Health Archives - Diabetes Counselling Online

Why So High?

February 24, 2015 by Imagine_David 1 Comment

So often I hear ‘why so high’ from my clients, people living with diabetes.

So often I hear no diabetes specialised health care professionals asking ‘why so high’ when a person living with diabetes is in a bed in pain following an infection requiring a surgical procedure.

So often I hear ‘Its all too hard, Im not going to bother with this diabetes stuff, its all so confusing’ – diabetes burnout! arrrghhhh!

“Diabetes is not a death sentence, but it can feel like a life one. It can really shake up your world. After diagnosis, day-to-day activities that were once simple and straightforward such as eating, exercising, even enjoying a late night out with a few glasses of red, suddenly require greater attention, forward planning and consideration.

After a while it can feel like there is never time out from diabetes management, which like an octopus, sends its tentacles into every area of your life. Sometimes you will feel totally in control of this juggle and marvel at how well you manage. At other times, monitoring your blood glucose levels (BGLs), medication and insulin on top of the hurdles of everyday life, will become a time-sucking intrusion in your day. In particular, when you are overloaded with lots of other responsibilities and tasks, or when diabetes is not ‘playing fair’, your daily ‘must do’ diabetes management list can become an exhausting marathon. In your lowest moments, this can weigh heavily and feel an enormous burden, even a curse.” from our eBook Put the Brakes on Diabetes Burnout

Up and down we go!

So, the next tome you have a question like ‘why so high’ consider some of the things here in this chart:

Causes	Ask These Questions	Take Action
		If your answers to the questions are yes, follow these suggestions.
Food	Have you increased your portion sizes? Have you changed your eating habits or food choices? Have you eaten too many high-fat foods?	You may need to measure food more accurately to check portion control. If you think your eating pattern is changing, your medication or exercise plan may need to change.
Activity	Have you decreased or eliminated your usual activity? Are you doing too little physical activity?	Physical activity is a key to blood glucose control. Ask your healthcare team about starting a program.
Medication	Have you been taking the prescribed doses? Have you been taking the medication at the right time?Do you have “spoiled” insulin? Does your insulin look different? Was your insulin exposed to very hot or cold temperatures? Has your insulin expired?	Take the right dose at the right time. If you have any questions ask a diabetes educator. Throw away the bottle and open a new bottle. Check the expiration date on bottle.
Monitoring	Is the drop of blood too small? Are you using the correct technique? Could your meter be dirty? Have your strips expired? Have your strips been exposed to very hot or cold temperatures or not been kept in an airtight, dry, container? Is your meter calibrated to the current bottle of strips?	See a nurse educator to be sure your technique is correct and your meter is functioning the right way. Learn how to clean the meter.Throw away the strips and get a new bottle. Check the code on the strip bottle.
Illness, infection, injury and surgery	Are you feeling well? Do you have any infections?	Follow sick day rules. Contact your healthcare team for questions or help.

Some of my clients have found it helpful when visiting their health care professionals to share their knowledge about diabetes. You might find it helpful to download and complete this DIABETES KNOWLEDGE QUESTIONNAIRE (old rtf format) and take it with you to your next doctor and/or diabetes educator and/or dietitian appointment.

One of the problems for people living with diabetes of course is not FEELING the high blood glucose level. A blood glucose level of 10-15mmols is likely NOT to cause the symptoms of:

Being excessively thirsty
Need to wee more often than normal
Feeling tired and lethargic
Always feeling hungry
Having cuts that heal slowly
Itching, skin infections
Blurred vision
Gradually putting on weight
Mood swings
Headaches
Feeling dizzy
Leg cramps

However, just because you feel ok doesn’t mean that things are healthy.

Treatment of High BLOOD GLUCOSE LEVEL

For Type 1 diabetes

Plan ahead. Work with your doctor or Diabetes Educator for advice about increasing your dose of short acting insulin in this situation – before you need to.

You may need extra doses on top of your usual dose, and also you may need insulin (e.g. 2-4 units every 2 hours).

Test your blood glucose levels frequently. Measure your ketone level if the blood glucose level is over 15 mmols.

Drink extra water or low calorie fluids to keep up with fluid lost by passing more urine.

Contact your doctor or go to hospital if:

Vomiting stops you from drinking and makes eating difficult
Blood glucose levels remain high
Moderate to large ketones are present in the urine.

In type 1 diabetes, high blood glucose levels can progress to a serious condition called Ketoacidosis.

