Managing Early Diabetes: Nutrition Tips and Lemon Water Benefits

About diabetes?

Hello, Dietitian Tsai: Thank you for your response on September 25th.
On the day my blood sugar was high, I was feeling very fatigued (due to insomnia the night before).
Could this have caused my elevated blood sugar? The cardiologist mentioned that I am in the early stages of diabetes (with a fasting blood sugar of 130 and HbA1c of 6.4%) and that I can manage it with dietary control without medication.
May I ask Dietitian Tsai if I can drink lemon water given my condition?
Here is my daily diet: For breakfast, I have half a bowl of white rice and one serving of a vegetable (mostly okra).
For lunch, I have half a bowl of white rice and three small servings of vegetables (from a bento box).
Sometimes, I eat 8-10 pork and cabbage dumplings (each about 21 grams), with more vegetables than meat.
For dinner, I have half a bowl of white rice, half a fish (variety may vary), one serving of a vegetable (mostly sweet potato leaves, cabbage, or broccoli), and one bowl of soup (mostly radish and pork soup, ginger clam soup with about 3 pieces totaling around 30 grams, winter melon and pork soup, winter melon soup, fish soup, or shiitake mushroom meatball soup).
If I eat out, I might have half a bowl of fried rice with shredded meat, three pieces of small tofu, and ginger clam soup (about 5 small pieces totaling around 25 grams) or fish ball soup with one serving of a vegetable (mostly sweet potato leaves).
I hardly eat anything outside of my main meals, and I only occasionally eat two pieces of sugar-free biscuits when I feel extremely hungry.
Thank you for your response, Dietitian Tsai.

P.S.: I also have high blood pressure, protein in urine, gastroesophageal reflux, and indigestion.

Da Pang, 40~49 year old female. Ask Date: 2014/09/26

Dr. Cai Xiuwen reply Nutrition

Hello! For prediabetes, it is recommended to maintain a regular high-fiber, low-fat diet.
However, based on your eating habits, it seems that your breakfast and lunch often lack protein sources, which can lead to low energy levels and increased hunger during the day.
I suggest incorporating tofu into your breakfast or drinking unsweetened soy milk between meals.
Your lunch should include eggs, fish, and meat, as long-term protein deficiency can lead to malnutrition and affect your immune system.
You are consuming a lot of vegetables, which is a great habit to maintain.
When eating out, remember to avoid fried and oily foods.
Additionally, it's important to note that unsweetened cookies are simply cookies without added refined sugar, but that doesn't mean they won't affect your blood sugar levels.
Cookies are made from flour and fats, and they can still impact blood sugar after digestion.
Regarding blood sugar issues, you can generally eat any fruit, but portion control is crucial.
Sweeter fruits are not off-limits, but their intake should be moderated.
Even less sweet fruits, such as guava and lemon, contain fructose, and consuming them in excess can still affect blood sugar levels.
Drinking lemon water is fine if you use one lemon a day, but juicing multiple lemons, even without added sugar, can raise blood sugar levels.
Staying hydrated is important for your body's metabolism, so in addition to limiting lemon intake, you can drink more tea.
Factors such as fatigue, stress, insomnia, and colds can all affect blood sugar levels, so I recommend maintaining a regular lifestyle, ensuring good sleep, and engaging in appropriate exercise to help control your blood sugar.
You are currently monitoring your blood sugar regularly, which is an excellent habit.
Continuous monitoring helps you understand your blood sugar fluctuations and reminds you to pay attention to your diet and lifestyle.
You are doing very well so far; keep up the good work!
This message is from Dietitian Tsai Hsiu-Wen at Nantou Hospital, Ministry of Health and Welfare.
Wishing you health and safety!

Reply Date: 2014/09/26

More Info

Managing early diabetes effectively requires a comprehensive approach that includes dietary modifications, regular monitoring of blood glucose levels, and lifestyle changes. Your current situation, with a fasting blood sugar of 130 mg/dL and a hemoglobin A1c of 6.4%, indicates that you are in the prediabetes stage. This is a crucial time to make adjustments to prevent the progression to type 2 diabetes.

Diet and Nutrition Tips
1. Balanced Meals: Your current diet includes a good amount of vegetables, which is excellent for fiber intake. However, it seems that your meals may lack sufficient protein. Incorporating protein sources such as tofu, eggs, fish, or lean meats can help stabilize blood sugar levels and keep you feeling full longer. Aim for a balanced plate that includes carbohydrates, proteins, and healthy fats.

2. Carbohydrate Control: While rice is a staple in many diets, portion control is essential. Consider reducing the amount of white rice you consume and replacing it with whole grains like brown rice or quinoa, which have a lower glycemic index (GI) and provide more fiber.

3. Snacking Wisely: It’s good that you are mostly avoiding snacks, but if you find yourself hungry, opt for healthy snacks like nuts, seeds, or yogurt, which can provide protein and healthy fats without spiking your blood sugar.

4. Hydration: Drinking water is crucial for overall health and can aid in digestion. While drinking water does not directly lower blood sugar levels, staying hydrated helps your kidneys flush out excess sugar through urine. Aim for at least 2 liters of water daily, and this can include herbal teas or broth-based soups.

5. Lemon Water: Drinking lemon water can be beneficial. Lemons are low in carbohydrates and have a low GI. The vitamin C in lemons can also support your immune system. However, moderation is key; consuming the juice of one lemon per day is generally acceptable. If you are using multiple lemons, be cautious as the fructose content can still impact blood sugar levels.

Lifestyle Modifications
1. Regular Monitoring: Continue to monitor your blood sugar levels regularly. This will help you understand how different foods and activities affect your glucose levels.

2. Physical Activity: Incorporating regular physical activity into your routine can significantly improve insulin sensitivity and help manage blood sugar levels. Aim for at least 150 minutes of moderate aerobic activity each week, such as brisk walking, swimming, or cycling.

3. Sleep and Stress Management: Lack of sleep and high stress can negatively impact blood sugar levels. Prioritize good sleep hygiene and consider stress-reducing techniques such as yoga, meditation, or deep-breathing exercises.

4. Consult Healthcare Professionals: Given your history of hypertension, proteinuria, and gastrointestinal issues, it’s essential to work closely with healthcare providers, including a registered dietitian, to tailor a plan that suits your specific health needs.

Conclusion
In summary, managing early diabetes through diet and lifestyle changes is a proactive approach that can lead to better health outcomes. Your current diet has a solid foundation, but incorporating more protein, controlling carbohydrate portions, and staying hydrated with water and lemon water can enhance your management strategy. Remember to monitor your blood sugar levels regularly and consult with healthcare professionals for personalized advice. With dedication and the right strategies, you can effectively manage your prediabetes and improve your overall health.

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