Recipe for diabetes management: One part education, one part lifestyle change
with Linda Wright, registered dietician, Columbia St. Mary's Diabetes Treatment Center
As part of a multi-disciplinary team, Linda Wright at Columbia St. Mary's Diabetes Treatment Center provides an essential service to patients with diabetes. In her role as a registered dietician, Wright determines the best medical nutrition therapy for each person, based on an individualized approach.
Weight problems are not unique to people with diabetes - Americans in general are getting fatter. The National Institute of Health (NIH) estimates that more than half of all U.S. adults are overweight or obese with a Body Mass Index (BMI) of at least 25. Though the cause of diabetes is unknown, obesity does seem to play a role. As obesity rates have risen dramatically over the past decade, so has the rate of adults who have developed type 2 diabetes.
No magic bullet
Along with regular physical exercise, a well-balanced, low-fat diet is an important way to keep diabetes under control. The American Diabetes Association (ADA) recommends that 60 to 70 percent of a person's diet come from carbohydrates and monounsaturated fats and 15 to 20 percent from protein.
Linda Wright, registered dietitian, Columbia St. Mary's Diabetes Treatment Center
"It's not going to happen with a diet or something as temporary as that. It's about lifestyle changes."
Body Mass Index is one of the most accurate ways to determine when extra pounds translate into health risks. BMI is a measure, which takes into account a person's weight and height to gauge total body fat in adults. Individuals who fall into the BMI range of 25 to 34.9 and have a waist size of over 40 inches for men and 35 inches for women are considered to be at especially high risk for health problems.
How to determine BMI
1. Multiply weight in pounds by 704.5.
2. Divide the result by height in inches.
3. Divide that result again by height in inches.
4. The result is your BMI.
Click to view BMI At-Risk Chart.
|
But Wright finds that looking at the person's current eating habits is a better treatment method than using a standard diet.
"I don't hand out a meal plan and say, 'You must follow it!'" she says. "We emphasize trying to increase the patient's understanding of the correlation between what they eat and their disease."
Depending on the individual, initial changes might be as simple as suggesting that the person eat three times a day or stop drinking sugar-filled soft drinks. On the other end of the spectrum, if the patient is more informed, she may suggest monitoring grams of carbohydrates.
But her main purpose is to educate, says Wright. A person who is open to suggestions and willing to make changes is more likely to be successful in managing his or her disease.
"With a behavioral approach to changing the person's eating habits and lifestyle, it's important for the patient to be realistic as to what he or she can do," says Wright. "A lot depends on where they are in the behavioral change process."
Many patients approach weight control with the hope that there is a "magic bullet," explains Wright. "Initially, some people resist putting the work in that is necessary to successfully control their disease. They don't always understand the big picture, long-term. They want it to happen today," she says.
Instead of focusing on a specific diet, Wright looks at why and when people eat the way they do and how it affects their disease. Armed with that kind of information, it is easier to make suggestions that will make a difference.
"It's not going to happen with a diet or something as temporary as that. It's about lifestyle changes," she says. "It's not realistic to expect to lose 30 pounds in a month. Rather than making weight goals, it's better to use other markers to monitor success."
People with diabetes have the tools to assess that success, says Wright. "By concentrating on monitoring blood sugar levels, the patient can see if we are on the right track," says Wright. "They may not see an immediate difference in weight, but blood sugar levels give the patient something tangible to see how these changes directly impact the disease."
In order to make appropriate changes to one's lifestyle, it's important to get out of the "diet frame of mind," says Wright. Once a patient truly understands the relationship between their eating behaviors and their disease it can be very rewarding for them to see how changes they've made are helping them control their diabetes and avoid future health complications. "I call it the 'Aha!' moment," says Wright.
