Managing Diabetes: Dietary Tips for Seniors with High Blood Sugar

Diabetes Recipe

Hello Doctor, my grandmother is 148 cm tall and weighs 31 kg.
She follows a lacto-vegetarian diet and has diabetes, hypertension, and hyperlipidemia, with blood sugar levels around 120-140 mg/dL.
She takes oral medications for blood sugar and blood pressure in the morning, and she also administers 16 units of long-acting insulin.
She usually consumes two cans of Original Ensure and one can of Quaker Complete diabetic formula, along with half a muffin (approximately 200 calories) and one egg in the morning.
In the afternoon, she has tofu pudding with a small amount of sugar (about 130 calories), and for dinner, she eats fruits like bananas, papayas, pears, or persimmons (approximately 60 calories).
Recently, she experienced a sudden increase in heart rate to 150 beats per minute and a spike in blood pressure to 180/78 mmHg.
I would like to ask the doctor how she can improve her condition, such as by increasing her protein intake or incorporating soy milk?

amy, 20~29 year old female. Ask Date: 2022/11/01

Dr. Li Jian reply Internal Medicine

The dietary principles for diabetes focus on a balanced diet, emphasizing the intake of foods rich in dietary fiber, such as whole grains, vegetables, and fruits.
It is important to avoid refined carbohydrate foods, such as sugar, desserts, fruit juices, honey, and sugary beverages.
Muffins are considered high-sugar, high-fat refined desserts and are not recommended for individuals with diabetes.

If a patient can base their meals on whole grains, consume at least 300 grams of vegetables daily, and choose high-quality proteins that are not fried, such as bean curd skin, bean curd, tofu, eggs, soy milk, and douhua (tofu pudding), aiming for 4 to 5 servings (approximately the size of 2 to 2.5 palms), this would be beneficial.
For snacks, they can opt for fruits or unsweetened douhua, soy milk, or steamed eggs, while also increasing fluid intake.

In addition to dietary adjustments, increasing physical activity, regularly monitoring blood glucose levels, and adhering to medication instructions from healthcare providers will likely lead to more stable symptoms of metabolic syndrome.

Reply Date: 2022/11/01

More Info

Managing diabetes, especially in seniors, requires a careful balance of diet, medication, and lifestyle choices. Your grandmother's situation, with her height of 148 cm and weight of 31 kg, indicates that she is underweight, which can complicate diabetes management. Her blood sugar levels ranging from 120-140 mg/dL, while not excessively high, still warrant attention, especially given her history of diabetes and the medications she is on, including insulin.

Dietary Management
1. Balanced Diet: A well-rounded diet is crucial for managing diabetes. Given that your grandmother is on a vegetarian diet, it is essential to ensure she gets enough protein, healthy fats, and fiber. Protein sources can include legumes, tofu, and dairy products. Incorporating a variety of vegetables can help provide necessary vitamins and minerals while also adding fiber, which is beneficial for blood sugar control.

2. Carbohydrate Monitoring: It seems that your grandmother's carbohydrate intake may be a concern. The muffin and the sweetened tofu dessert could be contributing to her blood sugar spikes. It is essential to monitor the total carbohydrate intake and consider the glycemic index (GI) of foods. Foods with a high GI can cause rapid increases in blood sugar levels. Instead of the muffin, consider whole grain options or a small serving of oatmeal, which has a lower GI.

3. Fruits: While fruits are healthy, they also contain natural sugars. Bananas, for instance, have a higher glycemic index compared to other fruits. It might be beneficial to limit high-GI fruits and focus on lower-GI options like berries or apples. Portion control is also vital; instead of a whole banana, consider half or pairing it with a source of protein or healthy fat to slow down sugar absorption.

4. Snacks: If she feels hungry between meals, encourage healthy snacks that are low in sugar and high in protein or fiber. Options could include a small handful of nuts, Greek yogurt, or vegetable sticks with hummus.

5. Hydration: Ensure she stays hydrated, primarily with water. While nutritional drinks like Ensure can be beneficial, they should not replace whole foods entirely.

Medication and Monitoring
1. Medication Review: Given her recent episode of a rapid heartbeat and high blood pressure, it is crucial to review her medications with her healthcare provider. The combination of blood sugar medications and insulin can sometimes lead to fluctuations in blood sugar levels, especially if her diet is not consistent.

2. Blood Sugar Monitoring: Regular monitoring of blood sugar levels is essential. If her levels are consistently in the 120-140 mg/dL range, it may be necessary to adjust her medication or dietary intake. Keeping a log of her blood sugar readings alongside her meals can help identify patterns and triggers.

3. Medical Consultation: Given her symptoms of a rapid heartbeat and elevated blood pressure, it is advisable to consult her healthcare provider promptly. These could be signs of underlying issues that need to be addressed, such as medication side effects or dietary imbalances.

Lifestyle Adjustments
1. Physical Activity: Encourage gentle physical activity, such as walking or chair exercises, which can help improve insulin sensitivity and overall health. However, ensure that any exercise regimen is approved by her healthcare provider, especially considering her age and health status.

2. Stress Management: Stress can significantly impact blood sugar levels. Encourage activities that promote relaxation, such as meditation, gentle yoga, or simply spending time in nature.

3. Sleep Hygiene: Ensure she has a regular sleep schedule, as poor sleep can affect blood sugar control.

In conclusion, managing diabetes in seniors requires a comprehensive approach that includes dietary adjustments, medication management, and lifestyle changes. It is crucial to work closely with healthcare providers to tailor a plan that meets your grandmother's specific needs and health conditions. Regular follow-ups and adjustments based on her response to dietary changes and medication will be key to maintaining her health and well-being.

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