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, their number could rise to 629 million by 2045.
Diabetes mellitusis a group of endocrine diseases associated with impaired glucose absorption and developing as a result of an absolute or relative deficiency of the hormone insulin, which leads to the development of hyperglycemia - a persistent increase in blood sugar levels. This disease is characterized by a chronic course, as well as disruption of all types of metabolism due to a violation of carbohydrate metabolism; The fat, protein, mineral and water-salt metabolism 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 insulin deficiency. Both genetic and environmental factors are involved in the development of type 1 diabetes - 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 an increase in blood sugar levels and a lack of carbohydrates in the cells, since glucose cannot penetrate into the blood sugar level but floats unused 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 recommended to reduce the carbohydrate load in the diet to 5-7% and increase the consumption of vegetable fats. While diabetics were previously advised to completely avoid simple carbohydrates, today people are increasingly relying on personalized nutrition with individual selection of food baskets and calorie calculations. The slogan is currently very popular: "With diabetes there are no restrictions, there is only the right lifestyle. "
The diet of patients with diabetes is based on the glycemic index. Essentially, this index reflects the speed at 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 - grains, fruits - have a lower index. The slower the absorption rate, the easier it is for the pancreas to cope with the load. Foods with a GI of up to 55 are broken down gradually and cause almost no increase in sugar.
Also do not forget about the insulin index of foods, which reflects the increase in insulin in response to food consumption. It is important for people with diabetes to take into account the insulin index of foods in order to predict the body's reaction when consuming certain foods and to correctly calculate the dosage of insulin preparations (short-acting and long-acting) used for injection after meals.
Every meal, including protein, triggers 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 subsequently leads to type 2 diabetes. Everyone's favorite snack in the form of dairy and fermented milk products such as cottage cheese, kefir and yogurt have a very, very high insulin index, which means that insulin levels fluctuate very much depending on your mood and irritability.
Let's consider different options and features of diets depending on the type of diabetes.
Basic nutritional rules for type 1 diabetes
With the first guyPatients are completely dependent on insulin injections and diet is designed with administration in mind. Diabetics need to study the presence of carbohydrates (bread units) in food to determine the dose of the hormone that helps in the absorption of these carbohydrates. A bread unit is a conventional concept that implies a certain amount of a product containing 12 grams of carbohydrates. It is recommended not to consume more than 12 units of bread per day. Since insulin is administered half an hour before meals, it is important to know exactly what is being eaten and in what quantity in order to absorb the carbohydrates in the food. For each main meal you should eat no more than 5-6 units of bread, for another meal 2-3.
You should almost completely avoid foods with easily digestible (simple) carbohydrates. These are sweets, jam, condensed milk, marshmallows, jam, halva, cakes, jam, etc. , as well as oatmeal and semolina porridge, mashed potatoes. Reducing the amount of carbohydrates in your diet, which increase blood sugar levels, reduces the need for medication. Consuming the same dosages as before switching to a low-carbohydrate diet may result in hypoglycemia. When starting this diet, it is necessary to measure your blood sugar regularly and adjust the dosage of your medications accordingly.
The daily calorie intake is divided into 4-5 meals throughout the day. According to the BJU ratio, the distribution looks like this: proteins make up 20-25% of the total food, fats – 30%, of which saturated fatty acids do not exceed 10%, carbohydrates 45-50%.
Basic nutritional rules for type 2 diabetes
Stricter restrictions are required for non-insulin-dependent variants of the disease. This is because this form usually occurs against the background of obesity and not only high levels of glucose but also insulin are found in the blood. However, it is very common that insulin resistance, which can later lead to type 2 diabetes mellitus, does not become noticeable for a very long time and people with insulin resistance are not always overweight, but the glucose level in the blood is constantly at a high levellevel and this situation leads to very sad consequences. Dietary nutrition for type 2 diabetes helps restore the ability of cells to absorb sugar and restore the sensitivity of cells to insulin.
Diabetes mellitus type 2it is primarily a disorder of carbohydrate metabolism. At the same time, other types of metabolism also suffer - lipids, proteins, minerals. Treatment for type 2 diabetes mellitus includes diet, moderate exercise, stress management, and medication (diabetic medications).
