Here are some tips to help make positive adjustments to your diet if you are Diabetic or Prediabetic.
 
Avoid Sugar and Sugar Sweetened Beverages:
We all love a good dessert, but overindulgence can cause imbalance in your diet and high blood glucose. Look for low sugar or sugar free desserts and beverages. Try using sugar substitutes like Coconut sugar or Monk fruit in place of regular sugar. Other substitutes you can try are Sugar Alcohols
 (be careful of gas, stomach cramping and/or diarrhea), Equal (Aspartame), Stevia, Sweet N Low (Saccharin), Splenda, or Acesulfame K.
 
Sodium: Limit to 2300mg or less.  If you have heart disease or kidney disease, your sodium may be more restricted.  Look for Salt free seasonings, also, use garlic powder, onion powder, celery, etc. instead of Celery salt, garlic salt, etc. 
 
Proteins: always include protein in each meal. Even plant-based proteins are great choices to include in meals.  Choose lean proteins like fish, egg whites, chicken and poultry. Limit red meats (beef, pork, veal and lamb) to a few meals per week. Wild game, however, can be used more often because the meat is lean. Other protein sources are nuts and seeds, beans and peas. Limit nuts and seed intake because they can also additional calories and fat to the diet.
 
Eat a balanced diet that contains carbs, protein and healthy fats. Eat foods like, legumes, whole grains, a variety of fruits and vegetables and low-fat milk and dairy products. Also, include nuts and seeds in small amounts.  Also, keep carbs balanced throughout the day.  The amount of carbohydrates you eat is individualized... not everyone requires the same amount of carbs.
 
It is good to follow a vegan or vegetarian diet or even include vegan or vegetarian meals from time to time if you regularly eat meat. Either way, ensure you get enough protein.  Some great vegan protein choices are soy and soy-based foods, beans and lentils, and quinoa. Depending on the type of vegetarian you are, you can enjoy low-fat dairy products like cottage cheese, milk and Greek yogurt.  If you eat poultry, you can have chicken, eggs, or turkey. If you eat seafood, you can eat fish and shellfish.
 
There are so many choices you can make to create exciting, healthful meals. Always know that you have many options to have an enjoyable lifestyle filled with great food.

​When you have Diabetes or if you are Pre-diabetic, good meal planning is crucial.  Not only will you have better blood sugar control and better Hemoglobin A1C, planning balanced, healthy meals will help with managing your weight, reduce risk for heart disease and reduce risk for kidney disease. 
 
When someone has a diet high in calories and fat, this can cause unnecessary rise in blood sugar. If blood sugar remains high for long periods of time, this can lead to kidney damage, nerve damage, and damage to the heart. Often, people with Diabetes can have Neuropathy, Retinopathy, Chronic Kidney Disease and Heart Disease.  Weight loss along with consuming the appropriate amount of fats, protein, carbs and calories will help control blood sugar and improve health, and also increase energy and result in better lab values.
 
So, how should you eat?  Along with lean protein, healthy fats, you should decrease carbs and when you do have carbs, ensure they are high fiber. Also, eat raw fruits and vegetables as well to increase fiber , and nutrients like vitamins, minerals and phytonutrients. An ideal meal would include:
 
Half of the plate should be vegetables
One fourth of the plate should be high fiber carbs
One fourth of the plate should be proteins like fish, chicken or plant proteins (beans, lentils)
Also include in your meal: one small fruit and 1 serving of fat like low calorie dressing or plant based butter.
 
                                      
 
















​

What else can you do to stay healthy? 
Invest in a Continuous Glucose Monitor (CGM).  The benefits of using a CGM are:  less finger sticks… you still need to calibrate your CGM during the day. CGMs monitor your blood sugar 24 hours per day so you have a better idea of how your blood sugar changes throughout the day and how what you eat affects your blood sugar.

