Diet for diabetes: basic rules and allowed foods

Currently, diabetes is a global problem. In the last ten years, the number of people suffering from diabetes has more than doubled to 425 million. According to forecasts, by 2045 their number may reach 629 million.

Diabetesare a group of endocrine diseases associated with reduced glucose absorption and develop as a result of 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 fat, 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 usually leads to absolute insulin deficiency. The development of type 1 diabetes involves both genetic and environmental factors - viral infections, diet, 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 the level of glucose in the blood and the starvation of the cells from carbohydrates, since the glucose cannot enter it, but floats inert 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 his 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 calculations. Currently, the slogan is very popular: "With diabetes there are no restrictions, there is only the right lifestyle. "

Diet for diabetes patients is based on the glycemic index. Essentially, this indicator reflects the speed with which sugar from them is absorbed 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 a rise in sugar.

Also, don't forget the food insulin index, which reflects the amount of insulin increase in response to food consumption. The insulin index of foods is important to consider for people with diabetes to predict the body's reaction when eating certain foods and to correctly calculate the doses of insulin preparations (short-acting and long-acting) to be used for injection aftermeals.

Any meal, even protein, causes a large 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 snack options in the form of dairy and fermented milk products, such as cottage cheese, kefir and yogurt, have a very high insulin index, meaning that your insulin swing will swing very wildly with your mood and irritability.

Let's look at different diet options and features depending on the type of diabetes.

Basic rules of nutrition for type 1 diabetes

With the first guyPatients are completely dependent on insulin injections and the diet is designed with insulin administration in mind. Diabetics should 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 no more than 12 units of bread per day. Insulin is given half an hour before meals, so it is important to know exactly what will be eaten and in what quantity the carbohydrates of the food will be absorbed. For each main meal you should eat no more than 5-6 units of bread and 2-3 for an additional one.

You should almost completely avoid foods that contain easily digestible (simple) carbohydrates. These are sweets, jam, condensed milk, marshmallows, jam, halva, cakes, jam, etc. , as well as oatmeal and semolina, mashed potatoes. Reducing the amount of carbohydrates in your diet, which raise blood sugar, reduces the need for medication. Eating the same doses as before switching to a low-carb diet can cause hypoglycemia. It is essential that you measure your blood sugar regularly while starting this diet and adjust your medication dose accordingly.

The daily caloric intake is distributed during 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 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 occurs in the context of obesity and not only high levels of glucose, but also insulin are found in the blood. However, it is very often the case that insulin resistance, which can then lead to type 2 diabetes, does not manifest itself in any way for a very long time, even people with insulin resistance are not always overweight, but thelevel of glucose in the blood is constantly maintained at a high level and This situation leads to very sad consequences. Nutritional nutrition for type 2 diabetes helps restore cells' ability to absorb sugar and helps restore cells' sensitivity to insulin.

Type 2 diabetes mellitusit is primarily a disorder of carbohydrate metabolism. But at the same time, other types of metabolism suffer - lipids, proteins, minerals. Treatment for type 2 diabetes includes diet, moderate exercise, stress management, and medications (diabetic drugs).

The type 2 diabetes diet is based on basic principles:

1. 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 daily are recommended 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.
2. 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 cardiovascular disease, one of the most common long-term complications of diabetes. Unsaturated fats are found in many foods, including nuts, avocados, fatty sea fish and olive oil.
3. Avoid processed foods– Nutritionists and doctors agree that avoiding processed foods has a positive effect on health. Because of the substances added to ensure a long shelf life, processed foods tend to have a high glycemic index. Regular consumption of such foods can adversely affect the health of a diabetic.

Healthy foods for diabetes

1. Green leafy vegetables

   Spinach, kale, 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 106g) a day reduces the risk of type 2 diabetes by 14%.

2. Legumes

   These high-fiber foods can help stabilize your blood sugar levels. Legumes are low in saturated fat, which can be bad for your heart.

3. Fish

   Omega-3 fatty acids– great helpers in the prevention of diabetes, reducing the risk of cardiovascular diseases. Omega 3 is needed in 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.

4. Olive oil

   A staple of the Mediterranean diet, it is important for heart health as 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.

5. 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.

6. Citrus

   All citrus fruits contain antioxidants - great helpers in maintaining the balance of insulin in the blood.

7. Wholegrain

   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 high blood glucose spikes, so if you want to eat a high glycemic index item, pair it with complex carbohydrates.

8. Cinnamon

   The tasty spice helps the body regulate insulin levels. Cinnamon is a type of insulin sensitizer, meaning it helps improve the cells' sensitivity to insulin. The spice helps with hypertension (chronic high blood pressure), reduces blood sugar concentration when used systematically in the required doses, improves overall well-being and has a positive effect on metabolic processes.

9. Ginger

   It is a catalyst for metabolic processes, reduces sugar levels, cholesterol and blood clotting indicators. Recommended for daily consumption fresh as a seasoning or base for tea.

Forbidden foods for diabetes

Today, doctors try not to strictly limit patients with diabetes and do not force them to strict limits in terms of permitted and prohibited foods. Even with type 2 diabetes, in which diet plays a role, you can eat a varied diet, but there are certain foods that people with this disease should eliminate from their diet. In fact, the following list is recommended to anyone who cares about their health to exclude it from their diet.

