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Old 02-12-2012, 04:05 AM   #1
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Borderline Diabetes--diet changes?

My dad's bloodwork came back borderline diabetes. He is a heart patient as well--congestive heart failure. The lab tech told him he doesn't have be rechecked (grrr), I will be calling the doc on that Monday. He was told just to not eat white bread, rice, and potatoes (which he doesn't eat). In Canada, a lab tech would not be the one to advise the person...my dad has a sugar issue--eats lots of cookies, chocolate bars, ice cream with frosting on it, etc. Because he doesn't know how to cook, he also makes a lot of pre-packaged pasta dishes (Mac-n-cheese, etc.). I know a lot of folks here are both heart patients and diabetic/borderline. Could you please help me out re: how to revamp his diet? He is my mom's primary caregiver--if something happens re: his health, it will affect my mom. My brother and I both live about 1400 miles away, this is not easy and our mom can't cook/prepare meals anymore.

Thanks.
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Old 02-12-2012, 04:27 AM   #2
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The definition of diabetes has been changing. It is possible that based on his age and overall health this is not the major concern. I will be surprised if his doctor does not retest in three months.

Increasing fiber, reducing concentrated sweets, alcohol and carbs in general. I shoot for about one third to one half of the daily requirement listed on the nutrition panel of most packaged foods.

Also some form of regular exercise such as walking.

Each persons needs can be very different. His doctor or a nutritionist should be the one to set up a program for him. If meal preparation is a real problem for them ask your doctor about meals on wheels, they offer specialized diets.
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Old 02-12-2012, 02:06 PM   #3
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What was his blood sugar and what time of day was the bloodwork drawn. You are correct, a lab tech should not be saying anything about levels or diet. I forget, how old is your Dad? You understand, you may not be able to change his diet...it's up to the doctor to recognize this and prescribe an oral medication for him.

Unless you plan on living there from now on, I really doubt you will be changing the way he eats.
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Old 02-12-2012, 02:35 PM   #4
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You've got a hard row to hoe. My husband managed to do it on diet alone, at least for now, but he was motivated to do it himself, and was only in is early 60s when diagnosed, and had me to cook it all. AND he doesn't have a sweet tooth. AND, while he has heart issues, they aren't serious.

I don't know how old your dad is, but chances are you aren't going to get him to make major changes in his diet voluntarily. If he's like many men of a certain age, he might even sort of resent having to provide his own food now that your mom is unable to do so, so will do whatever is easiest for him and what he wants.

I don't know what is affordable for your family, but one widower friend found Schwans to be a lifeline.
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Old 02-12-2012, 03:10 PM   #5
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Quote:
Originally Posted by CWS4322 View Post
He was told just to not eat white bread, rice, and potatoes (which he doesn't eat)...

...my dad has a sugar issue--eats lots of cookies, chocolate bars, ice cream with frosting on it, etc. Because he doesn't know how to cook, he also makes a lot of pre-packaged pasta dishes (Mac-n-cheese, etc.).
Before I begin I want to make it clear that I don't have diabetes, borderline, or insulin resistance so I am not speaking from experience on dealing with this issue. However I believe that the same concerns that diabetics have about diet should also concern everybody in general. I believe--although it may not be true, somebody please correct me if I'm wrong--that eating a bad diet with too many refined carbohydrates can lead to insulin problems, insulin resistance, and eventually may lead to various stages of diabetes. For this reason I think it's important that everybody should consider what their diet is doing to their blood sugar level. That is the entire basis of why I've tried to understand diet as related to diabetes. I know nothing other than what I've learned from reading on the subject.

I believe that a primary offender is consumption of overly large amounts of refined carbohydrates. This of course includes sugar and everything that contains it, and also includes bread, rice, potatoes... and to some degree pasta. (This is not an all inclusive list.) In fact I think consumption of pasta can be a big offender.

I believe that all of these foods should be restricted to a small part of dietary intake, not only on a daily basis but also on a per meal basis. These refined carbohydrates are too easy to digest--the simple starches are quickly converted to sugars which are absorbed directly into the blood stream and even in healthy people gives rise to a fast peak in blood sugar level. I believe that subjecting your system to this on a repeated basis can be harmful even to healthy people, and can cause an increasing tendency to insulin resistance and diabetes. (Somebody please correct me if I'm wrong.)

Glycemic index is an important concept, the relative degree to which various carbohydrates affect blood sugar levels, and should be addressed in management of diabetic diets. I have linked that to the Wikipedia article because I'm not sufficiently informed to explain it to others. Even healthy people should maintain their consumption of high GI foods within reason.

So I think that dad is going to have to control his consumption of sweets and should reduce pasta consumption. (I understand that pasta is worse for you the more it's cooked. This probably cannot be controlled in convenience foods.) Dad is going to have to go on a more balanced, healthier diet... or is going to have to accept the consequences. I can fully appreciate how difficult it is to switch to a healthy diet, or particularly how to influence somebody thousands of miles away and not motivated to make the change. I have absolutely no idea how to do it.