For Type 2 diabetes

Even for people NOT living with diabetes it is normal for blood glucose levels to go up and down throughout the day.

And an occasional high blood glucose level is not a problem.

However, if your blood glucose level remains high for a few days or if you are sick, enable your sick day plan and seek medical advice if unsure of what to do.

Further sick day plans can be found here:

MedlinePLus (USA)

Australian Diabetes Educators Association

Royal Australian College of General Practitioners

******* If in doubt always consult your health care professional *********

Please Share!

Case Study: George Mellows (Part 4) – A visit to the Diabetes Educator

February 18, 2015 by Imagine_David 3 Comments

George Mellows is aged 55. He lives with his wife and his two teenage children, aged 15 and 19.

George works Monday to Friday 8.30 am until 4.30 pm . He works at a desk in a sedentary role, getting minimal activity in his working day. George has not played any sport for some time, but he does enjoy playing lawn bowls.

*** Previous Posts: Part 1 here ; Part 2 here ; Part 3 here ***

George has now had diabetes 3 months. He has had a consultation with his dietitian and found some healthy choices to make that not only fit with his diabetes self care plan but also things he enjoys!

This past 2 weeks George has been measuring his blood glucose level with a view of discussing the results with the diabetes educator. George feels confident that he can identify the causes of hyperglycaemia

On diagnosis, George’s doctor commenced George on Metformin 500mg in the evening with dinner. This has not changed.

The table below is his most recent blood glucose levels. George has highlighted the blood glucose levels that are over his target in red.

The Visit

“Self-management means having a daily management plan, setting goals, solving problems and taking responsibility. But it certainly does not mean you are on your own. Mutual trust and respect between yourself and your doctor and other members of the health care team, as well as regular communication with them, are vital to effective self-management.

Previously, traditional care was based on doctors and health professionals being seen as the experts responsible for the diagnosis and management of care. It was accepted that people’s lives should be fitted around their diabetes with goals set by the health professionals.

But this approach is not effective. Diabetes requires daily management. Doctors are not available every day, leaving responsibility for day-to-day care on the patient and the family.

In addition, good results are difficult to achieve if the person involved is not an active participant or does not understand the reasons behind management decisions.

Patient Empowerment takes a new approach. It moves the focus from the doctor to the patient. It involves fitting diabetes into your lifestyle with you making the choices and taking charge of your management and the consequences.” Diabetes Australia

Tools

On arrival in the consultation room George was asked by the receptionist to complete:

* The Diabetes Distress Scale (download here DDS and HERE )

* The Diabetes Knowledge Questionnaire (download here DIABETES KNOWLEDGE QUESTIONNAIRE (old rtf format) )

George felt a little uncomfortable initially using these ‘tools‘ to complete these ‘tests’. However, the diabetes educator saw George acting a little uncomfortable in the waiting room and explained that the purpose of these tools would be to individualise the visit based on the knowledge and needs of George.

George felt more comfortable with this explanation, and managed to complete both before the visit started in person. *He also felt that it might have been good to complete these at home before the visit.*

"Enjoying a good quality of life is my goal" George — **“Enjoying a good quality of life is my goal” George**

“How did you feel about completing those tools George?” the diabetes educator asked as they sat down to start the session.

” At first it was a little like being in school; but when you saw I was puzzled about them, and explained how we could use them in this session, I felt like I was going to be listened to, not just spoken at and told what I should and shouldn’t do” replied George.

The diabetes educator then used these with George to open and lead the session. George was also a little surprised at this, expecting the diabetes educator to be focussed on his blood glucose levels.

The diabetes educator started with the knowledge questionnaire, only asking George about the question he had gotten incorrect. By the end of the first 20minutes George was feeling that he was learning new things despite al of the reading and research he had been doing on the internet.

George hadn’t even considered the importance of foot-care, despite being aware that diabetes can effect the nerves and the blood supply to parts of the body.

Diabetes Distress

Diabetes may lead to specific problems and increased stress, which we often call “diabetes distress”.

Daily life and general stress levels can affect your diabetes control. How well your diabetes is going can in turn affect your general stress levels – so it is a bit of a chicken and egg. It is very important to get the general stress in your life under control, as this will assist with your diabetes management. Likewise, feeling settled with your diabetes management will decrease your overall stress.

If you are struggling with stress at work, or in your personal life, it can be harder to manage diabetes and it suffers. We all experience stress and life would be boring without some stress! People say they would rather not have stress in their lives, but in fact we need a balance between just enough stress and not too much, to keep us alive and active. Not all stress is bad believe it or not.

