Can a newly diagnosed Diabetic who doesn't eat Dairy products eat this stuff?

[Samian Q]

Long story short: I have to do this patient teaching assignment tomorrow on a pt. I haven't met. However, from her patient record, her diagnosis is gastroparesis and her medical hx indicates she has DM.

Bingo! I can get my assignment done!!!

So I figured I'd do some patient teaching on nutrient sources for a diabetic diet that's dairy free (she doesn't drink milk or partake in dairy products).

However, I know jack-squat about nutrition. Nutritional knowledge is my Achilles heel, seriously.

Anyway, I came up with a list of foods that have Vitamin D and Calcium (two nutrients that obviously people who don't drink dairy need to think about). I figured this would be good reinforcement and a supplement to a diabetic diet, since it's oh-so-important that diabetics have a nutritionally balanced diet.

Could you let me know if the foods are OK for diabetics and non-dairy consumers?

[Samian Q]

So far I've listed "cod liver oil", "cooked swordfish", "cooked salmon", "Living Harvest hemp milk", "fortified orange juice", "Silk soy milk", and "egg yolk" for vitamin D. I haven't look up the calcium stuff yet.

Are those listed foods contraindicated?

Oh, and here's the Calcium foods I found: "fortified orange juice", "canned sardines", "tofu", "canned salmon", "kale", and "Chinese cabbage, bok choi".

Are those all dairy-free too?

[KatieMI, BSN, MSN, RN]

-OJ will cause hyperglycemia in diabetic client;

-egg yolk is very high in cholesterol (bad for everyone and especially for diabetics);

-fish oil generally not considered "food" in this country; it is a food supplement and so must be treated as such.

-bok choy and tofu are great but unless your client is Chinese/Japanese/Corean, he/she with all probability won't eat them, and if he/she is, that will be another story as these guys usually cook that stuff with good amount of soy sauce (which is awfully rich in sodium). They are also not available everywhere, highly perishable and quite expensive.

-and, I'm so sorry, but did you figure out financial situation of your client? Soy milk cost more than twice more than dairy one, hemp milk costs even more, and I'm not even mentioning swordfish and fresh (not canned - rich in sodium) sardines.

kale and other greens are good if only you can convince your client not to cook them without butter, pork fat, tons of salt, etc.

I would think about "light" soy and almond milk and yogurts, salmon (preferably fresh - canned one is very rich in sodium, and that's bad for diabetic kidneys) and greens (appropriately cooked) if client can afford it, able to get and cook it and will eat it. If not, I would call doc and ask for supplements right away. It is much easier and reliable. Milk-free diet (with non-organic, "traditional" substitutes and without exotics like hemp milk) adds roughly 20 to 30% to grocery bill. Not everyone can just afford it, plain and simple.

[Double-Helix, BSN, RN]

I think the foods you found are great if you want to address alternative ways to get vitamin D and calcium in a non-dairy diet. But they don't address the diabetes. It's not really necessary to find such exotic foods to get these nutrients. Adequate amounts of vitamin D can be obtained from a multi-vitamin and regular sun exposure. Calcium can be found in supplement for or abundantly in green, leafy vegetables like spinach, kale, okra, broccoli, and collard greens. It's also found in various kinds of beans, nuts and seeds.

The crux of a diabetic diet is counting carbohydrates and rationing them. It focuses on portion sizes of carbohydrate-rich foods, limiting empty sugary calories like soda, juice and candy. A great thing to do with your patient is teach her how to read a food label in order to learn how to portion her carbohydrates.

As the previous poster mentioned, orange juice is full of sugar. It's actually given to diabetics in small amounts when their blood sugar drops too low. You could also teach your patient the signs of hypoglycemia and what to do if she is feeling hypoglycemic.