The client who is diagnosed as a diabetic must face the challenges of restructuring their diet. A health diet and proper management can enhance their health by promoting stable glucose. The diabetic uses oral hypoglycemic agents, insulin or both must still monitor their eating habits and know what food groups to choose from to help them control their blood glucose levels.

A healthy diet is essential for the diabetic client. The diabetic food pyramid is not much different from the food pyramid for the non-diabetic population. However, it does parallel the National Cholesterol Education Program for the primary and secondary prevention of Coronary Heart Disease.

Total carbohydrates are the sum of all the sugars, starches, and fiber that the diabetic consumes. It has been proven that there are certain carbohydrates that can cause a rise in serum blood glucose levels. These carbohydrates are identified by their glycemic index. The glycemic index or GI is a measure of ingested carbohydrates effects on blood glucose levels. (1) Carbohydrates that are broken down quickly in the digestive tract are considered having a high glycemic index, whereas, carbohydrates that are broken down slowly have a low glycemic index. Depending on which type of carbohydrate a diabetic chooses or like to eat can have an impact on the blood glucose level. The glycemic index is not usually found on food labels. So how does one tell the difference between high and low glycemic index foods? It is not that hard to tell. Processed sweets, foods high in sugar, cakes, sweets, sweet breads and candy contain carbohydrates with a high glycemic index, basically all the goodies. Foods that have a low glycemic index are those foods that take the digestive system longer to break down, such as grains, fibers, fruit and vegetables. These low glycemic foods help the diabetic balance their blood glucose levels because the foods do not cause a rush of sugar into the blood stream. Instead there is a gradual release of glucose. The diabetic who is on insulin or oral hypoglycemic agents will be able to keep their blood sugar from spiking. Blood glucose levels can still get very high with insulin and oral hypoglycemic agents. This is what the diabetic needs to avoid. This is what is meant by the term, "tight glycemi control". A very good source of information for diabetics who would like to know more about glycemic index can be found at http://www.glycemicindex.com.

This site offer a database of the glycemic index of many brand name foods on the market. It can help the diabetic make educated healthy choices about the foods that they like to eat. The Glycemic Index recommends the following choices:

• Use breakfast cereals based on oats, barley and bran
• Use breads with whole grains, stone-ground flour, sour dough
• Reduce the amount of potatoes consumed
• Eat all other types of fruit and vegetables
• Use Basmati® or Doongara Rice®
• Enjoy pasta, noodles, Quinoa
• Enjoy salads vegetables with a vinaigrette dressing

It is recommended that the diabetic client lower their saturated fat intake. Choosing foods such as low-fat milk, cheese, and yogurt, and limiting lean meats to 5 ounces per day, are considered healthy. Avoid processed foods such as frozen French fries, frozen chicken finger, potato chips, and fried fast food. Cholesterol can be reduced by avoiding organ meats such as kidneys and liver, and by limiting egg yolks to two weekly. Egg Beaters® are a good substitute for eggs, especially if the individual likes a daily serving of eggs. If at all possible, alcohol should be avoided, however if it is not possible, then the diabetic should try to limit their intake to two or fewer daily. Alcohol is just empty calories and has no nutritional value.

Eating healthy by making choices from nutritional food groups can help the diabetic achieve stable blood glucose levels in conjunction with their current diabetic medication.