Diabetes diet

Diabetes mellitus is a common disease that every adult may have heard of. It can be congenital or acquired during life, but in any case it is chronic and cannot be completely cured. Many have heard that diabetes is not a disease, but a way of life. Finally, the patient must be on a special diet for life and use individually selected medications, not always insulin injections. In general, the diet in diabetes mellitus can not be considered a diet in the broadest sense of the word, because it does not have so many restrictions, and most banned products can be replaced by similar taste properties, but safe for the sensitive body of diabetics.

What is diabetes mellitus and its types

Diabetes mellitus is a chronic disease in which there is a violation of glucose metabolism. This may be due to a decrease in the amount of insulin hormone produced by pancreatic cells, then type 1 diabetes mellitus (insulin-dependent) is diagnosed or it results from regular overeating leading to obesity, severe stress and other factors, then type 2 diabetes mellitus develops (independentabout insulin).

Insulin is a biologically active substance that is released into the blood, capturing the glucose molecule and transporting it to the desired cells.

Type 2 diabetes is most often diagnosed today and requires more careful attention from a doctor, as well as adherence to special principles of diet, because it becomes a consequence of an unhealthy lifestyle that a person leads. By regularly ingesting large amounts of carbohydrates into the body, the pancreas works to wear out and eventually either stops coping with its function, or produces "damaged" insulin, which cells and tissues do not perceive. This means that such insulin cannot capture glucose and transport it to its destination, because the cells "do not see" it, ie. develops insensitivity to it. Not the least important role in this is played by the changes in the hormonal background that inevitably occur with age.

In both cases there is a sudden increase in the concentration of glucose (sugar) in the blood and the development of characteristic symptoms:

• increased thirst;
• dry mouth;
• weakness;
• deterioration of vision;
• increased appetite, etc.

Type 2 diabetes mellitus is most commonly diagnosed in 85-90% of patients. It usually occurs after the age of 40, and especially often after the age of 65. Such susceptibility of the elderly to the development of carbohydrate metabolism disorders is a consequence of reduced physical activity and decreased muscle mass which is the main consumer of glucose, and increasing abdominal obesity is becoming an additional factor increasing the risk of developing non-insulin dependent diabetes.

Abdominal obesity is the predominant deposition of adipose tissue in the abdomen.

Diagnosing diabetes is not difficult. For that, a blood glucose test is performed. Obtaining increased indicators serves as a reason for further examination and selection of optimal treatment tactics, one of the mandatory components of which is dietary correction.

Why it is important to follow basic dietary principles

In any type of diabetes mellitus, the blood sugar level rises, but despite this, the cells cannot receive it due to a lack of insulin or the development of insulin resistance. Because glucose is a monosaccharide that is a product of the breakdown of carbohydrates, it acts as the main source of energy in the body. Therefore, if the tissues do not receive it in sufficient quantities, they feel hungry, which due to the transmission of appropriate nerve impulses to the brain leads to the appearance of a similar feeling in humans. Therefore, in diabetes, patients can eat something, especially sweet, even an hour after a large meal.

As a result, patients are openly overeating high-calorie foods with carbohydrates, which in diabetes mellitus type 2 quickly leads to weight gain and progression of obesity. This leads to an even greater jump in blood glucose levels, an increase in the load on the pancreas, an increase in insulin production, an increase in tissue resistance to it, a worsening of the condition, ie. Creating a vicious state of vicious circle.

In such situations, if you do not intervene in time and interrupt this cycle, high sugar levels (hyperglycemia) will lead to the development of ketoacidosis and diabetic coma. At the beginning, the patient will feel a strong thirst and often go to the toilet, and then weakness, difficulty breathing will quickly join, a characteristic smell of acetone from the mouth and urine will appear, nausea and vomiting will appear. In the absence of competent medical care, there will be confusion and, ultimately, diabetic coma.

In addition, long-term uncontrolled diabetes mellitus (decompensated) can lead to the development of:

• retinal lesions with subsequent irreversible blindness;
• impaired renal function and chronic renal failure;
• poorly healing trophic ulcers on the legs, very difficult to treat;
• osteoporosis, fraught with the possibility of getting a fracture of any bone marrow, including the spine, even with a minor stroke;
• disorders of the heart and blood vessels, organs of the digestive tract, etc.

Therefore, it is important not only to diagnose diabetes mellitus on time and take medications prescribed by an endocrinologist, but also to strictly adhere to dietary recommendations.

Characteristics of the diet

The diet for type 1 and type 2 diabetes mellitus has some differences that patients should understand. As for the diet for insulin-dependent diabetes, in which patients receive lifelong replacement therapy in the form of regular insulin injections, physicians in different countries view the need to limit simple carbohydrates in different ways.

