Currently, diabetes is a global problem. Over the past ten years, the number of people with diabetes has more than doubled and reached 425 million, and according to forecasts, their number may reach 629 million by 2045.
DiabetesA group of endocrine diseases that are associated with a disturbance in the absorption of glucose and develop as a result of an absolute or relative absence of the hormone insulin, which leads to the development of hyperglycemia - a persistent increase in blood sugar. 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; fat, protein, mineral and water-salt metabolism is also disturbed.
Let's look at the causes of the disease. Type 1 diabetes is characterized by the destruction or destruction of pancreatic cells. This usually leads to absolute insulin deficiency. Both genetic and environmental factors play a role in the development of type 1 diabetes - viral infections, nutrition, toxins, hygiene. Type 2 diabetes mellitus is characterized by the development of insulin resistance and relative, but not absolute, insulin deficiency, and persistent hyperglycemia is manifested. The main problem with any type of diabetes is an increase in blood sugar and carbohydrate starvation of the cells, since glucose cannot enter, but floats idly in the blood.
The treatment of diabetes mellitus is based on dietary therapy. The general principles of nutrition, regardless of the type of diabetes, are that the patient is advised to reduce the carbohydrate load of the diet to 5-7% and increase the consumption of vegetable fats. In the past, diabetics were advised to completely avoid simple carbohydrates, but now more and more emphasis is being placed on personalized diets, with individual selection of food baskets and calorie calculation. At the moment, the slogan is very popular: "Diabetes has no limitations, only the right lifestyle exists. ""
The diet of diabetics is based on the glycemic index. This index essentially reflects the speed with which the sugar from them is absorbed into the blood. Products with a high index - jam, cakes, cookies - have a high absorption rate. Products with a low index - cereals, fruits - have a lower index. The slower the absorption, the easier it is for the pancreas to cope with the load. Thus, foods with a GI of up to 55 gradually break down and almost do not cause a sugar increase.
Don't forget about the insulin index of foods, which reflects the amount of insulin raised as a result of food consumption. The insulin index of food is important for diabetics to take into account in order to predict the body's reaction when eating certain foods and to correctly calculate the dose of insulin preparations (short and long-acting) to be injected after a meal.
Any meal, even protein, causes 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 later leads to type 2 diabetes. Everyone's favorite snacks in the form of dairy and fermented milk products like cottage cheese, kefir, and yogurt have a very, very high insulin index, which means your insulin swings fluctuate wildly with your mood and irritability.
Consider the different options and features of the diet depending on the type of diabetes.
Basic nutritional rules for type 1 diabetes
You should almost completely avoid foods containing 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 the diet that raise blood sugar levels reduces the need for medication. Eating the same amounts as before switching to a low-carb diet can cause hypoglycemia. When starting the diet, your blood sugar level should be measured regularly, and the medication dose should be adjusted accordingly.
The daily calorie intake is divided into 4-5 meals during the day. According to the BJU ratio, the distribution looks like this: proteins make up 20-25% of the total diet, fats - 30%, of which saturated fats make up no more than 10%, carbohydrates 45-50%.
Basic nutritional rules for type 2 diabetes
In the case of non-insulin-dependent variants of the disease, more serious restrictions are necessary. This is due to the fact that this form usually appears against the background of obesity, and not only high glucose levels, but also insulin can be found in the blood. Very often, however, insulin resistance, which can subsequently lead to type 2 diabetes mellitus, does not appear in any way for a very long time, and even people with insulin resistance are not always overweight, but glucose levels. the blood is constantly kept at a high level and This situation has very sad consequences. Dietary nutrition for type 2 diabetes helps restore cells' ability to absorb sugar and helps restore cells' insulin sensitivity.
The type 2 diabetes diet is based on key principles:
- Plenty of vegetables– The amount of vegetables consumed may depend on age, gender and the frequency of weekly exercise. As a general rule, women who exercise 30 minutes a day should eat at least 500 grams of vegetables a day. 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 and 1000 grams.
