Diet diabetes

Diabetes mellitus is a common disease that every adult may have heard of. It can be congenital or acquired during life, but nonetheless, it is chronic and cannot be completely cured. Many hear that diabetes is not a disease, but a way of life. After all, patients must undergo a special diet for life and use individually selected medications, and not always insulin injections. In general, nutrition in diabetes mellitus should not be considered food in a broad sense, as there are not many limitations in it, and most prohibited products can be replaced with similar flavor 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 (insulin-dependent) diabetes mellitus is diagnosed, or it may be the result of regular overeating that causes obesity, severe stress and other factors, then type 1 diabetes mellitus2 (insulin -independent) develops.

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

Type 2 diabetes is most often diagnosed at this time and requires the closer attention of a doctor, as well as adherence to special dietary principles, as it is the result of an unhealthy lifestyle led by a person. With the intake of large amounts of carbohydrates in the body, the pancreas works to wear out and eventually stop functioning, or produce "broken down" insulin, which cells and tissues cannot feel. This means that the insulin is unable to capture glucose and transport it to its destination, because the cells "do not see it", i. e. . develop sensitivity to it. Not a small role in this is played by changes in the hormonal background that inevitably arise with age.

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

• increased thirst;
• dry mouth;
• weakness;
• visual impairment;
• increased appetite, etc.

Type 2 diabetes mellitus is most frequently diagnosed, i. e. in 85-90% of patients. Usually occurs after 40 years, and especially after 65 years. The susceptibility of such elderly people to the development of carbohydrate metabolism disorders is due to decreased physical activity and decreased muscle mass, which are major users of glucose, and increasing abdominal obesity is an additional factor that increases the risk of insulin -independent diabetes.

Abdominal obesity is the dominant accumulation of adipose tissue in the abdomen.

Diagnosing diabetes is not difficult. For this, a blood glucose test is performed. Obtaining increased indications 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 nutritional principles

With any type of diabetes mellitus, blood sugar levels increase, but even so, the cells are unable to accept it due to lack of insulin or the development of insulin resistance. Since glucose is a monosaccharide that is the result of the breakdown of carbohydrates, it serves as the body’s main source of energy. Therefore, if the tissues do not receive it in sufficient amounts, they experience a feeling of hunger, which is caused by the transmission of appropriate nerve impulses to the brain, causing the emergence of similar feelings in humans. Therefore, with diabetes, patients may feel like eating something, especially sweet, even an hour after a hearty meal.

As a result, patients openly eat high -calorie carbohydrate foods, which in type 2 diabetes mellitus quickly lead to weight gain and the development of obesity. This leads to a greater increase in blood glucose levels, increased load on the pancreas, increased insulin production, increased tissue resistance to it, worsening conditions, namely the violent formation of vicious circles.

In such situations, if you do not intervene in a timely manner and stop this cycle, high sugar levels (hyperglycemia) will lead to the development of ketoacidosis and diabetic coma. At first, the patient will feel thirsty and often go to the toilet, then weakness, shortness of breath will quickly join, the special features of acetone from the mouth and urine will appear, nausea and vomiting will occur. In the absence of competent medical treatment, confusion and, eventually, diabetic coma will ensue.

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

• retinal lesions with subsequent irreversible blindness;
• impaired renal function and chronic renal failure;
• healing of trophic ulcers on the feet severely, very difficult to treat;
• osteoporosis, fraught with the possibility of getting skeletal bone fractures, including the spine, even with minor impact;
• disorders of the heart and blood vessels, organs of the gastrointestinal tract, etc.

Therefore, it is important not only to diagnose diabetes mellitus in a timely manner and take medications prescribed by an endocrinologist, but also to strictly follow the recommendations on nutrition.

Dietary characteristics

The diet for type 1 and type 2 diabetes mellitus has some differences that patients should understand. With regard to nutrition for insulin -dependent diabetes, where patients receive lifelong replacement therapy in the form of regular insulin injections, doctors in different countries see the need to limit moderate carbohydrates in different ways.

