Ask The Expert
Eating Well

I know it can be overwhelming when you are newly diagnosed. It seems that when you are told to avoid something, you suddenly crave it-even if you never cared for it before!

However, in the case of sweets, there are some important issues to be aware of:

• Sometimes, when your diabetes is not well controlled, you can feel increased hunger and have an increased craving for sweets simply because your body is in somewhat of a "starvation state"--if the glucose isn't able to get into the cells to provide energy (due to lack of insulin), the body doesn't get sufficient nutrition and thus you can feel hungrier.
• Realistically, however, most people love sweets, so of course it can be frustrating not being able to choose sweet things whenever you want.
• Very important: modern treatment of diabetes has changed due to studies that show it's not so much what kind of carbohydrate, or "sweet" you eat but rather what is the total amount of carbohydrate eaten at a meal or snack. This concept can work two ways:
• By reading the food label, if you chose 2 slices of bread that total 30 grams of carbohydrate, or chose a serving of ice cream with 30 grams of carbohydrate, your blood glucose might respond the same--although this is always individual and you should always check your blood glucose, both before a meal and 2 hours after, to see the response of the food. The point is that "sugar" foods are not forbidden--you just have to consider moderation, and fit them into the context of healthy nutrition.
• Secondly, when you read a food label, it's important to look at the total carbohydrate, not just the sugar content. For example, if you eat a triple serving of shredded wheat (which will say "0" on the label under sugar), you are still getting a significant amount of total carbohydrate, and you may find that your blood glucose rises above your target level.
• Some suggestions for snacks: sugar-free Popsicles or Fudgesicles, fat free, low sugar (sweetened with NutraSweet) yogurt, sugar free hot cocoa, graham crackers, pretzels, popcorn, or sugar free ice cream. A reasonable snack is usually 15-20 grams of carbohydrate.

Regarding recommendations for cookbooks:

• There are many cookbooks available through the American Diabetes Association or by calling their online bookstore (they can also send you a free catalog of books available) at 1-800-ADA-ORDER. I'd highly recommend you join the ADA, which includes a monthly subscription to Diabetes Forecast.

But the key message I want to leave you with is that it is very important for you to see a dietitian--this is considered a standard of care for all people with diabetes--especially since you are newly diagnosed. If you haven't already done so, please ask your doctor to refer you to a dietitian, preferably a certified diabetes educator, who can assess your individual pattern and needs. Please help the dietitian and yourself by keeping a log of your typical meals for a week--including time, type of food, and amount eaten--and don't forget to include any nibbling or snacks.