Controlling blood sugar when you are diabetic

People with diabetes often have challenges in achieving blood-sugar control. The type of blood-sugar lowering medication they use, such as the many forms of tablets or insulin, can cause fluctuations in blood sugar, which require consuming carbohydrate-containing foods so that the person can function.

People who perform self-blood-glucose monitoring often have challenges finding the right amount of carbohydrates to consume to achieve blood-sugar control. This is difficult as different foods of similar portions contain varying amounts of carbohydrate. The response of the carbohydrate to blood sugar can be affected by the preparation of the food, the mix of other macro-nutrients, such as protein and fat, and also the patient's body.

The health of the patient's digestive system (damage to nerves), other diseases, body weight and how sensitive the patient is to insulin, can make a whole lot of difference in the patient's response to a portion of carbohydrate-containing food. Many patients will say they cannot eat a particular food as it will spike their blood sugar, but yet can eat a similar portion of another carbohydrate-containing food without problems.

In my experience, patients with diabetes have reported good blood-sugar control with equal weight in boiled green bananas compared to other ground provision. Another food I have often recommended as a snack with reported good result in satiety and blood-sugar control, are nuts.

In a study of 117 patients with type 2 diabetes, researchers found that consuming two ounces of mixed nuts daily in place of carbohydrate-rich food, improves glycaemic control as evidenced by improved Haemoglobin A1c, a marker of glucose control over a three-month period. There was also reduction in serum lipid levels. This was reported in Diabetes Care (2011;34:1-5).

Dr David Jenkins of St Michael's Hospital in Toronto was lead researcher. The patients were randomly assigned to one of three groups for three months. One group of 40 patients had mixed nuts of 75 grams per day. The mixed nuts consisted of unsalted almonds, pistachios, pecans, hazelnuts, walnuts, peanuts, cashews and macadamias.

One group of 38 patients had half portion of the nuts and the other group of 39 patients had muffin made from whole wheat flour and sweetened with apple concentrate and no added sugar.

Nuts are a good source of protein, healthy fats and are low in carbohydrate. One ounce of peanuts has 165 calories, seven grams protein similar to one ounce meat, 14 grams fat, and five grams carbohydrate similar to one teaspoon sugar.

Because nuts are high in fat, they should be consumed in small portions, as it can contribute to excess calories. When consumed in small amounts, patients benefit from the sense of satisfaction in the fat for a longer period and the low carbohydrate will prevent spikes in blood sugar levels.

Rosalee M. Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email: yourhealth@gleanerjm.com.