Many people with diabetes think they have to eat special "diabetic" food , that they can never enjoy a slice of birthday cake or have their favorite meal. While none of these are true, you do have to be careful to pay attention to portions and make an effort to eat healthy.

Healthy eating isn't about deprivation; it's about eating smart so you can live a longer, healthier, happier life. As long as your blood sugar stays within the range set by your healthcare provider, you can eat the foods you enjoy. Be aware that other conditions may be affected by certain types of foods, therefore you may need to make limitations in other areas.

Here, you will find more than just healthy eating tips and delicious recipes. You can find information on knowing what's in the food you're eating, drinking alcohol, healthy snacking, counting carbohydrates, tips on how to lower blood glucose and understanding food labels.

Most people with diabetes are aware of how different foods affect their blood glucose, but question whether they can enjoy a glass of wine with dinner or a beer while watching their favorite sports game. Fortunately, most people with diabetes still can enjoy an occasional drink, but first need to check with your healthcare provider to avoid the possible side effects of alcohol including:

• Increased blood sugar; especially from mixed drinks
• Dangerously low blood sugar levels
• Nocturnal hypoglycemia, a condition resulting from drinking on an empty stomach
• Appetite stimulation
• Medication and insulin interaction
• Increased triglyceride levels
• Increased blood pressure

If you choose to drink alcohol, daily intake should be limited to a moderate amount. It is recommended that women drink 1 or fewer beverages per day, while men should have 2 or fewer alcoholic beverages per day. One alcoholic drink is equal to a 12 oz. beer, 5 oz. glass of wine, or 1 ½ ounce of distilled spirit (vodka, rum, whiskey, gin, etc.).

Here are some additional tips & guidelines that will allow you to drink sensibly:

• Wear an I.D. that notes you have diabetes.
• Drink only when blood glucose is under control.
• Monitor your blood sugar before, during, and after drinking alcohol. Remember to check before going to bed.
• Sip a drink slowly to make it last.
• Never drink alcohol on an empty stomach as food slows down the absorption of alcohol into the blood stream.
• Have water by your side to quench your thirst.
• Use calorie-free drink mixers like diet soda, club soda, diet tonic water, or water and avoid sugary mixed drinks.
• Drink alcohol with a snack or meal.
• Do not drive or plan to drive for several hours after you drink alcohol.
• Always carry along glucose tablets or another source of sugar.
• Don't mix alcohol and exercise as physical activity and alcohol will increase your chances of getting a low blood sugar.

It is recommended that you should avoid alcohol consumption if:

• You have a history of alcohol abuse or dependence
• You are currently pregnant
• You have liver disease, pancreatitis, advanced neuropathy/retinopathy, high blood pressure, or heart disease
• You have a tendency to become hypoglycemic or were unable to recognize symptoms of hypoglycemia in the past
• You are trying to lose weight

Navalee Loriston, MS, RD, LDN

Carbohydrates are the nutrient in food that raises blood sugar. Everyone needs carbohydrates every day for energy; however, people with diabetes need to make sure the amount of carbohydrate they are eating is correct for their individual needs. Most men need no more than 60 grams of carbohydrate per meal and no more than 25 grams per snack. Most women need no more than 45 grams per meal and 20 grams per snack. It is important to meet with a licensed dietitian to determine your individual needs.

Carbohydrates can be counted in several ways. One way is to look at the nutrition label on the package. Below is an example of how to determine the grams of carbohydrate you are eating from a nutrition label.

The last method of carbohydrate counting is to count exchanges. If you prefer to count exchanges, each of the exchanges listed below is approximately equal to 15 grams of Carbohydrate.

However you choose to count the carbohydrate in the food you eat, it is important to test your blood sugar before, and two hours after eating. Be sure to keep a record of your blood sugar before the meal, the amount of carbohydrate you ate in your meal, and your blood sugar two hours after the meal. If your blood sugar rises more than 50 mg/dl after a meal, show your health care provider your records, as you may need an adjustment in your prescribed diabetes management.

When we eat, the carbohydrates in our food become glucose in our blood; this period of time after we eat is known as postprandial. Blood glucose concentration following a meal is primarily determined by digestion and absorption of carbohydrates and its clearance from the circulation. Insulin secretion normally maintains blood glucose, but in individuals with diabetes, defects in insulin action or insulin secretion, impair regulation of postprandial glucose. Both the quantity and the source of carbohydrate influence postprandial glucose levels.

