Asian Americans have been increasingly diagnosed with Type 2 diabetes.

Risk factors include being age 45 and older, having a close family member with diabetes, heart disease, high cholesterol levels, obesity, and not getting sufficient exercise. Those who have dyslipidemia (low HDL cholesterol and a high triglyceride level) are also at risk. Those with hypertension (blood pressure of 140/90) are also at heightened risk of diabetes. For women, having gestational diabetes or delivering a baby weighing more than 9 pounds are risk factors, as is having polycystic ovary disease. About 11 percent of Americans adults (24 million) have diabetes. Asians and Pacific Islanders are named in the ethnic groups at particular risk of diabetes, with 1.4 times the risk as white Americans.

What is Type 2 Diabetes?

Type 2 diabetes, which is the most common type, occurs mostly in adults—although young people are increasingly diagnosed with this disease. Type 2 diabetes is associated with insulin resistance or the body’s inability to effectively use the insulin created. The pancreas often does not make sufficient insulin to maintain normal levels of blood glucose.

High levels of glucose in the blood may cause a number of symptoms: blurry vision, fatigue, frequent urination, hunger, weight loss, increased appetite, and excessive thirst. Type 2 diabetes may occur gradually and without any symptoms at all. Diabetes-related complications include blindness, heart disease, kidney failure, and limb amputation.

Type 2 diabetes may respond to doctor-prescribed oral medications, proper exercise, and a healthy and balanced low-fat, low-sugar diet. Health interventions also include careful testing of blood glucose levels, foot care, proper medication use, and proper exercise and diet. The diagnosis of Type 2 diabetes means a lot of life-changes, not least involving food.

Food Substitutes

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Making dietary changes may be difficult because of lifelong eating habits and comfort foods. Luckily, there is not one set diet for those with Type 2 diabetes but the application of disciplined eating tailored to the individual and dependent on how the individual’s body responds to the changes. Essentially, a healthy diet involves moderate eating on a consistent schedule, and the monitoring of carbohydrates (which directly affect blood sugar levels), and avoiding sugars and fats. Various mainstream health sources advise diets that emphasize vegetables, fruits and whole grains; they emphasize moderate portion sizes. Alcohol should only be consumed very sparingly and with caution because of the often high caloric content and the body’s response to the alcohol, which processes it similarly to fat.

Janet L. Kapp, a Registered Dietitian and Certified Diabetes Educator, suggests that it’s not realistic to eliminate certain foods entirely. People need to be able to eat foods that are important to their culture and well-being. Rather, she advocates portion control of foods that have the highest impacts on blood sugar levels. People with Type 2 diabetes need to eat regular portions on a regular schedule. They need to reduce saturated fat to reduce the risk of heart disease (since those with diabetes are at higher risk of heart disease).

“Sweets and other treats can be ‘traded’ off for other carbohydrate rich foods once in a while,” she said. Alcohol may be contraindicated by medications treating Type 2 diabetes and so should not be consumed without medical consultation.

A professional registered dietitian may help individuals create a workable healthy eating plan. Personal preferences are important to mention when talking with a dietitian. Risks to avoid involve bingeing or over-eating, such as during celebrations, vacations, parties, holidays, or dining out.

“Grain fiber is important. Instead of processed or refined grains such as polished white rice or the Chinese white steamed buns, International Community Health Services (ICHS) nutritionists encourage our diabetic patients to incorporate more whole grains into their diet such as red, black, or brown rice, and to replace traditional white noodles with soba noodles,” said Alice Chiu, a certifier for the ICHS Women, Infants and Children (WIC) Nutrition program.

Another strategy is the use of so-called “exchange lists” of equal food servings—based around the basic food types (starches, fruits, dairy, meat), and these exchanges are similar in the amount of carbohydrates, protein, fat, calories, and fiber. Consuming one item may be equivalent to consuming another and may offer more dietary variety. It is advisable to have a wide variety of foods to maintain proper nutrition and weight.

People with Type 2 diabetes should work with their physicians to ensure that their disease is being treated properly and with the appropriate medicines and advice. Sufficient exercise (and proper weight loss for those who are overweight) may delay or prevent Type 2 diabetes. People’s bodies respond differently to different interventions. Having the advice of a health professional is also helpful for determining a proper diet in order to manage a chronic disease which affects many but is often very manageable with the right interventions.

Alice Zahler, an ICHS Community Advocacy Supervisor, addressed some common myths about diabetes. “One of the major ones is that you have diabetes because you ate too many sweet/sugary foods. Sugary foods definitely have an effect on your blood sugar, but they are not the cause of diabetes and it takes more than just cutting sugary foods to manage diabetes well. Also, many Chinese believe that pumpkin is good for diabetes, but as a carbohydrate it actually raises blood glucose. In fact, many popular Asian root vegetables are starchy and high in carbohydrates.”

ICHS provides diabetes education classes and monthly free support groups, with courses taught in Cantonese, Korean, Mandarin, Samoan, Tagalog, and Vietnamese. This organization also offers one-on-one consultations to support “workable lifestyle changes.” ICHS also has a series of “Healthy Asian Recipes” cookbooks (in Chinese, Vietnamese, Korean, Tagalog, and Khmer) that are available on their website (http://www.ichs.com/index.php?page=Publications).

Disclaimer: This article is for information only and is not any kind of health or medical advisement.

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