of people with the condition, doesn’t mean the role of the RD isn’t
incredibly important to each individual.
The greatest challenge is the amount of time that each of us
has with any single patient and family members.
I know that I find myself having to decide how much I can convey in a
limited number of interactions.
Prioritizing my teaching goals becomes as important as teaching itself.
As we continue to think about patient and family education
approaches, I find it helpful to simplify education into 5 Easy Steps.
- Choosing the right foods: Using the USDA MyPlate or Diabetes
Plate as a guide can be an easy way to start understanding appropriate
portion sizes. This method encourages making half your grains whole,
choosing lean protein, low-fat dairy, and making half your plate fruits
and vegetables. I also like the Diabetes Food Model Kit as a visual in
making food choices. This can also
be a gateway into discussing meal planning with clients. Planning out
weekly meals increases the chances of eating a balanced diet and avoiding
processed convenience foods that are consequently lower in nutrients.
- Making the most of your carbohydrates:
Understanding the difference between simple and refined carbs vs complex
carbohydrates can help patients to get the most nutrients out of their
carbohydrate intake while maintaining stable blood glucose levels. Things like fruit, juices, honey,
syrups, and milk are defined as simple carbs that are quickly broken down
in the body and quickly spike glucose levels. Although teaching clients to
pair some of these items with a protein source can help to slow down
absorption and help to stable out glucose spikes. Items such as white bread and regular
pasta are refined carbs that have had the whole grain removed during
processing. These also break down quickly and spike glucose levels.
Complex carbohydrates take longer to break down and are absorbed more
slowly, avoiding a sudden blood sugar spike. These are items such as
starchy vegetables, whole grains and beans.
- Increasing physical activity offers
several benefits: Exercise helps muscles to use up excess glucose, and
therefore increase insulin sensitivity. By combining increased activity
and healthy eating habits, patients are more likely to experience
beneficial weight loss. Weight loss can help to reduce inflammation in the
body, a symptom of insulin resistance. As little as a 5% weight loss can
improve insulin sensitivity. And it's okay to start small! If patients are
nervous about starting to exercise, encourage them to start out by walking
for 15 minutes over their lunch break, and gradually increase as their
- Get enough sleep and reduce your
stress levels: too little sleep and/or poor quality sleep can increase
insulin resistance by increasing stress hormones in the body and thereby
lead to elevated blood sugar levels. Some tips to improve sleep quality
include avoiding caffeine and alcohol intake late in the evening, no
electronic devices in the bedroom, and keeping a cool, quiet, dark sleep
environment. Lack of sleep and other daily stressors can lead to mental
stress. This can then prevent weight loss and effective blood glucose
control. Help your client find a stress relieving activity that works for
- Make annual visits to your doctor:
Due to the increased risk for developing Type 2 Diabetes, it is important
to have glucose and A1C levels checked annually. Regular visits to a
doctor and dietitian can help to assess the success of your lifestyle
changes, and then recommend ways to increase your success. What works for
some patients may not work for all, there is more than one way to get the
results you need. Also, it may be necessary to continue seeing a dietitian
for continued support in order to make these changes a way of life and not
a short term solution to a problem.