Foods high in carbohydrates, like rice, potatoes and corn cause blood glucose levels to spike. People with diabetes have to manage their intake of carbohydrates to avoid these spikes. Controlling blood glucose to achieve normal or near-normal levels through food and nutrition interventions is the primary goal of diabetes management.

Here are some common terms that should help you understand foods role in blood sugar control:

Glycemic Index

The glycemic index of foods was developed to compare the postprandial blood sugar to constant amounts of different carbohydrate-containing foods. The glycemic index of a food is the increase above fasting in the blood glucose two hours after ingestion divided by the response to a reference food (usually glucose or white bread). The glycemic loads of foods, meals, and diets are calculated by multiplying the glycemic index of the foods by the amounts of carbohydrate in each food and then totaling the values for all foods.

Low Carbohydrate Diet

It is recommended that people with diabetes have around 130 grams of carbohydrates per day. The focus of a low-carbohydrate diet is to restrict the total carbohydrate intake to less than the recommended amount. Low-carbohydrate diets might seem to be a logical approach to lowering postprandial glucose; however, foods that contain carbohydrate are important sources of energy, fiber, vitamins, and minerals as well. Therefore, a low carbohydrate diet is not recommended in the management of diabetes.

Foods with high levels of fiber, fructose, lactose, and fat tend to have a lower glycemic response; therefore people try to focus their meals around these foods. Solely focusing on these foods is not recommended for the management of diabetes as there have been noted potential methodological problems with the glycemic index.

Sweeteners

Sugar alcohols are artificial sweeteners that contain half the calories of sucrose and have a lesser impact on blood sugar. Reduced calorie sweeteners approved by the FDA include sugar alcohols (polyols) such as erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, xylitol, tagatose, and hydrogenated starch hydrolysates. The use of sugar alcohols appears to be safe; however, they may cause gastric upset, especially in children.

The FDA has approved five nonnutritive sweeteners for use in the U.S. These are acesulfame potassium, aspartame, neotame, saccharin, and sucralose. Before being allowed on the market, all underwent rigorous scrutiny and were shown to be safe when consumed by the public, including people with diabetes and women during pregnancy.

It's important to test your own reaction to any food containing sugar alcohols because blood sugar responses vary from person to person.

Net Carbs

The term "net carb" refers to some types of carbohydrates that do not affect blood sugar and insulin the way other types do. Therefore, you can subtract these carbohydrates from a food's total carbohydrate count. For example, the carbohydrates in potatoes are converted almost instantly into glucose while foods that contain more fiber like whole grains are absorbed more slowly or may not be digested at all. When a food contains 5 grams or more of fiber, it is an accepted practice to subtract half the grams of fiber from a food's total carb count.

Food claims

The FDA regulates claims about the sugar content in foods. "Sugar free" means the product contains less than .5 grams of sugar per serving. "Reduced" sugar means a serving has at least 25 percent less sugar than the regular version of that food. "No added sugar" means that the product may contain natural sugars, such as those found in fruit and milk, but any additional sweeteners are artificial.

While carbohydrates are the main nutrient involved in blood glucose control, it is important to remember that carbohydrates are still a very necessary part of a healthy diet.

• Fruit: a natural carbohydrate source that provides vitamins, minerals, and fiber.
• Vegetables: a low carbohydrate food that also provides fiber, vitamins and minerals that are difficult to obtain from any other food source.
• Milk and Dairy: natural carbohydrates sources which also provide calcium

A dietary pattern that includes carbohydrate from fruits, vegetables, whole grains, legumes, and low-fat milk is encouraged for good health. A registered dietitian can help you determine how many carbohydrates to eat at each meal for a balanced diet.

Navalee Loriston, MS, RD, LDN

When first diagnosed with diabetes, the majority of people are most concerned about the types of foods they can eat. Some people are so confused and fearful of food that they begin to make drastic and often unhealthy changes to their diet.

Eating with diabetes does not have to be complicated. Start by filling half of your plate with low-carbohydrate vegetables, fill one-quarter of your plate with a lean protein and fill the remaining quarter of your plate with a healthy carbohydrate food, such as a whole grain.

