Nutrition for people with diabetes

Even 20-30 years ago, a person’s life with diabetes was full of prohibitions and restrictions: do not eat sweet, fatty, fried, smoked, do not eat white bread, instead of sugar use sorbitol and glucose. Unfortunately, these stereotypes are still alive among people with diabetes and among doctors. Meanwhile, diabetes is not a reason to forget about sweets, fruits and other delicious food. Strict nutrition recommendations are justified only when a person is illiterate in matters of control over his disease. Previously, when training systems did not exist and it was believed that diabetes treatment was a purely medical matter, a prohibition system was the only way to curb hyperglycemia.   However, having proved its inefficiency in type 1 diabetes mellitus, this system has exhausted itself, giving priority to a liberalized (flexible) diet based on training and self-control motivation.  

Being, in fact, different diseases with different causes, type 1 and type 2 diabetes require different approaches to nutrition. 

Why is the phrase that has become commonplace true: “We eat to live, but not live to eat”? As you know, overweight or obesity is the main risk factor for type 2 diabetes. Everything is very simple. When overeating, the caloric content of the daily diet significantly exceeds the energy expenditure, as a result, the extra calories turn into extra pounds. This is exactly the option that happens when a person lives in order to eat, and it is wrong to eat. That is why with type 2 diabetes, an important condition for the correction of hyperglycemia is the normalization of body weight with a low-calorie diet, increased physical activity and, if necessary, the use of tablets of hypoglycemic agents.   

A few simple rules that people with diabetes need to remember:

• Food should be fractional: it is recommended 5-6 times a day in small portions, preferably at the same time.
• Complex carbohydrates (cereals, fruits, vegetables) rich in dietary fiber should be consumed.
• It is necessary to reduce simple, fast-acting carbohydrates in the diet – pastries, sugary sodas, desserts.
• The use of large amounts of fiber (20–40 g per day) is recommended. These are various types of cabbage, carrots, radishes, green beans, rutabaga, bell pepper, eggplant, unsweetened fruits, etc.
• It is necessary to limit the intake of saturated fats (not more than 10%). At least 2/3 of the total amount of fat should be vegetable fats. You should eat low-fat varieties of meat, fish in boiled, baked and stewed form.
• It is necessary to limit salt intake to 3 g / day due to the high risk of arterial hypertension.
• It is recommended to limit the use of alcohol, taking into account its high calorie content and negative impact on the liver (no more than 30 g / day).
• Fast food must be ruled out completely.

Today, all food products must indicate the number of calories, so it’s enough to simply calculate your daily diet. An adult needs an average of 2 to 3 thousand kcal per day. However, it must be remembered that different people need a different amount of calories. According to nutritionists, women’s main metabolism is 5–10% lower than men’s, and old people’s 10–15% lower, than young’s, and, accordingly, less energy is needed.

In type 1 diabetes mellitus, the development of which is associated not with excess body weight, but with damage to the pancreatic beta cells that produce insulin, the main treatment method is insulin therapy. Therefore, the features of the diet for this type of diabetes are associated with the nuances of insulin therapy.  

As you know, food products contain 3 main groups of nutrients: proteins, fats and carbohydrates. But only carbohydrates immediately after eating raise blood sugar. That is why it is important for a person with type 1 diabetes to know how many carbohydrates are ingested with food, since the dose of insulin is calculated based on the amount of carbohydrates. For the convenience of calculating digestible carbohydrates, they use a concept such as a bread unit (XE).  

XE – a kind of measuring spoon for calculating carbohydrates. Regardless of the type and quantity of products, whether it is bread or an apple, 1 XE contains about 10-12 g of carbohydrates. People with diabetes usually know well how many bread units are contained in a particular product, and can independently calculate the required dose of insulin, which must be administered after their use. As a rule, there is one unit of insulin per 1 XE, but this need is strictly individual and can only be determined by constant monitoring of blood sugar level.