As the year comes to a close it is nice to finish old projects so you can have a clean slate for the New Year. In that spirit, here are answers to a few questions that my patients have asked through the year. Keep this information in mind as you start of 2013 with new resolutions to get or stay healthy!
What is the best sugar substitute?
There are currently six categories of non-nutritive sugar substitutes on the market: acesulfame potassium (Sweet One®), sucralose (Splenda®), neotame, aspartame (Equal®), saccharin and rebiana (Truvia®). All have been labeled as safe in the quantities recommended by the Food and Drug Administration (FDA). These quantities exceed by a large margin the amount consumed by the general user. However, theJoslinDiabetesCenterbelieves that the safety of these substitutes have not been sufficiently established for use in pregnancy. As a general rule, if you choose to use sugar substitutes it is best to be prudent and limit the total amount you consume each day. For example, a packet of sugar substitute in your coffee once a day, one on your morning cereal and a diet soda would be reasonable.
What is the best fruit to eat? Or “I can’t have grapes, right?”
Fruits provide important vitamins and minerals as well as fiber and a sweet taste in the diet. Two to three servings of fruit should be included in your diet on a daily basis. However, all fruits contain carbohydrate and have to be accounted for in your mealplan, or if you are dosing your insulin based on carbohydrate amounts. Some fruits, such as apples, pears and berries, have a lower glycemic index than others and are digested more slowly, producing a gentler, more rounded glucose curve.
Although often perceived as high glycemic index grapes are actually in the low moderate range on the scale. Because it’s often difficult to stay within the recommended portion size of 12 large or 17 small grapes, many people see high blood glucose numbers after eating grapes.
Why is it a problem having only (non-starchy) vegetables and meat for dinner?
Skipping a significant source of carbohydrate at meals can lead to hypoglycemia for those taking insulin or oral medicines that cause the pancreas to secret insulin. For those on lifestyle control or medications such as metformin, the risk of hypoglycemia isn’t an issue. Rather, if you are avoiding carbohydrate foods at one meal you may be eating too many at another or if you are limiting or avoiding them altogether you may be missing out on a number of important nutrients, such as the B vitamins, magnesium, copper, phosphorus, iron, calcium and fiber.