Diet taboos for patients with hyperglycemia

The first is that indiscriminate taboos lead to nutritional imbalances, the second is the large intake of invisible high-glycemic foods, and the third is that extreme dieting to control sugar causes blood sugar fluctuations.

I was chatting with an endocrinology nurse at a community hospital last week, and she complained about an old patient who dared not touch a morsel of fruit for half a year and ate brown rice with boiled vegetables. As a result, the glycosylated hemoglobin increased from 6.8 to 7.2. He was also diagnosed with iron deficiency anemia. When I asked about it, I found out that he did not even dare to eat more grains. He only ate less than half a bowl of staple food every day and ate cucumbers when he was hungry. His blood sugar fluctuated and his blood sugar fluctuated, which was worse than that of someone who occasionally ate a few bites of an apple.

Many people’s understanding of glycemic foods is still that “sweet = raises glycemic rate quickly”, but this is not the case. For example, the GI (glycemic index) of white steamed buns can reach 88, which is much higher than the 70 of cantaloupe. If you eat one white steamed bun, your blood sugar will rise much faster than if you eat two small pieces of cantaloupe. There is also a very common controversy here: some sugar control guidelines require that the GI of all foods must be below 55, and any food that exceeds the standard should not be touched. However, many clinicians actually advise patients not to be so stuck - after all, everyone's pancreatic islet sensitivity is different. Some people eat half a banana and their blood sugar soars to 10, while some eat a whole banana and the test is only 7.5. There is really no need to stick to the table. Oh, by the way, here’s a quick tidbit. High GI foods may not necessarily raise your blood sugar after eating them. It also depends on the GL (glycemic load). Simply put, it means considering the total carbohydrate content eaten. For example, watermelon has a GI of 72, but only 5g of carbohydrates per 100g. If you eat a small piece of about 100g, the GL is only 3.6, which will not put a big burden on your blood sugar at all.

Speaking of which, I encountered something more interesting last time. Some people heard that eating bitter melon can lower blood sugar. They ate cold bitter melon all the time. As a result, their stomachs were damaged and their blood sugar did not drop much. There is no natural food that can directly lower blood sugar. Those who say that eating bitter melon, okra, and pumpkin can lower blood sugar are all IQ taxes. Don’t believe it.

The easiest thing to fall into is actually invisible candy, which many people don’t pay attention to at all. A young man told me before that he drank sugar-free Coke every day to control his sugar. As a result, he gained three pounds and his blood sugar did not come down. Later, he discovered that he drank a "sugar-free latte" every afternoon and added two pumps of vanilla syrup to make it taste better. One pump of that thing has 10g of sugar. Two pumps of it directly exceeds the daily quota of added sugars. There is also the rock sugar used when making braised pork ribs and braised pork at home, the maltodextrin and crystallized fructose added to the "sugar-free biscuits" sold outside, and even sour-tasting salad dressing and blueberry jam. There are so many invisible sugars that you can't imagine. Don't just pop them into your mouth just because it says "sugar-free" on the package. Look through the ingredient list. If the top three include fructose syrup, maltodextrin, and refined starch, then no matter how "sugar-free" they are, you need to avoid them.

Nowadays, there are many dietary schools on sugar control on the Internet. The low-carb group says that we should completely cut out sugary foods such as refined rice and flour, and the daily carbohydrate intake should not exceed 100g. The vegan group says that we should reject all animal foods and only eat whole grains and vegetables. In fact, both of them are a bit extreme. I have seen an aunt who has been following a low-carb diet for three months, and her ketone body was so high that she almost suffered from ketoacidosis. I have also seen patients who eat a vegetarian diet every day, whose protein intake is insufficient, and their immunity is in a mess. In fact, what is more recommended in clinical guidelines is individualized adjustment: for young patients with good pancreatic islet function and newly diagnosed, it is okay to occasionally try a low-carbohydrate diet to control weight. For those who have been diagnosed for three to five years and have poor pancreatic islet function, it is better to distribute according to the total calories, with carbohydrates accounting for 40% to 50%, protein accounting for 30%, and fat accounting for 20%. It is safer to take a steady approach.

Let me tell you a little trick I use to help patients adjust their diet. If you really don’t know what you can and cannot eat, just take a fingertip blood test two hours after eating. It is much more reliable than memorizing hundreds of taboos on the Internet. I once had a patient who loved watermelon and was afraid to eat it at first. Later, he tried eating a small piece and his blood sugar was only 6.9. After that, he could eat it once or twice a week. His mood improved and his blood sugar became more stable.

In fact, sugar control is really not an ascetic of "you can't eat this or touch that". Don't be blinded by various taboos on the Internet. Find out your own blood sugar patterns, avoid the three big pitfalls mentioned at the beginning, and occasionally take a few bites of what you want. As long as you control the amount, there will be no problem at all.