Currently, diabetes is a global problem. In the last ten years, the number of people suffering from diabetes has more than doubled to reach 425 million. According to forecasts, by 2045 their number could reach 629 million.
Diabetesis a group of endocrine diseases associated with impaired absorption of glucose and which develop as a result of an absolute or relative deficiency of the hormone insulin, resulting in the development of hyperglycemia - a persistent increase in blood glucose 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 destruction or destruction of pancreatic cells. This often leads to absolute insulin deficiency. The development of type 1 diabetes involves 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 the increase in blood glucose levels and the lack of carbohydrates in the cells, since glucose cannot enter but floats idly in the blood.
The 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 to 7% and increase the consumption of vegetable fats. Previously, it was recommended that diabetics eliminate simple carbohydrates completely, but today there is an increasing emphasis on personalized diets with individual selection of staples and calorie calculations. Currently, the slogan is very popular: "With diabetes there are no restrictions, there is only the right lifestyle. "
The diet of diabetes patients is based on the glycemic index. Essentially, this index reflects the speed at which their sugar is absorbed into the blood. Products with a high index - jams, cookies, 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 handle the load. Thus, foods with a GI of up to 55 are broken down gradually and almost do not cause an increase in sugar.
Also, don't forget about the food insulin index, which reflects the amount of insulin increase in response to food consumption. It is important to take into account the insulin index of foods so that people with diabetes can predict the body's reaction to consuming specific foods and correctly calculate the doses of insulin preparations (short and long acting) that will be used for injection after meals .
Any meal, even protein, causes a large release of the hormone insulin. And the more insulin swings you have during the day, the more likely you are to develop insulin resistance, which will subsequently lead to type 2 diabetes. Everyone's favorite snack options in the form of dairy and fermented dairy products like cottage cheese , kefir and yogurt, have a very, very high insulin index, which means that your insulin fluctuation will fluctuate very strongly along with your mood and irritability.
Let's consider different options and features of diets depending on the type of diabetes.
Basic nutrition rules for type 1 diabetes
With the first typepatients are completely dependent on insulin injections and the diet is designed taking into account its administration. Diabetics need to study the presence of carbohydrates (bread units) in food to determine the dose of the hormone that will help their absorption. A unit of bread is a conventional concept that implies a certain amount of any product containing 12 grams of carbohydrates. It is recommended to consume a maximum of 12 units of bread per day. Insulin is administered half an hour before meals, so it is important to know exactly what will be ingested and in what quantity to absorb carbohydrates from food. For each main meal, you need to eat no more than 5-6 pieces of bread and 2-3 for an additional one.
You should almost completely avoid foods that contain easily digestible (simple) carbohydrates. These are sweets, jams, condensed milk, marshmallows, marmalade, halva, cakes, jams, etc. , as well as oat and semolina porridge, mashed potatoes. Reducing the amount of carbohydrates in the diet, which raise blood sugar, reduces the need for medications. Consuming the same dosages as before switching to a low-carb diet can cause hypoglycemia. It is necessary to measure your blood sugar regularly when starting this diet and adjust your medication dosage accordingly.
The daily calorie intake is distributed throughout the day into 4-5 meals. According to the BJU ratio, the distribution is as follows: proteins make up 20-25% of the total diet, fats - 30%, of which saturated no more than 10%, carbohydrates 45-50%.
Basic nutrition rules for type 2 diabetes
More serious restrictions are needed for non-insulin-dependent variants of the disease. This is due to the fact that this form often arises against the background of obesity, and not only high levels of glucose, but also insulin are found in the blood. However, it often happens that insulin resistance, which can subsequently lead to type 2 diabetes mellitus, does not manifest itself in any way for a long time, and even people with insulin resistance are not always overweight, but the level of glucose in the blood is constantly maintained at high levels and this situation leads to very sad consequences. Dietary nutrition for type 2 diabetes helps restore cells' ability to absorb sugar and helps restore cellular sensitivity to insulin.
Type 2 diabetes mellitusIt is 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 fundamental principles:
- Plenty of vegetables– The amount of vegetables consumed may depend on age, sex and frequency of exercise per week. As a general rule, women who exercise up to 30 minutes a day are advised to consume at least 500 grams of vegetables daily. 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 of diabetes. Unsaturated fats are found in many foods, including nuts, avocados, fatty marine 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 that are added to ensure a long shelf life, processed foods tend to have a high glycemic index. Regular consumption of these foods can negatively affect the health of diabetics.
