Currently, diabetes is a global problem. Over the past ten years, the number of people with diabetes has more than doubled to 425 million, and it is predicted that by 2045 the number could reach 629 million.
Diabetesis a group of endocrine diseases associated with impaired glucose absorption and developing as a result of an absolute or relative deficiency of the hormone insulin, leading to the development of hyperglycemia - a persistent increase in blood sugar levels. This disease is characterized by a chronic course, as well as a violation of all types of metabolism due to a violation of carbohydrate metabolism; the metabolism of fats, proteins, minerals and water-salt is also disturbed.
Let's look at the reasons for the development of this disease. Type 1 diabetes is characterized by the breakdown or destruction of pancreatic cells. This usually leads to absolute insulin deficiency. The development of type 1 diabetes involves both genetic and environmental factors: viral infections, nutrition, toxins, hygiene. 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 any type of diabetes is an increase in blood sugar levels and carbohydrate deprivation of cells, because glucose cannot enter them, but floats in the blood in slow motion.
Treatment of diabetes mellitus is based on diet therapy. The general principles of nutrition, regardless of the type of diabetes, are that the patient is advised to reduce the carbohydrate load in the diet to 5-7% and increase the consumption of vegetable fats. Previously, diabetics were recommended to completely eliminate simple carbohydrates, but today there is an increasing emphasis on personalized diets with individual selection of food baskets and calorie calculation. Currently, the slogan is very popular: "With diabetes there are no restrictions, there is only a good lifestyle".
The diet of diabetic patients is based on the glycemic index. Essentially, this index reflects how quickly their sugar is absorbed into the bloodstream. Products with a high index - jams, biscuits, cakes - have a high absorption rate. Products with a low index - cereals, fruits - have a lower index. The slower the absorption rate, the easier it is for the pancreas to cope with the load. So, foods with a GI of up to 55 break down gradually and cause almost no increase in sugar.
Also, remember the insulin index of foods, which reflects the amount of insulin increased in response to food consumption. The insulin index of foods is important to consider for people with diabetes in order to predict the body's reaction when eating specific foods and to correctly calculate doses of insulin preparations (short-actingand prolonged) which will be used for injection after meals.
Any meal, even protein, causes a significant release of the hormone insulin. And the more insulin fluctuations you have throughout the day, the more likely you are to develop insulin resistance, which will eventually lead to type 2 diabetes. Everyone's favorite snack, in the form of dairyand fermented dairy products, like cottage cheese, kefir, and yogurt, have a very, very high insulin index, which means that insulin variation will vary very greatly depending on your mood and irritability.
Let's consider different options and features of diets depending on the type of diabetes.
Basic nutritional rules for type 1 diabetes
With the first typepatients are completely dependent on insulin injections and the diet is designed keeping in mind its administration. Diabetics should study the presence of carbohydrates (bread units) in foods to determine the dose of hormone that will help absorb them. A unit of bread is a conventional concept that implies a certain amount of any product containing 12 grams of carbohydrates. It is recommended not to consume more than 12 units of bread per day. Insulin is administered half an hour before meals, so it is important to know exactly what will be eaten and in what quantity to absorb the carbohydrates contained in food. For each main meal, you should eat no more than 5-6 units of bread and 2-3 additional units.
You should almost completely avoid foods containing easily digestible (simple) carbohydrates. These are sweets, jam, condensed milk, marshmallows, marmalade, halva, cakes, jam, etc. , as well as porridge from oatmeal and semolina, mashed potatoes. Reducing the amount of carbohydrates in your diet, which raise blood sugar, reduces the need for medication. Consuming the same doses as before switching to a low-carb diet can cause hypoglycemia. It is necessary to measure your blood sugar regularly at the start of this diet and adjust the dosage of your medications accordingly.
The daily calorie intake is distributed throughout the day into 4 to 5 meals. According to the BJU ratio, the distribution looks like this: proteins make up 20-25% of the total diet, fats - 30%, of which no more than 10% are saturated, carbohydrates 45-50%.
