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By Lara Rondinelli, RD, LDN, CDE
Occasionally, when I meet someone and tell them that I'm a dietitian and diabetes educator they say something like, "I feel bad for you, people can't really change their eating and lifestyle habits." Wrong! Yes, it can be challenging to change habits that you've had for years, but it can definitely be done with hard work, education, support, and planning. Here is a real life success story of a patient that I've seen (name has been changed to protect privacy).
Meet Jack
Jack is a 42 year old bachelor, newly diagnosed with type 2 diabetes. He is 5'11" and weighs 348 pounds. His hemoglobin A1C is 8.1 and he came to me in denial that he had diabetes, despite his doctor telling him he did. He was started on Metformin, 500 mg twice a day. Patient is not currently exercising, but has belonged to a health club in the past. Patient works in sedentary job for 8 to 10 hours per day. His diet history revealed:
Breakfast — often skips or grabs an "apple crunch" muffin and banana with black coffee from coffee shop (110 grams carbohydrate)
Lunch — double cheeseburger, large fries, and 1 medium regular coke (146 grams carbohydrate)
Dinner — Italian footlong sub on white bread, potato chips, and 1 medium regular coke (160 grams carbohydrate)
Snacks included apples, cookies, and peanuts
Patient drinks 2 regular sodas per day and consumes 3 to 5 regular beers and 2 to 3 vodka and cranberry drinks per week.
At our first visit we discussed criteria for diagnosis of diabetes and patient accepted his diagnosis. General healthy eating recommendations were given. Patient was educated on simple carbohydrate counting and label reading. Meal and snack suggestions were given. Patient was instructed to aim for 60 grams of carbohydrate or less per meal. Patient set the following goals:
- Stop drinking regular soda — all drinks will be unsweetened.
- Take lunch to work 2 days per week.
- Eat 3 meals per day (no more skipping breakfast).
- Walk 15 minutes — 3 days per week.
- Track food intake via "Lose It" on his iPhone
I continued to see Jack monthly over the next 4 months. He did well meeting goals and even started making breakfast at home. He was having the most difficulty meeting his exercise goal. He stopped drinking regular soda, decreased alcohol consumption, and changed to light beer. He ate 3 meals per day and took his lunch to work almost daily. He did very well tracking his food intake on his iPhone.
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