Knowing what to eat can be confusing; but the truth is that healthy eating should be practiced whether you are living with diabetes or not. Here are some tips on making healthful food choices for yourself and your family:

• Eat lots of fruits and vegetables. Aim for 5 or more servings per day.
• Plan your meals to include non-starchy vegetables such as spinach, carrots, asparagus, broccoli and green beans.
• Choose whole grain foods over processed grain products, like brown rice and whole wheat pastas. Aim for at least 3 servings of whole grains every day.
• Include dried and canned beans and lentils into your meals.
• Enjoy fish in your meals 2-3 times a week.
• Choose lean cuts of beef and pork; look for cuts of meat that end in "loin" such as pork loin and sirloin. Remove the skin from chicken and turkey.
• Choose low fat and non-fat dairy such as skim milk, non-fat yogurt and low-fat cheese. Enjoy 3 servings of low-fat dairy foods per day.
• Choose water and calorie-free "diet" drinks instead of regular soda, fruit juice and other sugar-sweetened drinks.
• Choose oils for cooking instead of solid fats that can be high in saturated and trans fats.
• Cut back on high calorie snack foods and desserts like chips, cookies, cakes, and ice- cream.
• Watch your portion sizes of all foods; even the healthy ones. Eating too much of anything can result in weight gain.
• Choose the healthiest carbohydrates. Aim for natural forms such as beans, fruit, milk, and whole grains.
• Choose high-fiber foods to fill you up and prevent heart disease. Include oatmeal, beans, fresh fruit with skin, vegetables and whole grains into your meal plan.
• Focus on eating healthy fats (monounsaturated and polyunsaturated) which can improve cholesterol levels. Include fish, nuts, seeds, olive oil and avocado for a healthy diet.
• Don't skip meals as it can lead to hypoglycemia or overeating at your next meal.
• Plan your meals. This the most important part of healthy eating. Take time to grocery shop and keep healthy foods on hand.

Eating with diabetes does not have to be complicated. Start by filling half of your plate with low-carbohydrate vegetables, fill one-quarter of your plate with a lean protein and fill the remaining quarter of your plate with a healthy carbohydrate food, such as a whole grain.

Navalee Loriston, MS, RD, LDN

Diets rich in dietary fiber have been shown to have a number of health benefits for people with and without diabetes. For people with type 1 diabetes, a high fiber diet has contributed to lower blood glucose levels, while people with type 2 diabetes have shown improved blood sugars, lipids, and insulin levels. A diet rich in fiber has also been associated with lowering blood cholesterol, reducing the risk for heart disease, and an improvement in insulin resistance, the underlying condition of type 2 diabetes.

For these reasons, it is important that people with diabetes include an adequate amount of fiber in their diets. The recommended minimum intake is about 25 to 30 grams of fiber per day.

People with diabetes are encouraged to choose a variety of fiber containing foods such as legumes, fruits, vegetables, nuts and whole grain products because they also provide vitamins, minerals, and other substances important for good health.

Fruit– Whole, fresh fruit with edible skin or seeds (apples, pears, and berries, etc.) contain the most amount of fiber. Fruit juices have most of the fiber removed and should not be considered a good fiber source. Aim for 2 cups of fruit per day.

Vegetables– Vegetables are high in fiber and low in calories and carbohydrates, making them an excellent part of a healthy diet. Both fresh and frozen vegetables are good options. Aim for 2-3 cups of vegetables per day.

Beans and Legumes– This includes dried and canned black beans, kidney beans, pinto beans, chick peas (garbanzos), white beans, lentils and peas.

Whole Grains– Include barley, oats, bran, whole wheat, quinoa, wild rice, rye, and buckwheat to increase your daily amount of fiber. A serving of whole grains should contain at least 3 grams of fiber to be considered a good source.

Nuts– Although nuts are high in calories, when eaten in moderation, they provide a good amount of fiber and should be included as part of a healthy diet.

Food preference, limited food choices, and gastrointestinal side effects are potential barriers to achieving high-fiber intakes. Fiber should be gradually increased in your diet to prevent any undesirable side effects. Here are some tips on getting more fiber into your diet:

When you consume dietary fiber, most of it passes through the intestines and is not digested. For this reason, if a serving of a food contains more than or equal to 5 grams of dietary fiber, you can subtract half the grams of dietary fiber from the total carbohydrate serving of that food when carbohydrate counting.

