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Once upon a time, the diet advice for people with diabetes was fairly concise, and it went something like this – “Don’t eat sugar!” Well, guess what? That strategy didn’t seem to cure anybody. Strike one. Next up was an attempt at the one-size-fits-all, handy-dandy, pre-printed tear-off diet sheet that directed you to follow your 1,800-calorie diabetes diet plan (or whatever calorie level you were assigned to). Not that many people were thrilled with being told to eat the exact same tedious diet pattern day after day for the rest of their lives. Strike two. Most recently, health experts have come to the conclusion that dietary interventions for people with diabetes should be individualized. That’s a home run, finally!

From here on out, when I use the word “diet” I’m referring to your overall food choices and pattern of eating. I don’t mean diet in terms of a temporary fix or in the sense of dieting for weight loss (although that can be built into the plan). When I say “diet,” I’m referring to the way you eat or aim to eat most of the time.

The management of diabetes has a dietary component. What you eat, how much, and when you eat it directly affects your blood glucose and overall health. Diabetes and diet principles are inseparable. Now throw in a few more variables such as exercise, stress, body weight, concurrent health problems, and medications. It isn’t uncommon to feel like you’re a juggler trying to keep six balls in the air without ever slipping up. If you can relax and focus on one variable at a time, diabetes self-management becomes doable. Instead of thinking about juggling, imagine that each aspect of diabetes management is a piece of a larger puzzle. Diabetes & Carb Counting For Dummies is designed to help you put those pieces together.

The current diabetes trend lines are alarming. It’s impossible to keep up with the statistics because they change so fast, but the 2016 tally has the count at 29 million Americans with diabetes and 86 million more with prediabetes. That’s one out of every three American adults on the path to diabetes – unless action is taken. Studies conclusively show that diet and exercise are the most effective strategies for slowing or reversing that trend. I’m writing this book to reach as many people with diabetes and prediabetes as possible. This book provides an overview on diabetes and looks at dietary strategies and diabetes self-management principles. The nutrition information is geared for overall health; in other words, even people without diabetes will find worthwhile content.

About This Book

It’s impossible to approach diabetes management without focusing on food. Finding out more about diet, especially carbohydrates, gets to the very core of diabetes treatment. Sure, medications are important, but you can’t just slap on a medication and ignore diet because you can out-eat any medication. Managing your diet doesn’t have to mean giving up all of your favorite foods. On the contrary, you should be able to eat most foods. It’s a matter of balancing carbohydrate intake with exercise and medications (if you take them). While there is room for individual preference, the diet you choose to follow should support overall health, provide a variety of nutrient-dense foods in appropriate portions to promote a healthy body weight, and assist in reaching treatment targets for blood glucose, lipids, and blood pressure.

This book has a focus on understanding and managing carbohydrate, but it addresses all aspects of diet with diabetes. As each topic is covered:

❯❯ You’re provided with clear, understandable information that thoroughly explains each concept.

❯❯ You know why the recommendations are being made and what the payoffs are.

❯❯ You’re made aware of potential consequences should you opt out of the advice.

Diabetes self-management takes some effort, but you’re worth it. Taking care of your diabetes improves health and reduces risks. The rewards may be a little less tangible than saving up for a flat-screen TV, but health and quality of life are far more important than material things. Remember: The best things in life aren’t “things” at all.

A few more comments and clarifications about this book:

❯❯ I’ve chosen to use the term blood glucose because glucose is the type of sugar streaming through your blood vessels, but it is equally acceptable to call it blood sugar. In the United States, blood glucose is measured in milligrams per deciliter (mg/dl). If you’re accustomed to millimoles per liter (mmol/L), simply divide mg/dl by 18.

❯❯ Occasionally, I include sidebars, shown in shaded boxes. Some, but not all, of the sidebars provide personal stories that uncover solutions to common diabetes management issues. Feel free to skip sidebars or anything with the Technical Stuff icon, which highlights information that’s interesting but not essential to understanding carb counting and diabetes.

❯❯ Diabetes doesn’t define you, so you will never hear me call you a diabetic. You are a person who has been dealt the diabetes card, but the deck is not stacked against you. Play your cards wisely and chances are you’ll have a winning hand.

❯❯ Within this book, you may note that some web addresses break across two lines of text. If you’re reading this book in print and want to visit one of these web pages, simply key in the web address exactly as it’s noted in the text, pretending as though the line break doesn’t exist. If you’re reading this as an e-book, you’ve got it easy – just click the web address to be taken directly to the web page.

Foolish Assumptions

When planning the content for this book, I thought critically about who my potential readers would be. I assumed there would be diversity because, for starters, there’s more than one kind of diabetes. Additionally, many people with diabetes are simultaneously trying to manage weight, cholesterol, or blood pressure.

I’ve made the following assumptions about who you might be:

❯❯ You have diabetes: type 1 diabetes, type 2 diabetes, or any other form of glucose dysregulation. You may have been recently diagnosed or you may have had diabetes for years (or decades) and are looking for up-to-date, accurate, and tangible information.

❯❯ You’ve heard that diet, weight control, and exercise are foundational strategies for managing diabetes or preventing prediabetes from progressing to type 2.

❯❯ You may have developed gestational diabetes or be a woman with pre-existing type 1 or type 2 diabetes who is committed to having a safe pregnancy and a healthy baby.

❯❯ You may be a parent of a child with diabetes or have a family member or other loved one with diabetes, and you want to know how you can help.

Icons Used in This Book

The four icons used throughout this book identify different kinds of information.

A tip may save you time, simplify a concept, improve health, or present you with your “aha” moment of the day.

This icon identifies essential information, a take-home message worth sharing with family and friends. This symbol also identifies concepts that you should discuss further with your healthcare provider, such as medication dosing adjustments.

Don’t skim over or ignore any warnings. This icon is there to protect you from harm.

Text marked with this icon provides details that are not essential to the book’s main theme – for example, an interesting scientific explanation, background details on a study, or information pertaining to a subset of readers who use medical devices.

Beyond the Book

In addition to the content in this book, you can access free companion materials online. Simply navigate to www.dummies.com and search for “Diabetes & Carb Counting For Dummies Cheat Sheet.” From there you’ll be able to read or print several useful articles about choosing carbs wisely, making better food choices, and more.

Where to Go from Here

Please feel free to read this book’s chapters in any order. For Dummies books are not linear, meaning content doesn’t build sequentially. Each chapter develops a core concept and provides usable information that stands alone yet ultimately dovetails with other pieces of the diabetes puzzle. Review the table of contents and see whether any particular chapter is calling your name.

If you aren’t sure where to begin, Chapter 1 provides a glimpse of the key content in the book and directs you to the appropriate chapters where you can find more details on each topic. Chapter 2 is a great place to get an overview on diabetes.

Be sure to read Chapter 4 sooner rather than later. Chapter 4 has concepts and illustrations that are integral to much of the rest of this book. It explains what happens to food after you eat it – how the body processes carbohydrates and then uses, stores, and even creates glucose. It also explains what happens when glucose levels rise too high or fall too low.