Diabetes Control

If you have HIV-induced diabetes issues, keeping your health in check is an ongoing issue. The connection between diabetes control and diet has been a medical goal since the mid 1850s, when a French physician suggested that patients with diabetes should consume copious quantities of sugar to replace what was being lost in the urine. Another French physician noticed that his diabetic patients reduced sugar in their urine when food was rationed during the Franco-Prussian war. An Italian doctor treated diabetes by keeping his patients under lock and key in order to get them to adhere to his dietary advice. Fad diets were rampant during the early 1900s and included an oat cure, a rice cure, and others that severely limited the variety of food consumed. A diabetic doctor in the United States published a book on diet control of diabetes that advised starvation diets with bed rest, which backfired when malnourished patients died of infectious complications. During the 1920s the high-fat, low carbohydrate diet was introduced. Each of these diets had issues that could lead to many other health complications. Later these diets were abandoned in favor of (wait for it) eating a well-balanced diet with realistic modifications to control blood glucose and diabetic complications of cardiovascular, kidney, and other related diseases and (again, wait for it) exercise! More recent guidelines emphasize lifestyle change with an emphasis on learning how to eat well with exercise. Lifestyle changes are often tough to make and require a commitment. Studies on education and counseling suggest that these methods work pretty well as long as they are ongoing to support the keeping good changes in place. This means that education and counseling is not a 'one-time deal' if you want to live well with diabetes. Think of it as a long-term commitment and find the resources you need to not only improve your knowledge but to support you long-term in living well--without the lock and key! Fields-Gardner is the director of services for the HIV nutrition company Cutting Edge and is a member of the International AIDS Society and the American Dietetic Association's Dietetic Practice Group on HIV and AIDS. She is the author of Living Well With HIV and AIDS: A Guide to Nutrition and a coauthor of HIV Medications: Food Interactions and A Clinician's Guide to Nutrition in HIV and AIDS.