A consultation at a community health clinic: a dietitian discusses dietary management, portion control, and blood glucose with a patient newly diagnosed with type 2 diabetes.
- Adam White · turn 1
Good morning, Ms Zhou. I’m Adam White, the dietitian. Thank you for coming in today.
周女士，早安。我是營養師亞當·懷特（Adam White）。感謝您今天前來。
- 周靜 · turn 2
早上好，White 先生，我是周靜。謝謝你今天安排時間見我。
Good morning, Mr White. I’m Jing Zhou. Thank you for making time to see me today.
- Adam White · turn 3
Please, call me Adam. How are you feeling today?
請叫我亞當就好。您今天感覺怎麼樣？
- 周靜 · turn 4
我今天感覺還好，謝謝。
I'm feeling fine today, thank you.
- Adam White · turn 5
That’s good to hear. I understand you’ve recently been diagnosed with type 2 diabetes. How are you coping with the news?
很高興聽到這個。我知道您最近被診斷出患有2型糖尿病。您對這個消息適應得如何？
- 周靜 · turn 6
我的確挺擔心的。我以前一直覺得自己的身體還不錯，所以確診的時候真的有點難以接受。我也想了解一下，有沒有辦法控制二型糖尿病的發展，不讓病情越來越嚴重。
I am indeed quite worried. I always thought my health was fairly good, so when I was diagnosed, it was really a bit hard to accept. I’d also like to know if there's any way to control the progression of type 2 diabetes so it doesn't get worse and worse.
- Adam White · turn 7
It’s completely understandable to feel that way. Managing diabetes involves making some adjustments to your lifestyle, especially your diet. Have you made any changes to your eating habits since your diagnosis?
有這種感覺完全可以理解。控制糖尿病需要在生活方式上做出一些調整，特別是飲食方面。自確診以來，您的飲食習慣有做出任何改變嗎？
- 周靜 · turn 8
有啊。剛一確診之後，我已經在嘗試減少糖分和碳水化合物的攝入。我現在很少喝汽水，也不太敢吃甜點了，但是我不知道自己做得夠不夠。
Yes, I have. Right after being diagnosed, I started trying to reduce my intake of sugar and carbohydrates. I rarely drink soft drinks now and hardly dare to eat desserts, but I don't know if I'm doing enough.
- Adam White · turn 9
That’s a good start. We’ll work together to refine your diet plan and make sure you’re on the right track. We want to minimise the risks associated with diabetes and keep you healthy. How do you usually plan your meals?
這是個良好的開端。我們會共同完善您的飲食計劃，確保您走在正確的軌道上。我們希望盡量減少與糖尿病相關的風險，讓您保持健康。您平時通常是如何規劃飲食的？
- 周靜 · turn 10
你知道我是中國人，飲食習慣和西方人不太一樣。我們家平時吃米飯和麵條比較多，也會炒一些蔬菜和肉。早餐有時候就是一碗粥，午餐和晚餐一般都會吃米飯。不過現在我也明白，我需要在食物選擇和攝入量方面更加注意。
As you know, I'm Chinese, so my eating habits are somewhat different from Westerners. At home we usually eat a lot of rice and noodles, and stir-fry some vegetables and meat. Breakfast is sometimes just a bowl of congee, and for lunch and dinner we generally eat rice. But now I understand that I need to be more careful with food choices and portion sizes.
- Adam White · turn 11
It’s great that you’re aware of that. You don’t necessarily have to give up rice or noodles altogether. What matters is the amount you eat, the type of carbohydrate you choose, and what you eat with it. We’ll focus on balancing your meals with the right mix of carbohydrates, protein and healthy fats.
您能意識到這一點非常棒。您並不一定非要徹底戒掉米飯或麵條。重要的是您的食用份量、您選擇的碳水化合物種類，以及您搭配什麼一起吃。我們將著重於平衡您的飲食，合理搭配碳水化合物、蛋白質和健康脂肪。
- 周靜 · turn 12
那我就放心一點了。我本來還以為得了糖尿病之後，米飯、麵條這些東西就完全不能碰了。那我是不是只要把每餐的飯量減少就可以了？
That puts my mind at ease a bit. I originally thought that once you get diabetes, you couldn't touch things like rice and noodles at all. So do I just need to reduce the amount of rice I eat at each meal?
- Adam White · turn 13
Portion control is certainly important, but there’s more to it than simply eating less. Ideally, you should include plenty of vegetables, a moderate amount of high-fibre carbohydrates and a source of lean protein. Foods that are high in fibre can also help you feel fuller for longer and may help with blood glucose control.
控制份量當然很重要，但這不僅僅是少吃那麼簡單。理想情況下，您的飲食應包含豐富的蔬菜、適量的高纖維碳水化合物和優質瘦肉蛋白。富含纖維的食物還能幫助您維持更長時間的飽足感，並可能有助於控制血糖。
- 周靜 · turn 14
高纖維的碳水化合物具體是指甚麼呢？我平時吃的白米飯算嗎？如果不算，是不是一定要改吃糙米？
What specifically counts as high-fibre carbohydrates? Does the white rice I usually eat count? If not, do I definitely have to switch to brown rice?
