Dysphagia and diabetes, Dual management. by dysphagiadietitian.com, Cat Ludwig, RDN, LD. yellow background with an orange square on the right containing diabetes supplies: glucose monitor, pills, syringe, test strips.

Diabetes & Dysphagia: Dual Management

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Two Problems: Diabetes & Dysphagia

You are probably thinking, this can’t get any worse…now I have to deal with the idea of learning about managing blood sugar, plus swallowing issues?! I already don’t know what to eat. How do I manage diabetes & dysphagia at the same time? This is where the Dysphagia Dietitian comes in to help you out!

  1. You need to see a Speech Therapist for the Dysphagia. This is to determine what level of diet modification needs to be prepared and eaten to prevent problems like food and drink ending up in your lungs instead of your stomach.
  2. You need to see an Endocrinologist and diabetes educator (usually a nurse) for determining how well your body is producing hormones that help you balance your blood sugar. This team will help you understand what diabetes is and ways to manage it.

Lastly, you need to talk to a Dietitian. This healthcare professional (like me!) can help you come up with a plan for managing both conditions at the same time. My goal is to alleviate some of your stress and help you understand both situations and how you can succeed at living a healthy, fulfilling life and learn to enjoy food again. You can be successful at managing both Diabetes & Dysphagia.

Diabetes Management

Diabetes is a health condition where the body struggles to keep your blood sugar normal. This can happen for any number of reasons. Talk to your doctor. You will have bloodwork done to determine what your body is doing and will give you a starting point. You should be referred to an Endocrinologist (a doctor that specializes in hormones). The hormones that help manage your blood sugar are probably “out of whack” and this may be step number one in getting your blood sugar under control.

One of the great things about food is that it can be used to help manage so many diseases, like diabetes. Food can be helpful or harmful to the body. Dietitians* specialize in helping you understand why this is important and how to make small changes to improve your health.

*Disclaimer – We (RD’s) are NOT the food police.

Diabetes can start to be managed with food, by learning these three things about food:

  • What to eat
  • When to eat
  • How much to eat

What To Eat (this is the fun part!)

The USDA MyPlate found at myplate.gov. A white background with a blue circle in the upper right corner with the word dairy in it. a fork to the left of a plate, the plate is split into 4 sections with two large sections and the words vegetables on a green background, grain on an orange background. The two smaller sections representing fruits on a red background and protein on a purple background. The myplate method will help manage dysphagia and diabetes.

Food should be delicious and colorful. It should contain a variety of different types of foods, including fruit, vegetables, whole grains, and meats.

I recommend having multiple colors on your plate at as many meals as possible. The USDA website MyPlate, is a fantastic resource for learning how to include all food groups into your diet.

The visual that the USDA website uses is simple yet descriptive and if you are able to get creative with your groceries you can make some fantastic meals that are healthy and delicious.

Many people break food into what we call “Macronutrient” categories. This means that food is categorized as protein, fat, and carbohydrates. This is a HUGE topic and one I am going to avoid for now (If you want more information on this please contact me). I want you to understand that food is so much more than protein, fat, and carbs. I want to talk about FOOD and will opt for the categories MyPlate uses: fruit, vegetable, grain, and meat/protein.

Each of these categories should be eaten throughout the day and the MyPlate website will help guide you about how much to eat each day! Building a daily eating plan with your dietitian will also greatly benefit you. If a visual at meals might help, check out this plate. Another trick to try is portioning out all the food right after you cook it so you don’t have to portion it later. This makes reheating the right amount super easy at your next meal!

When To Eat

Spacing meals out evenly gives the body time to digest food and regulate blood sugar. I am sure you have heard about people who only eat three meals a day, and others who eat every 2 or 3 hours. Every person’s body is different and learning how your body manages food is a skill to be learned. Eating at the same time every day puts your body in a routine, this way it knows what to expect and how to respond.

Learning to listen to your body is another skill that will help you figure out when to eat and how much to eat. The Japanese culture has the idea that you should eat until you are two thirds full. But how do you know when you are two thirds full?

How Much To Eat With Diabetes & Dysphagia

How much to eat at one time is the hardest part to learn for most people. Most of us were taught to be part of the “clean plate club“. This term originated from our grandparent’s generation. In 1917 it was a campaign that was launched during World War 1 to prevent food waste.

This idea made people stop listening to their bodies. Your stomach and your brain send signals to each other, this is how you know you are hungry. The stomach is very slow at sending signals to the brain, this is why most people don’t realize they are too full until they are uncomfortably full.

The intuitive eating movement is trying to change this concept by getting you to slow down when you eat and listen to the signals your body is sending you. Some people need to wait 20 minutes for their brain to realize they are full, some people need to wait 45 minutes to realize they are full.

Our portion sizes have become so massive that our stomachs and waistlines can’t keep up. The My Plate website has examples of what a portion size is for different foods in each group. Learning to control how much you eat at each meal or snack will be tremendously effective at balancing blood sugar.

Putting How, What, & When Together

Your Dietitian will help you develop a plan (not a diet!) that is perfect for you. It is important to remember that this takes time and will not be fixed overnight. Give yourself some grace. Set goals, then set up a plan to reach those goals. Check in with your dietitian regularly so that adjustments can be made to your plan. This will improve your success overall.

Dysphagia Management

The first step to managing dysphagia is knowing what texture, or consistency, of food you can safely chew and swallow. Every person is different. Dysphagia is a problem that can cause severe anxiety and fear around the idea of eating and drinking. Working with a Speech Therapist and a Dietitian will give you the tools you need to safely meet your nutritional needs.

Having a support group is also extremely helpful for learning to manage your symptoms. There are several Facebook groups you can join that are supportive and helpful. One member of a Dysphagia group I found even wrote a book on managing dysphagia! It’s called Dysphagia Naturally, by Julia Tuchman. She has been dealing with Dysphagia herself for many years. She has great insight and experience and wants to share it with those who need it.

Know Your Food Consistency

Do you need pureed? Minced and moist? Easy to chew? Are you on a Regular consistency diet but need thickened liquids? Does your jaw click or hurt when you chew? Do you have broken teeth that cause pain? Are you able to move food around in your mouth properly with your tongue? These questions are all extremely important for figuring out how to swallow food and liquids successfully.

A Speech Therapist will help you with a plan for managing difficulty swallowing. She can give you exercises to help strengthen the muscles in your throat and techniques for making swallowing easier.

A dietitian will then help you develop a meal plan and give instruction on how to properly chop or puree your food to make it safe to eat. She can also give you ideas on how to manage your nutritional status. This can include preventing weight loss, managing anemia, diabetes, kidney problems, or other specific issue.

Merging Management of Diabetes & Dysphagia

Managing both issues can be stressful but with the right support you can be successful. Take the most serious issue and address it first. You may get conflicting answers on what is more serious so find a trusted source and discuss your options. Your support system will benefit you on your journey to health and wellness.

If you feel that this is too much to manage on your own and are unsure where to turn, I invite you to contact me so we can work together. Dysphagia Dietitian is an expert in food and nutrition and will provide support, compassion, and guidance in meeting your specific needs and health goals. I will review your needs and help develop a plan for managing diabetes and dysphagia that works best for you.

Let’s make eating fun and flavorful again! Send me an email ag DysphagiaDuo@gmail.com

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