Currently, diabetes is a global problem. Over the past ten years, the number of people with diabetes has more than doubled and reached 425 million. According to forecasts, by 2045 their number could reach 629 million.
diabetesis a group of endocrine diseases related to impaired glucose absorption and develops due to an absolute or relative lack of the hormone insulin, resulting in the development of hyperglycemia - a continuous increase in blood glucose levels. The disease is characterized by a chronic course, as well as violations of all types of metabolism due to violations of carbohydrate metabolism; metabolism of fats, proteins, minerals and water salts 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 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 glucose levels and cell carbohydrate starvation, because glucose cannot enter it, but floats idle in the blood.
Treatment of diabetes mellitus is based on diet therapy. The general principle of nutrition, regardless of the type of diabetes, is that patients are 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 increased emphasis on personal diet with individual selection of food baskets and calorie counting. Currently, the slogan is very popular: "With diabetes there are no restrictions, there is only the right lifestyle. "
Nutrition for diabetics is based on the glycemic index. Basically, this index reflects the speed of sugar from them absorbed into the blood. Products with a high index - jam, biscuits, 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. Therefore, food with a GI of up to 55 is broken down gradually and almost does not cause an increase in sugar.
Also, do not forget about the food insulin index, which reflects the amount of insulin increase in response to food consumption. Food insulin index is important to take into account for people with diabetes to predict the body's reaction when consuming certain foods and to correctly calculate the dose of insulin preparations (short and long acting) that will be used for injections after meals.
Any food, even protein, causes a large release of the hormone insulin. And the more insulin changes you experience during the day, the more likely you are to develop insulin resistance, which in turn will lead to type 2 diabetes. Everyone's favorite snack option is in the form of dairy and fermented milk products, such as cottage cheese, kefir and yogurt, has a very high insulin index, which means that insulin swings will swing very strongly along with your mood and irritability.
Let's consider different diet options and features depending on the type of diabetes.
Basic dietary rules for type 1 diabetes
You should 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 your diet, which raises blood sugar, reduces the need for medication. Taking the same dose 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 dose accordingly.
Daily calorie intake is distributed throughout the day into 4-5 meals. According to the BJU ratio, the distribution looks like this: protein makes up 20-25% of the total diet, fat - 30%, of which saturated is no more than 10%, carbohydrates 45-50%.
Basic dietary 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 usually appears against the background of obesity, and not only high levels of glucose, but also insulin is present in the blood. However, it very often happens that insulin resistance, which can then lead to diabetes mellitus type 2, does not manifest itself in any way for a very long time, and although people with insulin resistance are not always overweight, but the glucose level inblood is always kept at a high level and this condition leads to very sad consequences. Dietary nutrition for type 2 diabetes helps restore cells' ability to absorb sugar and helps restore cells' sensitivity to insulin.
Diet for type 2 diabetes is based on the main principle:
- An abundance 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 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 fat– the presence of sufficient amounts of unsaturated and monounsaturated fats in the diet helps maintain cholesterol levels within normal limits and reduce the risk of cardiovascular disease, one of the most common long-term complications of diabetes. Polyunsaturated fats are found in many foods, including nuts, avocados, fatty ocean fish, and olive oil.
- Avoid processed foods– nutritionists and doctors agree that avoiding processed foods has a positive effect on health. Due to ingredients added to ensure a long shelf life, processed foods tend to have a high glycemic index. Consuming such food on a regular basis can 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 serving (about 106 g) a day reduces the risk of type 2 diabetes by 14%.
Beans
These fiber-rich foods can help stabilize your blood sugar levels. Legumes are low in saturated fat, which can harm your heart.
fish
Omega-3 fatty acids – a great helper in preventing diabetes, reducing the risk of cardiovascular disease. Omega 3 is needed by the body for the synthesis of red blood cells and cell membranes, it helps in the absorption of other vitamins by the body, and most importantly, it suppresses chronic inflammation, which is a sure companion of insulin resistance.Olive oil
A staple of the Mediterranean diet, it's important for heart health because it's packed with polyunsaturated fatty acids. This fat (also found in large quantities in nuts) is 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 diabetes. Whole grains are rich in fiber, which helps the body regulate blood sugar levels. Complex carbohydrates are a kind of buffer that protects us from high blood glucose rises, so if you want to eat products with a high glycemic index, combine them with complex carbohydrates.
Cinnamon
The delicious spice helps the body regulate insulin levels. Cinnamon is a type of insulin sensitizer, that is, it helps increase the sensitivity of cells to insulin. Spices help with hypertension (chronic high blood pressure), reduce the concentration of sugar in the blood when used systematically in the necessary doses, improve overall well-being, and have a positive effect on metabolic processes.
ginger
It is a catalyst for metabolic processes, reducing sugar, cholesterol and blood clotting indicators. Recommended for fresh daily use as a seasoning or base for tea.
Forbidden foods for diabetes
Today, doctors try not to strictly limit diabetic patients and do 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 some foods that people suffering from this disease still need to remove from the diet. In fact, the list below is recommended for anyone who cares about their health to exclude from their diet.
sweet
The black list includes sugar and all products that contain 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, bread, white bread and bread.
