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New guidelines

Other changes

What are you willing to do?

New guidelines

The updated advice stresses the important role diet has always played in keeping blood sugar in the near-normal range. But the new guidelines allow more of a personal touch that can make planning your meals easier.

No more "standard diet" In the past, if you were diagnosed with diabetes, your doctor often handed you a standard preprinted diet sheet. No more.

One set of guidelines no longer applies to everyone. The new set of recommendations stress the need for personalizing your diet. If you have diabetes, ADA encourages you to work with a registered dietitian to develop a meal plan based on your food preferences, health concerns such as weight or blood cholesterol level, and insulin therapy.

Other changes

Reasonable weight goals -- Being overweight can make it more difficult to control blood sugar. But rather than encouraging you to reach your ideal weight, new guidelines suggest "reasonable" weight goals. Dropping as few as 10 to 20 pounds may be enough to improve blood sugar control.

Flexible fat levels -- If you're at a healthy weight and have a normal blood cholesterol level, new guidelines encourage you to keep fat to no more than 30 percent of total calories. (These are the same guidelines recommended for all Americans.)

However, if you need to lose weight or have high cholesterol, some experts suggest 20 to 25 percent of calories from fat is healthier. These lower levels correspond to those recommended by the National Cholesterol Education program for all people with cardiovascular disease.

The key is individualization. If you're used to eating about 50 percent of daily calories from fat, lowering fat to even 40 percent can help you lose weight and improve blood cholesterol levels.

Calculated use of sugar -- Sugar is no longer forbidden. People with diabetes have long been told simple carbohydrates--sweets such as table sugar, honey, jelly and candy--cause a rapid rise in blood sugar.

Complex carbohydrates -- Starches such as breads, cereals and potatoes--were believed to cause a moderate rise in blood sugar.

But new information shows table sugar affects blood sugar about the same as bread, rice or potatoes.

We have learned that the total amount of carbohydrate in the diet, rather than its source, is the critical factor affecting blood sugar levels after meals.

Using modest amounts of sugar may not interfere with blood sugar control--as long as you substitute a sugary food for a starchy food that contains an equal amount of carbohydrate.

What are you willing to do?

You don't need special foods or unusual diet strategies to keep your blood sugar well controlled. Meal planning for diabetes continues to be a nutritionally balanced, flexible style of eating.

Greater flexibility, however, takes responsibility. More than ever, it's critical that you work with a registered dietitian and the rest of the diabetes team to learn how to enjoy more variety within the limits of your diet.