Recent Diabetes Diagnosis, What Should I Eat?

Transcript:

LEAH: Welcome to Dishing Up Nutrition brought to you by Nutritional Weight and Wellness. As a dietitian over the years, I have had new clients who make appointments with me and they come in because they recently received blood tests from their doctor that showed or informed them that they are now either prediabetic or possibly even diabetic. And for many people, that number on the paper serves as a stimulus or something as a motivator that something needs to change and what they're doing with their lifestyle. So as again, as a dietitian, when people come in to see me, the biggest question that they have typically is okay, now, “What should I be eating for my blood sugar for my diabetes, for my prediabetes.” So today, Nikki and I are going to answer those very same questions. So we're going to break it down for you and talk about the foods to eat that are helpful, and the foods to try to avoid or not to eat that are harmful for blood sugar control.

So my name is Leah Kleinschrodt. I'm a Registered and Licensed Dietitian. And joining me in this discussion today is Nikki Doering, who is also a Registered and Licensed Dietitian. Nikki and I both see clients at Nutritional Weight and Wellness, and we help many clients who are prediabetic or diabetic change their eating habits to take charge of their blood sugar. And Nikki and I also both have some personal stories of our own about blood sugar control and diabetes. So we want to take a little bit of time throughout our hour here together today to just share some of our personal experiences.

NIKKI: That is so true, Leah. Good morning.

LEAH: Good morning.

NIKKI: Good morning, listeners. Listeners, I have a question for you. Is giving up sugar such as breads, pizza, pasta, crackers, and all of those high sugar foods easy? Of course it's not. I mean, we know that. It's because sugar makes just about anything taste good. So what makes it hard to give it up. At Nutritional Weight and Wellness, we encourage clients who are prediabetic or diabetic to first change their mindset about food. We ask them to do this by preparing their mind and find their motivation. When working with clients, we often ask, what do you want to accomplish with our appointment? Or maybe what is your goal? What is your motivation to give up some of your favorite foods or possibly your favorite foods, particularly if some of your favorite foods are those high sugar foods? So today's topic: diabetes. It's a big one.

LEAH: Yep.

NIKKI: And it affects, I believe all of us. I think some of us have diabetes. Some of us are affected because we have a loved one or a friend, or we've heard about it a lot in the news. It's, I think everyone can say, yes, I've heard about it or know about diabetes. Even for me, I had gestational diabetes when I was pregnant with my son, and knowing now what I know really is critical and crucial for my blood sugar control. And I've learned that eating real food is a huge component of that blood sugar balance.

LEAH: Yeah. So, yes, Nikki, we definitely want to hear a little bit more about your personal journey and experiences and what you learned about that importance of controlling blood sugar, especially during your pregnancy. And I also wanted to point out some of those foods that you mentioned before. We call them high sugar foods. But I would say a lot of people don't think about some of these foods as being high sugar. So you mentioned bread. You know, when was the last time you thought that bread was a sugary or high sugar food; or pizza or crackers and things like that? So maybe like some of the listeners ears are burning right now. Like I haven't heard you mention things like candy or cookies or anything like that. All you've said is pizza and bread.

NIKKI: Yes.

LEAH: Yeah. So for some people, you know, that, you know, giving up sugar or even trying to cut back on those high sugar foods is sometimes almost like giving up your best friend or, or almost kind of giving up on a relationship that you've had for a really long time. And maybe, you know, there may be some listeners out there that get a high even from eating a handful of Skittles or drinking that morning coffee mocha that has those pumps of high fructose corn syrup syrups in them.

So if you are one of those people, it, it may really be very challenging to start trying to, again, either cut back or eliminate these foods altogether, at least for the first couple of weeks. And Nikki, you and I were talking about this as we were preparing for the show, that, you know, giving it up initially can definitely be hard. But with each day that passes, it becomes easier to be free of the sugar and free of the processed carbohydrates. And from what I've noticed in counseling clients is one of the best parts is, is that you don't have to A: be perfect or B: do this for months on end before you even seeing little results. Like it's even within days, three to four days, you can really notice a huge difference in your energy levels, in your pain levels, in your moods, in your sleep, because blood sugar is something that changes so quickly based on the foods that we choose day in and day out, that we can make a ton of headway and you can feel so much better so quickly just because those blood sugars change so rapidly.

