What should you eat if you have diabetes?
In the metabolic disease diabetes mellitus, the body lacks the hormone insulin or its effect is reduced. As a result, there is a risk that the blood sugar level in the blood rises too high. To prevent this, the diet of people with diabetes plays an important role. It also depends on the type of diabetes.
The right diet for type 1 diabetes
Patients with type 1 diabetes must first learn to correctly assess the carbohydrate content of a planned meal. This is the only way to inject the correct amount of insulin required to utilize the nutrients. If too little insulin is injected before a meal, there is a risk of hyperglycemia. If the dose of insulin is too high, the blood sugar drops too low, leading to hypoglycemia. Both hyperglycemia and hypoglycemia are potentially dangerous.
The correct insulin dose depends on the type and amount of carbohydrates consumed. Wholemeal products, for example, contain more long-chain or complex carbohydrates, which require lower insulin levels than short-chain carbohydrates, which enter the bloodstream more quickly. The latter are found in white flour products and sweets, for example.
Diabetes patients are recommended to undergo diabetes training and individual nutritional advice after diagnosis. In addition to other content, it teaches everything important about proper diabetes nutrition.
The right diet for type 2 diabetes
In type 2 diabetes mellitus, the body’s cells only respond to a reduced extent to the blood sugar-lowering hormone insulin. This insulin resistance is favored by being overweight. This means that the correct diabetes diet for overweight type 2 diabetics is aimed at weight loss. Regular physical activity helps to achieve this goal. If the excess kilos can be shed, insulin resistance is often reduced and the amount of insulin available works better again.
The diabetes mellitus diet for overweight people should therefore be as calorie-reduced as possible. Patients can find out how many calories are “allowed” per day from their dietician.
Which foods should be avoided?
In principle, no foods are completely forbidden for people with diabetes mellitus. But there are foods that are better for their health than others. With type 1 diabetes, it is important to balance the intake of carbohydrates with insulin. Type 2 diabetics need to avoid foods that are high in calories because they may be overweight.
The same applies to diabetics as to healthy people: sweets should only be included in the diet in small quantities. It is also important to be aware of the hidden sugars in foods and convenience products. Ketchup, fruit yoghurt and muesli, for example, are not primarily classified as sweets, although they often contain a lot of sugar. This must be taken into account in the diabetes diet.
A particular problem with many sweets is the combination of sugar and fat: the body does not metabolize sugar and fat at the same time. The sugar is therefore first converted into energy and burned, while the fat is stored in the tissue and promotes obesity.
Sweeteners (such as stevia) & diabetes
There are some alternative sweeteners that are often recommended in the diet of diabetics – instead of refined sugar because they do not raise blood sugar levels or raise them less. Sweeteners include sugar substitutes and sweeteners.
Sugar substitutes include sorbitol, mannitol, isomalt and xylitol. They contain fewer calories than sugar and only cause a slight increase in blood sugar levels. In contrast, sweeteners (such as acesulfame-K, aspartame, stevia) do not provide any calories and do not increase blood sugar levels.
There is also no evidence to date that sweeteners such as stevia are “addictive” and trigger hunger attacks – possibly leading to weight gain. However, experts point out that products sweetened with stevia sometimes contain added sugar.
You should also be careful not to consume stevia in excess. The EFSA recommends a maximum of four milligrams of steviol glycosides per kilogram of body weight per day (ADI value). This amount is considered safe. The consequences of a possible overdose are unclear.
As a general rule, we should not consume more than the recommended amount of sweetener or a maximum of 50 grams of sugar per day. Eating less sweet also makes things easier for yourself: the body does not get used to the taste and therefore has less of a craving for sweets.
By the way: Diabetes patients who also suffer from the rare metabolic disorder phenylketonuria must not consume aspartame. This is because the sweetener contains phenylalanine. This protein building block (amino acid) is not broken down by the body in phenylketonuria, resulting in symptoms of intoxication. Other sweeteners (including stevia), on the other hand, do not contain phenylalanine. They are therefore a good alternative in the diabetes diet for people with phenylketonuria.
Diabetes and alcohol
Diabetes patients should therefore only consume alcohol in moderation and always in combination with a carbohydrate-rich meal. In this way, hypoglycaemia can be avoided.
