The Exchange System Doesn't Work!

| Sep 1, 1991

For the past 10 years, I have been telling people with diabetes to drink fruit juice only if they are having a hypoglycemic reaction. My feelings on this issue have now been backed up in a recent study published in the Diabetes Educator (volume 17, number 4). Marilyn Sullivan, MS, RD, CDE and Robert Scott, MD found that both fruit juice and decaffeinated cola raised patients blood sugar at a similar rate. They concluded by stating: "When it comes time to revise the Diabetic Exchange Lists for Meal Planning, the authors may want to reconsider listing fruit juices as acceptable choices from the fruit list to be used in routine meal planning."

In order to follow the exchange system, one must eat the same amount of starches, proteins, fruits, and fats every morning. This same policy must be followed for lunch and dinner as well. Exchanges are based on how many calories an individual needs, as well as the type and amount of insulin or oral medication required. The exchange system is designed to work if glucose levels are always within a normal range (80-120mg/dl). But this is rarely the case. It is obvious that stress, exercise, hormones, and illness alter glucose levels. All of us need to be equipped to handle these unexpected blood sugar changes. It is inappropriate to eat the same amount of food on a 350 glucose level as on a 110 glucose level. A powerful tool at our disposal is the ability to alter what we eat.

Since both fruit and starch have an immediate effect on blood sugar, I suggest to cut out all fruit if your blood sugars are high. In addition, I recommend cutting back, not cutting out, on starch. If blood sugars are low before a certain meal, it makes sense to increase your starch and fruit intake.

Beverly Mack is a registered dietitian and Certified Diabetes Educator. She has been teaching for ten years and has had diabetes for 16 years. She is presently an educator at The Diabetes Center at Mount Zion Hospital and is also in private practice.

Click Here To View Or Post Comments

Categories: Blood Sugar, Diabetes, Diets, Food, Food News, Insulin

Take the Diabetes Health Pump Survey
See What's Inside
Read this FREE issue now
For healthcare professionals only
  • 12th Annual Product Reference Guide
  • Insulin Syringe Chart
  • Insulin Pen Needles Chart
  • Fast-Acting Glucose
  • Sharps Disposal
  • Blood Glucose Meters Chart
  • Insulin Pumps Chart
See the entire table of contents here!

You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View

See if you qualify for our free healthcare professional magazines. Click here to start your application for Pre-Diabetes Health, Diabetes Health Pharmacist and Diabetes Health Professional.

Learn More About the Professional Subscription

Free Diabetes Health e-Newsletter

Top Rated
Print | Email | Share | Comments (0)

You May Also Be Interested In...

Click Here To View Or Post Comments

Comments 0 comments - Sep 1, 1991

©1991-2015 Diabetes Health | Home | Privacy | Press | Advertising | Help | Contact Us | Donate | Sitemap

Diabetes Health Medical Disclaimer

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. Opinions expressed here are the opinions of writers, contributors, and commentators, and are not necessarily those of Diabetes Health. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website.