James K. Robinson
Many diabetics, those people diagnosed as having the disease called diabetes, are advised to lose weight, easily said, but sometimes difficult to accomplish.
The advice usually emphasizes eating the right foods and avoiding the wrong foods, cutting down on quantity, not overeating.
And also, to increase or to start to exercising regularly.
So those are the generalities -- unless the diabetic is provided with a more detailed meal planning guide, it is left for the individual to work out their own approach and ways to achieve a weight-loss goal, to find out for themselves just what to eat and how much to eat.
Initially, it can be a complicated process to determine a weight target and what foods are appropriate, so if possible the diabetic should request the healthcare team to give advice and a tailored diet plan.
Simply stated, the reason weight is gained is because more food is consumed than is needed to stay alive. The body converts any excess and stores it in the form of fat.
Expressed in calories, some foods are richer, weight for weight, than others. Fats provide more calories per gram than do non-fats. The body needs fat, just as it needs protein and carbohydrate, but it makes sense to eat less fatty foods.
Nutritionists have established ratios of carbohydrates, proteins, and fats considered appropriate to maintain good health for the general population.
Carbohydrates supply most of the glucose needed by the cells of the body for energy. Although if there were no carbohydrates, the body would use protein to make the glucose needed. It is the glucose that is the problem for the diabetic whose body cannot control the glucose content in the same way as the non-diabetic. In the case of the diabetic, much of the glucose does not get into the body cells that need it but stays in the blood stream for a long time, and that is harmful and damaging.
There are different categories of carbohydrate, classified by the complexity of the content of their sugar containing molecules, of which there are many, and the more complex they are the longer it takes for the body's digestive system chemical actions to break them down to glucose. The longer time in doing so diminishes the peak of the increased glucose load in the bloodstream that always occurs after eating. With the diabetic, that elevated blood-glucose conditions lasts longer than it does for the non-diabetic, that is the problem.
That is what diabetes is all about, high blood sugars for too long a time, leading to so many other health problems.
There are two conflicting schools of thought regarding the amount and ratio of carbohydrates, compared to other essential nutrients, which should be consumed by the diabetic.
Carbohydrates provide glucose and glucose is the problem for the diabetic
So the approach followed by some well-known and successful medical practitioners is to keep the main source of glucose, the carbohydrate ratio, to the low end of the scale in comparison to the protein and fat content. Some suggest as low as 15%, some 25%. In this way, less sugar be will be manufactured which surely make a lot of sense.
One well-known and leading advocate of the low carbohydrate approach, a type 1 diabetic himself, now in his sixties, is Richard K. Bernstein, M.D. author of the 'Diabetes Solution' and also the 'Diabetes Diet'. This could be a worthwhile read for those diabetics who need to lose weight and who are having trouble controlling their blood glucose levels.
There are many other physicians who agree with Dr. Bernstein's views and many research studies confirm the effectiveness of the low carbohydrate diet, supported by exercise and certain vitamin and dietary supplements.
The other approach suggests consuming a higher carbohydrate intake, as high as 55 to 65 percent, and is recommended by the American Diabetes Association and other national diabetes associations and many other organizations dealing with diabetes, including many physicians and nutritionists. As many complex carbohydrates as possible are preferred in such a dietary approach.
Nevertheless, the American Diabetes Association, defying logic somewhat, recognizes that lower carbohydrate diets are helpful to diabetics in controlling their high glucose problems but in their view, even though producing the right results, are too difficult to follow for any length of time.
Perhaps the individual would be better able to make that decision, but the national diabetic associations make little effort to make diabetic patients aware of what the lower carbohydrate diets can accomplish.
Excellent and comprehensive diabetes meal planning and advice is available from both the low carbohydrate and the higher carbohydrate advocates.
Losing weight and following a weight loss program is a serious process and should the discussed with a doctor. It is the right and responsibility of the diabetic patient to decide which route to follow, but it is wise to confide in and discuss the merits of their choices with their doctor. Much of the control and management of the diabetic condition is left to the patient and requires monitoring levels of glucose in the blood every day and sometimes, when control is poor, several times each day.
I have been a diabetic for 20 years or more and bring a patient's perspective to my two blog-sites where I cover a wide range of diabetes topics of interest to fellow diabetics, especially the newly diagnosed.