Diabetes 2020: 5 Easy Steps for Patients and Families

Posted by Erin Nugent, Registered Dietitian, Kansas City on 1/9/2020

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. 

  1. 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. 
  1. 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.
  1. 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 endurance increases.
  1. 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 them.
  1. 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.

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