NIKKI: Yes, I would a hundred percent agree with everything you just said, Leah. It doesn't, you don't have, perfection is not what we ask and it, it can happen rather quickly. So now I want people to think about this. What is your personal motivation to be free of sugar and processed carbs? Like I mentioned earlier, I had gestational diabetes. So my big motivation is to prevent prediabetes and heal my insulin resistance and to prevent type two diabetes in the future. That's my motivation.

Perhaps our listeners want to avoid maybe a foot infection like their grandfather or grandmother may have experienced because those infections can occur with those advanced diabetes diagnosis. Or maybe someone listening wants to avoid becoming blind from the damaging effects of high blood sugars. I used to work at a clinic years ago, an eye clinic I should mention. And, that is actually where I learned about how diabetes damages the eye. This was before I was even a dietitian. So I had no idea and the doctors would show the images of the eyes and they would say, “Oh yeah, right here is the damage to the blood vascular systems of the eye.” And it was just, and that damage happened because of the high blood sugars. So it was kind of a cool visual and it stuck with me even today as a dietitian. I, I had no idea.

LEAH: Yeah. They, well, it made a big impact on you. And probably when you, again, when you can see some of that damage, it's a powerful reminder to the clients or patients themselves too like, “Oh, this is something that I need to take seriously.”

NIKKI: Exactly. And they could actually say, go to your doctor, because I believe you have blood sugar issues or diabetes.

LEAH: Absolutely.

NIKKI: So the other thing too, that people might want to avoid is memory loss or Alzheimer's disease, which maybe they read about in a research article. So all things that you want to kind of avoid that diabetes diagnosis and high blood sugars.

LEAH: Yep. So here is just a little bit more interesting information kind of building on what Nikki just said. So there was an article that was published in May of 2020. So just a little over a year ago now. And the title of this article was Type 3 Diabetes and its Role Implications in Alzheimer's Disease. So I wanted to just read a couple of sentences to you from the abstract of the paper. So if anybody is familiar with reading research papers, usually there's a little summary at the beginning of that paper. They call it the abstract. And so we're just going to take a couple, a couple of quotes from that abstract there. And what this abstract said is “The exact connection between Alzheimer's and type two diabetes is still in debate. However, poorly controlled blood sugar may increase the risk of developing Alzheimer's. And this relationship is so strong that some have called Alzheimer's diabetes of the brain or type three diabetes.”

NIKKI: So that might be new for listeners hearing wow, there's diabetes type three. I mean, I've heard of other types. We mentioned gestational diabetes earlier. So I thought this was a perfect opportunity to just talk a little bit about the different types of diabetes. So, type one diabetes is when your body doesn't produce enough insulin on its own because of damage to the pancreas. Insulin comes from the pancreas. And so people that have type one diabetes need to have insulin to live.

LEAH: Right. They require that insulin. No question.

NIKKI: Exactly. Now type two diabetes is a little different. It's more of a progressive long-term type of diabetes. And it happens when we're eating maybe too many excess sugar, too much processed carbs, and it causes the pancreas to produce too much insulin, then which coats the cells and limits the delivery of that sugar into the cell for energy. And then that damages the cell. And then over time that can become type two diabetes. And I think that's a perfect time to take a break.

LEAH: Yeah. So we revisit that kind of discussion when we get back on the other side of our break. So you are listening to Dishing Up Nutrition, brought to you by Nutritional Weight and Wellness. And if you have a family member who has prediabetes or type two diabetes, or you yourself have these diagnoses and you're puzzled over what to eat, this is the show for you that will give you some ideas about foods that increase blood sugar and foods to help lower and stabilize those blood sugars. And we'll be right back.

