Currently, diabetes is a global problem. During the last ten years, the number of people suffering from diabetes has doubled and reached 425 million. According to forecasts, by 2045 their number may 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 continuous 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 fat, protein, minerals and water salts are 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 usually leads to an absolute lack of insulin. The development of type 1 diabetes involves genetic and environmental factors - viral infections, food, toxins, hygiene. Type 2 diabetes mellitus is characterized by the development of insulin resistance and relative and not 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 starvation of cells with carbohydrates, since glucose cannot enter it, but floats in the blood.
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 a growing emphasis on personalized diets with an individual selection of food baskets and calorie calculations. Currently, the slogan is very popular: "With diabetes there are no restrictions, there is only the right way of life. "
The diet for patients with diabetes is based on the glycemic index. Basically, this index reflects the speed with which sugar from them is absorbed into the blood. Products with a high index - jam, cookies, sweets - have a high absorption rate. Low index products - cereals, fruits - have a lower index. The slower the rate of absorption, the easier it is for the pancreas to cope with the load. Thus, foods with a GI of up to 55 are gradually broken down and almost do not cause a rise in sugar.
Also, do not forget about the insulin index of foods, which reflects the amount of increase in insulin in response to food consumption. The insulin index of foods is important to take into account for people with diabetes to predict the body's reaction when consuming specific foods and to correctly calculate the doses of insulin preparations (short-acting and long-acting) to be usedfor injection after meals.
Every meal, even protein, provokes a huge release of the hormone insulin. And the more insulin swings you have throughout the day, the more likely you are to develop insulin resistance, which will then lead to type 2 diabetes. Everyone's favorite food options in the form of milk andFermented dairy products like cottage cheese, kefir, and yogurt have a very, very high insulin index, which means that your insulin swings will fluctuate wildly along with your mood and irritability.
Let's consider the different options and features of diets depending on the type of diabetes.
Basic rules of nutrition for type 1 diabetes
You should almost completely avoid foods that contain easily digestible (simple) carbohydrates. These are sweets, jam, condensed milk, marshmallows, marmalade, halva, sweets, jam, etc. , as well as oatmeal and semolina porridge, 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-carbohydrate diet may cause hypoglycemia. It is necessary to measure blood sugar regularly during the initiation of this diet and adjust the dose of the drugs accordingly.
The daily intake of calories is distributed throughout the day in 4-5 meals. According to the BJU report, the distribution looks like this: proteins make up 20-25% of the total diet, fats - 30%, of which saturated no more than 10%, carbohydrates 45-50%.
Basic rules of nutrition for type 2 diabetes
More severe 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 then lead to type 2 diabetes mellitus, does not appear in any way for a very long time, and even people with insulin resistance are not always overweight, but the levelof glucose in the blood is constantly kept at a high level and this situation leads to very sad consequences. Dietary food for type 2 diabetes helps to restore the ability of cells to absorb sugar and helps to restore the sensitivity of cells to insulin.
The diet for type 2 diabetes is based on the main principles:
- Plenty of vegetables- The amount of vegetables consumed may depend on age, gender 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 a day. For more intense exercises, 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 unsaturated and monounsaturated fats in the diet helps maintain cholesterol levels within normal limits and reduces the risk of developing cardiovascular disease, one of the most common long-term complications of diabetes. Polyunsaturated fats are found in many foods, including nuts, avocados, fatty fish, and olive oil.
- Avoid processed foods– nutritionists and doctors agree that avoiding processed foods has a positive effect on health. Because of 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 high in nutrients like vitamin C, beta-carotene, and magnesium, which help prevent diabetes. One portion (about 106 g) a 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 bad for your heart.
Fish
Omega-3 fatty acids – excellent helpers in the prevention of diabetes, 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 the body absorb other vitamins, and most importantly, they suppress chronic inflammation, which is a sure companion of insulin resistance.Olive oil
A staple of the Mediterranean diet, it is important for heart health as it is packed with polyunsaturated fatty acids. These fats (also found in large amounts in nuts) are important in preventing diabetes by helping the body effectively control blood sugar levels.
nuts
As a source of unsaturated fatty acids, walnuts are rich in magnesium, another important nutrient. Global research shows that people who eat nuts regularly have lower rates of diabetes.
Citrus fruits
All citrus fruits contain antioxidants - excellent helpers in maintaining the balance of insulin in the blood.
Whole grains
Eating whole grain bread, quinoa and brown rice lowers 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 blood glucose increases, so if you want to eat a product with a high glycemic index, combine it with complex carbohydrates.
cinnamon
The delicious spice helps the body regulate insulin levels. Cinnamon is a type of insulin sensitizer, meaning it helps improve the sensitivity of cells to insulin. The spice helps with hypertension (chronic high blood pressure), lowers blood sugar concentration when used systematically in the necessary doses, improves general well-being and has a positive effect on metabolic processes.
Ginger
It is a catalyst for metabolic processes, lowers sugar level, cholesterol and blood coagulation indicators. Recommended for fresh daily consumption as a spice or base for tea.
Forbidden foods for diabetes
Today, doctors try not to strictly limit patients with diabetes and not to force them to strict limits 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 disease will need to eliminate from their diet. In fact, the following list is recommended for anyone who cares about their health to exclude it from their diet.
Sweet
The black list includes sugar and all products containing it in excess. We must forget ice cream, chocolate, marmalade, jam, sweets, preserves, halva and other sweets.
Bakery
Sweet bakery products are prohibited: muffins, cookies, buns, white bread and bread.
