by Linda Ruholl, RN, PhD
The newly diagnosed type 2 diabetic must make many life changes in a short
period of time. According to the American Diabetes Association, dietary control
is essential to all diabetics. It can put off the advent of insulin therapy
for years, or perhaps indefinitely. Patients who take no oral medications need
to tightly control carbohydrate intake, but carb counting can be confusing and
expensive. Basic education from a dietitian or certified diabetic educator (CDE)
is essential. These ten simple strategies help cut expenses.
1. Be cautious about purchasing special "diet" or "low carb"
foods.
Many "diet" items are quite expensive when you take into consideration
other alternatives. Try the smallest size first. Look for coupons and use them
at a market that doubles the face value of the coupon. Read the label to find
out the manufacturer's definition of a "serving." It probably won't
be a "bowlful." Some manufacturers of so-called "low carb"
foods keep the carb numbers down by shrinking the serving size.
2. Be equally careful about buying special cookbooks.
It's all too easy to spend $15 or $20 for a cookbook, only to discover the 250-page
book has exactly three recipes you and your family would even consider eating.
Go the library instead. If you have a card, you can take a cookbook home to
spend more time examining it. If you are not a regular patron, study the cookbooks
at the library and copy likely recipes onto 3x5 inch index cards. Your local
library may also have back issues of DIABETES FORECAST or similar diabetic-focused
magazines you can examine or check out.
3. Make your own "healthy" sweets.
Fresh fruits have natural sugars, and you can easily enhance these flavors.
Thicken water with a little cornstarch, pour it over the fruit and cook gently
until the fruit is soft, but not mushy. Add Equal or Splenda to taste. After
one or two tries, you will know how much is enough. Sample the generic sweeteners;
they are considerably less expensive than the brand name stuff, and many people
can't tell the difference in a blind taste test.
4. Overhaul your favorite recipes.
Many recipes in traditional cookbooks are high in sugar, especially white sugar.
Convert them to a lower carb version by substituting an artificial sweetener.
Our family's experience is that aspartame and sucralose taste satisfyingly sweet,
but other sweeteners leave a bitter aftertaste. Bulk packages of these products
include conversion charts that list exactly how much to substitute for a given
amount of sugar.
5. Invest in a couple of compact and inexpensive reference books.
Total calorie intake and carbohydrate counts are both important. The Doctor's
Pocket Calorie, Fat and Carbohydrate Counter, by Allan Borushek, will give you
plenty of information about foods you prepare yourself. Other sections give
data about restaurant and international foods, as well as counts for many US
fast-food chains. Borushek's book measures only 4.5 by 6 inches, and is about
a half-inch thick, making it small enough to fit into a coat pocket, purse or
glove compartment. At $6.99, it is a good buy.
A second inexpensive guidebook is The New Glucose Revolution Complete Guide
to Glycemic Index Values. The book has two sets of tables: an A to Z listing
of foods with their respective GI and carb count, and a listing of foods ranked
from low to high GI. This lets you compare foods within a category and make
some predictions about how quickly a given food will raise your blood sugar.
For example, a quick check of the dry ready-to-eat cereal section shows you
that All-Bran has a GI of 38, but Kellogg Corn Flakes rates a 92. This guide
is also a bargain at $6.95.
6. Look at directions for food preparation with an open mind.
Packaged foods will often stretch to make more servings. For example, our favorite
vanilla diet pudding mix calls for two cups of skim milk and makes four servings.
Try adding three cups of milk next time. The mixture sets up just the same,
and you get six cups of pudding instead of four. I add a half-teaspoon of vanilla
and a little extra sweetener before mixing.
7. Plan fast food and family restaurant trips carefully.
If you are planning to take the kids or grandkids to McDonald's, don't despair.
You can eat there, too. McDonald's publishes A Full Serving of Nutrition Facts,
which gives the full gamut of nutritional information about all their menu choices.
Many of the sandwiches are very high in carbs, but there are a number of options
that contain less than 30 grams of carbohydrates, such as Chicken McNuggets
and the salads with grilled chicken.
Tuck some of the nutrition sheets from other restaurants into a folder and slip
them under your passenger seat. When you travel, you will be able to find something
suitable. One useful website contains information about ten different fast food
restaurants, including Arby's, Burger King, Hardee's, Taco Bell, Subway, and
Wendy's. Go to www.fatcalories.com, and you can search each restaurant's offerings
by carb count or by total calorie count. The data base ranks the choices from
highest to lowest number of carbs.
8. Pay for food and not for packaging.
Many nutritious foods are inexpensive. A good example is cereal. You can eat
it for breakfast, a quick lunch or for a snack. Cereal by the bag is cheaper
than boxed cereal. A generic plastic bag of raisin bran cereal sells for 10.8
cents per ounce in the Midwest, while boxed raisin bran cereal costs 16.6 cents
per ounce. You would pay 10.5 cents per ounce for toasted oats in the bag, but
16.9 cents per ounce in the box. Over a year's time, the difference adds up.
9. Use the internet to learn about your condition.
Both commercial and public service sites have good information The American
Diabetes Association (ADA) site is the mother lode of current and accurate information.
There is a special section of this site for the newly diagnosed diabetic. It
will help clear up confusion about carbohydrate counting and other issues. Check
out the ADA at (www.diabetes.org).
DIABETES DIGEST offers a one-page glycemic index list of the 300 most common
foods. You can access it at (www.diabetesdigest.com). This same site has a useful
one-page sheet of hints, Ten Tips for Taming Your Cravings.
10. Keep track of your daily blood sugars, and glycosated hemoglobin levels,
as well as your blood lipid levels.
Health providers find it easier to interact with an informed and motivated patient.
Your doctor or nurse practitioner will be impressed with your organizational
skills, and will work harder with you to manage your diabetes cost-effectively.
The newer oral medications for diabetes are quite expensive. Why enrich the
pharmaceutical industry if you can avoid it?
Go to (www.equal.com) to download your own copy of EASY EVERYDAY LOGBOOK. This
booklet has a section where you can track your lipid and HbA1c levels, as well
as day-by-day sheets for carbohydrate counting and blood glucose tracking. This
same site offers a two-page educational offering titled: Ready, Set and
Start Counting: How to Use Carbohydrate Counting to Keep Your Blood Glucose
Healthy. Use this information to supplement and review the information
you received from your dietitian or certified diabetic educator.