Olga, a 42-year-old Colombian woman, was referred to me by her doctor. After a routine physical, she had recently been diagnosed with Type II diabetes and firmly stated that prior to initiating drug therapy, she wanted to control her blood-glucose (sugar) levels with diet. Olga was surprised by her diagnosis. “Although my grandmother had diabetes, I never thought that I could get it. I am not overweight, and I run after my daughter all day.” Olga sounded even more perplexed when she said, “I did not even have one symptom. It was just a routine physical.” (For symptoms, see list below.) Unfortunately, Olga is not alone. Approximately 18 million Americans have diabetes, and Latinos are disproportionately afflicted. According to the American Diabetes Association (ADA), two million or 8.2 percent of all Latinos age 20 or older have diabetes. However, not all Hispanic groups are affected equally. Approximately 24 percent of Mexican Americans in the United States, 26 percent of Puerto Ricans, and 16 percent of Cubans between the ages of 45 and 74 have diabetes. The ADA has not released diabetes statistics for other Latin subgroups.

Small Steps—Big Rewards
If your blood-glucose levels are higher than normal but not high enough to diagnose you as diabetic, you have pre-diabetes and are at risk of developing the condition in the future. A simple blood test can determine if you have pre-diabetes. If you do, I have two words for you: food and move. That is, less food and more movement. A 5 percent reduction in weight—for a person who is 200 pounds, that’s only 10 pounds—and 30 minutes of physical activity (dancing counts!) yield better results than taking a diabetes medication.

Scoring With Diabetes: It’s in the Numbers
The most important step in managing your diabetes is to keep your blood-glucose levels as close to normal as possible. If you have diabetes, your blood-glucose levels should be between 90 and 130 mg/dl.

At least twice a year, your doctor will perform a blood test known as A1C. The A1C test measures your average blood-glucose levels for the past three months. An A1C of less than 7 can reduce complications such as heart, eye, and kidney disease.

Managing or Preventing Diabetes Latin Style Doesn’t Mean Saying “Adios” to Rice and Beans
One of Olga’s main concerns was food. She was already mourning the anticipated loss of rice and beans from her plate, not to mention of her beloved arepas. She thought that starches and sweets would be relegated to an occasional indiscretion.

What Olga did not know was that many of her favorite foods—including arepas— could be part of her meal plan.

From the Caldero to the Table
Carbohydrate is the nutrient in foods that raises blood-glucose levels the most. However, “carbohydrate” should not be an expletive for people with diabetes. People with diabetes need to budget their carbohydrate intake. They still need carbohydrates; they just don’t need gargantuan portions. When it comes to carbohydrates, size does matter.

The first step is to find out where the carbohydrates are. (For a list of carbohydrate foods, see right.)

Once you know which foods contain carbohydrates, you need to find out how much of them you can have at every meal. A certified diabetes educator or a registered dietitian can help you figure that out and adjust your diet accordingly. To find one in your area, visit www.diabeteseducator.org or www.eatright.org 

Not all carbohydrate foods have been created equal. While controlling portions is still important, also take care to select high-quality carbohydrates. I define high-quality carbohydrates as those that have the most vitamins, minerals, and fiber. Excellent-quality carbohydrates in the Latin diet are all types of beans, corn, and oats. Portion control still applies, even when selecting high-quality carbohydrates, such as corn tortillas instead of flour or old-fashioned oats instead of instant.

If you are looking for low-carbohydrate options, non-starchy vegetables such as salads, eggplant, zucchini, and okra offer a “carbohydrate bargain.” Cup per cup, they have about one-third less carbohydrate than starches and root vegetables. Make them the focal point of your plate. When you cut back on the rice, double up on the vegetables.

Watch your P’s and Q’s (Portion and Quality)
Protein foods such as eggs, poultry, fish, and beef minimally impact blood-glucose levels. Fats such as oils, butter, and margarine do not impact blood-glucose levels. Select high-quality proteins and fats such as skinless poultry, lean meats, fish, nuts, and olive and canola oils.

The Bottom Line: Diabetes is More than Just a Little Sugar
Diabetes is a condition that if left uncontrolled can seriously impact your quality of life. The good news is that by keeping the numbers in check, making small changes in food choices, and increasing physical activity, you could stave off many complications. I tell my patients to choose one healthy goal per month. At the end of the year, you will have 12 healthy goals. Your first goal could be to take the risk test and visit your doctor. You could be in control of your health today!