Healthy foods for diabetes
Green leafy vegetables
Spinach, cabbage 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 g) per day reduces the risk of developing type 2 diabetes by 14%.
Legumes
These fiber-rich foods can help stabilize blood sugar levels. Legumes are low in saturated fat, which can be harmful to the heart.
Fish
Omega-3 fatty acids– great help in preventing diabetes, reducing the risk of cardiovascular diseases. Omega 3 is needed by the body for the synthesis of red blood cells and cell membranes, assists in the absorption of other vitamins by the body and, most importantly, suppresses chronic inflammation, which is a safe companion to insulin resistance.
Oil
A staple of the Mediterranean diet, it is important for heart health as it is rich in monounsaturated fatty acids. These fats (also found in large quantities in nuts) are important in preventing diabetes by helping the body effectively control blood sugar levels.
Nuts
As a source of monounsaturated fatty acids, walnuts are rich in magnesium, another important nutrient. Global research shows that people who eat nuts regularly have lower rates of diabetes.
Citrine
All citrus fruits contain antioxidants - great helpers 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 rich in fiber, which helps the body control blood sugar levels. Complex carbohydrates are a kind of buffer that protects us from large increases in blood glucose, so if you want to consume a product with a high glycemic index, combine it with complex carbohydrates.
Cinnamon
The tasty seasoning helps the body regulate insulin levels. Cinnamon is a type of insulin sensitizer, that is, it helps improve the sensitivity of cells to insulin. The spice helps in the treatment of hypertension (chronically high blood pressure), reduces the concentration of sugar in the blood when used systematically in the necessary dosages, improves general well-being and has a positive effect on metabolic processes.
Red-haired
It is a catalyst for metabolic processes, reduces sugar levels, cholesterol and blood clotting indicators. Recommended for daily consumption fresh as a seasoning or tea base.
Prohibited foods for diabetes
Today, doctors try not to strictly limit diabetes patients and not force them into strict limits regarding permitted and prohibited foods. Even with type 2 diabetes, where diet plays a role, you can eat a varied diet, but there are a number of foods that people suffering from this disease will still have to remove from their diet. In fact, the list below is recommended for anyone who cares about their health to exclude from the diet.
Sweet
The blacklist includes sugar and all products that contain excess sugar. We must forget about ice cream, chocolate, marmalade, jam, sweets, preserves, halva and other sweets.
Bakery
Sweet bakery products are prohibited: muffins, cookies, buns, white bread and bread.
Fatty foods
These dishes can greatly increase glucose levels. For this reason, diabetics 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 flavorings, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial cutlets, dumplings, sausages and sausages.
Trans Fats
Its consumption will harm not only diabetics, but also healthy people. Prohibited products include margarine, confectionery shortening, spreads, potato chips, hot dogs and hamburgers.
Fruits
It is not recommended to consume certain fruits and nuts that cause a strong increase in blood sugar. Among them are dried apricots, dates, figs, raisins, persimmons, melons, grapes, bananas.
Table No. 9 for diabetes
This diet was developed by scientists specifically for diabetics and has long been used in hospital and home treatments.Table #9 includes:
- 300g of fruit;
- 80g of vegetables;
- 100g of mushrooms;
- 1 Tbsp. natural fruit juice;
- 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;
- 40-60g of fat.
Main dishes
- Soups: vegetable soup, cabbage soup, borscht, vegetable and meat okroshka, light fish or meat broth, mushroom soup with cereals and vegetables.
- Poultry, meat: rabbit, veal, chicken, stew, chopped, boiled, turkey.
- Fish: pike, navaga, cod, pike perch and lean seafood, boiled, steamed, boiled, baked in juice.
- Snacks: vegetable mix, vinaigrette, dietary fish and meat gelatin, vegetable caviar, unsalted cheese, seafood salad with butter.
- Candy:desserts based on berries, fresh fruits, berry mousses, sugar-free fruit jellies, sugar-free jams and marmalades.
- Egg dishes: boiled eggs, egg white omelet, on plates.
Other Diet Strategies for Diabetes
Of course, we must not forget that all diets are drawn up strictly individually, taking into account the age and gender of the patient and his 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, this has proven itself well.mediterranean diet, which is based on daily physical activity.
The basic principles of the diet are:
- fractional meals 5 times a day - 3 main meals and 2 snacks;
- breakfast should be richer in carbohydrates, consisting mainly of complex carbohydrates;
- light dinner consisting of lean proteins and vegetables;
- During the day you need to consume more than 1 kg of vegetables and various herbs;
- It is important to maintain an alcohol 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, which are found in oils, fatty fish and seafood. These fatty acids have a huge impact on preventing atherosclerosis, improving insulin sensitivity, and helping immune cells detect inflammation and suppress it.
