Goals of Diabetes Management
The three cornerstones of diabetes management are diet, physical activity and medication if needed (i.e., insulin or oral glucose-lowering agents). Food raises blood glucose and blood fat levels. Activity and medications lower blood glucose and blood fat levels.
Key principles are:
• Diabetes management should consider nutrition, physical activity and pharmacologic therapies.
• Achieve weight control through reducing calories
• Reduce intake of dietary fat (specifically saturated fat)
• Individualize guidelines for carbohydrates based on the type of diabetes you have and the control of your blood sugar levels.
With type 2 diabetes, the main focus is on weight control, because 80% to 90% of people with this disease are overweight. A meal plan, with reduced calories, even distribution of carbohydrates, and replacement of some carbohydrate with healthier monounsaturated fats helps improve blood glucose levels. Examples of foods high in monounsaturated fat include peanut or almond butter, almonds, walnuts, and other nuts. These can be substituted for carbohydrates, but portions should be small because these foods are high in calories.
The diet for diabetes does not mean a ‘sugar free’ diet. Sugar can be eaten as part of a balanced, healthy diet without having a harmful effect on blood glucose control. However, you should still try to cut down on sugary foods and drinks since eating them has implications for tooth decay, weight control and the overall balance of your diet.
Blood glucose control depends on diabetes medication and lifestyle factors, such as how much activity you do as well as what you eat.
As we are all different in terms of our nutritional needs, the limits are different too. Lots of foods contain sugar – natural or added – and it is the overall food choices you make, rather than just one food, that will determine whether you are eating a healthy diet.
People with diabetes can eat any kind of fruit, regardless of the sugar content. Everyone is encouraged to eat at least five portions of fruit and vegetables every day. Spreading the fruit you eat through the day will avoid a sudden rise in blood glucose levels. Although some fruits have a lower glycaemic index, which shows how foods affect blood glucose levels, the important thing is to increase the amount of fruit you eat, including a wide variety of different fruits.
How can I keep my blood glucose at a healthy level?
• Eat about the same amount of food each day.
• Eat your meals and snacks at about the same times each day.
• Do not skip meals or snacks.
• Take your medicines at the same times each day.
• Exercise at about the same times each day.
Diabetes - Diet: Recommendations
Reduce the amount of dietary fat.
The old approach to diabetes was to focus on eliminating refined sugars and foods that turned into sugars—starches, breads, fruits, etc.—from the diet. The rationale was based on the fact that diabetics' urine contains sugar. Unfortunately, with all of the complex carbohydrates eliminated, fat and protein are all that is left in the diet.
The new approach focuses more attention on fat. Fat is a problem for diabetics. The more fat there is in the diet, the harder time insulin has in getting sugar into the cell.
In persons with diabetes there are two primary goals for fat consumption: limit saturated fat and dietary cholesterol.
Saturated fat is linked to low density lipoprotein (LDL) cholesterol levels. It is recommended that less than 10 percent of calories should come from saturated fat. Total fat should be 15 percent of total calories
Carbohydrate choices should come from whole grains breads, cereals, pasta, brown rice, beans, fruits and vegetables. Increasing dietary fiber is a general guideline for the entire population rather than specifically for people with diabetes.
Keep protein intake in the range of 15-20% of total calories
Protein intake accounts for 15 to 20 percent of total daily calories consumed among the general population as well as those with diabetes
Sugar. It was previously believed that simple sugars are more rapidly digested and absorbed than starches, and therefore are more likely to cause high blood sugar level.
AVOID THESE FOODS
Below is a list of foods to avoid. Some will be obvious – others less so.
• Sugar and artificial sweeteners, including honey. The only allowed sweetener is stevia. (Sugar is a problem as it is addictive. I suggest you cut down gradually until you can do without. The other option is to go 'cold turkey' and stop it altogether. This will give you withdrawal symptoms, just like stopping any other addictive drug. But this will wear off within about two weeks.)
• Sweets and chocolates, including so-called sugar-free types. (If you want a chocolate treat, say once a week, then eat Continental dark chocolate with 70% or more cocoa solids, not the British stuff where sugar is the first named ingredient.)
• Grains and foods made from them: wheat, rye, barley, corn, rice, bread, pasta, pastry, cakes, biscuits, pies, tarts, breakfast cereals, et cetera.
• Sweetened, fruit and low-fat yogurts
• Cottage cheese (except in small amounts)
• Drink less alcohol
• Beware of commercially packaged foods such as TV dinners, "lean" or "light" in particular, and fast foods, snack foods and "health foods".
Now that you think there is nothing left to eat, these are foods you can eat:
• Include the organ meats: liver, kidneys, heart, as these contain the widest range of the vitamins and minerals your body needs (weight for weight, liver has 4 times as much Vitamin C as apples and pears, for example);
• All poultry: chicken (with the skin on), goose, duck, turkey, etc. But be aware that turkey is very low in fat, so fat needs to be added.
• Eggs (no limit, but avoid "omega-3 eggs" as these have been artificially fed which upsets the natural fatty acid profile)
• All cheeses (except cottage cheese as this has a high carb content and very little fat)
• All animal and meat fats – without restriction – never cut the fat off meat.
• Fish and seafood of all types
• Vegetables and fruits as allowed by carb content.