Currently, diabetes is a global problem. In the past ten years, the number of people with diabetes has more than doubled and reached 425 million, and according to predictions, 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 lack of the hormone insulin, which results in the development of hyperglycemia - a persistent increase in the level of glucose in the blood. 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 and 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 usually leads to an absolute lack of insulin. The development of type 1 diabetes includes genetic and environmental factors - viral infections, nutrition, toxins, hygiene. Type 2 diabetes mellitus is characterized by the development of insulin resistance and a relative, but not absolute, lack of insulin and is manifested by persistent hyperglycemia. The main problem with any type of diabetes is an increase in the level of glucose in the blood and starving the cells of carbohydrates, because glucose cannot enter it, but floats idly 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 advised to completely eliminate simple carbohydrates, but today there is an increasing emphasis on personalized diets with individual selection of food baskets and calorie calculation. At the moment, a very popular slogan is: "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 is absorbed from them into the blood. Products with a high index - jam, cookies, cakes - have a high absorption rate. Products with a low index - 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 an increase in sugar.
Also, don't forget about the insulin index of food, which reflects the amount of insulin increase in response to food consumption. The insulin index of foods is important to take into account for people with diabetes in order to predict the reaction of the body when consuming certain foods and correctly calculate the doses of insulin preparations (short and long-term) that will be used for injections after eating.
Every meal, even protein, causes a large 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 later lead to type 2 diabetes. high insulin index, which means that the insulin swing will swing very strongly along with your mood and irritability.
Let's consider 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, cakes, jam, etc. , as well as oatmeal and semolina porridge, mashed potatoes. Reducing the amount of carbohydrates in the diet, which raise blood sugar, reduces the need for medication. Consuming the same doses as before switching to a low-carbohydrate diet can cause hypoglycemia. It is necessary to measure blood sugar regularly while starting this diet and adjust the dose of the medicine accordingly.
Daily caloric intake is distributed throughout the day in 4-5 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 rules of nutrition for type 2 diabetes
More severe restrictions are needed for insulin-dependent variants of the disease. This is due to the fact that this form usually appears against the background of obesity, and there are not only high levels of glucose in the blood, but also insulin. However, it very often happens that insulin resistance, which can later lead to type 2 diabetes mellitus, does not manifest itself in any way for a very long time, and even people with insulin resistance are not always overweight, but the level of glucose in the blood is constantlymaintains at a high level and this situation leads to very sad consequences. A type 2 diabetes diet helps restore cells' ability to absorb sugar and helps restore cells' sensitivity to insulin.
The type 2 diabetes diet is based on key 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 for up to 30 minutes a day are advised to consume at least 500 grams of vegetables a 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 or 1000 grams.
- Unsaturated fats- the presence of an adequate amount of polyunsaturated and monounsaturated fats in the diet helps to 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 seafood, and olive oil.
- Avoid processed foods- nutritionists and doctors agree that avoiding processed food has a positive effect on health. Due to substances added to ensure a long shelf life, processed foods tend to have a high glycemic index. Regular consumption of such food can negatively affect the health of diabetics.
Healthy food for diabetes
Green leafy vegetables
Spinach, cabbage and bok choy are low in calories but rich in nutrients such as vitamin C, beta-carotene and magnesium, which help prevent diabetes. One portion (about 106 g) per day reduces the risk of developing type 2 diabetes by 14%.
Legumes
These high-fiber foods can help stabilize blood sugar levels. Legumes are low in saturated fat, which can be bad for your heart.
A fish
Omega-3 fatty acids - great helpers in the prevention of diabetes, reducing the risk of cardiovascular diseases. Omega 3 is needed by the body for the synthesis of red blood cells and cell membranes, they help in the absorption of other vitamins in the body, and most importantly, they suppress chronic inflammation, which is a sure companion of insulin resistance.Olive oil
The basis of the Mediterranean diet, it is important for heart health because it is full of monounsaturated 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 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 - great helpers in maintaining insulin balance in the blood.
Whole grains
Eating whole grain 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 a high rise in blood glucose, 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, that is, it helps to improve the sensitivity of cells to insulin. The spice helps with hypertension (chronically elevated blood pressure), reduces the concentration of sugar in the blood when used systematically in the necessary doses, improves the general condition and has a positive effect on metabolic processes.
Ginger
It is a catalyst of metabolic processes, reduces the level of sugar, cholesterol and indicators of blood clotting. It is recommended for daily fresh consumption as a spice or as a base for tea.
Forbidden foods for diabetes
Today, doctors try not to strictly restrict patients with diabetes and do not force them to strict restrictions regarding permitted and prohibited foods. Even with type 2 diabetes, in which diet plays an important role, you can eat a variety of foods, but there are a number of foods that people suffering from this disease will still have to remove from their diet. In fact, we recommend the list below to anyone who cares about their health to exclude from their diet.
Sweet
Sugar and all products containing it in excess are on the black list. We must forget about ice cream, chocolate, marmalade, jam, sweets, preserves, halva and other sweets.
Bakery
Sweet bakery products are prohibited: muffins, biscuits, buns, white bread and bread.
High-fat food
These foods can significantly increase glucose levels. For this reason, a diabetic should avoid duck, pork, lamb, fat, 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 aromas, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial cutlets, dumplings, sausages and sausages.
