By Cynthia York-Camden MS, RD, LDN

Diabetes is on the rise in the United States and many of us are surprised by our doctor with a new diagnosis of Diabetes or Pre-Diabetes.  It can be very overwhelming walking out of the doctors office and wondering "Now what can I eat?".  As a registered dietitian in a local hospital setting, I enjoying helping people discover foods that will fit with thier new diagnosis of diabetes.   We start by looking at foods they usually enjoy and then look at ways to fit these foods or similar foods in their plans for eating with diabetes.  Here is an example of a clients usual intake and how we would work together to make healthier changes.  Notice how we just wrote down the usual day and then step by step looked at some positive changes.. After meeting with a dietitian, many people are happy to say "I can still eat the foods that I love!"  

Usual Morning meal: Large bowl of Honey nut Cheerios,Banana on cereal,2 pieces of white toast, Coffiee, Orange Juice 12 ounces.

New morning meal:  1 cup Honey nut cheerios, Use 1/2 banana and save the other half for a snack or freeze it for healthy smoothies, Try whole grain breads and cut back to one piece of toast, Limit juice to 4 ounces and consider eating a small orange or cup of fresh fruit instead of juice. 

Comments:  Breakfast is important for many reasons including consistent blood sugars and successful wieght loss (if needed).  Try looking for cereals with more than 5 grams fiber.  Don't give up with one cereal but keep trying till you find the one you love.  Use the label to find the serving for 15 grams or one carbohydrate serving.  Could also cut out the juice and eat 2 slices of whole grain bread with more than 3 grams fiber if prefered. Read labels and look for bread that contains 15 to 20 grams per serving..  Try the lighter breads which give two slices for only 15 grams of carbohydrate. 

Usual Midday meal:  Skip this.. too busy to eat.. Maybe drink some juice or a sports drink. 

New midday meal: Start with something small for lunch such as 1/2 sandwich with fruit and veggies from home.  If you prefer to drink your lunch try the weight reduction type drinks or meal replacement drinks.  Keep total carbohydrates under your personal amount..  On average most people can shoot fro 45 to 60 grams per meal.   

Comments: Experiment with foods that are quick and easy for you.  Work with your dietitian to find the right amount of carbohydrates to keep your blood sugars in your target range. 

Usual afternoon food: Get very hungry and sometimes get a candy bar from the vending machine at work.  If at home eat whatever is available. 

New afternoon food: Bring a small granola bar or weight reduction type snack bar to prevent temptation.  Can also pack some whole grain crackers, dry roasted nuts and small piece of fruit.  

Comments: Experiment with snack choices that help keep you going until time to eat the evening meal.  Usually want to stay below 30 grams of carbohydrate for this time.. work with your dietitian to find out the amount that works for you.  Find the right amount of carbohydrates to keep blood sugars in your target range. 

Usual evening meal: Eat out or order pizza or chinese after work.. too busy to cook.

New evening meal: Dust off the crock pot to have meals ready when you com home.  Italian beef with vegetables.  Add a bag salad and fruit for dessert. 

Make a quick healthy  personal pizzas at home using whole grain pita bread and your favorite low fat toppings and vegetables.  Use only 1/4 cup low fat cheese.  Use leftover meat for toppings..  Be sure to heat any leftovers to 165 F in microwave.  To finish pizza melt the cheese in the broiler for 5 minutes or until brown.  Enjoy with a salad and fruit for dessert.

Comments:  Think about buying a quick meals cookbook from the American Diabetes Association.  Quick meals a home can be just as tasty and even faster than ordering from a restaurant.  Save your restaurant money for something fun that you have not been able to afford. 

Usual bedtime snacks:  Eat salty and crunchy foods in front of the TV.  Try healthier choices but eat the whole bag..

New bedtime snacks:  Plan snacks in the evening, however portion out 15 to 30 grams of carbohydrate and hide the rest.  Choose whole grains, more than 3 grams of fiber, fresh fruit, choices.  Example: 5 whole grain crackers with a small apple and 5 whole baby carrots. Could also do 2 to 3 cups of air pop corn. 

Comments:  Break the cycle of unconscious eating by not eating in front of the television.  Stay in the kitchen and talk to you family.  Be conscious of what you eating and try taking breaks between bites.. yum! 

Usuall diet:  Sometimes wake up hungry and eat leftovers in the middle of the night.

New diet plan:  Try not to eat in the middle of the night unless your blood sugar is low.  New consistent eating during the day may make nighttimes easier once you get into a new routine. 

Comments: Try changing your routine to make sure you are getting the right amount of sleep. If you have not been eating much in the evening.. then a bedtime snack may also help with this concern. Take your blood sugar at these times and talk to your doctor about any low blood sugars. Medications may need to be adjusted to prevent low blood sugars or high blood sugars at night.  

 Always remember to talk to you doctor and dietitian about any changes in your meal planning routine.  Check your blood sugars regularly.  If you have not seen a dietitian contact your doctor and ask him for a referral to a local dietitian.  You can also look for diabetes dietitians on the web at http://www.rdlink.com/directory_of_dietitians/diabetes_find_a_diabetes_dietitian_on_the_web.html