- Adam White · turn 15
White rice is relatively low in fibre, so you could consider replacing some of it with brown rice or other whole grains. But you don’t have to change everything overnight. Making gradual, sustainable changes is usually more effective than going from one extreme to the other.
白米的纖維含量相對較低，因此您可以考慮用糙米或其他全穀物替代其中的一部分。但您不必在一夜之間徹底改變所有習慣。循序漸進、可持續的調整，通常比從一個極端走向另一個極端更加有效。
- 周靜 · turn 16
明白了。那我可以先把一半白米換成糙米，等習慣之後再慢慢調整。可是我聽朋友說，糖尿病患者最好少吃多餐，這樣可以防止血糖突然升高，是真的嗎？
Understood. Then I can start by replacing half of the white rice with brown rice, and gradually adjust after getting used to it. But I heard from friends that diabetes patients should eat smaller, more frequent meals to prevent blood glucose spikes—is that true?
- Adam White · turn 17
Regular meals can be helpful, but frequent meals and snacks aren’t necessary for everyone. It depends on your medication, blood glucose levels, activity and individual needs. I’d rather tailor your meal pattern to you than give you a one-size-fits-all rule.
規律進餐可能會有幫助，但頻繁進食和加餐並不是對每個人都必要。這取決於您的用藥情況、血糖水平、活動量和個人需求。我寧願為您量身定制飲食模式，而不是套用一刀切的規則。
- 周靜 · turn 18
原來是這樣。我現在還沒有打胰島素，醫生只是讓我先改善飲食和增加運動。他還叫我定期測血糖，包括空腹血糖。
I see. I'm not on insulin yet; the doctor just told me to improve my diet and exercise more first. He also told me to test my blood glucose regularly, including fasting blood glucose.
- Adam White · turn 19
That makes sense. Your fasting blood glucose gives us useful information about how your body is managing glucose when you haven’t eaten for several hours. Over time, your GP will probably also monitor other measures to see how well your diabetes is being controlled.
這很合乎情理。您的空腹血糖能為我們提供有用的資訊，反映您在數小時未進食時身體對葡萄糖的調節情況。隨著時間的推移，您的全科醫生可能還會監測其他指標，以評估您的糖尿病控制得如何。
- 周靜 · turn 20
我還有一個問題。我最近上網查了很多資料，有些文章說壓力太大會令皮質醇升高，然後血糖也會升高。我工作壓力一直都很大，這會不會讓我的糖尿病惡化？
I have another question. I looked up a lot of information online recently, and some articles said excessive stress causes cortisol levels to rise, which in turn raises blood glucose. My work has always been very stressful—could this worsen my diabetes?
- Adam White · turn 21
Stress can affect blood glucose, so managing stress, getting enough sleep and staying physically active are all useful. But try not to get overwhelmed by everything you read online. Diabetes management is about the bigger picture rather than one particular hormone or food.
壓力確實會影響血糖，因此調節壓力、充足睡眠和保持身體活動都很有用。但盡量不要被網上看到的每件事弄得手足無措。糖尿病管理看重的是整體狀況，而不是單一某種荷爾蒙或食物。
- 周靜 · turn 22
說得也是。我現在看到甚麼都會擔心。有時候看到食品包裝上寫著「低脂」，我就覺得應該比較健康。可是有人又跟我說，有些低脂食品其實含很多糖，我現在都不知道應該相信甚麼了。
That's true. Right now, I worry about everything I see. Sometimes when I see 'low fat' on food packaging, I assume it must be healthier. But then someone told me some low-fat foods actually contain a lot of sugar, so now I don't know what to believe.
- Adam White · turn 23
Food labels can certainly be confusing. “Low fat” doesn’t automatically mean a product is suitable for someone with diabetes. We need to look at the overall nutritional information, including carbohydrates, added sugars, saturated fat, fibre and portion size.
食品標籤確實容易令人困惑。「低脂」並不自動意味著該產品適合糖尿病患者。我們需要查看整體的營養資訊，包括碳水化合物、添加糖、飽和脂肪、纖維以及食用份量。
- 周靜 · turn 24
那脂肪方面呢？我上次驗血的時候，醫生還說我的膽固醇有點高。他說糖尿病加上膽固醇過高，將來可能會增加心臟病和中風的風險。
What about fat? When I had a blood test last time, the doctor also said my cholesterol was a bit high. He said having diabetes along with high cholesterol might increase the risk of heart disease and stroke in the future.
- Adam White · turn 25
That’s correct. Diabetes can increase your risk of cardiovascular disease, and high cholesterol is another risk factor. That’s why we’ll also look at the types of fat in your diet. Generally, we want to limit saturated fat and choose healthier unsaturated fats where possible.
