In this ongoing column, Kaiser Permanente doctors answer commonly asked questions.
Living well with diabetes is not about being perfect. It’s about doing the little things consistently and in partnership with a trusted healthcare professional.
I have diabetes. Do I need to give up rice and the local foods I’ve eaten my whole life?
Managing diabetes is usually less about avoiding one particular food and more about understanding portions, carbohydrates and how you put meals together.
Think of carbohydrates as “tricklers” or “gushers.” Foods that release glucose into the bloodstream more gradually are the tricklers. They have more fiber or are carbohydrates eaten with protein and healthy fats that tend to be digested more slowly. Gusher foods send glucose into the bloodstream more quickly—especially highly refined carbohydrates, and sugary foods and drinks.
Both white and brown rice contain carbohydrates that can raise blood sugar. Brown rice has more fiber, so it acts more like a trickler. But that doesn’t mean white rice is automatically off the table. Portion size matters and so does what you eat with it. Fatty meats and highly processed foods—especially those high in saturated fat—can also worsen insulin resistance, making it harder for the body to respond to insulin and manage blood sugar. A smaller serving of rice paired with fish, chicken or tofu and plenty of vegetables can produce a steadier rise in blood sugar than a large bowl of rice eaten on its own.
Poi, ‘ulu and sweet potato also contain carbohydrates, so portions still matter, but they can be part of a balanced eating plan. For many people, the most sustainable approach isn’t giving up local food. It’s learning how to turn more meals from gushers into tricklers.
If I’m eating better and exercising, what else should I be doing to manage my diabetes?
Food and physical activity are essential, but they’re only part of good diabetes care. Diabetes can affect the heart, kidneys, eyes, nerves and feet—sometimes before you notice any symptoms. Regular monitoring helps your care team identify concerns early and adjust
your treatment before complications become more serious.
Start by knowing your A1C through a simple blood test that shows your average blood sugar level over the past three months. Testing helps you and your care team understand whether your treatment plan is working. It’s also important to:
- Take your medications as prescribed and refill them before they run out. If you have side effects, concerns about cost or difficulty remembering doses, talk with your care team rather than stopping a medicine on your own.
- Keep up with labs and screenings. Blood and urine tests can identify early signs of kidney problems. Regular screenings can detect problems early, allowing treatment to begin sooner and help protect your health.
- Know your blood pressure and cholesterol numbers. Managing them is an important part of protecting your heart, brain, kidneys and eyes. Your individual goals and screening schedulemay vary, so ask your care team what else you should be doing to protect your health.
Ka‘ahukane Leite-Ah Yo, MD, is a board-certified internal medicine physician. He practices at the Kaiser Permanente Mapunapuna Medical Office and is a graduate of the University of Hawai‘i John A. Burns School of Medicine. Dr. Leite-Ah Yo completed his internal medicine residency at the UCLA David Geffen School of Medicine and additional fellowship training at Oregon Health & Science University.
If you have a medical question for the doctor, email cynthia@generations808.com.
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