Elaine’s shelves were lined with books celebrating the art of cooking and eating: “Marcella’s Italian Kitchen,” “Silver Palate Cookbook” and “Patricia Wells at Home in Provence.” When she learned she had diabetes, her initial reaction was despair. “How can I live the way I want to live on a diabetic diet?” she thought to herself.

Diabetes basically is an abnormality in the way the body produces or uses insulin, a hormone needed to convert carbohydrates into energy. People with type 1 diabetes (and some with type 2) are unable to produce insulin and are dependent on regular injections, which must be coordinated carefully with food that is eaten, particularly carbohydrates.

How well you manage the disease depends on what you eat, how much and even the timing of meals. Doctors in the past, in an effort to control the patient’s blood sugar, make stringent demands. And a few patients, such as Elaine’s mother, were able and willing to follow them.

Elaine learned the diabetic diet she feared no longer exists. While a newly-diagnosed diabetic must make lifestyle changes and learn to be aware of food choices, the strict rules of the past have been replaced with flexible guidelines tailored to the patients tastes and cultural preferences. No foods — even sweets — are forbidden.

The majority of diabetics, like the majority of Americans, die of cardiovascular-related diseases. So nutritional guidelines for diabetes are similar to those recommended for healthy living, focusing on weight control and maintaining healthy levels of cholesterol.

For years, a heart-healthy diet was identified as simply low fat, but doctors know now it’s more a matter of distinguishing between good fats and bad fats. Fats to be avoided are saturated fats (from animal products) and trans fatty acids (a highly processed vegetable oil used mainly for commercial baked goods and fast foods).

Doctors usually recommend diabetics get no more than 10 percent of their calories from saturated and trans fats and less than 300 milligrams a day of cholesterol, a goal that can be accomplished mainly through limiting your intake of fatty meats, fried foods and high-fat dairy products.

Monounsaturated fats (from olive oil, canola oil, nuts) and some polyunsaturated fats may actually lower cholesterol if used as substitutes for less healthy fats. And fatty fish are high in beneficial omega-3 fatty acids.

In 1994, when it officially ended the prohibition against concentrated sweets, the American Diabetes Associa-tion recommended a more flexible approach to nutrition therapy. What a diabetic needs is not a one-size-fits-all formula for meal plans but instead a rather dramatic change in lifestyle and behavior.

It’s crucial for the patient to monitor blood sugar levels and keep them under tight control. This in turn requires greater understanding of foods and their potential effect on blood sugar, blood pressure, cholesterol and weight.

Elaine learned the cookbooks she loved could continue to guide her in getting maximum enjoyment from every meal.



Rupp is information and assistance case manager with the Northern Oklahoma Development Authority Area Agency on Aging.