I have been a nurse and a certified diabetes educator for the past 11 years. I would like to share a experience I had with one of my patients.
We know that we can prevent or at least delay complications related to diabetes by keeping the blood sugar as close to normal as possible without risking low blood sugar. I provide diabetes education to individuals in individual or group classes. Many patients are very frightened when they come to see me as they don’t know what to expect. Mr. Thomas came to see me with his wife last year. The first thing he said to me was, “I don’t want you to take away all the foods I like. My wife has told me I can’t eat ice cream and drink soda anymore. Please help me!”
Mrs. Thomas immediately stated, “I have to watch him all the time. He eats too much”.
After doing a quick assessment, I explained what happens in the body when diabetes develops. I explained that we approach eating differently now. There is no “Diabetic Diet” anymore. Many myths and misconceptions still continue to exist about how people with diabetes should eat. Most foods are not forbidden to people with diabetes. The emphasis should be on portion control. I explained that Mr. Thomas could still eat ice cream and I talked about reading food labels and the importance at looking at the serving size, carbohydrate content, calorie content, and fat content. I also explained that Mr. Thomas should be the one making decisions about the foods he wants to eat. If his wife is constantly watching his food intake, he will sneak food when she is not looking. Patients need to know they can still have small portions of the food they really enjoy. I did explain that regular soda has a large amount of calories and carbohydrates. Mr. Thomas agreed to try seltzer mixed with lemon instead of regular soda. When he left our session, he seemed relieved. He knew he had to lower the portions of food he ate, but he was so happy to know that he could still eat his favorite foods. Can you imagine someone telling you to never eat your favorite foods again?
I don’t believe patients suffer diabetes related complications because they eat cookies or ice cream. I believe they are at greater risk for complications, if their blood sugars remain above recommended levels. There are several ways to keep blood sugars as close to normal as possible. Healthy eating is just one way. Exercise, monitoring blood sugars, taking medications, healthy coping, problem solving, and risk reduction are also just as important to review with patients. These behaviors are also called the American Association of Diabetes Educator’s 7 self-care behaviors. They summarize the information we share with patients. I am happy to report that Mr. Thomas’s blood sugars are within recommended levels. His fasting blood sugars are between 90 and 110. His 2 hour post meal blood sugars are less than 180. He is exercising regularly by walking with his wife at the mall at least 4 days per week. He tests his blood sugars once to twice daily. He takes Glucophage XR 2ooo mg with his dinner meal. He now drinks seltzer instead of regular soda. He lost 10 pounds. And most of all, he is happy.
Lori OKeefe RN, BSN, CDE