So what is a CGM?
It is a wearable device that tracks your blood sugar. People using insulin injections and using insulin pumps can determine how much insulin is needed.  Also, CGMs will show fluctuations of blood sugar. You can get the “big picture” of how your blood sugar affects you, like how you feel, how food and activity affects you blood sugar.  Also, other benefits are: if you are ill or undergoing stress, the CGM will track how your blood sugar is affected.  Your doctor can even download data from your CGM and provide individualized care and your dietitian can utilize the data, too.  Your health care team can view trends and patterns and treat you and give you guidance to improve how your diabetes is managed. Even if you are pre-diabetic, a CGM can give you the same benefits.  CGMs  can even alert you if you are having low or high blood sugar so you can treat it more effectively. 
​
Even though a CGM is not a cure, it can be an essential aid to help manage diabetes and pre-diabetes and improve your overall health. Fingersticks are still needed to calibrate the CGM, use for in the moment blood sugar checks, especially if you are not feeling well. Always call your doctor if you have very high and very low blood sugar levels as these can be life threatening if left untreated.



Symptoms of Hyperglycemia (high sugar) and Hypoglycemia (low sugar)
 
           

My parents never made me take cod liver oil, probably because of the traumatic stories they told about their childhood experience with having to take it. It certainly did not sound like a good time!  Well, my Grandmothers may not have known all the benefits of giving fish oil but they knew it was important in keeping their children healthy.  We know so much more about fish oil and the many benefits of regular consumption. I will discuss some of these benefits right now.
First… what is fish oil or Cod liver oil (CLO)?  This oil is made from the livers of fish and CLO is specifically from cod fish liver.  When fish eat certain algae they end up having those nutrients in their bodies and their liver. The nutrient that will be the focus of this article is Omega 3 fatty acids… Omega 3s.  There are different Omega 3s. Two of the more popular and studied are DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid). DHA and EPA have a wide array of benefits for just about every part of the body. These fatty acids are critical for growth and development of babies and children, especially for brain development. Many parents are turning to Omega 3s to help with speech delays and even behavior. 
Omega 3s also help with improving vision.  They can help with combating dry eye, aid in treating Macular Degeneration, and reducing risk of Glaucoma.  Also, Omega 3s have anti inflammatory benefits that assist with improvement of many age related ailments that are linked to inflammation such as heart disease, arthritis, Rheumatoid Arthritis and Omega 3s also help to reduce occurrence of cardiac events.
People with ADHD have lower blood levels of DHA, so supplementation helps with Improved focus. Some people even have great benefits with improving behavior.  DHA can also help reduce risk of developing Alzheimer’s, dementia, as well as other mental abnormalities. Even, blood pressure and circulation can be supported by Omega 3s.
 
So what else can Omega 3s do?  It was before mentioned that Omega 3s help reduce inflammation. Chronic inflammation gives rise to cancer, gum disease, and auto immune conditions. Omega 3s can even help lower the inflammation from exercise and support muscle recovery.
 
So Omega 3s are providing benefits to people of all ages. Even pregnant women benefit from taking DHA for their fetal development namely brain and nerve development. Many Prenatal vitamins contain omega 3s, DHA and EPA.  These fatty acids are not i=only available in cod liver oil and vitamins. With enough consumption of cold water fish in the diet, someone could get enough Omega 3s from diet alone. Many people do not eat that much fish, so other options are CLO, fish oil, Omega 3 supplements and DHA/EPA supplements. Sources of Omega 3s are Cod fish, salmon, tuna, sardines, herring and algae.  Some other sources are flaxseed, walnuts and flaxseed oil.  There are some foods that are fortified with Omegas like milk and yogurt. As far as supplements there are fish oil supplements in liquid and capsule form as well as algae oil that are liquid and capsule formulations. Krill oil is also another option. Also of note, some people do take Vitamin E along with Omega 3s to maximize the benefits. Doses do vary. Children do not need as much how ever adults do need higher doses to see benefits. However, diabetics should be mindful when dosing Omega 3s as very high doses can cause a spike in blood sugars. Also, Omega 3s can lower blood pressure so very high doses many cause low blood pressure. Some European studies have shown that up to 5000mg of DHA, for adults, was tolerated with not adverse effects, but only you an make a sound decision on how much to use. Other studies have be conducted using 2000 to 3000 mg successfully. There are so many more benefits from Omega 3s. It would be great to explore the possibilities.