• Include high-fiber cold cereal, oat bran, or oatmeal into your breakfast meals. Boost up the flavor by adding fresh or dried fruits.
• Sprinkle flax meal, wheat germ, nuts, high fiber cereal or seeds onto cold or hot cereal, yogurt, cottage cheese, fresh fruit or frozen yogurt.
• Substitute whole-wheat flour or oat bran for at least one third of the all-purpose flour in baked goods recipes
• Coat chicken or fish with crushed bran cereal before baking
• Sprinkle casseroles or baked vegetable dishes with crushed bran cereal.
• Order or make your own pizza with a whole-wheat crust and vegetable toppings.
• Add frozen vegetables to soups, sauces, casseroles, or pasta dishes
• Try different types of whole grains, such as barley, kasha, bulgur, quinoa, spelt, wild rice, and couscous.
• Add beans to soups, stews, salads, tacos, and salsa.
• Remember to drink plenty of water to enhance the effectiveness of fiber and to prevent constipation.

Navalee Loriston, MS, RD, LDN

Feeling a little hungry between meals, but still want to keep blood sugars under control? Then, simply have a snack. Snacks can stave off hunger and overeating, while keeping blood sugar levels from dropping too low. You can have something as simple as a small piece of fruit, or something a little more fun and flavorful. When it comes to snack selections, think protein, fiber, and healthy fats.

Here are some fruity, crunchy, savory and even sweet snacks that contain approximately 15 grams of carbohydrates or 1 carbohydrate (1 bread/starch) exchange.

Fruity

• 1 small pear and a small handful (12) almonds
• 1/2 cup of blueberries and 1/2 cup of low-fat cottage cheese
• 1 small apple with 1 tbsp peanut butter
• 1 small apple
• ½ cup unsweetened applesauce or fruit cup
• 4 medium fresh apricots
• 7 dried apricots
• 1 small banana
• ¾ cup blueberries
• 1 cup cubed cantaloupe
• 12 cherries
• ½ grapefruit
• 17 small grapes
• 1 cup cubed honeydew melon
• 1 kiwi
• 1 small nectarine
• 1 small orange
• 1 medium peach
• 1 small pear
• ¾ cup fresh pineapple
• 2 small plums
• 1 cup raspberries
• 1¼ cup whole strawberries
• 1¼ cup cubed watermelon
• One half banana with 1 Tbsp peanut butter
• ½ cup low-fat cottage cheese and ½ cup light peaches
• Kabobs made with 1 C melon and 1 oz low-fat cheese

Crunchy

• 4 baby carrots & 4 celery stalks with 5 tbsp hummus
• 4 Celery stalks with natural peanut butter
• Veggies with ranch or bleu cheese dip
• Handful of walnuts or pecans
• Celery and dip made from 1 Tbsp peanut butter and 2 Tbsp raisins
• ½ C sugar snap peas and 2 Tbsp hummus
• 5 slices melba toast
• 6 almonds, 6 cashews or 10 peanuts

Savory

• 1/2 cup of low-fat cottage cheese
• 3 peanut-butter sandwich crackers
• Small baked potato topped with salsa and 1 oz low-fat cheese
• Light Multi-Grain English Muffin with 1 Tbsp nut butter
• ½ cup light tuna or egg salad in one half of a whole-wheat pita
• 3 whole-wheat crackers with 2 tbsp natural peanut butter
• 1/2 turkey sandwich on whole-wheat bread with mayo
• 1 String Cheese/ cheese stick
• 1 Hard boiled egg

Salty

• 2 cups of popcorn with 1 tbsp butter
• 36 Pepperidge Farm® Goldfish® Crackers
• 7 Ritz® Crackers
• 15 fat-free potato or tortilla chips
• 12 Original Wheat Thins®
• 13 Reduced-Fat Wheat Thins®
• ¾ ounce pretzels
• 6 saltine crackers
• 5 reduced-fat Triscuits
• 2 rice cakes (4² diameter)
• 10 Low sodium black olives
• 1 cup edamame

Sweet

• 2 sugar-free fudge sickles
• 5 vanilla wafers
• 3 small sugar-free cookies
• ½ cup sugar-free ice cream
• 1 cup nonfat fruit-flavored light yogurt
• 3 gingersnap cookies
• cup sugar-free frozen yogurt
• ½ cup sugar-free pudding with a dollop of whipped cream
• 1/2 cup of sugar-free pudding
• Sugar-free gelatin with 3 tbsp. whipped topping
• 1 dark chocolate truffle
• 3 graham crackers ( 2½² square)
• ½ low-fat granola bar
• 15 Teddy Grahams®

