Managing diabetes is not always easy

 My husband has type 2 diabetes, and lately he has been frustrated about his blood sugar. Even though he gives himself the proper dose of insulin according to his carbohydrate intake, his glucose levels often don’t go down as much as they should. He has a doctor’s appointment, but can you shed some light about what’s going on?

Talking with his doctor, or a registered dietitian or diabetes educator, to gain some insight is a good idea. But many things can affect blood glucose levels. He might need to adjust his insulin, but physical activity, or lack of it, can make a big difference. Worry, frustration and feelings of burnout regarding diabetes have also been associated with higher blood sugar levels, according to a 2010 study in the journal Diabetes Care. The biology and the science behind insulin and blood sugars aren’t as cut and dried as you might wish.

Your husband also might benefit from a new online course developed by Ohio State University Extension. “Dining with Diabetes: Beyond the Kitchen” is available for free at go.osu.edu/DWD_BTK, as part of the online eXtension campus, which is a service of the U.S. Cooperative Extension System. The course includes:

  • Narrated PowerPoint presentations on “Carbohydrates,” “Fats and Sodium,” and “Vitamins, Minerals and Fiber.”
  • Videos with ideas on making smarter decisions at the grocery store.
  • Links to information from authoritative sources.
  • Quizzes to test your knowledge.
  • The ability to post questions and experiences — and to read those of other participants.

Participants who sign up and view all presentations and videos, complete the quizzes, and submit a final evaluation are eligible for a quarterly drawing for a $100 Amazon gift card.

Your husband might particularly be interested in one of the resources available in the course, a blog post from the Joslin Diabetes Center. It describes how a high-fat meal can affect blood glucose, both by slowing the time it takes for the glucose to be digested and reach the bloodstream, and by affecting the liver’s ability to absorb glucose. Depending on your husband’s eating habits, this might help explain what’s happening with him.

The online course is an offshoot of in-person Dining with Diabetes classes offered periodically in 27 Ohio counties by OSU Extension. The three-session program, co-presented by an Extension educator and a certified diabetes educator, provides information on menu planning, carbohydrate counting and other topics, and includes live cooking demonstrations of healthy recipes with taste-testing. To find out if the program is offered near you, contact your county Extension office. Find it at go.osu.edu/extoffices.

Living with the ups and downs of diabetes can be aggravating. But getting answers to questions when they arise, and connecting with others facing the same issues, can help.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or filipic.3@osu.edu.

Editor: November is National Diabetes Month. This column was reviewed by Dan Remley, Food, Nutrition and Wellness field specialist for Ohio State University Extension.

Eat fruit, but know how it affects blood sugar

Fruit Harvest Selection in BowlsI know I should be eating more fresh fruit, but I have type 2 diabetes. Last weekend I enjoyed a few slices of watermelon, and I was surprised when I tested my blood sugar and saw that it spiked over 200. Should I forget about eating more fresh fruit?

No! Fresh fruit should be included in every diet, even if you have diabetes. Aim for 1.5-2 cups a day.

Fresh fruit contains all sorts of nutrients, including vitamins, minerals, phytochemicals and fiber. As you probably experienced with the watermelon, fruit can also satisfy your sweet tooth while providing huge nutritional benefits that cake and candy simply don’t offer.

But you should be aware that, as with any carbohydrate-containing foods, portion size matters to your blood sugar. And, different fruits have different levels of carbohydrates and fiber, both of which affect your blood sugar, or blood glucose. You likely already know that unmanaged high blood glucose can cause serious, even life-threatening consequences, including blindness, kidney disease, heart and vascular disease, and neuropathy (a disease of the nervous system).

The American Diabetes Association recommends that people with diabetes keep their blood glucose level to less than 180 milligrams per deciliter of blood two hours after eating. For people without diabetes, the normal level is less than 140 mg/dl. You and your doctor may have set your after-meals target lower, but whatever the case, it’s good to recognize what might spike your blood sugar so you can take steps to reduce your risk.

Fruits lower in carbohydrate and higher in fiber will likely have less of an effect on your blood sugar. Below is the calorie, carbohydrate and fiber content for specific portion sizes of some common fruits. Find information about other fruits in the National Nutrition Database, available under “What’s In Food” atnutrition.gov.

  • Raspberries, 1 cup (4.3 ounces): 65 calories, 15 grams carbohydrate, 8 grams fiber.
  • Peach, medium (5.3 ounces, about 1 cup sliced): 60 calories, 14 grams carbohydrate, 2 grams fiber.
  • Strawberries, 1 cup halves (5.4 ounces): 50 calories, 12 grams carbohydrate, 3 grams fiber.
  • Orange, 1 cup sections (6.5 ounces): 85 calories, 21 grams carbohydrate, 4.5 grams fiber.
  • Blueberries, 1 cup (5.2 ounces): 85 calories, 21 grams carbohydrate, 3.5 grams fiber.
  • Apple, extra small (3.5 ounces, about 1 cup sliced): 55 calories, 21 grams carbohydrate, 3.5 grams fiber.
  • Cantaloupe, 1 cup diced (5.5 ounces): 55 calories, 13 grams carbohydrate, 1.5 grams fiber.
  • Banana, extra large (5.4 ounces, about 1 cup sliced): 135 calories, 35 grams carbohydrate, 4 grams fiber.
  • Honeydew, 1 cup diced (6 ounces): 60 calories, 15 grams carbohydrate, 1.5 grams fiber.
  • Grapes, 1 cup (5.3 ounces): 105 calories, 27 grams carbohydrate, 1.5 grams fiber.
  • Watermelon, 1 cup diced (5.4 ounces): 45 calories, 11.5 grams carbohydrate, 0.5 grams fiber.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, orfilipic.3@osu.edu.

Editor: This column was reviewed by Dan Remley, specialist in Food, Nutrition and Wellness with Ohio State University Extension. OSU Extension is the outreach arm of the College of Food, Agricultural, and Environmental Sciences at The Ohio State University.

For a PDF of this column, please click here.