BREAK

NIKKI: Welcome back to Dishing Up Nutrition. Almost 50% of adults in the U.S. are either diabetic or prediabetic. To understand what foods increase the risk of developing prediabetes or type two diabetes, I suggest taking in one of our online courses. It's called Reducing the Risk of Prediabetes and Type 2 Diabetes; perfect topic for that goes along with her show today. From now until August 31st, you can take this class for only $10. So call 651-699-3438 to take advantage of this great class and this great offer. Invest an hour, only an hour of your time to really understand the power of real food.

So before break, we were talking about the types of diabetes. So we talked about one diabetes, type two, kind of how prediabetes and insulin resistance goes, develops into type two diabetes.

LEAH: Yep.

NIKKI: And there's one other diabetes that I wanted to mention was gestational diabetes. So it was something I mentioned earlier that I had with when I was pregnant with my son and this one really occurs later, well, not later in pregnancy, but mid-ish later of pregnancy. So after week 20, usually you're tested. I can't even remember; around week 25 or 26 of pregnancy. And, it usually occurs because of some kind of insulin resistance. For me it was an interesting story because I was totally adverse to sugar for the first time in my life. I was like, I don't even want to look at sugar. I don't want to look at breads, pastas. Even fruit made my stomach turn. So it was kind of shocking when I got the diagnosis.

LEAH: I’m sure.

NIKKI: And, my thought is, it was developed because of how I was eating prior to my pregnancy. I had that insulin resistance from eating low fat for years. As a dietitian and eating, you know, portion sized high sugar foods like gummy bears. And then as a teenager, I was drinking a lot of soda and a lot of processed foods. So I think that led to that gestational diabetes. It typically goes away at the end of your pregnancy, which mine did. It was gone. And, but did that insulin resistance go away? No, I still had that and I still deal with that today. So those are the types of diabetes, you know, that there's several types is basically where we're going with that.

LEAH: Yeah, absolutely.

NIKKI: So back to type two diabetes. So it, again, it doesn't happen overnight. It is a slow progressive condition. And like we mentioned, it's, you know, insulin resistance kind of goes into prediabetes kind of goes into type two diabetes. And that process can take years. And usually it comes from eating too many processed carbs or high sugar foods for a really long time.

Here's an example of a high sugar breakfast. And this breakfast that I'm about to talk about is classic Nikki in middle school and high school. I mean, this was like, oh yeah, I've, that sounds like what I ate. So a big bowl of breakfast cereal, maybe one and a half or two cups with skim milk poured on top, a little sugar sprinkled on top for of course, you know, flavor.

LEAH: Yep.

NIKKI: And along with maybe a slice of toast and a glass of orange juice. If you have just, so if you ate that breakfast, you just consumed about 160 grams of carbs and a breakfast really should not contain more than 30 grams of carbs. So you can kind of see we're going from 160, and really we should only be eating 30.

LEAH: That's a wide…

NIKKI: A wide birth.

LEAH: Exactly.

NIKKI: When your body converts that 160 of carbs into glucose, your body has about 40 teaspoons of glucose or sugar to deal with. And your body may only be able to manage about a quarter of that amount at one time. So we're talking about maybe 10 teaspoons and perhaps even less. I know that we really kind of say less is better. So rather than 160 grams of carbs, let's try and do 30 grams of carbs, which would be a lot easier to manage your blood sugars with that amount of carbs. And how we're getting that number, that how are you getting carbs to teaspoons of sugar? We're just taking four grams of carbs, which you can get out on a food label and dividing it, dividing that number, like the 160 by four. And that equals teaspoons. So that's where we got the teaspoons. So four grams of carbs equals one teaspoon of sugar.

LEAH: Yep, exactly. So, so let's break that down even a little bit more, Nikki where okay; if we, we had this high sugar breakfast that was the cereal, the skim milk, maybe some sugar sprinkled on top of that, the toast, the, the orange juice, again, very high carbohydrate, high sugar breakfast there; 160 grams of carbs.