Foreign endocrinologists believe that there is no need to reduce the amount of its use in type 1 diabetes with properly selected insulin therapy. Domestic doctors believe that this is fraught with unintended consequences and stress the need to limit the consumption of moderate carbohydrates, but do not abandon them completely, as in insulin -independent diabetes. In type 2 diabetes mellitus, such disagreements are not justified, as sugar consumption can have adverse consequences, which cannot be questioned 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 arranged in such a way that these daily dietary guidelines conform to the developed norms.

Therefore, today with diabetes mellitus, patients are given a diet called No. 9 in various modifications, the differences between them are not significant. Which schedule is most appropriate for a particular patient is determined by the endocrinologist, based on the results of the analysis and the person’s condition.

In general, diet No. 9 is designed in such a way as to normalize carbohydrate metabolism by reducing the amount of moderate carbohydrates consumed and, thus, lowering blood glucose levels. As a result, the possibility of blood sugar becomes normal, preventing the development of possible disorders of fat metabolism and complications of the disease.

Diet No. 9 assumes a complete rejection of moderate carbohydrates against the background of daily consumption of not more than 300 g of complex carbohydrates while maintaining the amount of protein foods within physiological norms.

Basic nutritional principles

If there is diabetes mellitus of any type, the following recommendations should be considered:

• foods must be fractional and consist of at least 5 foods, especially with insulin-dependent forms;
• breakfast is a mandatory meal;
• when compiling the menu, one should adhere to the physiological ratios of protein (meat, fish dishes, dairy products), carbohydrates (cereals, bread) and vegetables, respectively, should include 25%, 25%and 50%;
• nutritional advantage is always given to foods with low glycemic index and high percentage of plant fiber;
• each meal is started with vegetables, and protein is left at the end;
• the amount of salt should not exceed 5 g per day;
• fasting for diabetes is prohibited, if necessary, to lose weight, this is done by increasing physical activity;
• when choosing a method of cooking vegetables, it is recommended to prioritize minimum heat treatment or leave it completely, boiling, baking and steaming are very suitable;
• A vegetarian diet for diabetes is not the best option, although it helps improve the disease and increase insulin sensitivity, you can switch only with the permission of an endocrinologist.

Nutrition for type 1 diabetes

Insulin -dependent diabetes is usually diagnosed early. Because the cause of its development is the destruction of pancreatic cells that synthesize insulin, the patient must be given insulin therapy, and the drug and its dose selected individually. Insulin injections completely cover the lack of hormone production in the body, so a significant dietary restriction is not required, but the child's parents, and then himself, must learn to calculate the amount of carbohydrates consumed correctly to suit. insulin dose given. For this purpose, a table has been specially created showing the number of grain units mentioned in each product.

In type 1 diabetes mellitus, it is only necessary to rule out:

• any sugary drinks, including juices;
• ready breakfast cereals;
• sweets.

You can eat no more than 7 XE per serving, and up to 25 XE a day. In this case, the sum of all carbohydrates consumed per serving is summed. For example, 2 XE is contained in 3 tbsp. l. ready pasta, 4 tbsp. l. rice, 14 tbsp. l. beans or 420 g of tomatoes.

1 XE equals 12 g of carbohydrates or 20 g of bread.

Sweets are not banned at all, but only those who can control blood glucose levels several times a day can afford them, they calculate XE accurately and can regulate the dose of insulin given independently.

In severe type 1 diabetes mellitus, patients were given diet No. 9b and large doses of insulin. This involves the consumption of 400-450 g of carbohydrates and is very close to the diet of most modern people. It is permissible to take 20-30 g of sugar per day.

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

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

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

Nutrition for type 2 diabetes

In most cases, obesity is the leading cause of the disease. Therefore, diet for type 2 diabetes is the first and foremost component in the treatment and prevention of complications. With its help, we can normalize sugar levels and control weight, thus preventing the occurrence of unwanted changes and deterioration of the condition.

