General dietary guidelines for diabetes
Diabetes is currently a global problem. Over the past ten years, the number of people with diabetes has more than doubled to 425 million. According to forecasts, by 2045, their number could reach 629 million.
Diabetes mellitus is a group of endocrine diseases associated with impaired glucose uptake and developing due to an absolute or relative deficiency of the hormone insulin, resulting in hyperglycemia – a persistent increase in blood glucose. This disease is characterized by a chronic course and a violation of all types of metabolism already due to a violation of carbohydrate metabolism; fat, protein, mineral, and water-salt are also disturbed.
Let’s turn to the causes of the development of this disease. Type 1 diabetes mellitus is characterized by the destruction or destruction of pancreatic cells. This usually results in absolute insulin deficiency. Both genetic and environmental factors such as viral infections, diet, toxins, and hygiene are involved in developing type 1 diabetes.
Type 2 diabetes mellitus is characterized by the development of insulin resistance and relative rather than absolute insulin deficiency and is manifested by persistent hyperglycemia. The main problem with diabetes mellitus is increased blood glucose levels and carbohydrate starvation of cells since glucose cannot enter it but floats in the blood.
The basis of the treatment of diabetes is diet therapy. The general principles of nutrition, regardless of the type of diabetes, are that the patient is shown to reduce the carbohydrate load in the diet to 5-7% and increase the consumption of vegetable fats. Previously, people with diabetes were advised to eliminate simple carbohydrates. Still, today there is more and more emphasis on personalized diets with a unique selection of a food basket and calculation of calories. The slogan is trendy: “With diabetes, there are no restrictions. There is only the right way of life.”
The glycemic index is used to figure out what diabetics should eat. This index shows how quickly the blood takes up the sugar in them. High-index foods, like jam, cookies, and cakes, have a high absorption rate. Cereals and fruits, which have a low index, are not as good. The pancreas can handle the load better when the absorption rate is slow. So, foods with a GI of up to 55 are broken down slowly and rarely raise blood sugar levels.
Also, do not forget about the insulin index of products, which reflects the number of insulin rises in response to eating food. The insulin index of foods is essential for people with diabetes to predict the body’s reaction when consuming specific foods and correctly calculate the doses of insulin preparations (short and prolonged action) that will be used for injection after meals.
Any meal, even protein, provokes a significant release of the hormone insulin. And the more insulin swings you have throughout the day, the more likely you will develop insulin resistance, eventually leading to type 2 diabetes. So, everyone’s favorite snack options in the form of dairy and sour-milk products, such as cottage cheese, kefir, and yogurts, have a very, very high insulin index, which means that the insulin swing will swing very strongly along with your mood and irritability.
Consider different options and features of diets depending on the type of diabetes.
Basic dietary guidelines for type 1 diabetes
In the first type, patients depend entirely on insulin injections, and the diet is built considering its introduction. Diabetics need to study the presence of carbohydrates (bread units) in products to determine the hormone dose that will help them absorb them. A bread unit is a conventional concept that implies a certain amount of any product containing 12 grams of carbohydrates.
It is recommended to consume no more than 12 bread units per day. Insulin is administered half an hour before meals. Hence, it is essential to know precisely what will be eaten and in what quantity to assimilate the carbohydrates in food. For each main meal, you need to eat no more than 5-6 bread units and 2-3 for an additional one.
You should almost completely abandon foods containing easily digestible (simple) carbohydrates. These are sweets, jam, condensed milk, marshmallows, marmalade, halva, cakes, jam, oatmeal, semolina porridge, and mashed potatoes. Reducing the number of carbohydrates in the diet, which increase blood sugar, reduces the need for medications. Using the exact dosages before transitioning to a low-carbohydrate diet can cause hypoglycemia. It is necessary to regularly measure blood sugar during the beginning of this diet and adjust the dosage of medications accordingly.
The daily calorie content is distributed throughout the day for 4-5 meals. According to the BJU ratio, the distribution looks like this: proteins make up 20-25% of the total diet, fats – 30%, no more than 10% are saturated, and carbohydrates 45-50%.