So what does 30 grams of carbohydrate look like? So let's just do a quick example of that. What would be a better breakfast example? So something, a better breakfast example that would fit in that 30 grams of carbs would be, you know, either a couple of eggs and some sausage or some sausage links. And so again, that's protein; getting very little carbohydrate from there. We do want color, colorful carbohydrates. We want our, our vegetable carbohydrates still to come in there because they're very nutrient rich; very fiber rich. And so say if you did those sausage links with a cup of shredded cabbage, and something like that, that would be about four grams of carbohydrates. Again, you get a lot of cabbage for very little carbohydrate, and then you can round out the carbohydrate amount with about half a cup of mashed sweet potatoes. Or if you, maybe if you had grilled or roasted some red baked potatoes, you know, the night before, having a half a cup of that will get you somewhere in the ballpark of 20 to 25 grams of carbohydrates. So if you did that, you know, a cup of cabbage and about a half a cup of some kind of starch, like those potatoes, that'll get you right in that ballpark of 30 grams of carbohydrates.

NIKKI: Really yummy.

LEAH: Yep, very yummy, delicious; who doesn't love a little sausage in the morning? And you sauté all of that, you know, maybe sauté that cabbage with some butter or some olive oil just to get those, those stabilizing fats in there. But that's the kind of breakfast that's going to give you an energy boost in the morning, but not crash you an hour or two later.

NIKKI: Yep, your brain will be happy.

LEAH: Absolutely. And so it is a fact that high sugar or high glucose levels in your blood cause problems for many different parts of your body. Nikki, you mentioned a couple of those before. Your eyes being one of those, your brain, you just mentioned that, your heart, your kidneys, especially because these areas in the body have little tiny blood vessels in them that you, sometimes you can only see even like microscopically or with really advanced technology. But it's these little tiny blood vessels that when sugar kind of gets out of control, these are the ones that tend to sustain most of the damage from that high blood sugar.

So over time, the stress from that high carbohydrate eating, that high sugar, eating causes things like kidney failure to set in. And then, you know, long-term if that continues to progress, then we're talking about kidney dialysis is going to be needed eventually to support that kidney function. So think about all of those future health problems you could have if you choose to continue eating some of these high sugar foods, that, you know, that's eventually what ended up being the cause of the prediabetes and type two diabetes. Well, eventually it causes some of those organs to whittle away as well.

NIKKI: Yes. And I think this is a perfect time to kind of explain insulin. And so insulin's job; it's a hormone in our body and it, what it does is carry that sugar into the cell. So that's what we talk about the blood sugar and that insulin kind of balance.

LEAH: Yep.

NIKKI: So insulin resistance blocks the delivery of sugar into the cell resulting in less energy. So long term, when cells are deprived of glucose, sugar, it damages the cells. Even hearing loss can be one of the first indications of that damage happening, which was new for me. I, doing research for the show, it was, it was new.

LEAH: Yeah, absolutely. Well, and again, that's not one that people typically think about a lot, but maybe something like that doctors who test the ears and stuff, that's something that they, they do see. So we will pick up on our topic on the other side of break. You are listening to Dishing Up Nutrition. Many people today believe that diabetes is irreversible and people with diabetes, they're just destined to suffer ongoing and progressive decline with their health from heart disease, kidney failure, Alzheimer's disease and so forth. But it is clear from the evidence that diabetes is controllable and even reversible with nutritional lifestyle changes. So we will be talking about that topic more on the other side of break. And we’ll be right back.

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NIKKI: Welcome back to Dishing Up Nutrition. As a dietitian and someone who has struggled with sugar cravings, I realize that I personally need support maintaining a healthy, low sugar diet. I also need someone to remind me to exercise, to get eight hours of sleep, maybe to eat my lunch rather than work through my lunch and choose sparkling water over maybe that glass of wine. When I need support, I make an appointment with my nutritionist every, maybe two to three weeks, so I can avoid any of my future diabetes concerns and just keep on track. We all need that support.

