Diabetic Diet

What is it ?

Diabetes is a disorder where the level of sugar (glucose) in the blood is raised above normal. There are two types of diabetes. In type 1 (insulin dependent diabetes) insulin injections are essential. Type 2 (non-insulin dependent diabetes can be controlled either by diet alone or with additional tablets, although some patients require insulin. Diet is of utmost importance for both types.

What is it used for ?

The main aim of the diet is to try and keep your blood sugar level as near normal as possible. In this way the risks of any of the long-term problems of diabetes are reduced. The benefits of good control are seen in the eyes, nerves and kidneys. Diet also influences the condition of the main arteries which supply blood to heart muscle and the brain. Getting the balance of foods correct can therefore reduce the risk of heart attack and stroke. In diabetes, diet is one of the positive things which you can personally influence. All it takes is for you to make a few simple lifestyle changes.

How does it work ?

Are there foods that I can eat that will not affect my blood sugar? The main groups of foods that you can eat without worrying are vegetables and fruit. In fact, their vitamins may help protect your heart. Within this food group, pulse vegetables such as lentils, black-eyed beans, chick peas, moong beans, haricot beans, butter beans, red kidney beans and even baked beans can actually reduce the amount of sugar in the blood if you eat them regularly. Eat as much fruit as possible, too. Try and become used to having fruit for your snacks or when feeling hungry rather than nibbling on things like biscuits that have a high fat content. Drinks such as water, soda water, tea and coffee without sugar, and sugar free squash and diet drinks are all fine. Feel free to use artificial sweeteners, if you need them. You should not be afraid to eat starchy foods. Bread, breakfast cereal, potatoes, rice, pasta, green banana, yam and chapatti, should form the main basis of your meals. Some of these starchy foods seem to help control the blood sugar. You should try and eat these foods as regularly as possible. All types of fish are very good for you, and there is evidence to suggest that oily fish such as mackerel, sardines, pilchards, salmon and herring benefit your heart. Why cut down on fat? Probably the most important thing you should do is to try to cut down on your fat and oil intake. One of the major aims of the diet is to reduce the risk of heart disease. Animal fats and oils are bad for your heart, since they lead to hardening of the arteries (arteriosclerosis). If a check of your blood fat levels shows high values of cholesterol, such fat restriction will be even more important: you may need fat-lowering tablets as well. Fat is also very high in energy. Reducing your use of fats and oils will help you lose weight.

What foods are high in fat? There are the visible fats that you can see in or on foods, such as cooking oils. These include all the vegetable oils, ghee, lard, butter, margarine, meat fat and dripping. There are also the foods that have hidden fats such as biscuits. In general you should try and cut down on fried foods and snacks such as samosas, and high fat foods that come from "take-aways". You should try and remove the fat from your meat, and use less butter, margarine and ghee in your food. Try a low fat spread instead. Try and encourage your family to move from using full fat milk to a lower fat milk, such as semi-skimmed or skimmed milk and reduce the amount of cheese that you eat. Make yoghurt using skimmed milk or buy low fat types. Cream and chocolate covered biscuits and cakes should only be eaten on special occasions, as should pies and pasties. Which foods should I avoid completely? There are no hard and fast rules. You should attempt to reduce the amount of sugar in your diet, particularly if you are overweight. If you must eat foods which are high in sugar, such as sugar itself, chocolates, sweets, jams and honey, cakes and puddings, tinned fruit in syrup, ordinary squashes and fizzy drinks such as colas, Lucozade, then try and have them together with other foods. In general it is better for your overall health and diabetic control if you can avoid sugar and sweet foods.

What does the diet involve ?

There are six important points to consider. FIRSTLY, if you are overweight, then losing even a small amount can have a dramatic effect in reducing your blood sugar level. You may even notice an effect on your blood glucose level just from beginning to diet; before there is even any weight loss. SECONDLY, it is important to eat regularly. At a minimum this means breakfast, lunch and your evening meal. Some people who are having insulin need snacks between meals: check with your doctor or dietitian on this point. Without the snacks the blood sugar may fall to very low levels in between the main meals. A bed-time snack is essential for everybody who takes insulin: it reduces the risk of a low blood sugar attack (hypo) at night. In general, for people with insulin-dependent diabetes eating more frequently improves blood sugar control. In non-insulin dependent diabetes, snacks tend to make you put on weight. Your dietitian will advise you whether a bed-time snack is needed. THIRDLY, eat more fibre-rich foods oats, beans, dahl and pulses can help control your blood sugar, lower the blood fat levels and give you more regular bowel movements too. FOURTHLY, try to include vegetables and fresh fruit at each of your meals this is important in trying to protect your heart. FIFTHLY, cutting down the fat in your food will help protect your heart. Cutting down on the amount of sugar you eat will make your blood sugar easier to control. Also cut down on your salt intake. This will help if you have a tendency to high blood pressure. Cut down on any alcoholic drinks. They give you calories which you do not need. Drinking alcohol on an empty stomach can also make you prone to hypos. LASTLY, do not cut down on starchy foods such as bread, chapatti, rice, pasta and potatoes. Many people believe that if you have diabetes, you should eat less of these foods. That is not the case, you should carry on enjoying these foods in the amounts you currently eat them. Remember; if you are on insulin, you should always carry some sugar lumps or Dextrosol with you, in case of a hypo .

What to watch out for …

Although all these principles are important, it is understood that you will need to "let go" occasionally. A party or celebration can be enjoyed by you as well! If you do eat more on occasions and you are taking insulin, do remember to raise the dose. Your doctor, nurse or dietitian will advise on how much you may need to give.

What if not followed ?

Damage is more likely to occur to the eyes, kidneys, nerves and heart and arteries generally. Never hesitate to contact your dietitian: he or she is there to help you.