The diet for type 2 diabetes is based on essential principles:
- Abundance of vegetables– The amount of vegetables consumed may depend on age, gender and frequency of physical activity per week. In general, women who exercise for up to 30 minutes a day are recommended to consume at least 500 grams of vegetables daily. For more intensive training, 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 a sufficient amount of polyunsaturated and monounsaturated fats in the diet helps 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.
- Avoid processed foods– Nutritionists and doctors agree that avoiding processed foods has a positive effect on health. Processed foods tend to have a high glycemic index due to the added substances that ensure a long shelf life. Regular consumption of such foods can have a negative impact on the health of a diabetic.
Healthy foods 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 (approx. 106 g) per day reduces the risk of developing type 2 diabetes by 14%.
legumes
These fiber-rich foods can help stabilize your blood sugar levels. Legumes are low in saturated fat, which can be harmful to the heart.
Fish
Omega-3 fatty acids– great helpers 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, 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 because it is rich in monounsaturated fatty acids. These fats (which are 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, nuts are rich in magnesium, another important nutrient. Worldwide research shows that people who regularly eat nuts are less likely to develop diabetes.
Citrus fruits
All citrus fruits contain antioxidants - great helpers in maintaining insulin balance in the blood.
full grain
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 sharp increase in blood sugar. So if you want to eat a product with a high glycemic index, combine it with complex carbohydrates.
Cinnamon
The tasty spice helps the body regulate insulin levels. Cinnamon is a type of insulin sensitizer, meaning it helps improve cells' sensitivity to insulin. The spice helps with hypertension (chronic high blood pressure), when used specifically in the required dosages, reduces the sugar concentration in the blood, improves general well-being and has a positive effect on metabolic processes.
Ginger
It is a catalyst for metabolic processes, lowers sugar levels, cholesterol levels and blood clotting indicators. Recommended for daily fresh consumption as a seasoning or tea base.
Forbidden foods for diabetes
Today, doctors try not to strictly restrict patients with diabetes and not to impose strict limits on allowed and forbidden 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 those affected still have to eliminate from their diet. In fact, anyone who cares about their health is recommended to exclude the following list from their diet.
Sweet
Sugar and all products that contain it in excess are on the black list. We have to forget about ice cream, chocolate, jam, jam, sweets, preserves, halva and other sweets.
bakery
Sweet baked goods are prohibited: muffins, cookies, rolls, white bread and bread.
Greasy food
These dishes can significantly increase 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 products
They contain a variety of flavors, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial cutlets, dumplings, sausages and sausages.
Trans fats
Their consumption harms not only a diabetic, but also a healthy person. Banned products include margarine, confectionery shortening, spreads, French fries, hot dogs and burgers.
fruit
Eating certain fruits and dried fruits that cause a sharp rise in blood sugar is not recommended. These include dried apricots, dates, figs, raisins, persimmons, melons, grapes, bananas.
Table number 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 contains:
- 300 g fruit;
- 80 g vegetables;
- 100 g mushrooms;
- 1 TBSP. natural fruit juice;
- 300 g of meat or fish;
- 200 g low-fat cottage cheese, 500 ml fermented milk products;
- 100-200 g bran, rye, wheat bread mixed with rye flour or 200 g grain (ready), potatoes;
- 40-60g fat.
Main course
- Soups: Vegetable, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, fish or light meat broth, mushroom soup with cereals and vegetables.
- poultry, meat: rabbit, veal, chicken, stewed, minced, boiled, turkey.
- Fish: Pike perch, navaga, cod, pike and lean seafood, stewed, stewed, boiled, baked in juice.
- Snacks: vegetable mix, vinaigrette, jellied dietary fish and meat, vegetable caviar, unsalted cheese, seafood salad with butter.
- sweets:Desserts made from berries, fresh fruit, berry mousse, sugar-free fruit jelly, sugar-free jam and marmalade.
- Egg dishes: soft-boiled eggs, egg white omelet, in dishes.
Other Diet Strategies for Diabetes
Of course, it should not be forgotten that all diets are drawn up strictly individually, taking into account the patient's age and gender, as well as his level of physical activity.
Therefore, today there are several options for nutritional strategies for diabetes. If normalization of body weight is required in a patient with type 2 diabetes mellitus, this has proven itself well.Mediterranean cuisine, 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 higher in carbohydrates and consist mainly of complex carbohydrates.