All patients should monitor their blood glucose levels independently daily using a household glucometer, and if a stable high rate is obtained, see a doctor immediately.

If a patient is diagnosed with insulin -free disease of mild or moderate levels, and his or her weight is in the normal range, he or she is given a No. 1 basic diet. 9 with a daily caloric intake of up to 2500 kcal. In such a situation, you can consume no more than 275-300 g of complex carbohydrates from various sources per day.

If there is obesity, it is necessary not only to keep glucose levels in the normal range, but also to lose weight, as its excess negatively affects the effectiveness of treatment and the well -being of patients. Therefore, in such cases, the patient is given a reduced diet No. 9, which is characterized by a reduced caloric content due to a greater restriction of the amount of complex carbohydrates allowed per day. In this case, the endocrinologist calculates this rate individually based on the degree of obesity. Therefore, in different cases, patients may be allowed to consume 100 to 225 g of carbohydrates, and the total caloric intake should not exceed 1700 kcal per day.

What is not allowed

Therefore, with type 2 diabetes mellitus, it is necessary to exclude diet foods that contain fast carbohydrates, i. e. foods that are broken down into glucose and absorbed into the bloodstream within 15 minutes. They give energy quickly, but do not cause a feeling of fullness, so after eating them, the feeling of hunger returns very quickly. This includes:

• sugar;
• honey;
• sweets, classic pastries;
• ice cream, chocolate;
• marmalade, jam, jam, preservatives;
• sweet vegetables, fruits, berries (grapes, bananas, dates, pineapples, persimmons, dried fruits);
• white bread, bread;
• semolina;
• smoked meats, fatty dishes;
• mayonnaise;
• fast food, snacks.

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

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

• potatoes;
• bit;
• corn;
• carrot;
• soy products;
• pasta;
• roti.

If you are obese, you should avoid all high -fat foods:

• butter and vegetable oil, spread;
• sour cream, fatty cheese, cottage cheese, cream;
• lard, fatty meats 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 vegetables, eggplant, cucumbers, radishes, cauliflower, pumpkin, zucchini, radishes, etc.

It is important to try to completely abandon foods with large amounts of fat, especially canned foods, products of the meat processing industry, store sauces. They are replaced with boiled or stewed meat (chicken, rabbit, turkey, low -fat yogurt without additives).

What can

Carbohydrates are an indispensable part of the daily diet, and they must be on the diabetic menu, but only in acceptable quantities. Patients are only allowed to eat foods with slowly absorbed carbohydrates and a high fiber content. Ia:

• vegetables;
• whole wheat bread with bran;
• whole grains (8-10 tablespoons), except fine rice.

Since sugar in any form is prohibited for diabetics, its substitutes that do not contain glucose have been specially made. Many of them are sweeter than sugar and can be used in minimal amounts. Modern sweeteners include xylitol, stevia, sorbitol, fructose. But studies show 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 sweet taste exceeds sugar by 10-30 times (depending on the form of release: powder from an ingredient or extract called stevioside).

It is important for patients to know the glycemic index of food. Today, there is a special table that helps you navigate the options and calculate the allowable usage rate correctly. In diabetes, preference should be given to foods with a GI less than 55 (apples, cucumbers, cherries, broccoli, lettuce, milk, cauliflower, etc. ). They break down slowly and cause little or no increase in blood sugar levels. Such products can be eaten up to 200 g per serving, but preferably together with protein foods.

Heat treatment improves the GI.

It is allowed to use:

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

When making homemade compotes, sweeteners are added to them instead of sugar.

Nutrition for gestational diabetes

Pregnant women with a genetic predisposition to the development of diabetes mellitus may face a development called gestational diabetes at 20-24 weeks. This arises against the background of the presence of hereditary reduced tissue sensitivity to inulin, which is amplified by hormones produced during pregnancy in increasing amounts: estrogen, prolactin, cortisol. They are able to block insulin and cause blood sugar to rise.