Basic dietary guidelines for type 2 diabetes
More severe restrictions are needed for the non-insulin-dependent variant of the disease. This is because this form usually appears against the background of obesity, and not only high levels of glucose but also insulin is found in the blood. However, it often happens that insulin resistance, which can lead to type 2 diabetes, does not manifest itself for a very long time. Even people with insulin resistance are not always overweight. Still, blood glucose levels are constantly kept at a high level, and this situation leads to unfortunate consequences. Dietary nutrition in type 2 diabetes helps restore cells’ ability to absorb sugar and helps restore the sensitivity of cells to insulin.
Type 2 diabetes is primarily a disorder of carbohydrate metabolism. But at the same time, other types of metabolism also suffer – lipid, protein, and mineral. Therapy for type 2 diabetes includes diet, moderate exercise, stress management, and medications (hyperglycemic drugs).
The diet for type 2 diabetes is based on fundamental principles :
- Abundance of vegetables – the number of vegetables consumed may depend on age, gender, and frequency of exercise per week. As a rule, women who exercise up to 30 minutes daily are recommended to consume at least 500 grams of vegetables daily. With more intensive classes, the number of vegetables is recommended to be increased to 800 grams. Men’s recommended amount of vegetables is 600 and 1000 grams, respectively.
- Unsaturated Fats – Polyunsaturated and monounsaturated fats in the diet help keep cholesterol levels within normal ranges and lower the risk of heart disease, one of the most common long-term complications of diabetes. Unsaturated fats are found in many foods, including nuts, avocados, fatty sea fish, and olive oil.
- Avoiding Processed Foods – Nutritionists and doctors agree that avoiding processed foods is good for health. Due to the substances added to ensure long shelf life, processed foods tend to have a high glycemic index. Regular consumption of such products can adversely affect the health of a diabetic.
Useful foods for diabetes
- Green leafy vegetables
Spinach, kale, and bok choy are low in calories but rich in nutrients like vitamin C, beta-carotene, and magnesium, which help prevent diabetes. One serving (about 106 grams) daily reduces the risk of type 2 diabetes by 14%.
These fiber-rich foods can help stabilize blood sugar levels. Legumes are low in saturated fat, which can harm your heart.
Omega-3 fatty acids are great helpers in preventing diabetes and reducing the risk of cardiovascular disease. Omega 3 is needed by the body for synthesizing red blood cells and cell membranes. They help absorb other vitamins by the body and, most importantly, suppress chronic inflammation, which is a faithful companion of insulin resistance.
- Olive oil
One of the Mediterranean diet’s staples is vital for heart health as it contains monounsaturated fatty acids. These fats (also found in high amounts in nuts) are essential aids in preventing diabetes, as they help the body effectively control blood sugar levels.
As a source of monounsaturated fatty acids, nuts are rich in magnesium, another important ally. World studies show that people who regularly eat nuts have lower rates of diabetes.
All citrus fruits contain antioxidants – great helpers to keep insulin balance in the blood.
- Whole grains
Eating whole grain bread, quinoa, and brown rice may reduce the risk of developing diabetes. Whole grains are rich in fiber, which helps the body control blood sugar levels. Complex carbohydrates are a kind of buffer that protects us from high rises in blood glucose, so if you want to eat a product with a high glycemic index, combine it with complex carbohydrates.
Delicious spice helps the body regulate insulin levels. Cinnamon is a kind of insulin sensitizer; that helps improve cells’ sensitivity to insulin. The spice helps with hypertension (chronically high blood pressure), reduces sugar concentration in the blood when used systematically in the required dosages, improves overall well-being, and positively affects metabolic processes.
It is a catalyst for metabolic processes and reduces the level of sugar, cholesterol, and blood clotting. Recommended for new daily use as a seasoning or tea base.
Forbidden foods for diabetes
To date, doctors are trying not to limit diabetic patients strictly and not to drive them into a strict framework regarding allowed or prohibited foods. Even with type 2 diabetes, in which diet plays a role, you can eat varied, but several foods still have to be removed from the diet for people suffering from this disease. The list below recommends excluding anyone who cares about their health from the diet.
