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Understanding the glycemic index

Along with identifying the amount of carbohydrate in a meal, the glycemic index (GI) is an important dietary strategy used to manage blood glucose levels (BGLs), and the overall health of people living with diabetes. These two concepts are key, as all carbohydrate in food breaks down into glucose within approximately two hours of digestion.

Glucose metabolism

Carbohydrate is a macronutrient found in foods such as rice, bread, quinoa, pasta, cereals, fruit, starchy vegetables, legumes/pulses, milk, yoghurt and custard. It is also found in more processed, nutrient poor foods such as cakes, biscuits, chocolate, chips, lollies and sugar sweetened beverages. When we eat foods containing carbohydrate, they are digested and broken down into smaller sugars called glucose, fructose and galactose.

Glucose is immediately absorbed across the stomach lining into our bloodstream and fructose and galactose are converted to glucose before being absorbed into the blood stream. The rate at which glucose enters the blood stream from the food depends on a range of factors – this rate is the GI. Insulin is responsible for transporting this glucose from the blood stream into the trillions of cells in your body to be used for energy production.

The GI

As previously mentioned, the GI is used to rank carbohydrate containing foods according to their rate of digestion and therefore effect on BGLs after eating. Low GI foods are slowly digested and absorbed and produce small fluctuations in blood glucose and insulin levels.

In comparison, high GI foods are rapidly digested and absorbed, producing a more pronounced fluctuation in blood glucose levels.

GI 

Historically, carbohydrate foods were referred to as simple or complex, suggesting that ‘simple’ carbohydrate foods are digested more quickly compared to more ‘complex’ carbohydrates. However, the introduction of the GI illustrated the complexity of this topic and made the words simple and complex terms of the past.

It is also commonly believed that low fibre foods have a high GI and in comparison, high fibre foods have a low GI. This is not always the case. It is not the amount of fibre or carbohydrate that determines the GI of a food.

Factors influencing the GI  

Some of the factors influencing the GI include:

  • The type of starch (amylose versus amylopectin) found in the food – amylose breaks down slower into glucose therefore foods with a lower amylose content will have a higher GI (e.g. Jasmine rice).
  • The type of sugar – the disaccharides (two simple sugars joined together) fructose and lactose will breakdown more slowly compared to glucose, this is why milk, yoghurt and most fruits have a low GI.
  • The physical state of the food – highly processed foods often have a high GI because the processing makes the starches and the sugars more easily digested. This is why instant oats have a higher GI than traditional rolled oats.
  • The fat and protein content of the food or whole meal – remember, we eat foods in combination (not isolation). If a meal has a high fat or protein content the digestion of the whole meal, including the carbohydrate content, will be delayed. This is why pizza and chocolate have a low GI. Did we mention that low GI doesn’t always mean healthy!
  • The acidity of the food – adding acid (e.g. lemon or vinegar) to a meal will lower the GI.

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The amount is still key

Although the GI is important, the amount of carbohydrate eaten is still key. Enjoying a low GI carbohydrate food in a large portion size will still produce a high blood glucose response. As a general rule, most people should allocate just one quarter of their plate to low GI carbohydrate foods. Bulk up your meal with non-starchy vegetables and enjoy a small amount of a quality protein source (think eggs, chicken, tuna and salmon) for muscle maintenance and a sustained appetite.

Health benefits of more low GI foods

Switching your staples to low GI options is beneficial for your overall health and wellbeing. In the short-term, these foods will help to control your appetite, stabilise your energy levels, optimise your concentration levels and reduce the blood glucose response to a meal.

This will reduce the insulin spikes (where relevant) and improve insulin sensitivity – great for BGL and weight management. In the long term, these foods will help you manage a healthy weight, reduce levels of unhealthy blood fats, and help to prevent diabetes related complications.

Read the original article

Click here to read the original article. Published in Diabetes SA Living Magazine – July 2016, page 15.

Additional information

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SMART PROGRAMS

The SMART programs are a range of short group education sessions designed to help you manage your diabetes.

CarbSmart (for people with type 2 and gestational diabetes)

Confused about carbs? This session will make you an expert on the myths and facts of carbohydrates. Learn about the different types of carbs and the amount that is best for you.

FootSmart (for people with type 1 and type 2 diabetes)

Your feet are made for walking- so let's keep them healthy. This 90 minute session will teach you all you need to know about checking and caring for your feet.

MedSmart (for people with type 2 diabetes)

This workshop helps you understand what your medications are, what they do and how to address any concerns you may have.

MeterSmart (for people with type 2 diabetes)

This practical skills session will show you all the best techniques for using your meter to help manage your diabetes.

ShopSmart in a classroom (for people with all types of diabetes)

Do you know what is really going into your trolley? Learn how to decode food labels and spot the techniques used to trick you into buying unhealthy food. 

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The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered with the assistance of Diabetes Australia.

 
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Making the most of your Membership

Setting new goals focusing on your personal health and wellbeing

making-most-membershipSetting goals can help provide you with direction as well as motivation, particularly if you are feeling overwhelmed. By setting goals you are making a decision to act on something meaningful to you.

Some people like to set small, specific goals which can help from feeling overwhelmed. If you are unsuccessful achieving a small goal, you can always fine tune it. Here are a few tips about setting and achieving your health goals:

  1. Set small, appropriate goals.
  2. Be realistic. Set yourself up to succeed, however accept that sometimes you may not be successful the first time, don’t give up; try again. Take small steps.
  3. Understand you are an individual. When it comes to diabetes management your path is not the same as that of the person next to you. You may share the same goals, but your means of getting there may be different.
  4. Ask for help. Some things cannot be accomplished without help. 

