Nutrition Education: Diabetes Mellitus

What is Diabetes Mellitus

Diabetes mellitus is a medical condition where your body has high blood glucose levels (also known as blood sugar) that cannot be lowered. Your pancreas works to lower your blood sugar levels by releasing insulin. Insulin is a hormone that moves sugar out of your blood and into your cells to be used for energy. Diabetes mellitus occurs when your body either cannot make insulin or your body does not use insulin well leading to sugar staying in your blood.

Diabetes impacts roughly 38.4 million people within the United States, which is approximately 11.6%. Of those with diabetes, 1 in 5 will not know they are diabetic. The CDC also estimates 97.6 million American adults, or 29.5% of the US population, are pre-diabetic, which is high blood sugar levels that can progress to diabetes.

Types of Diabetes

Type 1 Diabetes

This type of diabetes is when your body makes little to no insulin. This type occurs after your immune system destroys the cells in your pancreas that make insulin. This type of diabetes is genetic and is usually diagnosed before the age 18.

Type 2 Diabetes

This type of diabetes occurs when your cells cannot use insulin produced by your pancreas well. It is the most common type of diabetes and occurs when your body builds up a tolerance to insulin. This type of diabetes is the most common and accounts for 95% of diabetes cases.

Pre-Diabetes

This type of diabetes is when your blood sugar is usually higher than normal but not high enough for type 2 diabetes. You do have a high risk of developing type 2 diabetes in the future.

Gestational Diabetes

This type of diabetes occurs during pregnancy when hormones from the placenta prevent insulin from fully working. Usually, this diabetes will resolve after the baby's birth, but the mother may be at an increased risk of developing type 2 diabetes. Sometimes the diabetes may continue on after pregnancy

ABCs of Diabetes

A

A1C

A1C is the short term for hemoglobin A1C (Hgb A1C). Hemoglobin (Hgb) is the molecule in red blood cells that lets them move oxygen and carbon dioxide throughout the body. If your blood sugar is high, the sugar may stick to the hemoglobin, which we call a hemoglobin A1C. The blood test will be measured as a percent to say what percent of your Hgb has a sugar attached to it. Red blood cells recycle in the body ~3 months so we measure the A1C levels as a 3 month average to see how much sugar stuck to your Hgb.

The goal for HbgA1C is to be less than 7% and to be checked twice to four times yearly but check in with your doctor to set a personal goal.

B

Blood Pressure

Blood pressure is the measure of pressure inside your arteries. When measured, you will get two numbers. One will be for the pressure when the heart beats (systolic) and one will be for when the heart rests (diastolic).

Too high of a blood pressure (also called hypertension) can cause damage to your blood vessels leading to risk of stroke, heart disease, or kidney disease.

The goal for blood pressure is to be less than 140/90 mmHg.

C

Cholesterol

Cholesterol refers to fat in your blood. There is LDL which is bad cholesterol as it will lead to heart and artery diseases. There is also HDL which is good cholesterol as it cleans up LDL.

The goal for LDL is to be less than 100 if you don't have heart disease or less than 70 if you do. The goal for HDL is to be higher than 40 for men and 50 for women.

Nutrition for Diabetes Mellitus

Eat at least 3 times per day: Breakfast, Lunch, and Dinner
Make sure to check your blood sugar when working out (and to eat a snack too)
Eat a balanced plate
Eat the same amount of food day to day
Avoid sugar-sweetened drinks and alcohol
Include healthy fats, protein, and fiber with every meal
Keep carbohydrates (sugars) to a fourth of your plate
- Foods with carbohydrates include items like grains like rice and bread, starches like potatoes and corn, dairy like milk, sweets like juice

Monitoring Diabetes Mellitus

When checking your blood glucose, you ideal want your levels to be:

80 to 130 mg/dL before meals
less than 180 mg/dL 2 hours after a meal

If your blood sugar levels become lower than 80 mg/dL, you will experience symptoms of hypoglycemia and may need to eat something with sugar (like a piece of candy).

If your blood sugar levels are higher than 180 mg/dL, you may experience symptoms of hyperglycemia. If this happens often, you may need to change your eating patterns, medications, or exercise routines.

Long term hyperglycemia can cause issues with your kidneys (nephropathy), nerves (neuropathy), and eyes (retinopathy). Diabetes also slows your ability to heal from injury so you will also need to monitor your feet for unhealing wounds.

Client Handout

NIH Diabetes Diet, Eating, and Exercise

American Diabetes Association

References

Diabetes Overview - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Published February 27, 2024. Accessed March 27, 2024. https://www.niddk.nih.gov/health-information/diabetes/overview
Eating Well & Managing Diabetes | ADA. Accessed March 27, 2024. https://diabetes.org/food-nutrition/eating-healthy
Overview - Nutrition Care Manual. Accessed March 27, 2024. https://www.nutritioncaremanual.org/topic.cfm?ncm_category_id=1&lv1=5517&lv2=274760&lv3=274761&ncm_toc_id=274761&ncm_heading=Nutrition%20Care
CDC. What is Diabetes? Centers for Disease Control and Prevention. Published September 5, 2023. Accessed March 27, 2024. https://www.cdc.gov/diabetes/basics/diabetes.html

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