Blood Sugar Control through Diet and Exercise

Jiuseppe M Russo RD, CD-N, Clinical Dietitian Manager

The American Diabetes Association® suggests the following blood sugar goals for people with diabetes.

Hemoglobin A1c
• <7% is the recommended goal for most patients
• <6% may reduce complications of diabetes to a greater extent, but increases the risk of potentially life-threatening hypoglycemia

Blood sugar
• 70–130 milligram (mg)/deciliter (dL) premeal or fasting
•<180 mg/dL 1–2 hours after beginning a meal

Choosing foods and beverages
Your food and beverage choices, as well as the amount of exercise you do, can help keep your blood sugar in the normal range. A registered dietitian can teach you what foods you can enjoy at each meal and the proper carbohydrate portions to help maintain your blood sugar levels.
Carbohydrate intake is key to blood sugar control. Carbohydrates are concentrated in sweeteners, such as sugar and honey, and sugary foods, such as candy and cookies.

Healthy carbohydrates
Healthy carbohydrates include:
• Whole grains—breads, cereals, pastas, and rice
• Vegetables, including starchy vegetables—potatoes, sweet potatoes, peas, corn, winter squash, lentils, and starchy beans (eg, kidney, black, pinto, navy, white, cranberry, and lima beans)
• Dairy foods—milk, yogurt, and cheeses
• Fruit—fresh, canned, dried, or preserved, as well as juices

Other carbohydrates:
Foods containing sugar and other sweeteners also are carbohydrates. You should limit these foods, because they are not very nutritious. However, with the help of a dietitian, you can include these foods into your meal plan every once in a while.
Limit the following foods:
• Concentrated sweets—sugar, honey, molasses, jams, jellies, and candy
• Sweet beverages—fruit drinks, fruit punches, regular sodas, sweetened tea, smoothies, sports drinks, and sweetened coffee drinks
• Desserts—pies, cakes, cookies, candy, doughnuts, ice cream, frozen yogurt, and sweetened gelatin
• Foods with added sweeteners—sweetened quick-cooking oatmeal, some sweetened breakfast cereals, and sweetened yogurts

Making health food choices
For good health and to help keep your blood sugar normal, choose a variety of foods each day.
Grains
• Enjoy whole-grain breads, cereals, rice, and pasta at least three or more times/day
• Choose other grains, such as white rice and pasta, in addition to whole grains, as long as you do not eat more carbohydrate than your meal plan allows
Vegetables
• Enjoy vegetables often at your meals
• Select from fresh, frozen, or canned vegetables (drain and rinse to remove excess sodium)
• Use creativity when preparing vegetables
• Fill your plate with vegetables and/or salad
Fruit
• Enjoy fruit or juice in limited portions at least three times/day
• Select fruits that are packed in their own juices, if using canned fruit
• Know that whole fruit (in general) is preferred over juice, because it usually contains more fiber
Dairy
• Choose lean or low-fat dairy foods (milk, yogurt, and cheese) two to three times/day
Protein sources
• Select lean meats, poultry without skin, fish, eggs (limit yolks to three/week), egg substitutes, nuts, seeds, and low-fat soy products
• Choose legumes and dried beans, which contain protein and carbohydrate (can use to meet your protein needs, as long as you consider their carbohydrate content)
Sugar-free products
• Satisfy your “sweet tooth” by choosing diet sodas, other diet beverages, sugar-free gelatin, and sugar-free candies

Tips for blood sugar control
The following tips will help you control your blood sugar.
Portion size
Limit portion sizes of carbohydrates. Too many carbohydrate servings or large portions of carbohydrates can increase your blood sugar levels. Use carbohydrate-counting guides and carbohydrate food lists for food sources and portions of carbohydrates.
As a general rule of thumb:
• One bread/rice or starchy vegetable serving has 15 grams (g) carbohydrate
• One dairy serving has 10–15 g carbohydrate
• One fruit has 15–20 g carbohydrate
• Nonstarchy vegetables have 4 g carbohydrate or less/serving

Carbohydrates
Take in at least 130 g of carbohydrate/day to keep your body running smoothly. Ask a registered dietitian to show you how to fit 130 g into a diet plan.

Food labels
Read food labels.

Snacks and meals
Include at least one carbohydrate with each meal and snack. Spread your carbohydrates into at least three meals and one to three snacks/day.

Blood sugar
Test your blood sugar 2 hours after meals to determine how much carbohydrate your body can tolerate for meals and snacks.

Weight
Lose weight if you are overweight. Losing a small amount of weight (as little as 10–25 pounds) can make a big difference in blood sugar control.

Exercise
Perform moderate aerobic exercise at least 150 minutes/week (or 30 minutes most or all days of the week) to help control blood sugar. If able, also perform resistance exercises three times/week (not on successive days).

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