So at Nutritional Weight and Wellness, we believe that getting control over your blood sugar numbers is one of the most important factors for long-term health. I highly recommend that you sign up for that online course, Reducing the Risk of Prediabetes and Type 2 Diabetes, and watch it from the comfort of your own home. I also suggest that you set up an appointment with one of the Nutritional Weight and Wellness dietitians or nutritionists, which we help our clients every day with balancing their blood sugars.

LEAH: Yup. That's one of our major foundations or major tenets. And following a plan that is designed just for you to bring your blood sugar numbers down will help you be successful. It improves your health in so many other ways. We encourage you to check with your health insurance company actually, because we're finding more and more clients have checked with their insurances and that their insurances are covering nutrition therapy or, or meeting with dietitians. So if you have questions either about insurance or what an appointment entails or, or what might be the right path for you, you can give us a call at (651) 699-3438. And remember, we do also do appointments via Zoom or via phone. So yes, even if you live far, far away from all of our twin cities offices, it's still possible to set up your appointment and to meet with one of our nutritionists and dietitians.

NIKKI: Yeah. I think I see a lot of clients with insurance coverage now. So it's so nice that they have that option.

LEAH: Yes, it's definitely been increasing over the last few years.

NIKKI: So before break, we were kind of talking about what causes, you know, what can happen if you have high blood sugars. And so, and the choices we have to make every day about the food we're eating. So it is a choice, the choice we have to make each and every day, each and every bite of food we put in our mouth. So it's our choice. Are you choosing high sugar foods or are you choosing lower carb, higher nutrient foods? Everyone, even me, knows how hard it can be to maintain a healthy diet; an eating plan low in sugar and high in nutrients, which is the exact diet to manage blood sugar levels and avoid type two diabetes. We understand that our bodies are hardwired to prefer sweets. So we must know, or we must use our intellect, we must use our brain, and our knowledge to overcome that desire for sweets.

One thing I do to stay motivated is check my own blood sugars. And that really helps me keep on track. And I learned how to check them when I had gestational diabetes. I had to check my blood sugars a lot. And now I test after certain foods I eat, because I'm curious, and to see if my numbers are high, or if they're within normal ranges. And if they're high, I avoid that food. Or I simply say next time I got to eat a smaller portion of it. So, and we'll talk a little bit more about the numbers in a little bit.

LEAH: Yeah. Well, and just to piggyback a little bit on that, Nikki, I tested my own blood sugar during my pregnancy as well. I did that for a couple of weeks in lieu of doing the typical Glucola, you know, gestational diabetes screening, you know, around like that week 26, week 28.

And yeah, I, I thought it was really interesting and maybe that's just me being a dietitian and just, again, testing those blood sugars, testing out what foods my body did well with and which carbs, especially specifically tended to spike my blood sugar. And so that is something, if the, for the listeners out there, you don't have to, you don't have to have a prescription. You don't have to have a diagnosis of diabetes to be curious, and just to go out and get a monitor and test your blood sugar and test it fasting in the morning, or test those blood sugars after meals and see what foods and, and specifically what carbohydrates your body and your blood sugar likes best. So this may come as a surprise to some of you out there, but about half of adults in the U.S. are either prediabetic or diabetic.

NIKKI: Right.

LEAH: So let's say that again: 50% of adults in the U.S. are either prediabetic or diabetic. And every 17 seconds, one American is diagnosed with diabetes. So this is, this is an alarming rate in, and as trends would say, it's not really heading in the right direction right now. The youngest person ever to develop type two diabetes was three and a half years old. And that breaks my heart a little bit, a little bit as a mama, right? I remember, and you do too, because we were talking about this, Nikki. Remember when type one diabetes used to be called juvenile onset diabetes? And then the other terminology, which is now called type two diabetes, was called adult onset diabetes. Well they had to switch that terminology, because this is a perfect example. All of a sudden we started seeing more of the type two diabetes; more of that insulin resistance-driven diabetes showing up in younger and younger populations with our teenagers and our kids.

