FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

DIABETIC FATHER RESPONSIBLE FOR THANKSGIVING CHOICES, NOT COOK

Question: My father is coming to our house for Thanksgiving dinner. He has recently been diagnosed with diabetes, and that is why I'm unsure of what I can serve him. I know he shouldn't have sugar, but are there other things I shouldn't prepare?

Answer: Diabetes, also called diabetes mellitus (DM), is a disease that is present in about 11 percent of the general population and more frequently in some ethnic and racial subgroups. Your father is one of the fortunate two-thirds of the total that is actually aware of his disease.

As you obviously know, diabetes mellitus is a disorder involving the metabolism of glucose (sugar). Type II DM accounts for over 90 percent of those with diabetes, and it commonly begins between the ages of 40 and 70. Your father's age probably puts him in this most common group. Also, 80 percent of those with type II DM are obese. Does he fit into this category as well? The answer to this question is a key point, since being significantly overweight has a central role in the onset of the disease as well as in its treatment.

Before I offer any meal suggestions for your Thanksgiving repast, I want you to clearly understand that it is your father's responsibility to follow a diabetic diet. You should not try to badger, belittle or coerce him into eating what you think he should. Type II diabetics rarely have immediate illness as a consequence of their eating choices today, so let his education and conscience be his guide. He may not choose to follow his diet today. That is OK -- it is his choice -- even though it may not be in his own best interest.

You are quite correct in assuming that a diabetic should not have sugar. That eliminates most of the usual sweet desert and candy treats. But the condition is a bit more complicated than that. You see, our bodies very quickly convert most carbohydrates into sugar. Therefore, foods that are primarily composed of carbohydrates -- such as white bread, white rice, potatoes and pasta -- are also on the list of fare to be avoided. In addition, essentially all those with type II DM also have trouble with their cholesterol and triglyceride levels. Consequently, they should limit the amount of fat they consume, too, to no more than 30 percent of their daily calories.

So what can you serve? A tossed salad or vegetable soup to start the meal would be nice. The turkey is fine. The dressing should be made from whole grain bread instead of white bread because the whole grains are absorbed less rapidly. Cranberry relish, if sweetened with an artificial sweetener, would be OK if consumed in moderation. Green beans are wonderful but corn isn't. Look in any diabetic cookbook. There are lots of tasty diabetic foods that the entire family will enjoy. It is also OK to prepare other dishes in a "non-diabetic" fashion for the rest of your dinner guests.

Remember that your father doesn't have to eat everything that is on the table, and he should only eat a modest portion of the foods he chooses. After you have looked at a diabetic cookbook, talk to him today about the menu, then let him make his own choices on Thanksgiving. Savor the assemblage of your friends and loved ones instead of worrying over what your father should and should not eat.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.