Some of the things that can lead to diabetes distress are:

Worry about food changes
Management of blood glucose levels
Weight management
Going onto insulin/medication
Hypos (low BGL)
Depression & mood swings – have been shown to be higher in people with diabetes
Relationship & sexual problems
Work stress, discrimination in relation to your diabetes
Disclosure – wondering if you should tell people about your diabetes
Lack of understanding or support from family/friends
Guilt, fear, worry, panic & anxiety about diabetes and your future
Risk of Complications
Feeling alone and isolated
Seeing or hearing about all the things that can go wrong
Feeling out of control
Other mental health problems such as an eating disorder
Feeling overwhelmed and exhausted
Lack of information

Blood Glucose Levels

Towards the end of the session the diabetes educator and George decided to take a careful look at the blood glucose levels that George had been measuring.

The diabetes educator asked “George, why do you test your blood glucose level?”

George was a little taken aback by this question. He thought that everybody just had to, that it was a part of having diabetes.

After a moment he said: ” To determine if my diabetes self care plan is working well, or if there needs to be some changes to my meal planning, or my exercise, or to my diabetes medication.”

George identified clearly the things that would impact on his blood glucose level, and also identified that weekdays at lunchtimes when he didn’t move very much was a problem for him.

Future Planning

The plan at the end of the session was to make an appointment with an exercise physiologist and a podiatrist, and then return to the diabetes educator in 6 months (unless he felt the need to return sooner).

George also had a plan to talk with his manager to have 60 minutes for lunch and go for a 20 minute walk each working day after he had eaten. This meant that he would have to work back an extra 30 minutes. But he also felt it was well worth it if it meant having a better quality of life, and potentially a longer working life (by minimising the risks to his health caused by high blood glucose levels).

George felt that he had achieved quite a lot in his first few months of living with diabetes, but was also aware that this was only the beginning of a lifelong journey.

Please Share!

D-thoughts on snacking

January 26, 2015 by Sally Leave a Comment

Happy Australia Day! And what good timing for a blog on snacking! It must be the ‘most asked’ question I get as a dietitian: “What are the best snacks for people with diabetes?”

It’s not really a black and white question as the answer depends on your personal diabetes requirements, your personal tastes, your ability to be mindful in your choices and your knowledge of healthy eating in general. So this blog aims to help you to be mindful in making snacking decisions.

We encourage you to choose foods that are higher in nutrients to add to your overall wellbeing, rather than ‘discretionary choices’ which everybody, diabetic or not, is encouraged to limit. It’s especially the case for us with diabetes… but it doesn’t mean missing out on delicious flavours!

Priority One

Your first priority needs to be your overall diabetes goals. Are you getting all the nutrients from your diet that you need for wellbeing? Are you needing to watch your weight? Is matching your food intake to your body’s ability to process carbs an issue for you?

A perfect segue to our Australian Dietary Guidelines… Are you actually meeting the quantities recommended in the 5 main food groups across your day?

In an ideal world we would choose snacks that are included in the foods that we are recommended to enjoy each day. In these examples I’m referring to the ‘Healthy Eating for Adults’ brochure, but there’s also a Healthy Eating for Children brochure for those thinking about their children with diabetes. In both cases, the actual food group listings are on page 2.

Each of the food groups has snacking potential, so there’s always plenty to choose from.

In the ‘Vegetables and legumes/beans’ group you can always find a low-carb snack if that’s what you’re after. Whether it’s raw veg to nibble on, celery with nut butter, blanched asparagus spears when they’re in season, tasty tiny tomatoes that burst with flavour in your mouth, hummous dip with veggie sticks, or even leftover cold roasted non-starchies or ratatouille (recipe in the files section of the closed ‘Diabetes and Food – let’s celebrate it!’ Facebook group). There are always options in this group of foods if one of them will meet what you’re looking for…

Next group down and a great one for those wanting something to satisfy a sweetness craving is the ‘Fruit’ group. With diabetes we are recommended to aim for about 2 serves per day, eaten at different times. However, some fruits are really low in carbohydrate, so we can have more of these without upsetting our glycemic control. Some of those include berries, passionfruit and kiwifruit. But still watch your quantities. If you want to know how much fruit will contain 15g of carbohydrate, take a look at www.calorieking.com.au , search for the fruit you are looking at, and adjust quantities to get to the 1 carb serve number.