Foods that make you healthy
These dishes can greatly increase glucose levels. For this reason, a diabetic should avoid duck, pork, lamb, bacon, 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 industrial cutlets, noodles, sausages and sausages.
Trans fats
Their consumption will harm not only a diabetic, but also a healthy person. Banned products include margarine, shortening, spreads, French fries, hot dogs and burgers.
Fruits
It is not recommended to consume some fruits and dried fruits that cause a strong increase in blood sugar. Among them there are dried apricots, dates, figs, raisins, dates, melons, grapes, bananas.
Table no. 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 no. 9 includes:
- 300 g of fruit;
- 80 g of vegetables;
- 100 g of mushrooms;
- 1 tablespoon. 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), potatoes;
- 40-60 g of fat.
Main dishes
- soups: vegetable soup, cabbage, beet soup, borsch, okroshka with vegetables and meat, fish broth or light meat, mushroom soup with cereals and vegetables.
- Poultry, meat: rabbit, beef, chicken, boiled, minced, stewed, turkey.
- Fish: pike perch, navaga, cod, pike and lean seafood, boiled, steamed, stewed, baked in liquid.
- Snacks: mixed vegetables, vinaigrette, diet fish and meat with jelly, vegetable caviar, unsalted cheese, seafood salad with butter.
- CONFECTIONERY
: desserts made from berries, fresh fruit, mousses with berries, sugar-free fruit jelly, sugar-free jam and marmalade. - Egg dishes: soft boiled eggs, egg white omelette, on plates.
Other Diet Strategies for Diabetes
Of course, we must not forget that all diets are compiled strictly individually, taking into account the age and gender of the patient, as well as 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 diabetes mellitus type 2, this is well established.Mediterranean diet, which is based on daily physical activity.
The basic principles of the diet are:
- partial meals 5 times a day - 3 main meals and 2 snacks;
- breakfast should be richer in carbohydrates, mainly consisting of complex carbohydrates;
- light dinner consisting of lean protein and vegetables;
- During the day you should consume more than 1 kg of different vegetables and herbs;
- It is important to maintain the 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, rapese and peanut. Animal fats are limited in the Mediterranean diet.
Special attention is paid to Omega-3 fatty acids and oleic acid, found in oils, fatty fish and seafood. These fatty acids have a major impact on preventing atherosclerosis, improve insulin sensitivity, and help immune cells detect inflammation and suppress it.
Carbohydrates in the Mediterranean diet are mainly complex with a low glycemic index - durum wheat pasta, beans, rice, lentils, wholemeal bread, vegetables and seasonal fruits.
Protein comes in the form of soft, low-fat cheeses, eggs, fish, seafood, and rarely poultry.
Another diet option for diabetes isLCHFand diet keto. The essence of this diet strategy is to consume low amounts of carbohydrates and high amounts of fat. Carbohydrates in fatty diets are limited to 50 grams per day, and in 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;
- carbonated sweet drinks;
- yeast bread, pastries;
- cereals, porridge, flakes and breakfast cereals;
- skimmed milk, kefir, yogurt;
- sweet curd;
- margarine.
In the LCHF diet concept, insulin is a dangerous thing, because after we eat something high in carbohydrates, the carbohydrates break down into glucose, the blood sugar level starts to rise sharply, and therefore the insulin level rises too much in order to transport the glucose tomuscles, liver and fat cells, that is, insulin is "responsible for our obesity". Furthermore, protein can raise insulin levels just as well as carbohydrates. And fats do not increase insulin at all, which is good for insulin resistance and, if necessary, to improve the sensitivity of cells to insulin.
Diabetes mellitus in children
Diabetes mellitus in children can be caused by hereditary predisposition, poor diet, including the consumption of excessive amounts 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 a therapeutic diet and administration of insulin for type 1 diabetes.
The diet of children with diabetes should be rich in vegetables such as cauliflower, onions, spinach and garlic. You can eat unsweetened fruit, meat, poultry and fish. It is advisable to give milk and cottage cheese that have a small 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 child with diabetes should learn how to calculate the consumption of bread units when feeding the child and calculate the required dose of insulin. Even the child himself should learn these skills as soon as possible.
Gestational diabetes mellitus
Anothertype of diabetes– gestational diabetes mellitus in pregnant women, which is quite common today.
Women are at particular risk:
- overweight or obese (BMI greater than 25 kg/m²– risk doubles, over 30 – triples);
- with multiple pregnancy;
- after IVF;
- with polycystic ovaries;
- with a large weight gain during real pregnancy;
- with glucosuria (glucose in the urine);
- having a close relative with diabetes;
- with a previous heavy 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 unborn child. Thus, at the age of 4-5, such children are many times more likely to experience overweight and obesity, at the age of 10-11 - increased blood pressure, in adolescence the risk of developing diabetes is 20-40%, danger. of the development of non-alcoholic fatty liver disease significantly increases.
If GDM is not detected in time or the expectant mother does not take any action to treat it, thenthe risk increases significantly:
- early aging of the placenta and, as a result, delayed fetal development;
- premature birth;
- polyhydramnios;
- the formation of a large or disproportionate or edematous fetus;
- increased blood pressure, preeclampsia;
- the need for a caesarean section;
- traumatization 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.
Therefore, it is important to understand that diabetes is not a kind of lifelong sentence, it only imposes certain obligations on a person regarding diet and physical activity. A proper and balanced diet is of great 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 often suffer, it is very important to change the lifestyle and eating habits themselves. 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 glucose transport in muscle cells, then in type 1 diabetes nutrition plays a role. a leadership role.