Basic nutritional rules for type 2 diabetes
Tighter restrictions are needed for non-insulin-dependent variants of the disease. This is due to the fact that this form usually appears against the background of obesity and not only high levels of glucose, but also insulin are found in the blood. However, it very often happens that insulin resistance, which can subsequently lead to type 2 diabetes mellitus, does not manifest itself in any way for a very long time, and even people suffering from insulin resistance are notalways overweight, but the level of glucose in the blood is constantly maintained at a high level and this situation leads to very sad consequences. Dietary nutrition for type 2 diabetes helps restore the ability of cells to absorb sugar and restore cellular sensitivity to insulin.
Type 2 diabetes mellitusis primarily a disorder of carbohydrate metabolism. But at the same time, other types of metabolism suffer - lipid, protein, mineral. Treatment for type 2 diabetes mellitus includes diet, moderate exercise, stress management, and medications (diabetes medications).
The diet for type 2 diabetes is based on key principles:
- Abundance of vegetables– The amount of vegetables consumed may depend on age, gender and frequency of physical exercise per week. Generally, women who exercise up to 30 minutes per day are advised to consume at least 500 grams of vegetables per day. For more intense exercise, it is recommended to increase the amount of vegetables to 800 grams. For men, the recommended amount of vegetables is 600 and 1000 grams, respectively.
- Unsaturated fats– the presence of an adequate amount of polyunsaturated and monounsaturated fats in the diet helps maintain cholesterol levels within normal limits and reduces the risk of developing cardiovascular diseases, one of the most common long-term complications ofdiabetes. Unsaturated fats are found in many foods, including nuts, avocados, fatty sea fish and olive oil.
- Avoid processed foods– nutritionists and doctors agree that avoiding processed foods has a positive effect on health. Due to the substances added to ensure a long shelf life, processed foods tend to have a high glycemic index. Regular consumption of such foods can harm the health of a diabetic.
Healthy Foods for Diabetes
Green leafy vegetables
Spinach, cabbage and bok choy are low in calories but high in nutrients like vitamin C, beta-carotene and magnesium, which help prevent diabetes. One serving (approximately 106 g) per day reduces the risk of developing type 2 diabetes by 14%.
Legumes
These fiber-rich foods can help stabilize your blood sugar levels. Legumes are low in saturated fat, which can be bad for your heart.
Fish
omega-3 fatty acids– excellent aids in the prevention of diabetes, thereby reducing the risk of cardiovascular diseases. Omega 3s are needed by the body for the synthesis of red blood cells and cell membranes, they help with the body's absorption of other vitamins, and most importantly, they suppress chronic inflammation, which is asure companion of insulin resistance.
Olive oil
An essential part of the Mediterranean diet, it is important for heart health because it is rich in monounsaturated fatty acids. These fats (also found in large quantities in nuts) are important in the prevention of diabetes by helping the body effectively control blood sugar levels.
Nuts
As a source of monounsaturated fatty acids, nuts are rich in magnesium, another important nutrient. Global research shows that people who regularly eat nuts have lower rates of diabetes.
Citrus
All citrus fruits contain antioxidants, which go a long way in maintaining insulin balance in the blood.
Whole grains
Eating wholemeal bread, quinoa and brown rice reduces the risk of developing diabetes. Whole grains are high 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 sugar, so if you want to eat a product with a high glycemic index, combine it with complex carbohydrates.
Cinnamon
This flavorful spice helps the body regulate insulin levels. Cinnamon is a kind of insulin sensitizer, meaning it helps improve cellular sensitivity to insulin. The spice helps to fight hypertension (chronic high blood pressure), reduces blood sugar concentration when used systematically in the required doses, improves general well-being and has a positive effect on metabolic processes.
Ginger
It is a catalyst of metabolic processes, reduces sugar levels, cholesterol and blood clotting indicators. Recommended for fresh daily consumption as a seasoning or tea base.
Prohibited foods for diabetes
Today, doctors try not to strictly limit diabetic patients and not impose strict limits on them regarding permitted and prohibited foods. Even with type 2 diabetes, in which diet plays a role, you can eat a varied diet, but there are a number of foods that people suffering from this condition will still need to remove from the diet. In fact, the list below is recommended for anyone concerned about their health to exclude it from their diet.