- Unsaturated fats- the presence of an adequate amount of polyunsaturated and monounsaturated fats in the diet helps to keep the cholesterol level within normal limits and reduces the risk of cardiovascular diseases, one of the most common long-term complications of diabetes. Unsaturated fats are found in many foods, including nuts, avocados, fatty seafood, 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 substances added to ensure a long shelf life. Regular consumption of such foods can negatively affect the health of a diabetic.
Healthy foods for diabetes
Green leafy vegetables
Spinach, kale, and bok choy are low in calories but rich in nutrients like vitamin C, beta-carotene, and magnesium that help prevent diabetes. One serving per day (approx. 106 g) reduces the risk of developing type 2 diabetes by 14%.
They are legumes
These fiber-rich foods can help stabilize 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 and reducing the risk of cardiovascular diseases. The body needs Omega 3 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, as it is full of monounsaturated fatty acids. These fats (also found in large quantities in nuts) are important in the prevention of diabetes, as they help the body to effectively regulate blood sugar levels.
Nuts
As a source of monounsaturated fatty acids, walnuts are rich in magnesium, another important nutrient. Global research shows that people who regularly eat nuts have a lower rate of diabetes.
Citrus fruits
All citrus fruits contain antioxidants - great helpers in maintaining blood insulin balance.
Whole grains
Eating whole grain bread, quinoa and brown rice reduces the risk of developing diabetes. Whole grains are rich in fiber, which helps the body regulate blood sugar levels. Complex carbohydrates are a kind of buffer that protects us from high blood sugar levels, 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, that is, it helps to improve the insulin sensitivity of cells. The spice helps with high blood pressure (chronic high blood pressure), when used systematically in the necessary doses, it reduces blood sugar concentration, improves general well-being, and has a positive effect on metabolic processes.
Ginger
It is a catalyst of metabolic processes, reduces sugar levels, cholesterol and blood clotting indicators. We recommend it for daily consumption fresh, as a spice or as a tea base.
Forbidden foods in case of diabetes
Today, doctors try not to strictly restrict diabetics and do not force them into 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 many foods that people with this disease must still eliminate from their diet. In fact, the list below is recommended for anyone who cares about their health to eliminate it from their diet.
Sweet
The blacklist includes sugar and all products that contain excessive amounts. We must forget about ice cream, chocolate, jam, marmalade, sweets, preserves, halva and other sweets.
Bakery
Sweet baked goods are prohibited: muffins, cakes, buns, white loaves and bread.
Fatty foods
These foods can greatly increase glucose levels. 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.
Half-done products
They contain a large number of flavorings, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial slices, dumplings, sausages, sausages.
Trans fats
Their consumption is harmful not only to diabetics, but also to healthy people. Prohibited products include margarine, shortening, spreads, French fries, hot dogs and hamburgers.
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 hospital and home treatment.Table No. 9 contains it:
- 300 g of fruit;
- 80 g of vegetables;
- 100 g of mushrooms;
- 1 tablespoon. natural fruit juice;
- 300 g of meat or fish;
- 200 g low-fat cottage cheese, 500 ml fermented milk products;
- 100-200 g of bran, rye, wheat bread mixed with rye flour or 200 g of cereals (ready), potatoes;
- 40-60 g of fat.
Main dishes
- Soups: vegetable, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, fish or light meat soup, mushroom soup with cereals and vegetables.
- Poultry meat: rabbit, veal, chicken, steamed, chopped, boiled, turkey.
- Fish: perch, navaga, cod, pike and lean seafood, steamed, steamed, boiled, fried in juices.
- Snacks: mixed vegetables, vinaigrette, jellied diet fish and meat, vegetable caviar, unsalted cheese, seafood salad with butter.
- Sweetness
: berry desserts, fresh fruit, berry foams, sugar-free fruit jelly, sugar-free jam and marmalade. - Egg dishes: soft eggs, egg white omelets, in foods.
Other Dietary Strategies for Diabetes
Of course, we must not forget that each diet is compiled strictly individually, taking into account the age and gender of the patient, as well as the level of physical activity.
Thus, there are now many options for a diabetes diet strategy. If it is necessary to normalize the body weight of a patient with type 2 diabetes mellitus, it is well proven.Mediterranean diet, which is based on daily physical activity.
