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Susan B. Dopart, M.S., R.D., C.D.E. Headshot

Diabetes Prevention: Love Carbs? 6 Steps To Avoid Diabetes

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As a registered dietitian, I often hear, "I've never met a carbohydrate I didn't like!" I can certainly understand the sentiment. Carbohydrates are everywhere, easily accessible, and made into tasty treats. At the same time, carbs can play a precarious role when it comes to diabetes, wreaking havoc on your blood sugar with potentially serious results.

Without having to "break up with carbohydrates" as one of my clients put it, how can you avoid becoming diabetic or better control your blood sugars if you are diabetic?

1. Read labels or choose foods without labels.
If you pick up an apple or some green beans you won't find a label. Herein lies the clue that you are consuming a healthy, unprocessed form of carbohydrate. Fruits and vegetables have built in fiber that delays the absorption of their sugar. This prevents an insulin spike, followed by a drop, which creates cravings for more carbohydrates or food.

If you choose a carbohydrate with a label, look at how many total carbohydrates are in a serving. The American Diabetes Association uses 15 grams of carbohydrate as one serving of carbohydrate. This is equal to a slice of bread. With this comparison, you can look at how many total carbohydrates are in a particular food, or how many slices of bread worth of carbohydrate you are consuming.

For example, a typical container of juice can be marked for two servings with each serving having 35 grams of carbohydrate. That's equivalent to more than four slices of bread -- without the benefit of the fiber.

2. Squash it! Substitute veggies for starchy carbs.
Most people can name the obvious starchy carbs -- potatoes, rice, pasta, cereal, bread, etc. Even in a less processed, high fiber form (whole grain pastas, breads, etc.) they still contain significant amounts of carbohydrates that can increase blood sugars.

Here are some healthy, nutritious, and satisfying substitutes that will result in fewer spikes to your blood sugar:

• Spaghetti Squash: This yellow squash is easy to prepare and substitutes nicely for pasta. Sprinkle with some parmesan cheese and enjoy with your favorite protein or meatballs and tomato sauce.
• Eggplant: This squash is underused and tastes great as a substitute for noodles in lasagna or in any vegetable dish. Eggplant can also be diced and sautéed with Indian spices for a meat-like side dish.
• Portobello Mushrooms: These mushrooms can be used as a pizza crust (scoop out insides and bake slightly before adding pizza toppings) or as a holder for any protein dish or hearty vegetable side.
• Butternut, Acorn, Delicata or Tahitian Squash: These squashes make great substitutes for potatoes and can be mashed or baked.

3. Increase your activity and move your body.
A landmark study in 2002 showed that even a 30-minute walk or other form of exercise per day can result in a 58 percent decrease in the incidence of diabetes. Activity and exercise have a powerful effect on normalizing blood sugars. Even if you never lost a pound from exercise, the internal changes have powerful benefits.

4. Increase protein and good fats...especially at breakfast.
Protein is not as alluring as carbohydrates, but it has a profound effect on blood sugars. Protein evens out your blood sugars and increases energy and satiety to make you feel full.

Eating more protein and a moderate amount of carbohydrate from unprocessed sources for breakfast sets a good blood sugar tone for the day. If you eat a large bowl of cereal with fruit, your blood sugars go up, spiking your insulin levels and resulting in a large drop. This is followed by a craving for more food and more carbohydrate along with less energy for the rest of the day. It's as if the blood sugars won the race instead of you.

A higher protein option might be cottage cheese topped with fruit and sliced almonds and cinnamon. It has protein, some healthy carbohydrate, and fat.

5. Eat regular, balanced meals.
Here's a phrase that has been way overused. But what does it really mean? Let's break it down to an easy formula:

• Eat within an hour of waking since you've been fasting overnight.
• Don't go more than four hours without food to keep your blood sugar and your metabolism even.
• Choose protein at each meal along with a healthy, unprocessed form of carbohydrate and some healthy fat. Do the same at snack time.

6. Regularly check your blood sugars.
If you're not diabetic, you may be scratching your head on this one. However, if you suspect you have diabetes, or have type 2 diabetes, this is one you don't want to ignore.

Checking your blood sugars first thing in the morning can show you how your body responded to the food you ate on the previous day. Below 95 is ideal. If your morning blood sugar is over 100, you could be diabetic or pre-diabetic.

Checking your blood sugars two hours after a meal shows you how your body responded to the meal. Less than 126 is the number to achieve. My most successful clients -- those who avoided diabetes or avoided the long-term effects of diabetes -- were diligent about checking their sugars. Most pharmacies carry several types of glucometers which are more user friendly than in the past and can impart power in a way no medical professional ever could.

Seem like a lot to do? Start with small reasonable changes. Eat a high-protein breakfast for a few weeks and slowly increase your walks. Small changes cause noticeable results in the body.

The diabetic epidemic is rising, but you can avoid becoming a statistic. A few lifestyle changes can mean a healthier you in 2011.

Susan is the author of "A Recipe for Life by the Doctor's Dietitian." For more information, visit

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