Soft
The black list includes sugar and all products containing it in excess. You should forget about ice cream, chocolate, marmalade, jam, sweets, preserves, halva and other sweets.
Bakery
Sweet baked goods are prohibited: muffins, cookies, brioches, white bread and bread.
Fat food
These dishes can significantly increase your glucose levels. For this reason, a diabetic should avoid duck, pork, lamb, lard, mayonnaise and cream. It is also recommended to exclude sweet yogurt, fatty cottage cheese and cheese.
Semi-finished products
They contain a large number of flavors, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial cutlets, dumplings, sausages and sausages.
Trans fat
Their consumption will harm not only a diabetic, but also a healthy person. Prohibited products include margarine, confectionery fat, spread, fries, hot dogs and hamburgers.
Fruits
It is not recommended to consume certain fruits and dried fruits which cause a sharp increase in blood sugar levels. Among them are dried apricots, dates, figs, raisins, persimmons, melon, grapes and bananas.
Table n°9 for diabetes
This diet was developed by scientists specifically for diabetics and has long been used in treatment both in the hospital and at home.Table n°9 includes:
- 300 g of fruit;
- 80 g of vegetables;
- 100 g of mushrooms;
- 1 tbsp. natural fruit juices;
- 300 g of meat or fish;
- 200 g of low-fat cottage cheese, 500 ml of fermented milk products;
- 100-200 g of bran, rye, wheat bread mixed with rye flour or 200 g of cereals (ready-made), potatoes;
- 40 to 60 g of fat.
Main dishes
- Soups: vegetable soup, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, light fish or meat broth, mushroom soup with cereals and vegetables.
- Poultry meat: rabbit, veal, chicken, simmered, chopped, boiled, turkey.
- Fish: pikeperch, navaga, cod, pike and lean seafood, stewed, steamed, boiled, cooked in juice.
- Snacks: mixed vegetables, vinaigrette, dietary fish and meat jellies, vegetable caviar, soft cheese, seafood salad with butter.
- Candy:berry-based desserts, fresh fruit, berry mousse, sugar-free fruit jelly, sugar-free jam and marmalade.
- Egg dishes: soft-boiled eggs, egg white omelette, in dishes.
Other Diet Strategies for Diabetes
Of course, we must not forget that all diets are developed strictly individually, taking into account the age and gender of the patient, as well as their level of physical activity.
Thus, 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 mellitus, it has proven itself well.Mediterranean diet, which is based on daily physical activity.
The basic principles of the diet are:
- split meals 5 times a day - 3 main meals and 2 snacks;
- breakfast should be richer in carbohydrates, consisting mainly of complex carbohydrates;
- light dinner of lean protein and vegetables;
- During the day, you should consume more than 1 kg of various vegetables and herbs;
- It is important to maintain a drinking regime - at least 7-8 glasses of water per day.
The main sources of fat in the diet are– unrefined olive oil, sometimes you can use sesame, rapeseed and peanut. Animal fats are limited in the Mediterranean diet.
Particular attention is paid to omega-3 fatty acids and oleic acid, found in oils, fatty fish and seafood. These fatty acids have a huge impact on the prevention of atherosclerosis, improve sensitivityinsulin and help immune cells detect and suppress inflammation.
The carbohydrates of the Mediterranean diet are mostly complex with a low glycemic index - durum wheat pasta, beans, rice, lentils, coarse bread, seasonal vegetables and fruits.
Protein comes in the form of low-fat soft cheeses, eggs, fish, seafood and rarely poultry.
Another diet option for diabetes isLCHFand keto diet. The essence of this dietary strategy is to consume low amounts of carbohydrates and high amounts of fats. Carbohydrates in fatty diets are limited to 50 grams per day, and in the keto diet the restriction is even more serious - no more than 10 grams of carbohydrates.
The following foods are completely excluded from the keto diet::
- sugar, honey, artificial sweeteners;
- sweetened soft drinks;
- sourdough bread, pastries;
- cereals, porridges, flakes and breakfast cereals;
- skimmed milk, kefir, yogurts;
- sweet curd;
- margarine.