Carbohydrates in the Mediterranean diet are predominantly complex and low glycemic - durum wheat pasta, beans, rice, lentils, coarse bread, seasonal vegetables and fruits.
Protein is presented in the form of low-fat soft cheeses, eggs, fish, seafood and rarely poultry.
Another diabetes diet option isLCHFand keto diet. The essence of this eating strategy is to consume low amounts of carbohydrates and large amounts of fat. Carbohydrates on high-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.
The following foods are completely excluded from the keto diet::
- sugar, honey, artificial sweeteners;
- sweet carbonated drinks;
- leavened bread, pastries;
- cereals, porridges, flakes and breakfast cereals;
- skimmed milk, kefir, yogurts;
- sweet curd;
- Margarine.
In the LCHF diet concept, insulin is dangerous because after we eat something rich in carbohydrates, the carbohydrates are broken down into glucose, the blood sugar level starts to rise sharply and consequently the insulin level increases too much to transport glucose for muscles, liver and fat cells, in other words, insulin is "responsible for our obesity". Additionally, proteins can raise insulin levels just as well as carbohydrates. And fats do not raise insulin, 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 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 in adults, consists of therapeutic diet and insulin administration for type 1 diabetes.
The diet of children with diabetes should be rich in vegetables such as cauliflower and cauliflower, onions, spinach and garlic. You can eat fruit, meat, poultry and fish without sugar. It is advisable to give milk and cottage cheese that have a low percentage of fat, as long as the child is not intolerant to cow's milk protein. When cooking meat or fish, you can use seasonings to promote better protein absorption.
All confectionery products, sweets, grapes, apricots, rice, baked goods, cookies, plums should be excluded. Parents of a child with diabetes need to learn how to calculate the consumption of bread units in the child's diet and calculate the required dose of insulin. The child himself also needs to learn these skills as early as possible.
Gestational diabetes mellitus
Othertype 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 pregnant women. The so-called gestational diabetes mellitus or pregnant diabetes is diabetes that appears during pregnancy and is limited to the duration of the pregnancy. During pregnancy, the production of sex hormones (estrogens and progesterone, hCG) and the hormone cortisol, which suppress the action of insulin, increases markedly. As a result, blood glucose levels rise in pregnant women. High blood sugar during pregnancy negatively affects the health of the woman herself and the health of the fetus, and therefore requires timely diagnosis and subsequent correction.
Women are at particular risk:
- overweight or obese (BMI greater than 25 kg/m²– the risk doubles, above 30 – triples);
- with multiple pregnancies;
- after in vitro fertilization;
- with polycystic ovaries;
- with large weight gain during a real pregnancy;
- with glycosuria (glucose in the urine);
- have close relatives with diabetes;
- with previous burdened pregnancy - GDM, birth of a large fetus, intrauterine fetal death.
Gestational diabetes is dangerous not only for the mother, but also affects the health of the fetus. So, at the age of 4-5 years, these children are many times more likely to be overweight and obese, at 10-11 years old - increased blood pressure, in adolescence the risk of developing diabetes is 20-40%, the risk of developing non-alcoholic fatty disease significantly increases the liver.
If GDM is not detected in a timely manner or the expectant mother does not take any measures to treat it, thenthe risk increases significantly:
- premature aging of the placenta and, as a consequence, delay in fetal development;
- premature birth;
- polyhydramnios;
- formation of a large, disproportionate or edematous fetus;
- increased blood pressure, preeclampsia;
- the need for a cesarean section;
- traumatization of women and children during childbirth;
- hypoglycemia (low blood sugar) and respiratory problems in newborns;
- The most serious complication of untreated GDM is fetal death.
Therefore, it is important to understand that diabetes is not some kind of life sentence; it simply imposes certain obligations on the person regarding nutrition and physical activity. Adequate and balanced nutrition is of paramount importance for any type of diabetes. And although reducing carbohydrates and saturated fats in the diet contributes to weight loss, the excess of which type 2 diabetics tend to suffer from, it is very important to change your own lifestyle and eating habits. And if in type 2 diabetes a good effect on lowering blood sugar levels is achieved not only by properly selected foods, but also by a set of physical exercises that help improve the function of transporting glucose to muscle cells, then In type 1 diabetes, nutrition plays a leading role.