Managing Diabetes: Key Questions on Blood Sugar and Diet - Internal Medicine

Dr. Xiao Yongxun reply Internal Medicine

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Question 1: Should I still strictly control my intake of starches and sugars?
Answer: Strictly controlling the intake of starches and sugars can indeed lower blood glucose and glycated hemoglobin levels, thereby improving conditions such as diabetes or glucose intolerance.
In fact, it is best to control total caloric intake along with regular moderate exercise.
The food consumed by humans primarily consists of carbohydrates, proteins, and fats; it is recommended that carbohydrates make up 50%, proteins 30-40%, and fats 15-20% of the total caloric intake.
Other nutrients, including fiber, vitamins, and minerals, can generally be considered negligible in terms of calories.
When carbohydrates, proteins, and fats are consumed in excess, most of the surplus food is converted into fat for storage through biochemical reactions and metabolism; this is because 1 gram of fat contains 9 calories, while 1 gram of protein or carbohydrates contains only 4 calories.
Therefore, storing energy in the form of fat is the most efficient method, which can lead to obesity.
Thus, it is advisable to eat until you are about 80% full, maintaining a normal distribution of macronutrients.
Overconsumption of meat, especially red meat, will also increase protein and fat intake, contributing to weight gain.
On the other hand, carbohydrate intake should avoid high glycemic index foods, such as white rice, white bread, steamed buns, pasta, and cakes, to prevent rapid spikes in postprandial blood glucose and insulin levels; instead, choose low glycemic index foods, such as brown rice, whole grain bread (which is often hard and less palatable, resembling a tough steamed bun; very few are commercially available), whole grain steamed buns, and coarse cereals.
In simple terms, consume less refined food and more natural foods.
Question 2: Should I measure my blood glucose daily? (I have a fixed appointment every three months for blood tests at the hospital)
Answer: Self-monitoring of blood glucose is recommended by diabetes experts worldwide; however, no one has specified the exact frequency.
In clinical practice, during the ongoing process of blood glucose control, it is advisable to first check fasting blood glucose; once stable, check postprandial blood glucose two hours after meals (starting from the beginning of the meal).
The frequency can range from multiple times a day to once a day, then to once every three days, and finally to once a week; of course, you can add additional checks as needed.
For example, after attending a banquet or gathering, you can check your blood glucose to assess whether the food consumed was appropriate.
Question 3: My colorectal specialist (I have hemorrhoids) advised me to reduce dairy products; can I take probiotics?
Answer: Many medications can cause constipation, such as calcium channel blockers, diuretics, adrenergic blockers, anticonvulsants, antidepressants, antihistamines, anticholinergic medications, aluminum-containing antacids, dopamine agents, non-steroidal anti-inflammatory drugs, anesthetics, antipsychotics, iron supplements, calcium tablets, morphine, sympathomimetic drugs, and more.
Therefore, your physician has indeed taken this into consideration.
Additionally, there are many other secondary causes that are difficult to enumerate.
Regarding non-pharmacological treatments, the main focus is on managing the underlying diseases or medications causing constipation, appropriate bowel training (for example, attempting to have a bowel movement 15-30 minutes after meals, as this is when the gastrocolic reflex occurs, which can aid in bowel movements), increasing dietary fiber intake, ensuring adequate hydration, engaging in moderate exercise, and getting sufficient sleep; avoiding staying up late and going to bed too late, as well as avoiding fried and refined foods.
The use of probiotics, while not strongly recommended, has been found to be beneficial in certain patients or studies by experts.
Due to minimal side effects, few people oppose their use.
*The above responses are for reference only; it is strongly recommended that you discuss these matters with your family physician.

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Reply Date: 2014/11/27