In the concept of the LCHF diet, insulin is a dangerous thing, because after eating something rich in carbohydrates, carbohydrates are broken down into glucose, the blood sugar level begins to rise sharply and, as a result, the levelinsulin increases considerably in order to transport glucose to the muscles, liver and fat cells, that is to say that insulin is "responsible for our obesity". Additionally, protein can increase insulin levels just as well as carbohydrates. And fat doesn't increase insulin at all, which is good for insulin resistance and, if necessary, improving the sensitivity of cells to insulin.
Diabetes mellitus in children
Diabetes mellitus in children can be caused by a hereditary predisposition, poor diet, including excessive consumption of simple carbohydrates and sweets, and the disease can also occur as a result of mental or physical trauma. Treatment of diabetes in children, as well as adults, consists of a therapeutic diet and administration of insulin for type 1 diabetes.
The diet of diabetic children should be rich in vegetables like white cabbage and cauliflower, onions, spinach and garlic. You can eat unsweetened fruits, meats, poultry, and fish. It is advisable to give milk and cottage cheese with a low percentage of fat, provided that the child does not have an intolerance to cow's milk proteins. When cooking meat or fish, you can use spices to promote better protein absorption.
All confectionery products, sweets, grapes, apricots, rice, baked goods, cookies, plums should be excluded. Parents of a diabetic child should learn how to calculate the consumption of bread units when feeding their child and how to calculate the required insulin dose. The child himself must also acquire these skills as early as possible.
Gestational diabetes mellitus
Anothertype of diabetes– gestational diabetes mellitus in pregnant women, quite common today.
Increased blood sugar during pregnancyand is one of the most common metabolic disorders in a pregnant woman. So-called gestational diabetes mellitus or diabetes of pregnant women is diabetes that appears during pregnancy and is limited to the duration of the pregnancy. During pregnancy, the production of sex hormones (estrogen and progesterone, hCG) and the hormone cortisol, which suppress the action of insulin, increases sharply. As a result, blood sugar levels increase in pregnant women. Hyperglycemia during pregnancy negatively affects both the health of the woman herself and the fetus, and therefore requires timely diagnosis and subsequent correction.
Women are particularly exposed:
- overweight or obese (BMI greater than 25 kg/m)²– the risk doubles, above 30 – triples);
- with multiple pregnancy;
- after IVF;
- with polycystic ovaries;
- with significant weight gain during a real pregnancy;
- with glycosuria (glucose in urine);
- having close relatives with diabetes;
- with a previous loaded pregnancy - GDM, birth of a large fetus, intrauterine fetal death.
Gestational diabetes is dangerous not only for the mother, but it also affects the health of the unborn child. So, at the age of 4-5 years, these children are several times more likely to suffer from overweight and obesity, at 10-11 years old - increased blood pressure, in adolescence the risk of developing adiabetes is 20-40%, the risk of developing non-alcoholic fatty disease increases significantly in the liver.
If GDM is not detected in time or the expectant mother does not take any measures to treat it, thenthe risk increases considerably:
- early aging of the placenta and, as a result, delayed fetal development;
- premature birth;
- polyhydramnios;
- formation of a large, disproportionate, or edematous fetus;
- increased blood pressure, preeclampsia;
- the need for a cesarean section;
- trauma of women and children during childbirth;
- hypoglycemia (low blood sugar) and breathing problems in a newborn;
- The most serious complication of untreated GDM is fetal death.
So it's important to understand that diabetes is not some kind of life sentence; it simply imposes certain obligations on a person regarding diet and physical activity. A proper and balanced diet is of paramount importance for any type of diabetes. And although reducing carbohydrates and saturated fats in the diet contributes to weight loss, which type 2 diabetics often suffer from, it is very important to change the lifestyle itself and eating habits. And if in type 2 diabetes, a positive effect on reducing blood sugar levels is achieved not only by correctly selected foods, but also by a set of physical exercises that help to improve the transport function ofglucose in muscle cells, so in type 1 diabetes, nutrition plays a role. a leading role.