So, how can we help you?

As a member of Diabetes SA you can access the support you may need to help you set and achieve your goals. You can book a consultation with one of our health professionals who can help you set realistic and achievable goals tailored to your specific needs. You can call us on the Helpline for advice and support along the way.

We have some great resources that are downloadable from our website, or call us for a printed version to be sent to you.

You may need some product advice, or a meter check-up. You may even need to update your meter or lancing device to one that is best suited to your needs. Our specialised staff can guide you in this respect; they will take the time you require to help you along your way. Make the most of our education sessions; we have a great line up of Expert Speakers this year who can motivate you and provide you with some of the tools you may need to work towards reaching your goal, as well as our regular program which is aimed at newly diagnosed as well as those people needing to update or refresh their knowledge.

Read the original article

Click here to read the original article. Published in Diabetes SA Living Magazine – March 2017, page 25.

Additional information

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Consumer Level Recall of insulin cartridge

11 July 2017

Pharmaceutical company Novo Nordisk A/S, in consultation with the TGA, has initiated a consumer level recall of some batches of their NovoPen Echo insulin cartridge holder after detecting there is a possibility they may crack or break if exposed to chemicals in certain cleaning agents.

People using a device with a cracked or broken cartridge holder can result in the device delivering a smaller dose of insulin than expected leading to high blood sugar levels, potentially putting the person at risk of hyperglycaemia.

Novo Nordisk has advised that if people clean the pens as described in the User Guide, there is no reason that cracking of the cartridge holder will occur.

The recall only relates to some batches of the cartridge holders and there are no reported problems with the insulin being administered. Novo Nordisk advises that the risk of patients experiencing high blood sugar levels due to an affected cartridge holder is extremely low.

Novo Nordisk is recalling all pens in the affected batches not currently issued to a patient. People with diabetes who use a NovoPen Echo should immediately check the batch number and if it is from one of the affected batches they should not use it but apply to Nova Nordisk for a replacement.

Click here to find out more.

 
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Diabetes SA's 2017 National Diabetes Week Seminar

Diabetes Behind Closed Doors

On Saturday 8th July Diabetes SA held the annual National Diabetes Week Seminar at the Adelaide Convention Centre in the City Rooms 1 & 2.

This year’s seminar theme was ‘Diabetes Behind Closed Doors’ where sensitive topics such as continence, sexual health and sleep were discussed.

After the opening speech by Diabetes SA’s Executive Manager Fiona Benton, guests were introduced to Dr Ian Tucker, a urogynaecologist from Adelaide Specialist Incontinence Services. Dr Tucker discussed diabetes and continence, specifically relating to women and women’s health. However, Dr Tucker did state that a lot of the common issues of incontinence found in women, may actually appear more frequently in men as well and encouraged men to seek advice from health professionals about these issues.

After Dr Tucker’s presentation, Dr Chris Rayner, a Gastroenterologist from the University of Adelaide, spoke about the latest research into whether activating “bitter taste receptors” in the gut might help control appetite and improve blood glucose responses at a subsequent meal.

Then it was time for morning tea. During morning tea, guests were invited to enjoy some seasonal fresh fruit salad with vanilla Greek yoghurt, vegetable crudités with hummus and tandoori chicken filo with minted yoghurt which was very popular. Guests were also invited to have a look at the variety of stalls available out in the foyer from the University of Adelaide and the SA Continence Resource Centre and of course Diabetes SA.

Diabetes SA’s stall was well attended with guests having the opportunity to meet staff and collect relevant resources, especially with regards to our new and exciting education programs that are being launched in July.

After morning tea, Dr Kim Pese, a Urologist from Urological Solutions presented valuable information about diabetes and sexual health for men, including erectile dysfunction and continence. Dr Pese discussed options for men who do have these issues and what treatment can occur to help.

After Dr Pese’s presentation, Dr Siobhan Banks gave a great presentation about diabetes and sleep. Dr Banks discussed sleep apnoea, restless legs syndrome and how diabetes can affect your sleep and how your sleep can affect your diabetes management.

Feedback from the 2017 National Diabetes Week Seminar was extremely positive with many guests verbally saying that the speakers were engaging and sensitively discussed the topics so that it was comfortable for everyone to ask questions. Thank you to all that attended the seminar, we really hope you enjoyed it.

Click here to see photos from the event.

Click here to watch the webcast.

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The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered with the assistance of Diabetes Australia.

 
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Research on intermittent energy restriction in type 2 diabetes at the University of South Australia

UniSA-logoResearchers at the University of South Australia, Professor Peter Clifton, Associate Professor Jennifer Keogh and Ms Sharayah Carter, are investigating the effects of intermittent energy restriction (5:2 diet) compared to continuous energy restriction in people with type 2 diabetes.

They are looking for volunteers to be involved in a short 4 week study where you will wear a continuous blood glucose monitor and follow the 5:2 diet.

If you have medication controlled Type 2 Diabetes, with HbA1c greater than 7%, you may be eligible to be involved, see eligible medications below:

• INSULIN

• GLICLAZIDE: Glyade®, Mellihexal®, Nidem®, Genrx Gliclazide®

• GLICLAZIDE ER: Diamicron®, Glyade ®, Oziclide®

• GLIBENCLAMIDE: Daonil®, Glimel®

• GLIPIZIDE: Melizide®, Minidiab®

• GLIMEPIRIDE: Amaryl®, Dimirel®, Aylide®, Diapride®, Gilmepiride Sandoz®

If you would like more information about the study please contact the Sansom Institute for Health Research:

Ph: 8302 1365 or Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 
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