1. Sweet

   The black list includes sugar and all products containing it in excess. We must forget about ice cream, chocolate, jam, marmalade, sweets, preserves, halva and other sweets.

2. Oven

   Sweet bakery products are prohibited: muffins, cookies, rolls, white loaf and bread.

3. Fattening foods

   These dishes can raise your glucose levels significantly. For this reason, a diabetic should avoid duck, pork, lamb, lard, mayonnaise and cream. It is also recommended to exclude sweet yogurt, fatty cottage cheese and cheese.

4. Semi-finished products

   They contain a large number of aromas, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial cutlets, pasta, sausages and sausages.

5. Trans-fatty acids

   Their consumption will harm not only a diabetic, but also a healthy person. Prohibited products include margarine, shortening, spreads, french fries, hot dogs and burgers.

6. Fruits

   It is not recommended to eat 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 both in the hospital and at home.Table No. 9 includes:

• 300 grams of fruit;
• 80 g vegetables;
• 100 g mushrooms;
• 1 Mr. c. natural fruit juice;
• 300 grams 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 (prepared), potatoes.
• 40-60 g of fat.

Main courses

• Soups: vegetable soup, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, fish or light meat broth, mushroom soup with grains and vegetables.
• Poultry, meat: rabbit, veal, chicken, boiled, chopped, boiled, turkey.
• Fish: perch, navaga, cod, pike and lean seafood, boiled, steamed, boiled, baked in juice.
• Snack: mixed vegetables, vinaigrette, fish and meat diet jelly, vegetable caviar, unsalted cheese, seafood salad with butter.
• Sweet:berry desserts, fresh fruit, berry mousse, sugar-free fruit jelly, sugar-free jam and marmalade.
• Egg dishes: soft-boiled eggs, scrambled egg white, 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, as well as his level of physical activity.

Thus, today there are several options for nutritional strategies for diabetes. If it is necessary to normalize body weight in a patient with type 2 diabetes mellitus, it has been well proven.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 more carbohydrate-rich, mainly consisting of complex carbohydrates.
• light dinner consisting of lean protein and vegetables.
• During the day you should 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 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, found in oils, fatty fish and seafood. These fatty acids have a huge 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, seasonal vegetables and fruits.

Protein comes in the form of soft, low-fat cheeses, eggs, fish, seafood, and rarely poultry.

Another diet option for diabetes isLCHFand keto diet. The essence of this nutritional strategy is to eat 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 severe - no more than 10 grams of carbohydrates.

The following foods are completely excluded from the keto diet::

• sugar, honey, artificial sweeteners.
• sweet carbonated drinks;
• yeast bread, pastries.
• cereals, porridges, flakes and breakfast cereals;
• skimmed milk, kefir, yogurts.
• sweet curd;
• margarine.

In the LCHF diet concept, insulin is a dangerous thing, because after we eat something rich in carbohydrates, the carbohydrates break down into glucose, the blood sugar level starts to rise sharply, and consequently the insulin level rises too much to transport the glucose to themuscles, liver and fat cells, i. e. insulin is "responsible for our obesity". Plus, protein can raise insulin levels just as well as carbohydrates. And fats don't raise insulin at all, which is good for insulin resistance and, if necessary, improving cell sensitivity 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 appear 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 unsweetened fruit, meat, poultry and fish. It is good 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, pastries, cookies, plums should be excluded. Parents of a child 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 child himself must also be taught these skills as early as possible.

Gestational diabetes mellitus

Othertype of diabetes– gestational diabetes in pregnant women, which is quite common today.

High blood sugar during pregnancyand is one of the most common metabolic disorders in an expectant mother. The so-called gestational diabetes mellitus or gestational diabetes is diabetes that occurs during pregnancy and is limited to the duration of pregnancy. During pregnancy, the production of sex hormones (estrogen and progesterone, hCG) and the hormone cortisol, which suppress the action of insulin, increases sharply. As a result, blood glucose levels rise in pregnant women. High sugar during pregnancy negatively affects both the health of the woman herself and the health of the fetus, and therefore requires early diagnosis and subsequent correction.

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 lot of weight gain during the actual pregnancy.
• with glycosuria (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 are many times more likely to develop overweight and obesity, at the age of 10-11 years - increased blood pressure, in adolescence the risk of developing diabetes is 20-40%, the risk of developingof non-alcoholic steatohepatitis significantly increases the liver.

If GDM is not detected early 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, a delay in the development of the fetus.
• Early Childbirth;
• polyhydramnios;
• formation of a large or disproportionate or edematous fetus.
• increased blood pressure, pre-eclampsia.
• the need for caesarean section;
• injury to women and children during childbirth.
• hypoglycaemia (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 some kind of life sentence; it only imposes certain obligations on a person regarding 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, from the excess of which type 2 diabetics often suffer, it is very important to change the very lifestyle and eating habits. And if in type 2 diabetes a good result is achieved in reducing blood sugar levels not only with properly selected foods, but also with a set of physical exercises that help improve the function of glucose transport in muscle cells, then in type 1 diabetes the dietplays a leading role.