Foreign endocrinologists believe that it is not necessary to reduce the amount of their consumption in type 1 diabetes with properly selected insulin therapy. Local doctors believe that this is fraught with undesirable consequences and insist on the need to limit the consumption of simple carbohydrates, but not complete abandonment, as in non-insulin dependent diabetes. In type 2 diabetes mellitus, such disputes are inappropriate, because the use of sugar can turn into terrible consequences, which is not in question in any country.

In addition, people with type 1 diabetes should be able to count units of bread (XE), and people with type 2 diabetes should be able to determine the glycemic index (GI). The diet should be structured so that these indicators of the daily diet correspond to the developed norms.

Therefore, today patients with diabetes mellitus are prescribed the so-called diet no. 9 in various modifications, the differences of which are insignificant. The endocrinologist determines which table is most suitable for a certain patient based on the results of analyzes and the person's condition.

In general, diet no. 9 is designed to normalize carbohydrate metabolism by reducing the amount of simple carbohydrates consumed and, consequently, by reducing blood glucose levels. As a result, it is possible to bring the amount of sugar in the blood to normal, prevent the development of possible disorders of fat metabolism and complications of the disease.

Diet no. 9 assumes complete rejection of simple carbohydrates in the background of daily consumption of no more than 300 g of complex carbohydrates, maintaining the amount of protein food in the physiological norm.

Basic nutritional principles

In the case of diabetes mellitus of any type, the following recommendations should be followed:

• food should be fractional and consist of at least 5 meals, especially in insulin-dependent form;
• breakfast is a mandatory meal;
• when compiling the menu, the physiological ratio of proteins (meat, fish dishes, dairy products), carbohydrates (cereals, bread) and vegetables should be adhered to, they should account for 25% and 25%, respectively;
• nutritional preference is always given to foods with a low glycemic index and a high percentage of plant fiber;
• each meal begins with vegetables, and protein remains at the very end;
• the amount of salt should not exceed 5 g per day;
• fasting for diabetes is prohibited, if necessary, in order to reduce weight, this is achieved by increasing physical activity;
• when choosing the method of cooking vegetables, it is recommended to give preference to minimal heat treatment or complete abandonment, it is ideal to boil, bake and steam;
• A vegetarian diet for diabetes is not the best choice, although it helps to improve the course of the disease and increase insulin sensitivity, you can switch to it only with the permission of an endocrinologist.

Diet for type 1 diabetes

Insulin-dependent diabetes is usually diagnosed as early as childhood. Since the cause of its development is the destruction of pancreatic cells that synthesize insulin, patients must be prescribed insulin therapy, and the drug and dosage are selected individually. Insulin injections fully cover the deficit in hormone production in the body, so no significant dietary restrictions are required, but the child's parents, and then the child himself, must learn to correctly calculate the amount of carbohydrates consumed to match the dose of insulin administered. For this purpose, tables have been specially made showing the number of so-called granular units in each product.

In type 1 diabetes mellitus it is necessary to refuse only:

• any sweet drinks, including juices;
• ready-made breakfast cereals;
• pastry shop.

You can eat a maximum of 7 XE per meal and up to 25 XE per day. In this case, the amount of all carbohydrates eaten is added up per serving amount. For example, 2 XE contains 3 tablespoons. l. ready-made pasta, 4 tbsp. l. rice, 14 tbsp. l. legumes or 420 g of tomatoes.

1 XE is equal to 12 g of carbohydrates or 20 g of bread.

Sweets are not strictly forbidden, but only those who control blood glucose levels several times a day can afford them, count XE accurately, and can self-regulate the dose of insulin administered.

In severe type 1 diabetes, patients are prescribed diet no. 9b and large doses of insulin. It involves the use of 400-450 g of carbohydrates and is very close to the diet of most modern people. It is allowed to take 20-30 g of sugar daily.

The endocrinologist who monitors the patient’s condition will definitely tell you how to distribute the amount of food between the individual doses, depending on the type of medication he or she has prescribed. Thus, with the introduction of insulin twice a day (morning and afternoon), it is necessary to compile a menu so that at that time it accounts for almost 2/3 of the total daily carbohydrate intake. Moreover, after each injection you must eat 2 times - 15 minutes after the injection and 3 hours after. Fractional nutrition and XE amount control are the basis of diets for type 1 diabetes.

If after the injection the patient suddenly feels weak, it indicates a lack of glucose in the body. In such situations, you should eat a piece of dark chocolate immediately.

Thus, in the form of insulin-dependent disease, the main difficulty lies in the need not to control the type of food, but its volume and the number of units of bread.