In the ‘Grain (cereal) foods’ group, it’s easy to calculate whether you’re going to meet your daily recommended amount. Often for people with diabetes this is a group that people actually tend to be low in. Instead of choosing a ‘discretionary item’, swapping in a low-GI high fibre grain snack such a piece of heavily grained toast with a topping to suit your taste can be a great option to satisfy your hunger and keep your BGLs stable. Or even a small bowl of your high-fibre cereal. Of course these options all contain carbs, but they are all much more nutritious than a cracker or sweet biscuit.

In the ‘Protein’ group, snacking options are easy to find, but it’s important to remember to try not to exceed the guidelines in terms of serve sizes and number of serves recommendations. This is because protein contains energy (or calories/kilojoules) that will cause weight gain if you have too much, although they shouldn’t upset your glycemic control. I recommend having a read of this blog on Protein : written earlier, if you’d like more info. The perfect snack from within this group for us with diabetes is really a handful of nuts, as the evidence behind inclusion of nuts in our diet is quite outstanding. Read more about nuts in this blog.

And last, but not least, is the ‘Dairy and/or alternatives’ group. I wrote a couple of blogs about dairy and diabetes as it’s such an important food group for us with diabetes. Here’s a link to the first one and the second one that contain more great ideas for snacking. My favourite snacking recommendations to help meet the nutritional guidelines are a low-fat yogurt (low sugar too if you’re watching your carb intake closely) or plain low-fat greek yogurt with berries mixed in. Or a low-fat milk based smoothie made on frozen berries, with a couple of teaspoons of chia seeds added for extra fibre. Even a cup of milk based coffee can do the trick… These should work well to satisfy hunger and provide you with the nutrients this group is known for.

Priority Two

Your second priority, also a very important one, is to ask yourself what do you actually feel like eating and why? Sometimes snacking can become a habit. People say “I have a sweet tooth and NEED a biscuit or cake”. (or whatever) This is important too, because if you deprive yourself of what you really want (or feel you need) all the time, then your craving will only grow bigger and you’ll end up overdoing it and regretting it later. Not a good thing, but happens all too often. If you can enjoy a small amount of what you feel you “need”, being mindful of enjoying every mouthful, savouring the textures and flavours that you’ve wanted so badly, then you’re in a better place to return to your ‘healthier’ options on a regular basis.

Do I really need to snack?

If you’re medicated for your diabetes, and are putting yourself at risk of a hypo if you don’t snack, then you should snack as you’ve been advised by your medical diabetes team. If in this case you’d rather not be snacking as you’re just not hungry, then you should talk to your d-team and arrange to have the medication adjusted so that you don’t need to snack.

For those of you where snacking has just become a habit, it’s worth thinking twice to see if you really are hungry before you just head for a snack. Is it out of habit or because you’re bored? Sometimes a drink of water will satisfy that ‘hunger’ feeling, which may actually be your body telling you that you’re dehydrated. If you’re bored, take the opportunity to go for a walk, call a friend, do something off your household chores list, read a book, or engage in your hobby.

If you are constantly actually hungry, it may be worth your while to visit an Accredited Practising Dietitian to see how your meal plan can be adjusted to help avoid that happening. Being hungry is not good or necessary for you to manage your diabetes and weight well.

More ideas?

In the Diabetes Counselling Online closed Facebook groups ‘Diabetes and Food – let’s celebrate it!’ and ‘Diabetes Weight Matters’ we’ve asked the members what their favourite snacks are and have created a document up in the files section of the groups. I think I still need to finalise the weight matters file, but it’ll be there soon. These are member ideas, not necessarily dietitian approved, so please use this blog as a thought process in helping to make your snacking decisions right for you.

Also in the current issue (February 2015) of the Australian Healthy Food Guide they’re running a feature relevant to this blog that you may find helpful. It’s entitled “Your Treat Foods Toolkit” and explains “why those ‘naughty’ treat foods are discretionary, and how they can fit into a healthy diet.” It’s written by an Accredited Practicing Dietitian, Brooke Longfield and can be found on page 34. Although not related specifically to diabetes, you’ll find it helpful for portion sizes and understanding more about ‘discretionary’ foods.

Happy snacking! Sally

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a linked list of all Sally’s Diabetes Counselling Online blogs here.

Please Share!

Case Study 1: George Mellows (1)

January 21, 2015 by Imagine_David Leave a Comment

Some things you can Control. Diabetes you can manage.