So fortunately for this particular three and a half year old, it was caught early and they were able to make the necessary lifestyle and dietary changes to reverse or to negate some of that diabetes. But I mean, just again, just reading this and knowing that even at three and a half years old, our children are not as resilient, you know, to some of these foods as maybe sometimes we think they are. It just continues to reinforce for me as a mother that balanced eating is important across the lifespan. So starting, as our kids are starting to eat foods and continuing on until the day we die, basically, that balanced eating and eating those real whole foods and making sure our blood sugars are in check is really important for everyone's health.

So that's why, you know, I choose to try to avoid, you know, offering my child that snack sized baggie of Cheerios to nibble on throughout the day, because that's just going to be pure carbohydrates. That's going to set my son off on a blood sugar rollercoaster and he's turning three in a week. We've, we're already dealing with more, you know, more big emotions and things like that. Well, I don't need to layer on, you know, a blood sugar rollercoaster on top of that. That's kind of how I think about it. So I really make the best effort that I can. And again, not always perfect, but I make the best effort that I can to make sure that I'm offering a, you know, a balance of those macronutrients; getting some good fats in there, getting some protein into him in addition to some of those carbohydrates.

NIKKI: Yes, I can relate to that blood sugar rollercoaster in my son, who's going to be five next month. So yes, if there's too much sugar, you can tell. He’s bouncing off the walls. Maybe a little sass comes out.

LEAH: Yes. Yeah. I, when I'm teaching about blood sugars to classes or clients, and we're talking about kids, I'll, I'll even say, you know, kids wear their hearts on their sleeves a little bit more than us adults do. We kind of have some of that frontal lobe brain development that keeps our emotions and our actions in check, but kids don't have that. So, you know, for us adults, a low blood sugar just might mean that we're “hangry”, but for a kid that might mean a meltdown or a tantrum, or they're slapping their sister or brother. And that's where some of those behaviors can really start to magnify.

NIKKI: Exactly.

LEAH: Yeah.

NIKKI: So Leah, how did it happen that nearly half of the U.S. adult population has a blood sugar problem? And doing research for today's show, I actually was, you know, looking at our website and kind of stumbled upon an article that was written five years ago, so in 2016. And, it was called Preventing Diabetes: You Have the Power to Choose Wisely, and it was really great. It really walked through a lot of things. But the beginning of the article says, “Today, so in 2016, 1 in three Americans is considered to be prediabetic or diabetic. And in nine years, half are projected to be.” So we're sitting at five years and we're already at half when we were in 2016, predicting it to take nine years. So that just shows we are exponentially, you know, creating this diabetes and blood sugar issue. And we can change. We have the tools to change; real healthy food in balance.

LEAH: Yep.

NIKKI: So why is it going so fast? It's because we love sugar. We love sweet. And because of this, we, and we mentioned earlier, our bodies are hard wired for that sweet taste. But what I find even more interesting; knowing that people, because people are drawn to sweet, the large food companies developed 56, 56 different types of sugar to add to their foods to increase sales. Certainly their foods taste good and their food is very convenient, but they're typically high in sugar and it might not be the added sugar. We're looking at carbohydrates too. So that total carbohydrates on the food label. And so it's hard to stop at just one. The more we eat, the more we want and the higher our blood sugar numbers go. And over time, like we mentioned, high blood sugars turn into eventually prediabetes and then eventually into diabetes.

And this really makes me think of those clients that come back, you know, we cut out sugar in there, you know, we lower and we start eating in balance. And they come back several months later and they've tried one of their favorite sugary foods, you know, because you treat yourself every once in a while. And they actually were like, oh goodness, “This is too sweet now. And I don't like it as much as I used to and I can stay away from it.” So it, it's hope. That's what I'm trying to give people hope is if you cut it out, it gets easier. And your taste buds change.

LEAH: Yes, absolutely. That's a great example. And I see that all the time too. Again, if people can even just stick with that for, you know, the lower sugar eating lower carbohydrate eating just even for a few weeks, it is amazing. Again, we mentioned that before, just the progress that you can make, the taste buds can change. And then, yeah. So then when you try to go back to some of those old things, or you can't, you're in a situation where you are trying one of those old foods again, it just doesn't have quite that same hold anymore, which is what we want. We want to break that strong hold that sometimes sugar can have over us. So for those of you who are listening, if you've been diagnosed with prediabetes and diabetes, again, you might be asking, what should I eat to reduce my glucose numbers?