Combination

• 2 Tbsp raisins and ¼ cup almonds
• Hard-cooked egg and one slice of whole-wheat toast with ½ teaspoon margarine
• 4 ounce sugar free rice pudding and ¼ cup nuts
• celery and dip made from 1 tbsp peanut butter and 2 tbsp raisins
• 5 reduced fat Triscuits® with 1 oz low-fat cheese
• Light Multi-Grain English Muffin topped with tomato sauce and 1 oz low-fat mozzarella cheese and then baked
• 10 Multi-Grain Wheat Thins® with 1 oz low-fat string cheese and 4 fluid ounces (fl oz) of tomato juice

Navalee Loriston, MS, RD, LDN

An important part of managing diabetes is deciding when, what, and how much to eat. Everyone has different likes, dislikes, and habits. There is no such thing as a "diabetic diet" that meets the needs of everyone with diabetes; different meal plans will suit different people. It is a good idea to work with a registered dietitian and/or certified diabetes educator to help develop a meal plan.

A diabetes meal plan is a guide that tells you how much and what kinds of food you can choose to eat at meals and snack times. A good meal plan should fit in with your schedule and eating habits, and should include the foods that you like to eat. The right meal plan will help you improve your blood glucose without sacrificing the pleasures of good eating. Here are some suggestions, strategies, and tips to develop and healthy and tasty menu.

Tips:

• Foods high in fiber may help you feel full longer and may lower blood sugar and cholesterol levels. Include both soluble (oats, barley, nuts, seeds, beans, lentils, some legumes, some fruits and vegetables) and insoluble (whole wheat products and some vegetables) in you meal plan.
• Drink water or "diet" drinks.
• Prepare raw vegetables and cut up fruit ahead of time so they are ready when you are ready to snack.
• Portion size is very important to avoid overeating; use your hands to help you out.
  • 2 fists: grains and starches
  • 1 fist: fruit
  • Palm of hand: lean protein
  • Tip of your thumb: fat
  • Open hands: vegetables

Strategies:

Try using the plate method for meal planning:

Start by filling half of your plate with low-carbohydrate vegetables, fill one quarter of your plate with a lean protein and fill the remaining quarter of your plate with a healthy carbohydrate food choice, such as whole grain pasta, sweet potato, or brown rice.
Then, add a glass of milk for your beverage and a piece of fruit for dessert. Simple and healthy!

Suggestions:

Here is a sample meal plan to use for healthy meal planning. You can easily swap out food choices for your favorites. Always consult your physician before beginning a new meal plan.

Breakfast (8 a.m.)

• 1 ½ cup high fiber, whole grain cereal
• 1 scrambled egg with 1 slice of low fat cheese
• 1 orange or 1 cup of melon
• 4 oz skim milk

Snack (10 a.m.)

• 4 small graham cracker squares
• 1 slice of low fat cheese

Lunch (12:30 p.m.)

• 1 whole wheat/grain pita or 2 slices whole grain bread
• 3 oz lean protein (turkey, roast beef, ham)
• Green leaf lettuce
• 1 tsp reduced fat mayonnaise
• 6-8 oz low fat yogurt or 1 small apple

Snack (3 p.m.)

• 1 Tbsp Peanut butter
• Whole grain crackers (5-6)

Dinner (6 p.m.)

• Green salad with low fat dressing
• 3 oz lean protein (fish, chicken, beef)
• ½ sweet potato or ½ cup whole wheat pasta
• ½ cup berries
• 8 oz skim milk

Evening Snack (8 p.m.)

• 2 cups air-popped popcorn

Navalee Loriston, MS, RD, LDN

Many consumers do not use or understand nutrition labels because they can be confusing. However, learning to understand food labels can make it easier to manage your diabetes while eating the foods you like.

The Nutrition Facts label provides consumers with information about the serving size, calorie, fat, cholesterol, sodium, total carbohydrate, protein, vitamin, and mineral content per serving of the foods they consume. Before heading to the grocery store, here some important things to know:

Serving Size: Unfortuantely, serving sizes are not uniform on every package. Some foods list servings sizes in count form (5 pieces) and some in units of measurement (cups). Remember that the nutrients listed are for one serving size. If you double your serving, then you need to double the nutrients as well.
Calories: The function of a calorie is to provide the body with energy needed fir daily activities. It is very important to eat only the necessary amount of calories you need per day to avoid weight gain. You can use the nutrition labels to compare similar products and determine which contains fewer calories. To find out how many calories you need each day, talk with a registered dietitian or certified diabetes educator.