George Mellows is aged 55. He lives with his wife and his two teenage children, aged 15 and 19.

4 weeks ago George was:

feeling excessively thirsty
was peeing more than normal
was feeling tired and lethargic
and was always feeling hungry

So, George went to visit his doctor. He described the symptoms, and his doctor sent him for a glucose tolerance test to test for diabetes. The results of this test confirmed a diagnosis of type 2 diabetes .

George was a little shocked as he has nobody in the family with diabetes, only a history of heart disease.

Until this diagnosis of type 2 diabetes George had no identified health problems.

Since his doctor discovered diabetes George has had some further blood work and had been found to have high cholesterol.

Measuring the Blood Glucose Level

George decided to start measuring his blood glucose levels as he was still feeling some symptoms, despite the doctor commencing George on Metformin 500mg in the evening with dinner. Table 1 below shows George’s blood glucose level test results.

George has yet to see a diabetes educator, dietitian, exercise physiologist or podiatrist.

Since starting the blood glucose level measurement George identifies, that despite commencing on Metformin, his blood glucose levels are above target.

Below is a table from the RACGP (Royal Australian College of General Practitioners) identifying the target blood glucose levels in type 2 diabetes. *Note: target blood glucose levels need to be individualised.

Targets for self-monitored glycaemic control in type 2 diabetes *

FBG (mmol/L)	Pre-prandial blood glucose (mmol/L)	Postprandial blood glucose (mmol/L)	Comment
6.0–8.0	6.0–8.0	6.0–10.0	NHMRC values

Based on his blood glucose levels after meal, George is concerned. He thought that taking his Metformin would be all that he needed to do. Now, he feels like he has failed.

George joined several groups of people living with diabetes on Facebook ( https://www.facebook.com/diabetes.counselling ) to see if he could glean some further understanding of diabetes self management.

“Self-management means having a daily management plan, setting goals, solving problems and taking responsibility. But it certainly does not mean you are on your own. Mutual trust and respect between yourself and your doctor and other members of the health care team, as well as regular communication with them, are vital to effective self-management.

But this approach is not effective. Diabetes requires daily management. Doctors are not available every day, leaving responsibility for day-to-day care on the patient and the family.

In addition, good results are difficult to achieve if the person involved is not an active participant or does not understand the reasons behind management decisions.

Georges Plan:

Research diabetes and prepare questions for doctor, diabetes educator, dietitian.
Meet with diabetes educator:
“Diabetes educators are healthcare professionals who focus on helping people with and at risk for diabetes and related conditions achieve behavior change goals which, in turn, lead to better clinical outcomes and improved health status. Diabetes educators apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and education to provide self-management education/self- management training.” American Diabetes Association

“Diabetes educators specialise in the provision of diabetes self-management education for people with diabetes.

They provide support for people with diabetes, including gestational diabetes, integrating clinical care, self-management education, skills training and disease specific information to motivate patients to:
- Understand diabetes and make informed lifestyle and treatment choices
- Incorporate physical activity into daily life
- Use their medicines effectively and safely
- Monitor and interpret their blood glucose patterns” Allied Health Professions Australia
Meet with dietitian: appointment booked
Meet with doctor: appointment booked

George plans to ask about different treatment options.

Here are some questions George has prepared for his team:

Is this the best medication for me?

If I get any side effects what do I do? If this medication does not work, what’s next?

Do you mean ….. ? Is there anything I should not be doing?

How soon should treatment start ?

Can the treatment start next month when I am back from holidays?

Can I stop the treatment when I can’t afford it?

How much will the treatment cost?

What can I do to prevent further problems?

What can I do to keep my condition from getting worse?

How will making a change to my habits help me?

Are there support groups or community services that might help me?

Which other HCP’s will be able to help me manage this health issue?

Hand in hand with your health care professionals you van achieve a good quality of life with diabetes — Hand in hand with your health care professionals you can achieve a good quality of life when living with diabetes

Over to You

What advice would you give to George?

What was your experiences of being diagnosed with type 2 diabetes ?

How did you access your diabetes educator, dietitian, counsellor etc?

**** Added January 26: Part 2 HERE *****

Next time we visit George, we shall see how he is progressing with his diabetes self care plan http://www.diabetescounselling.com.au/choices-in-diabetes-management/

In the meantime, healthy days to you.

Kind Regards,

David, Diabetes Educator @ Diabetes Counselling Online

Please Share!