And before we talk about food, I do want to just give us some parameters of what is normal blood sugar, and then where, where do those cutoffs come in for prediabetes and type two diabetes. So, a normal, what we would consider normal fasting glucose; so, you haven't eaten for, you know, 8, 10, 12 hours or so. Normal fasting glucose is 99 milligrams per deciliter or lower. So we want that number to be under 99. Prediabetes is between 100 to 125. And then type two diabetes is considered anything over 126. So I do want to come back and just discuss those numbers a little bit more on the other side of our third break. So hang with us.

You are listening to Dishing Up Nutrition. Did you realize the average child sees 10,000 ads for junk food on TV each year? And now with children missing so much school this past year, my guess is that that number is even a little bit more than 10,000 ads per year. The food industry spends over $13 billion marketing high sugar processed foods, and specifically to our children. And so from a very early age, children are exposed to these high sugar, overly processed foods. And as parents and grandparents who might be listening, what can you do to be a healthy role model for your children and grandchildren? We believe if you encourage cooking and eating real food at home, you will make a positive influence that will make a huge difference in your child's life. And we'll be right back.

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NIKKI: Welcome back to Dishing Up Nutrition. I'm pleased to announce that starting in September, we will be offering Nutrition for Weight Loss classes again at all six of our locations. We will be back in person teaching these classes and we look forward to seeing you there. Our September 20th class will be offered at our Maple Grove office and our new Woodbury location. There are classes scheduled in Eagan, St. Paul, Wayzata and North Oaks as well. Your nutrition educator will be wearing a mask. So we ask that you wear a mask as well, and we are limiting the number of people to provide for social distancing. So if you're interested in in-person classes, please give us a call at (651) 699-3438 to sign up and save your spot today. And I will just give a plug that many people wonder, do we have classes for diabetes? And we obviously said, talked about the hour long class, but I think Nutrition for Weight Loss is an amazing class to help anyone that's struggling with their blood sugars. So prediabetes diagnosis, type two diabetes diagnosis, or if you think that you might have insulin resistance. It's a wonderful class.

LEAH: Yes, absolutely. I whole heartedly agree with that. I can't tell you the number of times I've either had clients who are taking that series or the series I've been teaching that series, and I've heard clients talking about, you know, yes, they have type two diabetes or they're already on medications and things like that, that either they've reduced their medications or their blood sugars have normalized and such great success stories. And I mean, we have whole classes within that series that are dedicated to blood sugar balance and insulin resistance and going through those topics. So yes, it's a wonderful class for blood sugar control.

NIKKI: So if you have diabetes or if you have a friend or family member that has diabetes, grab them and take it together. Partnership is always great.

LEAH: Yes, absolutely. All right. So before we went to break, I was giving us, giving us our listeners here just some numbers of, okay, what are those parameters of what is normal versus abnormal blood glucose look like? So I just wanted to run through those numbers again, one more time, very quickly. Normal fasting glucose is 99 milligrams per deciliter or lower. And when I'm counseling my clients, I often say too like, I don't even really want you flirting with the high end of that range. You know, when we see 98 or 97 numbers, yes, you're considered normal, but that's still probably a little too high for what we want. So ideally I like to say to my clients, we're aiming for maybe 70, the eighties or the low, low nineties; somewhere in there. Now prediabetes is considered 100 to 125 milligrams per deciliter, and then anything over 126 milligrams per deciliter is, is type two diabetes.