Even more troubling (and again, please correct me if I'm wrong) I understand that heart problems such as congestive heart failure can lead to circulation problems that may affect the pancreas (which produces your insulin), and diabetes can affect the heart and circulatory system. IMO not addressing or under treating congestive heart failure and diabetes or diabetic conditions can lead to an ever increasing vicious circle where each problem makes the other one worse. It's sad for those who reach this point in their physical health where these problems become serious because any mistake or lack of seriousness in addressing the problem can have fatal consequences.


One additional thing, you should verify that dad followed the pre-test instructions regarding fasting. I believe that not following the instructions can lead to erroneous results.
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Old 03-12-2012, 06:00 AM   #6
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I think the hardest thing for us has been bread. I've never been a bread fiend myself, so I just thought a slice of bread is a slice of bread. Unlike other carbs (pasta, potatoes, rice), which seem to have similar enough carb counts, slices of bread can vary extraordinarily. I swear, you can buy a loaf of bread that has enough of your carb count for an entire day, and it doesn't look that different from another slice of bread which is half your carb count for lunch (my husband is on a 30-30-60 for meals with 15 for in between snacks). Trying to find those 15-grams-carb slices of bread so he can have a sandwich for lunch? I've found two brands (luckily, one is a rye bread with good whole grains) that fill the bill.
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Old 03-12-2012, 09:50 AM   #7
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There are a few types of bread that are very high fiber. Rye is good, and sourdough, for some reason, is lower in carbs than similar white bread.

I don't eat much bread at all any more--the low carb 'breads' are horrible, kind of a sandy texture. Instead, I use whole grain crackers--great with tuna or cheese. Not really a sandwich, but close enough for me. AND I COUNT those crackers, I don't just mindlessly grab a handful (or two, or three!)

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Old 03-12-2012, 10:40 AM   #8
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About 5 years ago, I was diagnosed with borderline diabetes. Diabetes played a big part in my mom's early demise, so I am bound and determined to do whatever I can to control it. Fortunately, a few lifestyle changes have worked in getting my blood glucose levels within a normal range.

Lots of things you can eat will help. Load up on green vegetables... spinach, kale, collards, chard. And broccoli is one of the best things you can eat. I probably eat three cups of broccoli every week.

Whole grains are a good choice and help satisfy ones appetite for carbs. Oatmeal is a good carb for borderline diabetics. Just don't make it with sugar.

If your dad likes sweets, have him eat berries instead of processed cookies. They are just as easy to grab as cookies, but wild blueberries, raspberries, and strawberries aren't overly sweet and won't spike blood sugar. Avoid apples, pears, and stone fruits. They've been genetically bred over the years to have a lot of sugar.

Lean proteins will satisfy hunger without adversely affecting blood glucose levels. Fish, chicken, and lean cuts of beef are all good. Small amounts of fats in the diet are fine and go a long way to sate hunger, but the majority shouldn't come from meat and dairy. Olive, canola, and flaxseed oils have a much better lipid profile.

In short, an overall change in diet toward healthier foods will help. There really aren't any magic bullets.

I've saved the one biggest change for last: exercise. Exercise helps more than anything. Just don't overdo it. Stretching, walking, swimming, and light weight training are all good for seniors. I hate to preach about this one because I don't do enough of it myself. But I can feel the difference when I do.
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Old 03-12-2012, 10:56 AM   #9
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One of the things I would suggest is that he have at least a few sessions with a diabetes counselor. I learned so much from mine.

Sugared soft drinks and juice (especially ones like orange juice) will raise the glucose levels a lot. Apple juice is better than orange juice (as far as glucose levels are concerned), but he shouldn't overdo. Fruit is better than juice. When I drink pop I stick to diet ones.

Also, sugar-free cookies are no better for him than regular ones. It isn't just the sugar we have to look out for. The flour and other things convert into sugar in our systems. Too many people hear "diabetes" and automatically think it just means to get rid of table sugar. It is really about foods that convert into sugar in your system and learning how to regulate them.

Most diabetics, and especially borderline diabetics, can eat most of the same foods everyone else eats--we just have to do it in moderation, and we need to check our blood glucose levels to see how different foods affect us.
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Old 03-12-2012, 11:26 AM   #10
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Get your medical information from physicians and other genuine authorities. There's a great deal that a single blood sugar test cannot give you. You will want to know if his blood sugar is consistently elevated and perhaps how it responds to challenges. Do not take the lab tech's opinion as to retesting. Development of diabetes (and remember that the thresholds for diagnosis are arbitrary, and "borderline" is not to be ignored) in the presence of heart failure is significant.

"Borderline diabetes" is, in fact, an outdated term, now termed "prediabetes." Prediabetes carries its own increase in heart disease and stroke. Diabetic therapies may aggravate heart failure AND diabetes is a risk factor for heart failure. If the diabetic issue can be controlled with diet, TWO known risks can be mitigated. If diabetes develops, you may not be able to avoid the risk potential.

In other words, the deck is stacked, and everything you can do is not too much to do.
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