- light dinner consisting of lean protein and vegetables;
- During the day you need to eat more than 1 kg of various vegetables and herbs;
- It is important to follow a drinking schedule - at least 7-8 glasses of water per day.
The main sources of fat in the diet are– unrefined olive oil, sometimes you can also 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 major impact on preventing atherosclerosis, improving insulin sensitivity and helping immune cells recognize and suppress inflammation.
Carbohydrates in the Mediterranean diet are predominantly complex with a low glycemic index - durum wheat pasta, beans, rice, lentils, coarse bread, vegetables and seasonal fruits.
Protein is available in the form of low-fat soft cheese, eggs, fish, seafood and rarely poultry.
Another diet option for diabetes isLCHFand keto diet. The core of this nutritional strategy is to eat low carbohydrates and high fat. On a fatty diet, carbohydrates 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;
- yeast bread, pastries;
- cereals, porridges, flakes and breakfast cereals;
- skimmed milk, kefir, yogurt;
- sweet curds;
- 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, blood sugar levels begin to rise sharply and, accordingly, insulin levels sharply transport glucose to the muscles, liver and fat cells, that is, insulin is "responsible for our obesity". In addition, proteins can increase insulin levels just as well as carbohydrates. And fats do not increase insulin levels at all, which is good for insulin resistance and, if necessary, improves the sensitivity of cells to insulin.
Diabetes mellitus in children
Diabetes mellitus in children can be caused by a hereditary predisposition, poor nutrition, including excessive consumption of simple carbohydrates and sweets, but the disease can also occur as a result of psychological or physical trauma. The treatment of diabetes in children and adults consists of a therapeutic diet and the administration 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 fruits, meat, poultry and fish. It is advisable to give milk and cottage cheese with a low fat content, provided the child does not have intolerance to cow's milk protein. When cooking meat or fish, you can use spices to promote better protein absorption.
All confectionery, sweets, grapes, apricots, rice, baked goods, cookies and prunes should be excluded. Parents of a child with diabetes need to learn to calculate the consumption of bread units when feeding the child and calculate the required dose of insulin. These skills must also be taught to the child as early as possible.
Gestational diabetes mellitus
One more thingtype of diabetes– Gestational diabetes mellitus in pregnant women, which is quite common today.
Increased blood sugar during pregnancyand is one of the most common metabolic disorders in expectant mothers. The so-called gestational diabetes mellitus or diabetes of the pregnant woman is a type of diabetes that occurs 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 effects of insulin, increases sharply. As a result, blood sugar levels rise in pregnant women. High blood sugar levels during pregnancy negatively affect both the health of the woman herself and the health of the fetus and therefore require timely diagnosis and subsequent correction.
Women are particularly at risk:
- Overweight or obese (BMI greater than 25 kg/m).²– the risk doubles, over 30 – triples);
- with multiple pregnancy;
- after IVF;
- with polycystic ovaries;
- with a sharp gain in weight during a real pregnancy;
- with glucosuria (glucose in the urine);
- have close relatives with diabetes;
- with a burdened previous pregnancy - GDM, birth of a large fetus, intrauterine fetal death.
Gestational diabetes is not only dangerous for the mother, it also affects the health of the unborn child. So, at the age of 4-5, the probability that such children suffer from overweight and obesity is several times higher, at the age of 10-11 - increased blood pressure, in adolescence the risk of developing diabetes is 20-40%, the risk of developing non-alcoholic fatty disease increases significantly in the liver.
If GDM is not detected in time or the expectant mother does not take measures to treat it, thenthe risk increases significantly:
- premature aging of the placenta and, as a result, delayed development of the fetus;
- premature birth;
- polyhydramnios;
- Formation of a large or 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 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 life sentence, but simply imposes certain dietary and physical activity obligations. Proper and balanced nutrition is of utmost importance in any type of diabetes. And although reducing carbohydrates and saturated fats in the diet contributes to weight loss, an excess of which type 2 diabetics often suffer from, it is very important to change the lifestyle itself and eating habits. And if in type 2 diabetes a good effect in lowering blood sugar levels is achieved not only by properly selected foods, but also by a set of physical exercises that help improve the transport function of glucose into muscle cells, then playsDiet plays a leading role in type 1 diabetes.