And just, I know Nikki has shared a little bit about her personal story. My personal experience with some of this is actually, gosh, I was thinking back. It's probably about 12 years ago now. I had, a couple of years, I did my physical and I had two years in a row where my blood sugar numbers were floating in that prediabetic range. You know, they weren't at the 125, but they were definitely over a hundred. I think I was around 105, 107. That was two years in a row. And my provider at the time actually put me on Metformin for a little while. So Metformin is one of those kind of primary, first lines of defense type of medications to lower blood sugars. But I thinking about that now, thinking back, I absolutely know where those high blood sugar numbers were coming from. I know at that time I was the low fat, no fat queen of everything like everything, I was going for everything that had that low fat or reduced fat or no fat label on there. And I was eating a decent amount of protein, but when you cut that fat out, then you're probably making up a lot of that missing fat with extra carbohydrates too. And without that balancing effect of the fat, I know absolutely that those were affecting my blood sugars and it was starting to show up in my lab work in my early twenties.

NIKKI: Wow. Yeah, that's a great story, Leah. And I think a lot of people can relate to that. And I also think, hey, it happens to us dietitians too. So…

LEAH: Absolutely.

NIKKI: So if you're looking at another lab number that your doctor might give you on your lab report, hemoglobin A1C, that's a number which is the average blood sugar number over three months. So normal hemoglobin A1C is 5.7% or below. So that comes in a percentage. Prediabetes A1C is 5.7 to 6.4%. And then the diabetic range of hemoglobin A1C is over 6.5%. So here's an example for you. If your fasting blood glucose number is 123, it indicates that you are prediabetic. So you need to make changes now, like Leah was mentioning, in your diet. And so Leah, let's talk a little bit about maybe the best food choices to lower that number.

LEAH: Yeah, a lot of our longtime listeners will know, we talk about the three main macronutrients. We talk about our fats, our proteins, our carbohydrates, or we sometimes we call them our PFC. So we know that fats; let's start with those fats, like butter, olive oil, bacon grease, avocado oil, and other good fats. They do not have an effect on our blood sugar. In fact, they, so they do not raise our glucose number. They actually keep our blood glucose stabilized in a good place. So I would encourage you to start thinking about with your meals, start choosing those good fats and incorporating a tablespoon of some of those good natural fats. And so we gave some examples of things like butter, olive oil, avocado oil; that would be about a tablespoon. Otherwise about a half of an avocado is about the equivalent of a tablespoon of oil or butter. And same thing; about two tablespoons of peanut butter or almond butter. Those nut butters, that'll get you right in that same ballpark. So we want good fats to anchor those blood sugars.

We want some protein in there. Protein affects the blood sugar a little bit, but usually not very much. So adding three to four ounces of some meat, fish, eggs; add that to the fat. So maybe that's a couple of eggs, those two ounces of pork or turkey sausage that we mentioned earlier.

And then we have our carbohydrates. So all carbohydrates do break down into sugar in the body, but some do so more than others and some do so faster than others. So our vegetables or the things that we pull out of the ground tend to have a much lower effect on our blood sugar. So if we combine say some of that sausage and had cooked that up in some butter, put some green beans on that plate and maybe a half a cup of carrots or a half a cup of black beans or half a cup of some of those leftover roasted potatoes. That's just enough to give you that normal blood sugar. Again, give you that little boost in energy, bump up that blood sugar just a little bit, but not too much so that you're spiking blood sugar or that you're crashing later on.

NIKKI: So listeners, the food is really important. Obviously we're just going on about that. But another important part of this blood sugar control is timing of when you eat. So if you develop a mindset that every three hours you will eat, just like Leah had described; the protein, the healthy fats, a little bit of carb, vegetable carb, a little starch. And you eat, you know, the tablespoon of natural, good fat, the three to four ounces of proteins, vegetables. You will see your high fasting blood glucose sugar level come back down to the normal range. And we've seen that clinically over and over and over again.

LEAH: Yep, clinically and in those classes. Yep, absolutely. Lots of clients notice their blood sugar start to normalize. All right; well, Nikki, this is a huge topic. We could talk about this for three more hours, but unfortunately we don't have the time to do that. We'll have to do another show. So for our listeners, our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. It's a simple, but yet powerful message that eating real food is life changing. Thank you for joining us and have a fabulous day.