Diet for type 2 diabetes

In most cases, obesity is the main cause of the disease. Therefore, diet for type 2 diabetes is the first and main component of treatment and prevention of complications. With its help, it will be possible to normalize sugar levels and control weight, thus preventing the appearance of unwanted changes and worsening of the condition.

All patients should monitor their blood glucose levels on a daily basis using household glucometers, and if stable high rates are achieved, consult a physician immediately.

If a patient is diagnosed with a form of mild or moderate insulin-independent illness and his weight is within normal limits, he is assigned a basic diet no. 9 with a daily caloric intake of up to 2500 kcal. In such situations, you can consume a maximum of 275-300 g of complex carbohydrates per day from various sources.

In the presence of obesity, it is necessary not only to maintain glucose levels within the normal range, but also to reduce weight, because its excess negatively affects the effectiveness of treatment and the well-being of patients. Therefore, in such cases, patients are prescribed the so-called reduced diet no. 9, which is characterized by a reduced calorie content due to an even greater limitation of the allowable amount of complex carbohydrates consumed daily. In this case, the endocrinologist individually calculates this rate based on the degree of obesity. Therefore, in different cases, patients may be allowed to ingest 100 to 225 g of carbohydrates, and the total caloric intake should not exceed 1700 kcal per day.

What is not allowed

Therefore, in type 2 diabetes mellitus, it is necessary to completely exclude from the diet foods that contain so-called fast carbohydrates, ie those that are broken down into glucose and absorbed into the bloodstream within 15 minutes. They quickly give a burst of energy, but do not create a feeling of satiety, so after eating them, hunger returns very quickly. These include:

• sugar;
• honey;
• confectionery, classic pastries;
• ice cream, chocolate;
• marmalade, jam, jam, canned;
• sweet vegetables, fruits, berries (grapes, bananas, dates, pineapple, persimmons, dried fruits);
• white bread, loaf;
• semolina;
• smoked meat, fatty dishes;
• mayonnaise;
• fast food, snacks.

Special recipes have been created for diabetics, including permitted baking products.

Diet number 9 does not require complete rejection, but recommends minimizing the amount consumed as much as possible:

• potatoes;
• beet;
• corn;
• carrots;
• soy products;
• pasta;
• bread.

If you are overweight, you will have to completely abandon all foods high in fat:

• butter and vegetable oil, spreads;
• sour cream, fatty cheeses, cottage cheese, cream;
• fat, fatty meat and fish, chicken with skin;
• nuts, seeds;
• alcohol, etc.

In such situations, it is recommended to replace these products with vegetables that have a beneficial effect on carbohydrate metabolism. These are leafy greens, eggplants, cucumbers, beets, cauliflower, pumpkin, zucchini, radishes, etc.

It is necessary to try to completely abandon foods high in fat, especially canned foods, meat industry products, sauces for storage. They are replaced by cooked or stewed diet meat (chicken, rabbit, turkey, low-fat yogurt without additives).

What can

Carbohydrates are an indispensable part of the daily diet and they must be present on the diabetes menu, but only in acceptable amounts. Patients should only eat foods with slowly absorbed carbohydrates and high fiber content. It:

• vegetables;
• wholemeal bread with bran;
• whole grains (8-10 tablespoons), with the exception of refined rice.

Since sugar in any form is forbidden to diabetics, its glucose-free substitutes have been specially created. Many of them are many times sweeter than sugar and can be used in minimal quantities. Modern sweeteners include xylitol, stevia, sorbitol, fructose. But studies have shown that some of them can have a negative effect on the body. Stevia is considered the safest sugar substitute today. It is obtained from natural raw materials, and in terms of sweetness it surpasses sugar 10-30 times (depending on the form of release: plant powder or an extract called stevioside).

It is important for patients to know the glycemic index of food. Today, there are special tables that help you find your way in choosing and correctly calculating the allowable consumption rate. In diabetes, preference should be given to foods with a GI of less than 55 (apples, cucumbers, cherries, broccoli, lettuce, milk, cauliflower, etc. ). They break down slowly and lead to little or no increase in blood sugar levels. Such products can be eaten up to 200 g during one meal, but preferably together with proteins.

Heat treatment increases GI.

It is allowed to use:

• potatoes (not more than 200 g per day);
• meat and vegetable soup dishes;
• lean meat and fish (chicken, turkey, pollock, pike, hake);
• lenses;
• fermented milk and low-fat dairy products, cheeses with a fat content of less than 30%;
• eggs (3-4 per week, but not more than 1 per day);
• vegetable oil (not more than 1 tbsp. l. per day);
• special sweets, waffles, bread for diabetics.

When homemade compotes are made, sweeteners are added instead of sugar.