Making Rice Nice for Diabetes

January 12, 2015 by Sally Leave a Comment

Rice is one of those grains that can be problematic for people with diabetes, so I thought it might help if we explain a little of why that is, why different rices have varying effects on our BGLs and ways to make rice more diabetes friendly.

You may know that, generally speaking, a quarter of a cup of cooked rice is one carb serve. You can see that in this snip from CalorieKing showing that half a cup of boiled rice = 28.8g carb (or 2 carb serves).

And this photo shows you what half a cup of cooked rice (2 carb serves) looks like on a plate.

You may also know that, particularly for us with diabetes, we’re better having rice that breaks down more slowly to glucose in our bloodstream, or low-GI rice. The main types in Australia of low GI rices are long grain rices including Basmati and Doongara. Even when choosing brown rice for the extra fibre, we’re best to choose brown Basmati or Doongara.

This mini-table gives you a feel for the glycemic indexes of various rice products.

Source: Low GI Diet Shoppers Guide 2014

Rice type	Glycemic Index	Glycemic Index rating
Aborio/risotto rice, boiled, SunRice	69	Medium
Basmati white rice, boiled, SunRice	59	Medium
Basmati white rice, SunRice, microwave pouch	52	Low
Calrose rice, brown, medium-grain, boiled	76	High
Calrose rice, white, medium-grain, boiled	87	High
Japanese style sushi rice, SunRice	89	High
Jasmine fragrant rice, SunRice	73	High
Long-grain rice, white, boiled 15 mins, Mahatma	50	Low
Low-GI Long-Grain rice, Brown, SunRice	54	Low

This is only a snapshot, but it indicates that there’s quite a difference in how quickly the different rice types break down to glucose in our bloodstream. It’s also worth bearing in mind that the longer you cook any rice the higher it’s GI rating will become, so try to keep it tender, not mushy.

What makes these rices different in GI is the type of starches they contain combined with the shape of the grains. The two main starches found in rice varieties are amylose and amylopectin. Wikipedia explains that high-amylose varieties of rice, the less sticky long-grain rice, have a much lower glycemic load. It’s to do with the chemical structure of the starches.

Nutritionally rice is mostly starch (80-90%). This snip from Wikipedia shows the nutritional content of Rice, white, long-grain, raw, and demonstrates that it doesn’t add a whole lot of nutrients to our meals other than carbohydrate.

By keeping your portion sizes reasonable, consuming protein foods and vegetables with your rice meal will add nutrients and lower the overall GI of the meal.

And dishes that you’ve previously always used rice in can be nutritionally enhanced by swapping in other forms of more nutritious grains such as barley, quinoa and cracked wheat. Why not do an experiment and try some swaps out for yourself? One of my dietitian colleagues makes her sushi with quinoa, and barley risotto is amazing! Here’s a recipe from Taste.com.au for it.

One trick with rice is to combine it with other grains for added fibre and nutrients and to further lower the glycemic index and improve that nutritional profile.

Fortunately more and more options are available to us.

The Australian company, SunRice, has a great range of ‘Health & Wellbeing’ rices and rice blends that you may like to consider trying.

And Coles also has recently launched some similar products that are all high in fibre and have a low glycemic index too. The varieties available are:

Brown Rice and Quinoa
Brown Rice and Chia seeds
7 Ancient Grains – a combination of brown rice, green lentils, millet, quinoa, sorghum, amaranth and chia seeds (the highest fibre variety).

These microwaveable packs usually contain 2 serves per pack. You should check the Total Carb per Serve column to check how many carb serves a ‘serve’ contains. It’s usually about two. They’re very convenient quality carb options to keep in your pantry.

Resistant starch

Just a reminder while we’re on the subject of starches, that cooked and cooled starches develop a crystalline structure which makes them resistant to digestion (hence their name) which lowers their glycemic index. So adding cooked and cooled rice to your salads is a great way of adding a serve or two of low-GI carbs to your meal to help manage your blood glucose levels and provide the many benefits associated with including low-GI carbs in each meal. The theory of resistant starch goes that if the starch resists digestion it will end up in the large bowel to feed the good bacteria which in turn improve our immunity and overall wellbeing. You can read more in the blog on fibre if you’re interested.

So I hope you learned how to make rice work better for you. Please let us know if you have any questions. Sally

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a linked list of all Sally’s Diabetes Counselling Online blogs here.

Please Share!

Causes

Ask These Questions

Take Action