Products containing excessive amounts of sugar are on the “no-sugar” list. It’s time to put the ice cream, chocolate, preserves, and other sugary treats out of our minds.
- Bakery products
Banned rich bakery products: muffins, cookies, buns, white loaf, and bread.
- Fatty foods
These dishes can significantly raise the level of glucose. For this reason, a person with diabetes should refuse duck, pork, lamb, lard, mayonnaise, or cream. It is also recommended to exclude sweet yogurt, fatty cottage cheese, and cheese.
- Semi-finished products
In their composition, they have a large number of flavors, stabilizers, and flavor enhancers. Do not eat fish sticks, ready-made industrial cutlets, dumplings, sausages, or sausages.
- trans fats
Their use will affect both diabetics and healthy individuals. Prohibited foods include margarine, confectionery fat, spread, french fries, hot dogs, and burgers.
Eating some fruits and dried fruits that cause a substantial increase in blood sugar is not recommended. They are dried apricots, dates, figs, raisins, persimmons, melons, grapes, and bananas.
Table number 9 for diabetes
The Soviet scientist M. Pevzner made this diet for diabetics, which has been used in hospitals and at home for a long time. Table number 9 includes :
- 300 g of fruit;
- 80 g of vegetables;
- 100 g mushrooms;
- 1 st. natural fruit juice;
- 300 g of meat or fish;
- 500 milliliters of fermented milk products and 200 grams of low-fat cottage cheese.
- 100-200 g of bran, rye, wheat bread combined with rye flour, or 200 g of cereals (prepared), potatoes;
- 40-60 g of fat.
Soups: vegetable, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, fish or light meat broth, mushroom soup with cereals and vegetables.
Meat and poultry: rabbit, veal, stewed, chopped, cooked chicken, and turkey.
Fish: pike perch, navaga, cod, pike, and low-fat seafood stewed, steamed, boiled, and baked in juice.
Snacks: include vegetarian caviar, vegetable caesar, unsalted cheese, aspic dietary fish and meat, vegetable mix of vegetables, and vinaigrette. Seafood salad with butter is another option.
Sweets: berry desserts, fresh fruit, berry mousses, sugar-free fruit jellies, sugar-free jams and marmalade.
Dishes with eggs: soft-boiled eggs, protein omelets, etc.
Other dietary strategies for diabetes
Of course, do not forget that all diets are made strictly individually, taking into account the age and gender of the patient and the level of his physical activity.
So, today there are several options for dietary strategies for diabetes. If it is necessary to normalize body weight in a patient with type 2 diabetes, the Mediterranean diet has proven itself well based on daily physical activity.
The main principles of the diet are :
- fractional meals five times a day – 3 main meals and two snacks;
- breakfast should be more carbohydrate, mainly consisting of complex carbohydrates;
- dinner is light, consisting of lean protein and vegetables;
- during the day, it is necessary to consume more than 1 kg of various vegetables and herbs;
- Observing the drinking regime – at least 7-8 glasses of water per day is important.
The primary sources of fats in the diet are unrefined olive oil; sometimes, you can use sesame, rapeseed, or peanut. Animal fats are limited in the Mediterranean diet.
Particular attention is paid to Omega 3 fatty acids and oleic acid found in oils, oily fish, and seafood. These fatty acids significantly impact the prevention of atherosclerosis, improve insulin sensitivity, and help immune cells detect inflammation and suppress it.
Carbohydrates in the Mediterranean diet are predominantly complex with a low glycemic index – durum wheat pasta, beans, rice, lentils, wholemeal bread, seasonal vegetables, and fruits.
Protein is available in low-fat soft cheeses, eggs, fish, seafood, and rarely poultry meat.
Another diet option for diabetes is the LCHF and the keto diet. The essence of this dietary strategy is to consume a small number of carbohydrates and a large amount of fat. Carbohydrates on fat diets are limited to 50 grams per day, and on a keto diet, the restriction is even more serious – no more than 10 grams of carbohydrates.
