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Managing Diabetes Magazine - diabetes

Wonderful Water
How much you need and how best to get it

Although the body can survive for long periods without food, we cannot live long without water. This simple element is essential to life. About 60 per cent of our body weight is made up of fluid, which plays many roles in the body. Water cools the body through sweat, transports nutrients to their destinations, and carries waste out through the kidneys. It provides a place for chemical reactions to occur, especially with medications. It lubricates the body and cushions it from injury.

Those with diabetes need to be particularly aware of their fluid status. Any reduction in fluid volume can seriously affect blood glucose levels and health. Imagine leaving a glass of orange juice out on the counter for three days. Once water starts to evaporate from the juice, what is left in the glass is more concentrated. The same thing happens very quickly in the body when a person has diabetes. Dehydration then affects high blood glucose levels.

You probably already know that high outdoor temperatures and activity levels can cause dehydration unless you take proper precautions and get enough to drink. Vomiting, diarrhea, high body temperatures and excessive sweating can also result in dehydration. Diuretic medications, which make the body produce urine, can have the same effect. Even high blood glucose can dehydrate. This in turn makes blood glucose levels rise, a dangerous and vicious cycle.

Staying hydrated

It is especially important to stay ahead of the game and drink to prevent thirst. By the time we feel thirsty, we are already dehydrated! Even more, the thirst mechanism also reduces as we age, so we become less aware of when we are thirsty. Common symptoms of dehydration include headaches, tiredness, high blood glucose, dizziness, thirst, and reduced exercise performance.

How much water is enough?

Do I have to drink eight cups a day?

New guidelines set by Health Canada suggest about 11 cups (2.7 litres) of fluid for women and 15 cups (3.7 litres) of fluid for men each day. Note that this amount means total fluid. It can include drinking water, water in beverages and water that is part of food. We need this amount because our bodies lose this quantity each day through regular body functions of waste elimination, evaporation and metabolism.

Although this seems like a lot of water, it adds up quickly when you count coffee, fruit and cucumber in the equation. Fortunately, you have many fluid options other than water. One easy way to increase fluid intake is to carry water with you and sip it all day. You will find it easier to tell how much you have taken in. Try having a drink along with every meal or snack. If you have a cup of fluid with each meal, you already drink three cups right off the bat. Add a few snacks that include fluid and you are up to five cups.

Be aware of drinking carbohydrates

Having diabetes means managing the amount of carbohydrate that you eat or drink in order to maintain healthy blood glucose levels. If you are drinking carbohydrates, it is crucial to stay very aware of portions and how much you are getting. Since liquids are absorbed and digested more quickly than solid foods, blood glucose levels rise more quickly.

Liquids not only affect blood glucose faster, but many liquids are very concentrated in carbohydrate. Although we may not think that fluid carries significant carbohydrate and calories, they can add up very quickly. Even juices labelled ‘unsweetened’ or ‘no sugar added’ may contain large amounts of natural sugars. For instance, even unsweetened cranberry juice contains over eight teaspoons of sugar per cup! No wonder it is so great for treating hypoglycemia (low blood glucose).

When it comes to hot drinks, there are many tasty treats to choose. Some are high in calories and sugar. Ask questions and use a little common sense to make smart choices. By choosing a skim milk latte over a café mocha with whole milk and whipped cream, you avoid 17 grams of fat, three teaspoons of sugar, and 150 calories.

You can make your hot beverages healthier in several ways.

Ask for the smallest size.
Skip the whip.
Ask for skim or low fat milk (1 per cent).
Ask for half the syrup in your drink at specialty coffee shops.

A few words about alcohol

Under certain conditions, you can drink alcohol in moderation. To do so, you need to have your diabetes under control and know how to recognize hypoglycemia (low blood glucose). As well, you must not have any other health problems that alcohol can make worse, such as high blood pressure, liver problems, high triglycerides, nerve damage, stroke or eye disease. Drinking alcohol in moderation means no more than two drinks per day for a man, one for a woman.

One major concern with alcohol is that it can cause hypoglycemia when you drink and take medication for diabetes. While drinking alcohol, make sure you eat foods rich in carbohydrate at the same time, such as a few plain cookies or a slice of bread and cheese. Carry a treatment for low blood glucose with you (such as three glucose tablets, three-quarters of a cup of regular pop or six Lifesavers™). Use your blood glucose meter to check exactly how alcohol affects your blood glucose levels.

If you still are not certain whether you should drink alcohol, talk with your health care professional first. You can find a new information booklet by the Canadian Diabetes Association by going to www.diabetes.ca and typing ‘alcohol’ in the search box.

Final tips

Water is the best way to hydrate your body. Try adding a squeeze of lemon or lime for added zing.
If you love fruit juice, dilute it with at least an equal amount of water.
Try chilled herbal teas for a carbohydrate-free refresher.
Learn to look at product labels, and remember to note the portion size!
Since liquid carbohydrates raise blood glucose faster, limit them as much as possible. Drinking carbohydrates with a meal can help to reduce the effect on your blood glucose.
If you can, eat your fruit rather than drink it.

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