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Dear Dr. Gourmet, My husband is 5'10" and 150 lbs. and was diagnosed with pre diabetes. We have been trying to find out how many carbs a day he should be eating or how many carbs per meal.
He does not need to lose weight and trying to maintain his current weight without eating a lot of carbs is difficult. He is very active in his job and cannot afford to lose any weight.
It seems everything that I read is for people to lose weight to help control their condition. Please can you give me a guideline of how to control the pre diabetes without losing any weight.
You are correct that most of our patients who have "pre-diabetes" are overweight. Those that are trim pose a little bit more of a challenge because often those who are overweight can work at losing weight and will have marked improvements in their blood sugar. The same principles apply, however, for your husband who is in the normal weight range. Read the full answer.
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Over
the years there have been a number of different strategies for diabetic
diets. For a long time diabetics were taught to use exchange lists. That
method worked well but was cumbersome for a lot of folks. More recently
the training has focused on counting carbohydrates at each meal or
snack. For diabetics who take insulin, being careful with regulating when
and what they eat is key and counting carbs works well for them.
The majority of diabetics, however, have Type 2 diabetes and don't take insulin. For these folks I have long felt that simply following a healthy diet is the best choice. A study published recently says that Mediterranean style diet is the best choice for helping control diabetes.
Researchers in Naples, Italy randomized 215 Type 2 diabetics to either
a low fat diet similar to the one now recommended by the American Diabetic
Association or a Mediterranean style diet providing about 50% of calories
from carbohydrates and 30% from fat. These were patients who had just been
diagnosed with diabetes.
The study looked at the number of diabetics who needed to be put on medication. The results are pretty amazing. Those following the Mediterranean style diet avoided medication 56% of the time while 70% of those following the low fat American Diabetic Association style diet ended up taking meds. Those on the Mediterranean style diet also lost more weight and had a greater improvement in their cholesterol and blood pressures.
We now have proof that the Mediterranean style diet is THE diabetic diet. You can get started learning about how to eat in our Mediterranean Diet section.
A Little More Fiber Can Help You Reduce Your Risk of Diabetes
More and more children and adolescents are considered overweight or even obese,
leading to a related rise in the cases of insulin resistance, pre-diabetes,
and type 2 diabetes among children.
BMI, WHR, and your risk of diabetes:
I've written previously about Body Mass Index and Waist to Hip ratio and their
usefulness in assessing your overall health. There's been some controversy in
medical circles, however, about whether Body Mass Index (BMI), Waist to Hip
Ratio (WHR) or simple Waist Circumference (WC) is a better predictor of type
2 diabetes.
Carbohydrates and Diabetes
Some studies have linked high glycemic index (GI: how quickly a carbohydrate
is absorbed) and high glycemic load (GL: the glycemic effect of carbs
in the diet) with an increased risk of Type 2 diabetes. In Western
diets, these foods include bread, potatoes, and sweet foods like desserts
or sweetened soft drinks - a large portion of the typical Western diet.
The Chinese (and other Asian populations) have a very different diet: rice
is their main staple food. Would the association between GI, GL,
and the incidence of Type 2 diabetes be different for those following a
Chinese-style diet?
Get Your Magnesium: Avoiding Type 2 Diabetes
We know that obesity is the single strongest risk factor for developing
type 2 diabetes. That said, it also appears that eating certain foods
helps to reduce the risk of type 2 diabetes. These foods, which include
whole grains, beans, nuts, and fruits and vegetables, are all high in
magnesium. Magnesium is involved in the metabolism of glucose and it is
thought that it then plays a role in the body's use of insulin - and therefore
type 2 diabetes.
A Look at Vinegar and Diabetes
There may be something to vinegar and diabetes after all: two studies from
Arizona State University's Department of Nutrition, led by Carol S. Johnston,
PhD., suggest that taking apple cider vinegar orally may help improve insulin
sensitivity and glucose levels.
To help prevent diabetes, take... wine?
One of the interesting things about scientific research is that sometimes you
start out to discover one thing and end up finding something else. Recently
a group of scientists from the University of Minnesota set out to investigate
whether a diet rich in flavonoids (an antioxidant found in fruits, vegetables,
and beverages like tea or wine) might help reduce the risk of Type 2 diabetes.
More Good News for Coffee Drinkers
About a month ago I shared with you an article regarding the long-term effects of caffeine intake among women. That study indicated that not only does caffeinated coffee not cause hypertension, drinking more caffeinated coffee (rather than only a cup or two a day) may actually help prevent hypertension. Now I have even more good news for those who drink caffeinated coffee. A recent study published in the Journal of the American Medical Association analyzed multiple existing studies performed both within the United States and in Europe in an effort to discover any connection between coffee intake and the risk of type 2 diabetes (adult-onset diabetes).
More Reason to Get More Whole Grains
Researchers at Johns Hopkins recently published a study which focused on the
relationship between eating whole grains, refined grains, or cereal fiber and
risk factors for heart disease, high cholesterol, and diabetes.