The principles of the diet a:
- fractional meals 5 times a day - 3 main meals and 2 snacks;
- breakfast should be richer in carbohydrates, consisting mainly of complex carbohydrates;
- a light dinner of lean protein and vegetables;
- During the day, you should eat 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 a– unrefined olive oil, sometimes we can use sesame seeds, rapeseed, peanuts. 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 an enormous effect on the prevention of atherosclerosis, improve insulin sensitivity, and help immune cells detect and suppress inflammation.
The carbohydrates in the Mediterranean diet are predominantly complex, with a low glycemic index - durum wheat pasta, beans, rice, lentils, wholemeal bread, seasonal vegetables and fruits.
Protein is presented in the form of low-fat soft cheeses, eggs, fish, seafood, and rarely poultry.
Another dietary option for diabetesLCHFand keto diet. The essence of this diet strategy is to consume low amounts of carbohydrates and high amounts of fat. The carbohydrate content of high-fat diets is limited to 50 grams per day, and in the case of 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, porridge, flakes and breakfast cereals;
- skimmed milk, kefir, yogurts;
- sweet cottage cheese;
- margarine.
In the LCHF diet, insulin is a dangerous thing, because after we eat a carbohydrate-rich meal, the carbohydrates break down into glucose, the blood sugar level begins to rise sharply, and accordingly, the insulin level increases greatly in order to transport glucose to the muscles, liver and fat cells, that is, insulin"responsible for our obesity". In addition, protein can increase insulin levels just like carbohydrates. And fats do not increase insulin at all, which is good for insulin resistance and, if necessary, improves the insulin sensitivity of cells.
Diabetes mellitus in children
Diabetes in children can be caused by a hereditary tendency, improper nutrition, including the consumption of excessive amounts of simple carbohydrates and sweets, and the disease can also develop as a result of mental or physical trauma. Treatment of diabetes in children and adults consists of a therapeutic diet and insulin administration to treat 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 advisable to give milk and cottage cheese that have a low fat content, provided that the child is not sensitive to cow's milk protein. When cooking meat or fish, you can use spices to promote better absorption of the protein.
All confectionery products, sweets, grapes, apricots, rice, baked goods, biscuits and plums must be excluded. Parents of children with diabetes should learn how to calculate the consumption of bread units when feeding the child and calculate the required dose of insulin. The child himself should be taught these skills as early as possible.
Gestational diabetes mellitus
Anothertype diabetes– gestational diabetes mellitus in pregnant women, which is quite common nowadays.
Women are particularly at risk:
- overweight or obese (BMI more than 25 kg/m²– the risk doubles, over 30 – it triples);
- with multiple pregnancies;
- after IVF;
- with polycystic ovaries;
- large weight gain during the actual pregnancy;
- with glucosuria (glucose in the urine);
- close relatives with diabetes;
- burdened by a previous pregnancy - GDM, birth of a large fetus, intrauterine fetal death.
Gestational diabetes is not only dangerous for the mother, but also affects the health of the unborn child. Thus, at the age of 4-5, such children are often overweight and obese, at the age of 10-11 - increased blood pressure, the risk of developing diabetes in adolescence is 20-40%, the risk of developing non-alcoholic fatty liver disease increases significantly.
If GDM is not detected in time or the expectant mother does not do anything to treat it, thenthe risk increases significantly:
- premature aging of the placenta and, as a result, delayed fetal development;
- premature birth;
- polyhydramnios;
- the development of a large or disproportionate or edematous fetus;
- increased blood pressure, preeclampsia;
- the need for caesarean section;
- traumatizing women and children during childbirth;
- hypoglycemia (low blood sugar) and breathing problems in newborns;
- 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, but only imposes certain obligations on a person in relation to diet and physical activity. Proper, balanced nutrition is extremely important for all types of diabetes. And although reducing carbohydrates and saturated fats in the diet contributes to weight loss, which type 2 diabetics often suffer from, it is very important to change the lifestyle and eating habits themselves. And if in type 2 diabetes not only properly selected foods, but also physical exercises aimed at improving the transport of glucose into muscle cells have a good effect on lowering blood sugar, then in type 1 diabetes nutrition plays a role. leading role.