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March 20, 2004

Meal Planning, Food and Diet, Type 2

Question from Anchorage, Alaska, USA:

My husband, has really rare Goodpasture's, Pulmonary Chronic-Fibrosis, Atrial Fib, a pacemaker, is on Plasmaphlersis, because of high steroids, Prednisone, and Cytoxan. I believe he has developed type 2 diabetes. At night, his bedtime blood sugar is between 113 and 125 mg/dl [6.2 to 6.9 mmol/L], with seven to eight hours to go before breakfast. The other morning, at 4:34 a.m., his blood sugar was 66 mg/dl [3.6 mmol/L]. I had to feed him a fruit bowl rather quickly to help him. It really scared both of us. He is very grouchy and stressed. I have asked his doctor. He says my husband can eat anything he wants. He is an excellent doctor. He just does not like diet questions. What is a good, low protein, because of his kidney failure problem; low potassium, because of his limit of 2400 mg per day; low phosphorus because of low limit of 1100 per day, nighttime snack for him? I think I may not survive this even though I am a certified nursing assistant and trained to be a registered nurse.

Answer:

It sounds as if your husband would benefit from meeting with a registered dietitian who specializes in diabetes meal planning. Meal plans nowadays are more individualized in order to increase adherence and normalize blood sugars. In light of all the other health conditions, your husband’s meal plan needs to be individualized to meet his health needs.

To find such a dietitian, you can:

Contact any nearby diabetes program, which may be located at a hospital, or medical school

Contact the local office of your national diabetes association

In the US, you could also call 1-800-TEAM-UP-4, a service of the American Association of Diabetes Educators.

JMS