Total Fat: Total fat tells you how much fat is in a food per serving. It includes fats that are good for you such as mono and polyunsaturated fats and fats that are not so good such as saturated and trans fats. When comparing foods, choose the food with the least amount of total and saturated fat.

Cholesterol: A form of fat found only in animal tissue. Excessive consumption of cholesterol can lead to cardiovascular disease and atherosclerosis.

Sodium: Also known as table salt is used to season and preserve foods. Excessive consumption is associated with high blood pressure. Choose foods with lower amounts of sodium.

Total Carbohydrate: Total carbohydrates include sugar and fiber. If you are carbohydrate counting, the food label provides the information you need for meal planning. Look at the grams of total carbohydrate, rather than the grams of sugar. If a food has 5 grams or more fiber in a serving, subtract half the fiber grams from the total grams of carbohydrate for a more accurate estimate of the carbohydrate content. When comparing foods, choose the one with more fiber.

Vitamins and Minerals: These are usually listed as a percentage based on a 2000 calorie diet. Choose foods with higher percentages as they are important for total body health.

Percent Daily Value: The Percent Daily Values are based on a 2,000-calorie diet. It represents the percentage of a nutrient provided in that specific food. Keep in mind that your Daily Values may be higher or lower depending on

Ingredient List: The ingredients of a food are listed in descending order by weight. The first two ingredients generally represent the largest portion of the food product. This is a good place to look for key words that you should avoid such as "trans", "hydrogenated" and "syrup" and words you should look for such as "whole grain" and "monounsaturated". If the first words are high fructose syrup, sugar, or enriched flour, then you may want to consider putting it back as it will cause an undesirable increase in your blood sugar without any nutritive value.

Lastly, remember that food labels can be a little tricky in their wording. Terms like low fat and low carbohydrate do not mean low calorie. Oftentimes, if something is taken out, then something else has been added in its place. Remember to look at all the nutrients before determining if a food fits within your meal plan. Take the time to read before you buy so you can truly enjoy your food.

Navalee Loriston, MS, RD, LDN

As the incidence of diabetes increases, people with diabetes are turning more and more to alternative therapies to help manage this condition. Despite the availability of numerous conventional therapies to control diabetes, many people also try alternative therapies because they are easily accessible and do not require a prescription. Some use dietary supplements in efforts to improve their blood glucose control, manage symptoms, and lessen the risk of developing serious complications.

Alternative therapies include dietary supplements such as vitamins and minerals, herbs, botanicals, fatty acids, amino acids and enzymes which come in different forms including, tablets, capsules, soft gels, liquids, powders, and bars.

Although there is insufficient data to back-up claims of the safety and effectiveness of alternative therapies, many consider these therapies to be "natural" and therefore less harmful than traditional medicine. In addition, many cultures have used herbs for generations and people believe that if it has been used over time, then it is safe.

Your health care provider is the best resource for assessing the risks and benefits of taking a dietary supplement. He or she should know the potential side effects of supplements and the risk for interactions with other medications.

Before beginning any alternative therapy, keep this in mind:

• Supplements do not have to undergo the same rigorous approval process as pharmaceutical drugs.
• Supplement manufacturers do not have to prove the safety, quality, or efficacy of their products before making them available to consumers.
• The U.S. Food and Drug Administration (FDA) does not regulate herbal products and alternative medicines.
• Product labeling may not be accurate or consistent.
• Supplements are sometimes sold without prior scientific testing to determine how it may affect the body.
• Supplements often can interact with other supplements, over-the-counter medicines, prescribed medications, and other foods, potentially causing adverse reactions.
• Remember that "natural" does not mean safe or effective.

If you decide to use alternative therapy to manage diabetes, please take these steps to ensure your safety:

• Always tell your doctor about any supplements you are taking, including multivitamins. List them as medications in your written records including dosage, how often, and for how long you've been taking the supplement.
• Tell your doctor why you are taking that supplement and ask questions about safety and efficacy.
• Inform your doctor if you intend to stop or have already stopped taking a supplement.
• Ask whether your supplement choice has any side effects on your medical condition or if it interacts with other medications or supplements that you may be taking.
• Never stop taking your prescribed diabetes medications without telling your health care provider.
• Continue to be forthright about the supplements you're taking, even if your doctor has discouraged their use.
• Continue to closely monitor blood glucose levels by testing as your physician recommends.

Remember, to guarantee safety, make sure that you tell your health care provider about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health to ensure total care.

Navalee Loriston, MS, RD, LDN