Trans fats
Their consumption will harm not only a diabetic, but also a healthy person. Prohibited products are margarine, shortening, spread, french fries, hot dogs and burgers.
Fruits
The consumption of certain fruits and dried fruits that cause a strong increase in blood sugar is not recommended. Among them are dried apricots, dates, figs, raisins, persimmons, melons, grapes, bananas.
Table no. 9 for diabetes
This diet was developed by scientists especially 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 tbsp. natural fruit juice;
- 300 g of meat or fish;
- 200 g of low-fat fresh 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;
- 40-60 g of fat.
Main meal
- Soups: vegetables, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, fish or light meat soup, mushroom soup with grains and vegetables.
- Poultry, meat: rabbit, veal, chicken, stewed, chopped, boiled, turkey.
- A fish: perch, navaga, cod, pike and lean seafood, stewed, steamed, boiled, baked in juice.
- Snacks: vegetable mix, vinaigrette, diet fish and meat jelly, vegetable caviar, unsalted cheese, seafood salad with butter.
- Sweets
: berry 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 Dietary Strategies for Diabetes
Of course, we should not forget that all diets are composed strictly individually, taking into account the patient's age and gender, as well as his level of physical activity.
So today there are several options for dietary strategies for diabetes. If it is necessary to normalize body weight in patients with type 2 diabetes, this has proven itself well.Mediterranean diet, which is based on daily physical activity.
The basic principles of nutrition are::
- fractional meals 5 times a day - 3 main meals and 2 snacks;
- breakfast should be richer in carbohydrates, mainly consisting of complex carbohydrates;
- a light dinner consisting of lean proteins and vegetables;
- During the day, it is necessary to consume more than 1 kg of different vegetables and herbs;
- It is important to maintain a drinking regime - at least 7-8 glasses of water a 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.
Special 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 the prevention of atherosclerosis, improve insulin sensitivity and help immune cells detect inflammation and suppress it.
Carbohydrates on the Mediterranean diet are predominantly complex with a low glycemic index - durum wheat pasta, beans, rice, lentils, wholemeal bread, seasonal vegetables and fruits.
Proteins are presented in the form of low-fat soft cheeses, eggs, fish, seafood and rarely poultry.
Another option is a diet for diabetesLCHFand the keto diet. The essence of this dietary strategy is to consume small amounts of carbohydrates and large amounts of fat. Carbohydrates on a high-fat diet are limited to 50 grams per day, and on a keto diet the restriction is even more severe - no more than 10 grams of carbohydrates.
The following foods are completely excluded on the keto diet: :
- sugar, honey, artificial sweeteners;
- sweet carbonated beverages;
- yeast bread, pastries;
- cereals, porridges, cereals and breakfast cereals;
- skimmed milk, kefir, yogurts;
- sweet curd;
- margarine.
In the concept of the LCHF diet, insulin is a dangerous thing, because after we eat something rich in carbohydrates, the carbohydrates are broken down into glucose, the blood sugar level begins to rise sharply, and therefore the insulin level rises greatly in order to transport glucose to the muscles, liverand fat cells, i. e. insulin is "responsible for our obesity". Moreover, protein can increase insulin levels just as well as carbohydrates. And fats do not raise insulin at all, which is good for insulin resistance and, if necessary, for improving 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 psychological or physical trauma. Treatment of diabetes in children, as in adults, consists of a therapeutic diet and the use of insulin for type 1 diabetes.
The diet of children with diabetes should be rich in vegetables such as white and cauliflower, onions, spinach and garlic. You can eat unsweetened fruit, meat, poultry and fish. It is preferable to give milk and cottage cheese that have 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 for better protein absorption.
All confectionery products, sweets, grapes, apricots, rice, pastries, cookies, plums should be excluded. Parents of a child with diabetes must learn how to calculate the consumption of bread units when feeding the child and calculate the required dose of insulin. The child himself should also learn these skills as early as possible.
Gestational diabetes mellitus
Otherstype of diabetes- gestational diabetes mellitus in pregnant women, which is quite common today.
Women are at particular risk:
- overweight or obesity (BMI greater than 25 kg/m²– risk doubles, above 30 – triples);
- with multiple pregnancy;
- after IVF;
- with polycystic ovaries;
- with great weight gain during the actual pregnancy;
- with glucosuria (glucose in the urine);
- having close relatives with diabetes;
- with burdened previous 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 years, such children have many times higher chances of experiencing overweight and obesity, at the age of 10-11 years - elevated blood pressure, in adolescence the risk of developing diabetes is 20-40%, the risk of developingnon-alcoholic fatty diseases significantly increases the liver.
If GDM is not detected in time or the expectant mother does not take any steps 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;
- high blood pressure, preeclampsia;
- need for caesarean section;
- traumatization of women and children during childbirth;
- hypoglycemia (low blood sugar) and breathing problems in the newborn;
- 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, but only imposes certain obligations on a person in terms of diet and physical activity. A proper, balanced diet is of utmost importance for any type of diabetes. And although the reduction of 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. And if in type 2 diabetes, a good effect in lowering blood sugar levels is achieved not only by properly selected food, but also by a series of physical exercises that help improve the function of transporting glucose into muscle cells, then in type 1 diabetes, diet plays an important role. leading role.