On a keto diet, the following foods are wholly excluded :
- sugar, honey, artificial sweeteners;
- sweet carbonated drinks;
- yeast bread, pastries;
- cereals, cereals, cereals, and dry breakfasts;
- skimmed milk, kefir, yogurt;
- sweet curds;
The idea behind the LCHF diet is that insulin is dangerous because when we eat something high in carbohydrates, the carbohydrates are broken down into glucose, blood sugar levels start to rise sharply, and insulin levels rise sharply to send glucose to the muscles, liver, and fat cells. In other words, insulin is “responsible for our obesity.” Moreover, protein can increase insulin levels just as well as carbohydrates. And there is no rise in insulin for fats at all, which is suitable for insulin resistance, if necessary, improving cells’ sensitivity to insulin.
Diabetes mellitus in children
Diabetes mellitus in children can be caused by hereditary predisposition and malnutrition, including excessive amounts of simple carbohydrates and sweets. The disease can also occur as a result of mental or physical trauma. Treatment of diabetes in children and adults consists of a therapeutic diet and insulin administration for type 1 diabetes.
The nutrition of children with diabetes should be rich in vegetables such as cabbage and cauliflower, onions, spinach, and garlic. You can eat unsweetened fruits, meat, poultry, and fish. It is desirable to give milk and cottage cheese to those with a low-fat content percentage, provided that the child does not have an intolerance to cow’s milk protein. You can use spices to improve protein absorption when cooking meat or fish.
All confectionery, candy grapes, apricots, rice, muffin cookies, and plums should be excluded. Parents of a child with diabetes need to learn how to use bread units when feeding a child and calculate the required insulin dose. The child must also be taught these skills as early as possible.
Gestational diabetes mellitus
Another type of diabetes is gestational diabetes mellitus, which is quite common today.
An increase in blood sugar during pregnancy is one of the most common metabolic disorders in a future mother. The so-called gestational diabetes mellitus or gestational diabetes is diabetes that appears during the period of gestation and is limited to the duration of pregnancy. During pregnancy, the production of sex hormones (estrogens and progesterone, hCG) and the hormone cortisol, which suppress the action of insulin, increase dramatically. As a result, blood glucose levels in pregnant women increase. High blood sugar during pregnancy negatively affects both the woman’s and the fetus’s health. Therefore, it requires timely diagnosis and further correction.
Women at particular risk :
- overweight or obese (BMI above 25 kg / m2 – the risk doubles, above 30 – triples);
- with multiple pregnancies;
- after IVF;
- with polycystic ovaries;
- with a significant weight gain in a natural pregnancy;
- with glucosuria (glucose in the urine);
- having close relatives with diabetes mellitus;
- with a burdened previous pregnancy – GDM, the birth of a large fetus, intrauterine fetal death.
Gestational diabetes is harmful to more than just the mother. It also affects the health of the unborn child. So, at 4-5 years old, such children are likelier to be overweight and obese. At 10-11 years old – an increase in blood pressure, and in adolescence, the risk of developing diabetes is 20-40%, and the risk of developing the non-alcoholic fatty disease is significantly increased liver.
If GDM is not detected promptly or the expectant mother does not take any action to treat it, then the risk increases significantly :
- early aging of the placenta and, as a result, fetal growth retardation;
- premature birth;
- the formation of a giant or disproportionate, or edematous fetus;
- increased blood pressure, preeclampsia;
- the need for a cesarean section;
- Traumatization of the mother and infant during childbirth;
- hypoglycemia (low blood sugar) and respiratory failure in the newborn;
- The most formidable complication of untreated GDM is fetal death.
Thus, it is crucial to understand that diabetes is not a life sentence. It only imposes certain obligations on a person regarding diet and physical activity. Proper, balanced nutrition is of paramount importance for any diabetes. And although reducing carbohydrates and saturated fats in the diet contribute to weight loss, the excess of which type 2 diabetics often suffer, it is imperative to change the lifestyle and eating habits. And suppose a good effect on lowering blood sugar levels in type 2 diabetes is achieved by eating the right foods and doing physical exercises that improve the way glucose gets into muscle cells than in type 1 diabetes. In that case, nutrition is the most critical factor.