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TOPIC - Diabetes
I was for several years on a low fat, high carbohydrate diet but began to experience elevated fasting blood sugar levels. The doctor put me on a low carb diet with moderate fat intake. The blood sugar stabilized below diabetes levels. I have now developed gout and am told to eat reduced quantities of meat and high-purine foods. The resulting low-carb, low-protein, moderate-fat diet doesn't seem to leave me with many alternatives. What do I do?
It is always a challenge when you have medical conditions which places restrictions on your diet. There are several things that you can do which would make it more manageable for you.

Firstly, with your diabetes you may be able to have moderate amounts of carbohydrates and still be able to maintain normal blood sugar levels. You will want to work with a dietitian and fine-tune the amounts by recording your food intake in detail and monitoring your blood sugar levels. Secondly, lose weight if you are overweight as it will normalize your blood sugar levels and reduce painful gout attacks. Thirdly, you may want to discuss medication for both the diabetes and gout with your doctor if you are currently not taking any. It will make it a little easier to manage the conditions and allow you more food choices.

My suggestion is to start by making an appointment with a dietitian and work out a diet that is manageable for you, as well as to work out a program to help you lose some weight. You may find that even a small amount of weight loss will improve your condition such that you may not need any medication. Good luck!
What is the RDA for a diabetic? Do you have an example of a Food Guide Pyramid especially made for a diabetic?
There is no RDA specifically for people with diabetes. The RDA are general guidelines to meet nutrient needs for majority of the normal healthy population. For people with diabetes, they have to modify their diet. If you would like information on what and how much to eat for a diabetic, check out the nutrition section of the The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) site or make an appointment with a dietitian so that he/she is able to provide you guidance on your diet. The American Diabetes Association has information on the Diabetes Food Pyramid.
I have a family history of diabetes although I am not diabetic. Do I have to cut down on sugar?
If you have a family history of diabetes, the best thing you can do is not gain excessive weight. Excessive weight gain will put you at a higher risk of developing diabetes.

Eating sugar will not give you diabetes. However, if you do have diabetes already, the you will want to monitor the amount of sugar that you are consuming especially simple sugars. If you are consuming a lot of sugar and that is contributing to weight gain, then you should cut down. Also keep your fat intake low - reduce the amount of oil in cooking, eat less deep-fried foods, trim the fat on meats, use less sauces and gravies. For more information about what to eat, consult a dietitian at the hospital.
I heard recently of Glycemic Index? How It works? What are the foods classified under High or Low GI, especially for reducing weight?
Glycemic Index (GI) is a system of measuring how fast foods containing carbohydrate triggers a rise in blood sugar -- the higher the number, the greater the blood sugar response. So a low GI food will cause a small rise, while a high GI food will trigger a dramatic spike. A list of selected foods with their glycemic values is shown below.

One list for Glycemic Index is based on glucose equal to a base value of 100; all other foods are measured relative to the rise in blood sugar that glucose causes. Other research has developed a list with white bread as the base value of 100 (for comparison sake, glucose is 1.42 times of white bread as a base value).

GI is mostly used by people with diabetes to select foods to control their rise in blood sugar. It is not as useful in reducing weight as GI is not based on calories, which is the key to weight loss.
Food Glycemic Index
Glucose 100
White rice 88
Cornflakes 83
French fries 75
Watermelon 72
Wholemeal bread 69
Cantaloupe 65
Brown rice 55
Orange juice 52
Instant/Cup noodles 47
Chickpeas 33
Soybeans 18
I would like to find out what type of food (other than sweet food) do I not eat to prevent diabetes. Is carbohydrates bad as well?
First of all, you cannot prevent diabetes by avoiding sweet foods - this is a common misconception. Diabetes is caused by the body's inability to either make enough insulin (in insulin-dependent diabetes, commonly known as Type I) or the inability to transport the glucose into the muscle cells despite high levels of insulin (as in non-insulin dependent diabetes, commonly known as Type II). If you do not have the above conditions, eating lots of sugar will not give you diabetes nor avoiding sugar prevent you from getting it.

However, if you have been diagnosed with diabetes, you should cut down on the amount of sweet foods (sugar, honey, sweetened drinks, candy, chocolate, etc.) that you eat to help control your blood sugar. You also have limit the amount of carbohydrates that you eat at each meal - examples of carbohydrates are rice, noodles, bread, buns, crackers, cookies, roti, pasta, etc. Carbohydrates are not bad per se, but they are converted to sugar when digested. Thus the more carbohydrates you eat, the more sugar will be in your blood. Since your body has difficulty getting rid of sugar, you need to limit the amount you put into your system at any one time so as not to overload and end up with high blood sugar.

To find out more about appropriate food intake for diabetes, consult a dietitian at your hospital.

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