Fatty foods
These foods can raise your 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 product
It contains a large amount of flavorings, stabilizers, and flavor enhancers. You can not eat fish sticks, ready-made industrial cuts, dumplings, sausages and sausages.
Trans fat
Their use will harm not only diabetics, but also healthy people. Prohibited products include margarine, shortening, spreads, french fries, hot dogs and burgers.
fruits
It is not recommended to take certain fruits and dried fruits 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 treatment in hospitals and at home.Table No. 9 inclusive:
- 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 cereal (ready), potatoes;
- 40-60 g of fat.
Main dish
- soup: vegetables, cabbage soup, beet soup, borscht, vegetable and meat okroshka, light fish or meat soup, mushroom soup with grains and vegetables.
- Chicken, meat: rabbit, veal, chicken, stew, mince, stew, turkey.
- fish: pike perch, navaga, cod, pike and lean seafood, boiled, steamed, stewed, baked in juice.
- Snacks: mixed vegetables, vinaigrette, fish and meat jelly nutrition, vegetable caviar, unsalted cheese, seafood salad with butter.
- sweets
: desserts made from berries, fresh fruit, berry mousses, unsweetened fruit jellies, unsweetened jams and marmalades. - Egg dishes: soft-boiled eggs, egg-white omelets, in dishes.
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, and the level of physical activity.
Therefore, today there are several options for nutritional strategies for diabetes. If it is necessary to normalize body weight in patients with diabetes mellitus type 2, it has proven itself well.Mediterranean diet, which is based on daily physical activity.
The basic principle of the diet is:
- split 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 protein and vegetables;
- During the day you need to 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 a day.
The main source of fat in the diet is– unrefined olive oil, sometimes you can use sesame, mustard seeds and peanuts. Animal fat is 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 major effect on the prevention of atherosclerosis, improve insulin sensitivity, and help immune cells detect inflammation and suppress it.
Carbohydrates in the Mediterranean diet are mostly complex with a low glycemic index - durum wheat pasta, beans, rice, lentils, wholemeal bread, seasonal vegetables and fruits.
Protein is presented in the form of low-fat soft cheese, eggs, fish, seafood and rarely chicken.
Another diet option for diabetes isLCHFand the keto diet. The essence of this nutritional strategy is to consume a low amount of carbohydrates and a high amount of fat. Carbohydrates on a fatty diet are limited to 50 grams per day, and on a keto diet the restriction is more serious - no more than 10 grams of carbohydrates.
The following foods are completely excluded in the keto diet::
- sugar, honey, artificial sweeteners;
- sweetened carbonated drinks;
- yeast bread, pastry;
- cereals, porridge, flakes and breakfast cereals;
- skim milk, kefir, yogurt;
- sweet curd;
- margarine.
In the LCHF diet concept, insulin is a dangerous thing, because after we eat something high in carbohydrates, carbohydrates are broken down into glucose, blood sugar levels start to rise sharply, and thus insulin levels rise a lot to transport glucose to the muscles, liver andfat cells, that is, insulin "is responsible for our obesity. "In addition, protein can increase insulin levels just like carbohydrates. And fat does not raise insulin at all, which is good for insulin resistance and, if necessary, to increase 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 insulin administration 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 fruit, meat, chicken and fish without sugar. It is advisable to give milk and cottage cheese that have a small percentage of fat content, provided that the child does not have an intolerance to cow's milk protein. When cooking meat or fish, you can use spices to promote better protein absorption.
All confectionery products, sweets, grapes, apricots, rice, baked goods, biscuits, plums should be excluded. Parents of children with diabetes need to learn how to calculate the consumption of bread units when feeding the child, and calculate the required dose of insulin. The children themselves also need to be taught these skills as early as possible.
Diabetes mellitus during pregnancy
One moretype of diabetes– gestational diabetes mellitus in pregnant women, which is quite common today.
Women have certain risks:
- overweight or obese (BMI over 25 kg/m²– double risk, over 30 – three times);
- with multiple pregnancies;
- after IVF;
- with polycystic ovaries;
- with significant weight gain during actual pregnancy;
- with glucosuria (glucose in the urine);
- have a close relative with diabetes;
- with burdened previous pregnancy - GDM, birth of a large fetus, fetal death in utero.
Diabetes during pregnancy is dangerous not only for the mother, it also affects the health of the unborn child. Therefore, at the age of 4-5 years, such children are many times more likely to be overweight and obese, at the age of 10-11 years - increased blood pressure, in adolescence the risk of developing diabetes is 20-40%, the risk of developing non-alcoholic fatty liver disease increases significantly.
If GDM is not detected on 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;
- large or disproportionate fetal formation or edema;
- increased blood pressure, preeclampsia;
- need for caesarean section;
- trauma to women and children during childbirth;
- hypoglycemia (low blood sugar) and breathing 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 only imposes certain obligations on a person regarding diet and physical activity. A proper and balanced diet is very important for any type of diabetes. And although reducing carbohydrates and saturated fat in the diet contributes to weight loss, the excess of which type 2 diabetes patients often suffer, it is very important to change the lifestyle and eating habits themselves. 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 set of physical exercises that help improve the function of glucose transport into muscle cells, then in type 1 diabetes nutrition plays a role. main role.