Editor’s note: This is the first of what will be a weekly column dedicated to educating our community on improving their health and answering common questions and debunking common myths about your health issues. Please feel free to suggest topics that you would like addressed. This column is not intended to replace regular (or irregular) visits to your health providers. Questions or suggestions can be emailed to Lmorton@ thevanhornadvocate.com or P.O. Box 8, Van Horn, Texas 79855.
By Gilda Morales, ANP, DC
Almost every time that I review a patient’s blood work and have to break the news that they have diabetes, I hear the same thing, “I don’t eat sweets, how can I be diabetic?” I then have to go into my usual spiel explaining that sweets/sugars are not the only thing that increases blood sugar. Maybe that’s the problem. Sugar is a term that is used alternately with glucose, which comes primarily from the metabolism of sugars and carbohydrates or starches. Your body cannot really discern the difference between sugars and starches like potatoes, breads, rice, pastas, and the worst culprit for our community—TORTILLAS! Usually, as I am going through the list of “avoids,” I can almost guarantee what the next question will be…What about corn tortillas? Then, I have to gently ask if the patient knows what is fed to pigs to fatten them up, and the patient will always answer—corn!
My next lecture to my patients is to reassure them that they will not starve to death, and that there are plenty of foods left to eat. I give them some ideas for adapting the typical Hispanic diet to conform to a diabetic or low carb way of eating. For example, Chiles Rellenos are not forbidden, just go easy on the frying and the cheese. Chile Verde con carne is fine, just forget the potatoes, and asado is also acceptable, as long as there is decreased fat and flour to thicken the sauce. Snacks that don’t raise blood sugar are nuts, jerky and avocados. Tamales, enchiladas or tacos, are not diabetic friendly, even if you only eat half a dozen!
Unfortunately, type 2 diabetes does not usually strike alone. Often, it is accompanied by two other conditions, high blood pressure and high cholesterol, which also have to be addressed. Type 2 diabetes is many times preceded by what is called the metabolic syndrome—high blood pressure, increased blood sugar, and an increase in the waist and weight. A family history of type 2 diabetes also increases the risk of one developing it as well.
Sometimes, if caught early, weight loss will help bring both blood sugar and blood pressure down, but managing diabetes can be difficult if the patient does not commit to a lifestyle change. Many patients think that diabetes medication is a “magic pill” that will take care of the disease and are shocked after their labs are repeated in 3 months. At that point, I have to point out the many risks to health that comes from uncontrolled diabetes, including kidney problems, cardiac artery disease, diabetic neuropathy or numbness and burning of the feet, as well as vision loss. At this point, if the patient whines about it being so hard to “diet,” I give them the choice of eating a tortilla, or being able to see the tortilla…that usually makes the point.
Current practices recommend that anyone over the age of 45, or with a family history or symptoms of diabetes, be checked for it. Traditionally, we use the HbA1c blood test to diagnose diabetes, which will give an average blood glucose level over the last 3 months, regardless of your eating a bag of Snickers before your test.
Bottom line, being diagnosed with diabetes is not the end of the world as long as the patient works closely with his/her health care provider to control it and minimize the long list of complications that can come from not controlling it.