Alcohol is also unfavorable for overweight diabetics for another reason: at around 7.2 kilocalories per gram, one gram of alcohol has a similarly high calorific value as fat. This makes it a real calorie bomb. However, being overweight increases the body’s need for insulin due to the increasing insulin resistance of the cells and has a negative impact on diabetes.
Alcohol also promotes nerve damage (polyneuropathies). Existing diabetic polyneuropathy may be exacerbated by alcohol consumption.
Which foods are good for diabetics?
First of all: diabetics, like all people in general, are recommended to eat a balanced, varied and wholesome diet. Macronutrients such as carbohydrates, fats and proteins as well as vitamins and minerals should be included in the diet in sufficient quantities. Less important than lists of the so-called “top 10 foods for diabetics” is the correct composition of the diet – especially with regard to the main nutrients.
What this looks like is a matter of debate among experts. In general, the following recommendations for a healthy diet apply:
- 45 to 60 percent carbohydrates
- 10 to 20 percent proteins (egg whites)
- 40 grams of fiber
- Maximum 6 grams of table salt
- Maximum 50 grams of pure sugar (glucose, sucrose)
Nutritionists give each patient suitable recommendations. These may differ from the above information. This is because the diet plan for diabetics must take into account the patient’s age, body weight and any concomitant and secondary illnesses, such as obesity, kidney damage or high blood lipid levels.
Almost more important than the exact percentage of the various macronutrients is their type and source. For example, wholemeal products are more beneficial than white flour products and vegetable fats are healthier than animal fats.
Diabetes nutrition: carbohydrates
Carbohydrates are sugar molecules that are linked to form more or less long chains. They are very important sources of energy for the human body, especially for the muscles and brain. One gram of carbohydrates has about four kilocalories.
The type of carbohydrate source therefore has a direct impact on insulin requirements. This is because high blood sugar levels, such as those caused by white flour products, chocolate, honey, sweet lemonade and cola or other sugary foods, require higher amounts of insulin in the short term to compensate for the fluctuations. This increases the risk of blood sugar levels getting out of control.
In type 1 diabetics, this happens if the dose or timing of the insulin injection does not exactly match the carbohydrate intake. In type 2 diabetics, whose bodies still produce some insulin, it takes longer for the excess sugar to be absorbed into the cells (prolonged hyperglycemia).
Diabetes patients are therefore well advised to cover their carbohydrate requirements as far as possible with long-chain carbohydrates, such as those found in wholegrain products, potatoes and pulses.
Diabetes diet: fat
As diabetes drastically increases the risk of arteriosclerosis (“hardening of the arteries”), it is important to limit cholesterol intake in the diet of diabetics. Cholesterol is found in all animal products such as milk, butter, cream, eggs and meat. These products should therefore be consumed sparingly. In addition, regular blood tests by your family doctor are advisable, as an elevated cholesterol level can only be detected by a blood test.
Diabetes diet: proteins
Experts recommend covering around 10 to 20 percent of the daily energy requirement with proteins. This recommendation applies if a diabetes patient shows no signs of kidney damage (diabetic nephropathy). However, if kidney weakness is present, protein intake must be limited.
Particularly recommended sources of protein are pulses (such as peas, lentils or beans), fish and low-fat meat.
Diabetes and cinnamon
According to some nutritionists, there are indications that diabetes is favorably influenced by the effect of cinnamon. Cinnamon stimulates the metabolism and may therefore have a positive effect on blood sugar regulation. Experts are also discussing whether a certain component of cinnamon (proanthocyanide) improves the effect of insulin on the cells.
Also good to know: Cinnamon, or rather the coumarin contained in cassia cinnamon in particular, is harmful to health in high quantities, especially to the liver. The German Federal Office for Risk Assessment recommends that an adult weighing 60 kilograms should not eat more than two grams of cinnamon a day.
To date, cinnamon has played no role in evidence-based nutritional therapy for diabetes.
Fruit for diabetics
Diabetes patients are generally recommended to eat enough fruit and vegetables every day. Both provide important vitamins and minerals as well as fiber.
Depending on the variety, fruit also contains varying amounts of fruit sugar (fructose). This has long been considered healthier than normal sugar. This is why many foods for diabetics contain fructose instead of conventional sugar. The same applies to many “normal” products (for non-diabetics).
However, diabetics – just like metabolically healthy people – are advised not to give their bodies too much fructose. This may have a negative effect on health: According to studies, a high fructose intake promotes obesity, for example, and potentially increases blood lipid levels.
