There is no cure for Type 2 diabetes, whose risk factors include age, family history, obesity and lack of physical activity. With this form of diabetes, the body either does not have enough insulin or cannot use the hormone efficiently. Insulin helps to convert sugar in the body to energy. For those who are pre-diabetic or have been diagnosed, losing weight and regular exercise will not reverse the condition but will help to manage blood glucose levels and slow down the progression of the disease.
Taking the disease seriously is the most important first step toward good health.
"There are still many people who feel, 'Oh, I can have a touch of sugar,'" says Al Whitaker, director, mission delivery New England, for the American Diabetes Association, which staffs an office in Rocky Hill. "They don't see the severity of [diabetes] unless they are at the complications stage."
Symptoms such as increased urination, constant thirst, extreme fatigue, an increased appetite and blurred vision should signal a visit to the doctor, says registered dietitian Lorie Reardon, who counsels diabetic patients as director of nutrition services at Charter Oak Health Center in Hartford.
"Often, people don't realize they have the symptoms of diabetes, and older folks may think [the symptoms] are just due to getting older. If anyone has any of these symptoms, they should address them with their doctors."
Reardon says that the diagnosis and the changes in diet, exercise, shopping habits and cooking preferences that help to manage blood sugar can seem overwhelming. When counseling patients, she focuses on diet first, asking them to write down the foods and beverages they consume in a typical day.
"Typical eating habits don't change drastically day to day, although some people may eat more generously on the weekends," she says. "We pick out the foods that they are eating in excess and [make plans] to either decrease or eliminate them. I look for simple carbohydrates — regular soda, desserts, candy — as the foods that will turn to sugar almost immediately after they are consumed, as opposed to complex carbohydrates such as whole grains that take longer to turn to sugar."
As a general rule of thumb, a diet rich in fruits, vegetables, whole grains and protein in proper portion sizes is the goal. The U.S. Department of Agriculture's "My Plate" for optimum health is divided into quarters: Vegetables should cover half of the plate, with the remaining half divided equally between whole grains and protein. Sensible portions of fruit and low-fat dairy products factor into the healthful diet.
Reardon recommends three meals a day and planned snacks to keep blood sugar at consistent levels. "We don't want people to skip meals," she says.
Choosing a variety of fresh and freshly prepared foods each day will provide fiber and nutrients minus the salt, added sugar and preservatives present in processed and takeout meals. "I tell my folks: Eat outside of the box; don't eat what's inside the box," says Reardon who is a member of the professional dietitians' organization, Connecticut Academy of Nutrition and Dietetics. "Processed foods are the downfall."
Reardon recommends shopping the perimeter of the supermarket where most fresh foods are displayed rather than the aisles that stock more processed foods. Reading labels takes time, but the ingredient lists and nutrient profile provide valuable information for choosing foods that are high in fiber and whole grains and low in sugar.
"I tell my folks to zero in on the total carbohydrates in an item," Reardon says. "It's an eye-opener for them to see how many carbohydrates are in a food they have been eating for years."
Although fresh fruit contains natural sugars, fruits such as apples, pears and berries tend to raise blood sugar levels less quickly than citrus fruits, Reardon says. Skip starchy vegetables such as corn, potatoes and peas in favor of greens, broccoli, cauliflower, carrots, tomatoes and cucumber.
Color plays a role in determining nutrients: sweet potatoes, brown rice and whole wheat pasta have more fiber and the carbohydrates turn to sugar more slowly than those in white potatoes, rice and pasta. Lean meats, poultry and fish, and low-fat dairy products can save calories, which helps in weight loss.
A good diet allows for fat, but choosing the most healthful ones is essential, says Nechama Cohen, founder and executive director of the Jewish Diabetes Association, based in Brooklyn, N.Y., and author of "Enlitened Kosher Cooking." The much-lauded Mediterranean diet has shown the excellent health benefits of nuts and olive oil, she says.
Making wise food choices, eating healthfully and watching portion sizes work in tandem with physical exercise to maintain or lose weight. Inactive individuals will have more success if they become more active slowly — taking the stairs rather than an elevator, parking farther away from a store and adding a few extra minutes to a brisk walk at each outing. "I say, 'Don't just sit I front of the TV,' " Reardon says. "If you want to watch TV, walk [in place] while you watch." According to the CDC, 150 minutes of physical exercise a week and a 5 percent to 7 percent reduction in body weight can reduce the risk of developing Type 2 diabetes by 58 percent.
Although a registered dietitian can work one-on-one to customize a diet plan for a diabetic patient, the American Diabetes Association's website, http://www.diabetes.org, has been revamped to become more interactive and provides a wealth of information, tips and strategies. A tool called "My Food Advisor" allows the user to type in a food or a recipe and receive a carbohydrate count and suggestions for lower carbohydrate alternatives.
For more on living with diabetes, visit the American Diabetes Association's website, http://www.diabetes.org. For more on local programs, click on "local offices" or call 203-639-0385.