Diet for gestational diabetes

Pregnant women with a genetic predisposition to develop diabetes mellitus may face the development of so-called gestational diabetes at 20-24 weeks. It occurs in the background of the presence of hereditary reduced tissue sensitivity to inulin, enhanced by hormones produced during pregnancy in increased quantities: estrogen, prolactin, cortisol. They are able to block insulin and cause a rise in blood sugar.

Often, after childbirth, carbohydrate metabolism gradually returns to normal, because the hormonal background normalizes. But regardless of that, if the basic principles of diet and nutrition are not respected, there is not only a risk of preserving diabetes mellitus, but also the development of complications that can lead to premature birth, pyelonephritis in the mother, fundus pathology, and complications during childbirth. For the purpose of timely detection of gestational diabetes during pregnancy, blood glucose tests are performed regularly, and if hyperglycemia is detected, a diet is prescribed.

In such situations, women are advised to:

• completely exclude from the diet simple carbohydrates (same sugar, sweets, chocolate, pastries, white and black bread, bananas, grapes, juices, dried fruits, etc. );
• limit your intake of complex carbohydrates to the amount recommended by your doctor;
• take away most of the daily diet for vegetables, unsweetened fruits;
• refuse to eat fatty foods, fried foods, semi-finished products, various sausages, smoked products;
• when choosing the method of cooking the product, give preference to baking, stewing, steaming;
• eat in part, preferably every 2 hours, highlighting 3 main meals (breakfast, lunch and dinner) as well as 2 additional ones (second breakfast, afternoon snack);
• drink at least 1. 5 liters of water.

Pregnant women with gestational diabetes are advised to measure their blood sugar after each meal.

All these recommendations are relevant for the postpartum period. In any case, in the first months of a child’s life, the breastfeeding mother is forced to sit on a hypoallergenic diet and refuse fried, fatty foods. The same diet will help eliminate gestational diabetes and avoid its transition to a chronic disorder of carbohydrate metabolism within 2-3 months after birth. If after this period of time the blood glucose level does not return to normal, the woman should consult an endocrinologist to review and develop treatment tactics.

Sugar reduction products

There are a number of foods that can help lower blood glucose levels. They are called hypoglycemic and are recommended for patients with diabetes mellitus. But because each person is a unique biological system and has individual characteristics, they can react to certain types of food in their own way, not just give allergic reactions. Therefore, although glucose-lowering foods can provide invaluable help to patients with diabetes mellitus, especially type 2, it is worth consulting an endocrinologist before starting daily use.

So, sugar-reducing foods include:

• Cherry (GI 22) - contains anthocyanin which helps lower blood sugar and blood pressure and removes so-called bad cholesterol. The daily norm is 100 g.
• Grapefruit (GI 29) - Contains naringin, a powerful antioxidant that helps increase tissue sensitivity to insulin. It is recommended to consume 1 medium-sized grapefruit or freshly squeezed juice from it daily (commercially unsuitable). But grapefruit can negatively affect the quality of absorption of various drugs, so it is necessary to consult a doctor before including it in the menu.
• Cinnamon is a source of polyphenols that help maintain blood sugar levels. The daily rate is 1/2 teaspoon. It can be added to cottage cheese, oatmeal, and is very suitable for making apple pans.
• Broccoli is a valuable source of fiber that is so beneficial for diabetes, and the substances it contains help slow down the rate of sugar absorption in the gut. The daily norm is 200 g.
• Blueberries are one of the healthiest foods for diabetics because they contain valuable glycosides, tannins, anthocyanins, which help maintain normal glucose levels and reduce the risk of developing diabetic retinal damage. The daily norm is 200 g.
• Oatmeal and millet porridge is rich in fiber, which helps maintain sugar levels.
• Artichoke is a natural source of insulin, which is why its use contributes to the normalization of glucose levels, and the presence of fructose in the composition provides a pleasant sweet taste, which allows it to be used raw or added to salads.
• Garlic is one of the healthiest foods for everyone because it contains many antioxidants, natural antibacterial and other substances. Its use makes the pancreas more active, which is very valuable for patients with type 1 diabetes.
• Fish - It has been shown that diabetic fish eat at least 2 times a week, and whenever possible, they try to replace meat dishes with it. It helps to normalize sugar levels, as well as to obtain essential polyunsaturated fatty acids.

Thus, the diet for diabetes mellitus can be varied and delicious. With a competent approach to menu planning, this will not cause rejection, but will, on the contrary, help increase energy and efficiency, because it largely corresponds to the principles of a rational diet. But remember, with diabetes, it is important to maintain a normal level of physical activity, because exercise increases tissue sensitivity to insulin.