Old ideas about diabetes are being replaced by new insights.
We used to think that diabetes that begins in adulthood was the result of low insulin production. We now know that some people produce enough insulin, but their bodies can't use it because they are overweight: Obesity can inactivate insulin receptors, so that the available insulin can't be used. For these folks, losing weight is the key to controlling diabetes.
We also used to think eliminating sugar was the cornerstone of the diabetic diet. We now know that controlling all types of dietary fat is essential, both to control weight and to reduce the risk of heart disease. In addition, a well-balanced diet eaten moderately throughout the day controls the blood sugar level to prevent the eventual side effects of diabetes.
Most of the food you eat is broken down to small particles and eventually becomes glucose, a sugary fuel that travels in your blood until it reaches cells that need it for energy.
When blood sugar levels rise after eating, the body releases insulin, which leads in a lock-and-key fashion to open cells to receive the glucose. If insulin is not available, or the insulin receptors are not working, glucose cannot leave the blood, and blood sugar levels rise even higher. (It's a lot like getting stuck on the Beltway with all the "on" ramps working but all the "off" ramps closed.)
Blood glucose levels that remain high for long periods over a number of years produce hazardous side effects such as damage to the nervous system and to the blood vessels of the eyes, kidneys, heart and feet. Blindness, heart attacks, kidney failure, and amputations may follow.
The good news is that damage can be reduced or prevented with a well-balanced diet, regular exercise and appropriate medical care.
The following food habits of special importance to the diabetic are recommended by the American Dietetic Association:
* Get on the low-fat bandwagon. Cut down on all types of fats and oils, to control your weight and to reduce your risk of heart disease.
* Eat less sugar and sugary foods; sweets are usually high in calories and may also be high in fat.
* Get moving! Regular exercise (at least three times a week) is an important part of your health program. Exercise burns calories, makes weight loss easier, and can help lower your blood glucose level.
* Be sensible about salt. For may people, eating too much salt or salty foods can cause blood pressure to go up. People with diabetes often have high blood pressure or will get it, so it's a good idea to watch salt intake.
* Check your watch. Skipping meals or eating at different times each day can make it difficult to keep your blood glucose level under control. Develop a regular meal schedule and stick with it.
Colleen Pierre, a registered dietitian, is the nutrition consultant to the Union Memorial Sports Medicine Center in Baltimore and national spokeswoman for the American Dietetic Association.