Often, after childbirth, carbohydrate metabolism gradually returns to normal, because the hormonal background is normalized. However, if the basic principles of nutrition and diet are not adhered to, not only is there a risk of maintaining diabetes mellitus, but also the emergence of complications that can lead to premature birth, pyelonephritis in the mother, fundus pathology, as well as complications during childbirth. For the purpose of timely detection of gestational diabetes during pregnancy, blood glucose tests are performed periodically, and if hyperglycemia is detected, a diet is prescribed.

In such situations, women are advised to:

• exclude simple carbohydrates from the diet (sugar, sweets, chocolate, pastries, the same white and black bread, bananas, grapes, juices, dried fruits, etc. );
• limit complex carbohydrate intake to the amount recommended by the doctor;
• throw away most of the daily diet for vegetables, fruits without sugar;
• refuse to eat fatty foods, fried foods, semi -finished products, various sausages, smoked products;
• when choosing a method of cooking a product, give preference to grilling, stewing, steaming;
• eat in fractions, preferably every 2 hours, with 3 main meals (breakfast, lunch and dinner), as well as 2 supplements (second breakfast, afternoon snack);
• drink at least 1. 5 liters of water.

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

All of these recommendations are relevant for the postpartum period. However, in the first months of a baby’s life, a breastfeeding woman is forced to undergo a hypoallergenic diet and reject fried fatty foods. The same diet will help get rid of gestational diabetes and prevent its transition to chronic carbohydrate metabolism disorders in 2-3 months after giving birth. If, after this period, blood glucose levels do not return to normal, the woman should see an endocrinologist for examination and development of treatment tactics.

Sugar reducing 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, he or she is able to react to certain types of food in his or her own way, and not just give an allergic reaction. Therefore, although glucose -lowering foods can provide invaluable relief for patients with diabetes mellitus, especially type 2, it is advisable to consult with an endocrinologist before beginning their daily use.

So, foods that lower sugar include:

• Cherries (GI 22) - contain anthocyanins, which help lower blood sugar and blood pressure, and get rid of the so -called bad cholesterol. The daily norm is 100 g.
• Grapefruit (GI 29) - Contains naringin, a powerful antioxidant that helps increase insulin sensitivity in tissues. It is recommended to take 1 medium -sized grapefruit or fresh juice daily (commercially not suitable). But grapefruit can 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 perfect for making casserole with apples.
• Broccoli is a very valuable source of fiber, which is very beneficial for diabetes, and the substances it contains help slow down the rate of sugar absorption in the intestines. The daily norm is 200 g.
• Blueberries are one of the healthiest foods for diabetics, as they contain valuable glycosides, tannins, anthocyanins, which help maintain normal glucose levels and reduce the risk of diabetic retinal damage. The daily norm is 200 g.
• Oatmeal and millet are rich in fiber, which helps maintain sugar levels.
• Jerusalem artichoke is a natural source of insulin, as its use contributes to the normalization of glucose levels, and the presence of fructose in the composition gives it a pleasant sweet taste, which allows it to be used raw or added to salads.
• Garlic is one of the healthiest foods for everyone, as it contains many antioxidants, natural antibacterials and other ingredients. Its use makes the pancreas function more actively, which is very valuable for patients with type 1 diabetes.
• Diabetics - fish are proven to eat at least 2 times a week, and if possible they replace meat dishes with it. This helps to normalize sugar levels as well as get essential unsaturated fatty acids.

Therefore, the diet for diabetes mellitus can be varied and tasty. With a competent approach to menu planning, will not cause rejection, but, on the contrary, will help increase energy and efficiency, as it largely corresponds to the principles of rational nutrition. But remember, it’s important for diabetics to maintain normal levels of physical activity, because exercise increases tissue sensitivity to insulin.