Why should I work so hard to improve my blood-sugar level?

Because you will feel more energy and a sense of well-being when your blood sugar enters the normal range. In addition, you will delay or prevent problems with your eyes, kidneys, and nerves as your blood sugar improves. Many doctors also believe that problems with heart disease, strokes, and hardening of the arteries may be delayed by good blood-sugar control. If you do not get any complications of diabetes, you will love a longer, healthier life.

Vitamins, Minerals and Diabetes

Vitamins, Minerals and Diabetes

Many vitamins and minerals have a role in blood glucose control. It is important that your body has enough of these vitamins and minerals so it can work as efficiently as possible. You may wonder if you need to take a supplement of any special vitamin or mineral to help improve your blood glucose control. Right now, the American Diabetes Association states there is little research indicating that taking supplements of individual nutrients or blends of nutrients actually improves blood glucose control. More research need to be done before we can confidently make that type of general recommendation.

However, there are times when you might want to consider taking a multivitamin plus mineral supplement, or take supplements of particular vitamins or minerals. Three such times follow:

1. When your diabetes is not in good control. Research shows that this may cause some nutrient deficiencies. A multivitamin plus mineral supplement is recommended.
2. When you are restricting calorie or carbohydrate intake. Because you may be eating less food or a smaller variety of foods, it may be difficult to consume the mix of foods you need to meet your nutrient needs. For some, taking a multivitamin plus mineral supplement is like an insurance policy; you are adding a little extra protection.
3. When you have difficulty consuming certain foods such as those high in calcium or iron and need a supplement to meet your daily requirements. However, do not consume more than 100% of the daily value (listed as %DV on the supplement label) unless you have discussed this with your dietitian and doctor.

If you choose to take a supplement, know that the supplement cannot replace a healthy diet. By choosing a variety of foods with an emphasis on whole grains, fruits and vegetables, and low-fat foods you can often meet your nutrient needs without supplements. It is the combination of foods you eat and the combination of nutrients the food provides that help your body work smoothly and efficiently.

What To Look Out For With Partly Digested Sugars (Sugar Alcohols)

Some sugars are not completely digested. You may recognize these sugars by the terms "sugar alcohol," "polycols," or "sugar replacers." Because they really do not contain any alcohol, the term "sugar alcohol" is often confusing. However, you will see this term used in the nutrition facts panel of a food label under Total Carbohydrate.

If there is only one sugar alcohol in a food, the specific ingredient name is listed (e.g., sorbitol). If two or more are used, the panel says "sugar alcohol." The individual names are always listed in the ingredient list. They include sorbitol, mannitol, xylitol, isomalt, malitol, lactitol, and hydrogenated starch hydrolysates. You can find these in a variety of foods including candy, cookie, throat lozenges, and chewing gum.

Main points to know. There are three main points to know about sugar alcohols:

• They are often found in foods that are labeled "sugar-free" or "no added sugar," but the food may still contain calories from other carbohydrates.
• They may cause stomachaches and excess gas.
• They should not be used to treat hyopglucemia.

We do not have enzymes in our mouth to start the digestion of sugar alcohols, so unlike other caloric sweetners, sugar alcohols will not cause tooth decay. In fact, since they are not completely digested, they have pluses and minuses. On the positive side, they produce a smaller rise in blood glucose than regular sugar, and give you additional low-carbohydrate food choices. On the negative side, they can cause stomachaches, excess gas, and even diarrhea because they are partially digested. Eating smaller amounts of such foods at one time can help eliminate the problem.

Sugar alcohols are sometimes added to food products that are sweetened with a low-calorie sweetener because they add bulk (filler) and few calories. When you take sugar out of a food, you not only lose the sweet taste, you also lose bulk. The sugar alcohols replace the bulk while the low-calorie sweetener replaces the sweet taste (since sugar alcohols are only half as sweet as other caloric sweeteners).

Additional points to know. There are two additional points that those who adjust their before-meal insulin based on the carbohydrate content of the meal should know.

• Sugar alcohols produce a slower and lower rise in blood glucose than other sugars or starches.
• On average, only half of the sugar alcohol carbohydrate needs to be counted into your carbohydrate grams, because only half of it is digested.

Because sugar alcohols are only partially digested, only half the carbohydrate grams listed next to the specific sugar alcohol (e.g., sorbitol) or the general term "sugar alcohol" are available to raise your blood glucose. To get the true amount of available carbohydrate from a food with a sugar alcohol, subtract half of the sugar alcohol grams from the Total Carbohydrate amount. As an example:

• Divide sorbital grams by two: 16 / 2 = 8
• Subtract 8 from 19 = 11 grams of total carbohydrate that are available to raise your blood glucose.

For some people, this will be a small amount of carbohydrate and will not make a difference. For others, however, it may help with blood glucose control, and choosing the amount of food to eat.