Diabetes is a metabolic disease, i.e. a metabolic disease. In people with type 2 diabetes, carbohydrate metabolism is disturbed due to insulin resistance. Therefore, patients must pay close attention to the amount and quality of carbohydrates (i.e. sugars) in the diet, because they have a direct impact on blood sugar levels. To put it simply – eating too much carbohydrate will lead to hyperglycemia. But carbohydrates are not the only food ingredient to look out for, and glucose is not the only parameter that determines the effectiveness of treatment in type 2 diabetes.
The approach to diabetes in nutrition has changed over time. When it was not yet known what the reasons for diabetes were and the exact mechanisms of its formation, diets were promoted that were more harmful than helpful, such as eating large amounts of carbohydrates to make up for the sugar deficiencies that the body lost in urine. When the nature of diabetes was thoroughly understood, it became clear that carbohydrates are the nutrient that you need to pay the most attention to. Because they directly lead to hyperglycemia, the main “problem” in diabetes. It is currently believed that the diet of diabetics should not depart from the principles of healthy recovery of people without diabetes – you should eat regularly and varied, rather smaller portions and more often (to avoid large breaks between meals), meals should be varied and high in fiber.
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The importance of diet in type 2 diabetes
Every patient with type 2 diabetes should pay attention to what they eat, but not everyone has the right diet to regulate blood sugar levels. At the initial stage of developing type 2 diabetes, a change in diet and increased physical activity are often sufficient to stabilize glycemia. This is called behavioral therapy, i.e. treatment consisting in lifestyle modification. For diabetics using behavioral therapy, diet and activity are crucial because they have no other “tools” for lowering sugar levels.
When treatment with diet and physical activity becomes ineffective, the patient begins to take medication. The so-called medicine The first line of type 2 diabetes is metformin (which increases tissue sensitivity to insulin), which is over time joined by drugs with other mechanisms of action: sulfonylureas, incretin drugs, and flosins. When combining different preparations with different mechanisms of action becomes ineffective, insulin is introduced into the treatment – first only basal insulin, with time insulin to meals. At the stage of drug treatment, when oral hypoglycaemic drugs regulate glycemia, diet is still very important. The drug doses are constant, adapted to a healthy diet with a moderate supply of carbohydrates. If you are taking medicine but are not following a diet, they will not work effectively (the patient will experience hyperglycemia). In other words, the medication is enough when the patient is on a diet, but they stop working when the patient does not.
At the stage of insulin therapy in type 2 diabetes, blood sugar levels depend on the dose of insulin. The role of healthy eating at this stage is primarily to maintain a healthy weight or reduce it if the patient is overweight or obese.
In type 2 diabetes, the main goal of therapy is to maintain optimal metabolic control of the disease, reduce excess body weight and maintain the desired body weight of the patient – emphasizes the Polish Diabetes Association, and as we know, excessive weight affects the vast majority of patients with type 2 diabetes. Therefore, a healthy diet for a patient with type 2 diabetes it must take into account the total caloric content of the diet, adjusted to the age, current weight and physical activity of the diabetic.
Weight reduction in patients with type 2 diabetes should be slow but systematic (0.5-1 kg per week). Test results confirm that a reduction of at least 5% in body weight compared to baseline weight results in measurable improvement in glycemic control.
Carbohydrates, protein and fats in the diabetic diet
Carbohydrates are the main source of energy for diabetics, they should cover about 45 percent. caloric demand. A higher supply of carbohydrates (up to 60%) is possible in patients who have high physical activity and when the carbohydrates consumed are high in fiber. The best source of carbohydrates for diabetic patients are whole grain cereal products with a low glycemic index (cereal, wholemeal bread, whole grain pasta). The consumption of simple, monosaccharides and disaccharides (honey, fruit, fruit juice, milk) should be kept to a minimum.
The proportion of fats in the diabetic diet should be as in healthy people and may range between 25-40 percent. caloric content of the diet, while paying attention to the type of fat consumed. Saturated (animal) fats should constitute less than 10 percent. the energy value of the diet monounsaturated fats should provide up to 20 percent. energy value of diet; polyunsaturated fats should constitute about 6-10% energy value of diet.
For most people with diabetes, just like in the general population, the share of energy from protein in the diet should be 15-20%. (approx. 1-1.5 g / kg / day). In patients with type 2 diabetes with excessive body weight, a low-calorie diet may contain as much as 20-30%. protein.
What to eat with diabetes?
Patients with type 2 diabetes should eat 5 meals a day (breakfast, 2 breakfast, lunch, afternoon tea and dinner), and the intervals between them should not be longer than 3 hours. The body is much better at sugar management if carbohydrates are supplied to it regularly, but at short intervals. For glycaemia and body weight, it’s much better to have lunch, afternoon tea and dinner instead of one large dinner. Five meals, which in total should not exceed the recommended number of calories per day for a sick person usually mean that they are small. Such a meal, and not a “nothing significant snack” will therefore be small natural yogurt and 5 strawberries, which can be successfully eaten in under 2 breakfasts.
The variety of diet and individual dishes is very important. Above all, avoid carbohydrate-only meals. Even complex sugars, but consumed “solo” are absorbed much faster than the same sugars in the presence of fat and protein. Therefore, composite meals increase blood sugar levels more slowly.
A simple rule to keep in mind is: vegetables with every meal. The vast majority of vegetables are low in calories and have a low glycemic index, and at the same time are rich in fiber , which should not be missing in the diet of diabetics. A healthy afternoon snack for diabetics will be a glass of vegetable juice with crispbread, and a healthy dinner of stewed vegetables with a small amount of pearl barley. In the off-season for fresh vegetables, it is worth learning how to prepare frozen food, which is not lacking in stores, and they are not at all a defective product. On the contrary, freezing is the healthiest method of preserving food. Various mixtures or solo vegetables should be boiled or stewed in a small amount of fat, as a healthy addition to lunch or dinner, or as an afternoon tea.
While vegetables are very desirable in the diabetic’s diet, it is much more cautious to approach fruit that is rich in sugar and simple fructose. As recommended, a person with diabetes can eat up to 300 grams of fruit per day, preferably divided into 2-3 portions.
Diabetics should limit the amount of salt consumed to 5 g per day. And this means that you shouldn’t add anything practically, because we supply the recommended amount with ready-made products – mainly bread and cured meat. In order not to overdo it with salt, it is worth learning to experiment with herbs that, although they do not replace salt in 100%, will allow you to significantly reduce it.