Vitamins and Minerals
People with diabetes have the same requirements for vitamins and minerals as people without diabetes. If you are eating a variety of foods, rich in vegetables, fruits, cereals, and grains, then you are most likely getting all the vitamins and minerals you need.
The one exception may be the need for calcium to prevent osteoporosis. Large doses of micronutrients have not been shown to help diabetes or blood glucose levels. In fact, large doses of some vitamins can be harmful. If you think you may not be getting all the vitamins and minerals you need, check with your dietitian before you take any vitamin or herbal supplements. A few changes in your food choices may correct the nutritional deficiency.
If you are thinking about becoming pregnant or are pregnant, you have slightly different nutritional needs. You may need a prenatal vitamin or a multivitamin. Folate is generally recommended during pregnancy. Check with your dietitian or doctor about your needs.
Salt
Many people with diabetes, especially those with type 2 diabetes, may also have high blood pressure. High blood pressure can increase the risk of heart disease and stroke. And for some people, too much dietary salt can increase blood pressure. So, if you tend to have high blood pressure, you may try reducing your salt intake.
But what does that mean? Just stop shaking table salt on your food? That’s part of it, but it may sometimes be difficult to figure out where all the salt in your diet is coming from. Many foods contain salt or another ingredient high in sodium, the element in salt that affects blood pressure. Sometimes it’s rather obvious, because the foods taste salty, such as pickles and bacon.
But there can be hidden salt in many foods, such as cheeses, salad dressings, cold cuts, canned soups, and fast foods. Even some peanut butters contain added salt.
Take the salt shaker off the table, read labels to get an idea of salt or sodium content, and try other flavorings such as herbs and spices to make your food tastier. Remember, a little salt goes a long way.
“People with diabetes can’t drink alcoholic beverages.”
Not true. If your blood glucose levels are on target, it is unlikely that an occasional alcoholic drink at mealtime will harm you. In fact, a recent study published in JAMA showed that light to moderate alcohol intake is associated with reduced risk of death due to coronary heart disease for people with type 2 diabetes. The key is to drink moderately. Moderate drinking is defined as no more than one drink a day for women and two drinks a day for men.
One drink is 12 ounces of regular beer, 5 ounces of wine, or 1 1/2 ounces of 80 proof distilled spirits. Remember these tips:
- Alcohol contains calories, almost as many per gram as fat. If weight loss is one of your goals, then you need to think about the extra calories from alcohol. Generally, alcohol is substituted for fat calories, with one drink equal to 2 fat exchanges or 90 calories.
- Alcohol can affect the blood glucose level, most often causing a very low blood sugar when consumed on an empty stomach. To prevent hypoglycemia, drink alcohol only with food if you use sulfonylureas or insulin.
- The signs of hypoglycemia (no matter what the cause) are very similar to the signs of inebriation. There is the risk that people will think you are intoxicated if they smell alcohol on your breath. They may not consider the possibility that you have a low blood sugar and need help quickly.
- Some people have hypoglycemia unawareness, a lack of symptoms of low blood sugar. Drinking alcohol increases their risk for hypoglycemia.
- Some medications, including some diabetes medications, require limits on alcohol use.
- If you have health problems such as pancreatitis, high triglyceride levels, gastric problems, neuropathy, kidney disease, or certain types of heart disease, you may be advised to abstain from alcohol.
- Do not drink and drive is sound advice for everyone. But because of the added risk for hypoglycemia from alcohol, it is especially true for people with diabetes.
Alcohol can affect your thought processes and inhibitions. It’s easy to overeat when you are drinking. In addition, you need to be able to think clearly enough to monitor your blood glucose levels and to know what to do should they drop too low. If you are drinking, make sure to tell a friend what to do in the event of low blood glucose. Your friend should be prepared to take action even if you are not able to cooperate.
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Martha M. Funnell, MS, RN, CDE
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan
Robert M. Anderson, EdD
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan
Shereen Arent, JD
National Director of Legal Advocacy
American Diabetes Association
American Diabetes Association Complete Guide to Diabetes