FALLS CHURCH, Va. — Good nutrition is important for any healthy lifestyle, but for diabetics balancing nutrition, activity and medication is vital. Carbohydrates, for example, are nutrients found in bread, milk, starchy vegetables and fruit that turn to sugar in the blood. Other simple carbohydrates found in sweets and sugared drinks are the first to limit when monitoring weight and blood sugar. A person diagnosed with diabetes is lacking insulin or is insulin resistant so that the body can’t process these sugars normally.

“It’s paramount to change nutrition to manage diabetes,” said Air Force 1st Lt. Abigail Schutz, the Chief of Clinical Dietetics at Joint-Base Elmendorf-Richardson, Alaska. “The body responds well to decreasing total carbohydrates intake for blood sugar management.  We also talk about pairing carbs with nutrients such as fiber or protein to control the rate of sugar going into the blood.”

Schutz said while she handles a lot of patients dealing with an initial diagnosis of diabetes, she also handles cases where people were initially diagnosed, and did not make the appropriate changes or need a review of the most current recommendations for diabetes management.

“There’s still a stigma against diabetes. It’s super common but people still want to hide it or feel ashamed by it,” Schutz said. “It can be managed very easily with some education, and I do think it’s important to encourage folks to seek help.”

Schutz said people tend not to know how the disease works and they go into denial about the need for behavior change. Her role, and the role of other dietitians, is to help clarify all of that.

For example, reading food labels is pretty important to diabetics and there are changes coming from the Food and Drug Administration to highlight different aspects of the food label. They’re adding a new section for “added sugars” so consumers will know how much of their calorie intake is being taken up by sugar.  This specific label change will help eliminate confusion.  In addition Vitamin D and Potassium will be listed. Vitamins A and C will no longer be required on the nutrition label. She said Vitamin D is something many people are deficient in and the identification of potassium on labeling is helpful for people that experience renal issues; which 40% of diabetics suffer from.

Some of the other changes include more realistic serving sizes based on what people are actually eating.  Larger and bolder fonts for the more important parts of the label like the calorie label and serving size will make it easier for clients to read.

“Label reading is huge in terms of education, especially for somebody dosing insulin,” Schutz said. “Insulin is dosed based on the carbohydrate load, and the ratio is crucial for Type 1 Diabetics. They don’t produce insulin, so they have to count their carbs.”  Folks with Type 2 Diabetes also can learn to carbohydrate count for better blood sugar control along with adequate activity and lifestyle changes such a stress management techniques.

She said behavior changes might take an appointment or two, but eventually a healthier lifestyle becomes second nature for people.

“Carbs are essential for the body to function. It’s a very common misconception that with diabetes you have to avoid carbohydrates, but actually our goal is just to make it consistent throughout the day. There are no “bad” foods or nutrients.  Many times, if you want a food, you can have it. Just reduce the portion size.”

Schutz said behavior change can be hard in any circumstance but seeing a dietitian is the right call.

“People get diagnosed with diabetes and think their life is over. But that education piece of what this looks like and how it can be managed is really important for quality of life,” she said. “Work with goals that are reasonable and doable or the disease never gets managed. Design behavior around those things.”

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