沒錯。糖尿病會增加患心血管疾病的風險，而高膽固醇是另一個危險因素。這就是為什麼我們也要關注您飲食中的脂肪類型。通常情況下，我們希望限制飽和脂肪，並盡可能選擇更健康的不飽和脂肪。
- 周靜 · turn 26
聽起來要注意的東西真的很多。我以前吃飯從來不看甚麼蛋白質、脂肪、纖維，只要覺得好吃、吃得飽就行。現在突然要改這麼多，我怕自己堅持不了。
It sounds like there's really a lot to pay attention to. I used to never look at protein, fat, or fibre when eating; as long as it tasted good and filled me up, that was fine. Now having to change so much all of a sudden, I'm afraid I won't be able to stick to it.
- Adam White · turn 27
You don’t need to get everything perfect from day one. Think of this as a long-term process. Small changes add up, and we’ll review your progress at each appointment. If something isn’t working for you, we can make adjustments rather than throwing the whole plan out the window.
您不需要從第一天起就把每件事做到盡善盡美。把這看作一個長期的過程。微小的改變會積少成多，我們會在每次覆診時回顧您的進展。如果某些做法不適合您，我們可以進行調整，而不是徹底推翻整個計劃。
- 周靜 · turn 28
這樣說我就沒有那麼大壓力了。我還聽說有些人減肥之後，二型糖尿病可以進入「緩解期」。是不是說只要我減掉足夠的體重，糖尿病就算治好了？
Putting it that way relieves a lot of pressure. I also heard that after losing weight, type 2 diabetes can go into 'remission' for some people. Does that mean that as long as I lose enough weight, the diabetes is cured?
- Adam White · turn 29
Remission is possible for some people with type 2 diabetes, particularly after significant and sustained weight loss, but remission doesn’t mean the condition has been permanently cured. Blood glucose can rise again, so ongoing monitoring and healthy lifestyle habits remain important.
對於部分2型糖尿病患者而言，緩解是可能的，特別是在顯著且持續減重之後；但緩解並不意味著病情得到了永久治癒。血糖仍有可能再次升高，因此持續監測和保持健康的生活習慣仍然至關重要。
- 周靜 · turn 30
明白。那我不應該把「緩解」理解成「治癒」。我以前也試過很極端的減肥方法，例如長時間空腹不吃東西。這次是不是也可以靠禁食快速把體重減下來？
Understood. So I shouldn't interpret 'remission' as a 'cure'. I've tried extreme weight-loss methods in the past, such as fasting for long periods without eating anything. Can I also rely on fasting to quickly drop weight this time?
- Adam White · turn 31
I wouldn’t recommend starting a restrictive fasting regime without discussing it with your doctor and dietitian first. Rapid weight loss and very restrictive diets aren’t suitable for everyone and, in some circumstances, can cause other problems. For example, rapid weight loss can increase the risk of developing gallstones.
在未事先諮詢醫生和營養師的情況下，我不建議開始嚴格限制熱量的禁食方案。快速減重和極端節食並不適合所有人，在某些情況下還可能引發其他健康問題。例如，體重下降過快會增加患膽結石的風險。
- 周靜 · turn 32
膽結石？這個我真的不知道。看來還是不能為了控制一個問題，又弄出另外一個問題來。
Gallstones? I really didn't know that. It seems I shouldn't create another problem just to solve one.
- Adam White · turn 33
Exactly. Our goal is to improve your overall health, not just bring one number down on a blood test. We’ll also discuss portion control and the importance of regular meals throughout the day, taking your individual circumstances into account.
正是如此。我們的目標是改善您的整體健康狀況，而不僅僅是拉低驗血報告上的某個數值。我們還會結合您的個人情況，討論份量控制以及全天規律進餐的重要性。
- 周靜 · turn 34
我很樂意學習如何管理自己的飲食。只要不是甚麼東西都不能吃，我覺得慢慢改變應該還是做得到的。
I'm very willing to learn how to manage my diet. As long as it doesn't mean I can't eat anything at all, I think taking it slow is manageable.
- Adam White · turn 35
Absolutely. I’ll provide you with a personalised meal plan, and we’ll schedule regular follow-up appointments to monitor your progress and make any necessary adjustments. I’d also like you to keep a simple record of what you eat and, if your doctor has asked you to monitor it, your blood glucose readings.
當然。我會為您提供一份量身定制的膳食計劃，並且我們會安排定期的覆診預約，以監測您的進展並做出必要調整。我還希望您記錄一份簡要的飲食日記；如果醫生要求您監測血糖，也請一併記錄血糖讀數。
- 周靜 · turn 36
好的，我會記下來。謝謝你，White 先生。我期待著在你的幫助下改善飲食，把糖尿病控制好。我現在至少知道應該從哪裏開始了。
Alright, I'll write it down. Thank you, Mr White. I look forward to improving my diet and keeping my diabetes under control with your help. At least now I know where to start.
- Adam White · turn 37
You’re welcome, Ms Zhou. Let’s work together towards your health goals. Remember, you don’t have to change everything at once. We’re aiming for changes you can stick with in the long run. I’ll see you at the next appointment.
不客氣，周女士。讓我們共同朝著您的健康目標努力。請記住，您不必一下子改變所有事情。我們的目標是做出能夠長期堅持的改變。我們下次預約見。
- 周靜 · turn 38
好的，謝謝你。下次見。
Alright, thank you. See you next time.
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