Sunday, December 2, 2012

How many grams of sugar is safe for a Type 2 diabetic?

Q. I want to help an adult friend who has type 2 diabetes eat the foods he likes.

He's been reading the nutritional facts, and he avoids foods that have more than 2 grams of sugar per serving.

How many grams of sugar should a diabetic consume? Of course, it's best that he doesn't consume any sugar at all, but please tell me the most amount of sugar a type 2 diabetic is allowed to consume.

A. David:

I wish Chadmg's answer where correct. Things will be SO much easier that way. Unfortunately, it is not. More boring, yes. But simpler and easier.

Now, I am personally thankfull it is this way (don't get me wrong). It is just that there ar so many people in this wotld that would benefit from it being the other way.

If you exterminate completely your friends sugars consumption, his blood sugar level will drop to 0 and you will certainly die. So he needs to eat the right amount of carbohydrates (sugars--more or less complex) for your body to use without collecting it all in his blood.

Even high power, high glycemic foods such like non diet chocolate milk can have a place in the life of a diabetic, in controlled amounts and under very special circumstances.

Say what?

Yes, you read it right.

The special circumstances are an hypoglycemia attack. And the required amount is 15 (perhaps up to 30) grams of carbohydrates.

A 200ml (6.7 oz) box of chocolate milk here contains 24 grams of carbohydrates (I read the label). Enough to push your friend's sugar level up by 80 mg/dL (4.4 mmol/L). Which is you are having a blood sugar level of 30 mg/dL (1.7 mmol/L), that will leave you at 110 (6.6), which is perfect.

Of course, you will also need to eat something more consistent such as a diet yogurt to keep it from going back down in 2 hours, which is how long those kind of sugars can push your glucose up.

Note how I did the calculations and how low the sugar level was to begin with.

The most is always defined by your glucometer and the following this formula:

=========================================
15 grams of carbohydrates = 50 mg/dL (2.8 mmol/L) rise
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According to this formula, 2 grams is way too low for him to avoid. He should try 15 grams.

Please note when I refer to carbohydrates, these don't mean fibers. Fibers are good. The more the better.

The reason is that fibers cannot be digested by our stomach, and they get defecated before reaching the blood. Indeed fibers might carry on some carbs with them to the excrement.

So, if you read that each portion of a food has 25 grams of carbs, but of them 20 are fibers, you can go and eat it without a problem.

Now, I am not a doctor. Talk to a doctor personally without applying any of this.

Moreover, if your doctor disqualifies me, then consider me disqualified. I am not a doctor, just a diabetic that knows from experience and conversations with lots of doctors and nutritionists and assisting to education talks doctors held.

If after this warning you still choose to disobey your doctor and obey me, don't blame me later for doing so. It could well be that this formula for some medical reason doesn't applies to your friend.

Now, I am type 1. For type 1s, you can also add a third factor to the equation:

15 grams of carbs = 50 mg/dL = 1 unit of insulin

But due to insulin resistance, this doesn't applies to type 2s. Howeverm if you measure how many insulin units drop you how much your friend's sugar level, he could get away with replacing his computed resistance level with the amount of of insulin your friend need to inject.

Note also that this relates specifically to insulin. In particular, to fast acting insulin (such as Humalog, ActRapid, etc). It does not apply to pills and does not apply to slower acting insulin with longer validity periods, such as Insulatard, any Mixtard, etc.


How bad is it for a diabetic to drink and smoke on a daily basis?
Q. Is it worse for someone who has Type I diabetes to drink and smoke marijuana almost everyday than for a non diabetic?

A. How bad is it? Deadly bad - no joke. It does not matter if you are a type 1 or type 2 diabetic as both are at a significantly increased risk of premature cardiovascular disease such as a heart attack. Even if your diabetes is perfectly controlled your risk remains higher than a non-diabetic. Diabetes is a progressive disorder also independent of your level of diabetic control. The most common cause of death for a type 1 or type 2 diabetic is a cardiovascular event such as a fatal heart attack. Drinking and smoking marijuana will make proper control of your diabetes difficult if not impossible. As previously noted even 'perfect' control reduces but does eliminate the increased cardiovascular risk that is the curse of all diabetics. Between the two alcohol is more damaging to a diabetic than marijuana. Diabetes is the one disease where accepting responsibility for the management of your disease is most important. You must be educated and in control of your diabetes. When you leave it up to the physician to be 'in control' outcomes are worse than if you accept control yourself. The only good news is that with modern analog insulins we are able to give diabetics the same glucose levels and variations after meals as that of a non-diabetic. Again - as noted above - this reduces but does not eliminate the risk of premature cardiovascular events. Let me offer you an example. If a non-diabetic person has suffered a heart attack their likelihood of a second heart attack over the next ten years has been well defined. A diabetic - even if perfectly controlled - and in the absence of known coronary artery disease - has the same likelihood of having a heart attack during the next ten years as someone who has had a heart attack due to obvious significant coronary artery disease. That is why diabetes is referred to as a 'coronary artery disease equivalent'. I would very strongly urge you to abstain from alcohol and marijuana. It will not only increase the length of your life but improve the quality of your life as well. I wish you the very best of health and may God Bless.


Where can I find a pretty diabetes bag?
Q. As a gift for my diabetic friend, I want to get her a pretty bag specialized to hold all her diabetes stuff. Online or just a store name where I can find would be most appreciated.

A. Give her a gift that you would give to anyone else, do not give her a diabetic related gift that is tacky, rude, and inconsiderate.

You should see your friend as a person, not as a victim of a disease, do not define her like that it is very insulting.

Get her a more thoughtful gift, your good intentions may be misunderstood and hurtful.


What is nutrition for you and its importance?
Q. Define nutrition in your own words and give its importance... Thanks for people who are willing to answer this!

A. Nutrition is an input to and foundation for health and development. Good nutrition is important for everyone. Healthful diets help children grow, develop, and do well in school. They enable people of all ages to work productively and feel their best. What people eat can also help reduce the risk for chronic diseases, such as heart disease, certain cancers, diabetes, stroke, and osteoporosis, which are leading causes of death and disability among Americans. Finally, eating right can reduce the risk of obesity, high blood pressure, and high blood cholesterol, which increase the risk of disease.





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