In diabetes mellitus, proper nutrition is an important treatment measure. Basically, the modern diabetes diet follows the rules of a healthy diet that also apply to people without metabolic disease. But what does that mean in concrete terms? In many cases, a change in diet and weight loss leads to a significant improvement in blood glucose levels. Fresh fruit, vegetables and salad, legumes, whole-grain rice and pasta, and low-fat dairy products are the basics of a proper diet for diabetics.
Carbohydrates and fiber
In the daily diet consumed, the proportion of carbohydrates for diabetics should be 45-60 percent. Vegetables, legumes, fruits and cereal products are particularly recommended, as they provide long-lasting satiety and are rich in fiber, vitamins and minerals. Above all, diabetics who inject insulin must calculate their carbohydrates. For this purpose, there is the auxiliary quantity bread unit (BE). One BE always means 10-12 g of carbohydrates. BE exchange tables make it easier to choose the correct BE amounts. Dietary fiber is particularly suitable for diabetics because it fills the stomach and is absorbed slowly into the bloodstream. 30 g of dietary fiber should be consumed daily. If possible, people with diabetes mellitus should consume foods with a low glycemic index, such as legumes, oats or whole-grain pasta, instead of foods with a high glycemic index. The glycemic index (GI) describes the immediate effect of foods on blood glucose levels. It uses the rapid rise in blood glucose caused by glucose (GI = 100) on blood glucose as a comparative value for the effect of other foods.
Sugar substitutes and sweeteners
Sugar substitutes are sweet-tasting sugar alcohols (carbohydrates) and can be processed like regular sugar. Their sweetening power is between 40 to 70 percent of that of household sugar, or about 150 percent in the case of fructose. Compared with normal sugar, they provide around half as many calories, at 2.4 calories per gram. In larger quantities, sugar substitutes can have a laxative effect – but most people can tolerate up to 20 g per day without problems. Sugar substitutes include:
- Erythritol (E number 968)
- Isomalt (E 953)
- Lactitol (E 966)
- Maltitol (E 965)
- Mannitol (E 421)
- Polyglycitol syrup (E 964)
- Sorbitol (E 420)
- Xylitol (E 967)
Sweeteners are distinguished from sugar substitutes: they are chemical compounds with a sweetening power 30 to 3,000 times greater than that of household sugar. Unlike sugar, sweeteners provide no calories or very few calories. Approved sweeteners:
- Acesulfame-K (E 950)
- Advantam (E 969)
- Aspartame (E 951)
- Acesulfame aspartame salt (E 951)
- Cyclamate (E 952)
- Neohesperidin DC (E 959)
- Neotame (E 961)
- Saccharin (E 954)
- Steviol glycosides “Stevia” (E 960)
- Sucralose (E 955)
- Thaumatin (E 957)
Fat is not equal to fat
Most people consume too much fat in the diet. However, a high percentage of fat in the diet delays the absorption of carbohydrates. In addition, choosing the right fats is important. Vegetable fats with monounsaturated and polyunsaturated fatty acids offer protection to the vessels against atherosclerosis and are more beneficial than animal fat. Therefore, a sensible diabetes diet consists of a consistent reduction of saturated fats in the diet.
- Polyunsaturated fatty acids are found in sunflower, safflower, wheat germ, soybean and corn oil.
- Olive and canola oil have a high proportion of monounsaturated fatty acids.
- 1-2 times a week add fish to the menu, which also contains unsaturated fatty acids.
- Fats of animal origin such as butter, milk fat, bacon and pork fat, as well as the vegetable coconut fat contain saturated fatty acids. They negatively affect fat levels and are considered a risk factor for cardiovascular disease.
- Consumption of meat and sausages better reduce.
Not too much protein for kidney damage
As with fat consumption, the average protein intake in Central European countries is too high. High protein intake puts a strain on the kidneys.Therefore, people with diabetes mellitus suffering from kidney damage in particular should pay attention to their protein content in the diet. For diabetics with microalbuminuria or advanced nephropathy, protein intake should be in the lower range of recommended values: 0.8 g/kg body weight/day or 47-48 g/day for women and 55-57 g/day for men.
Enjoy alcohol only in moderation
There is nothing wrong with a glass of wine or beer now and then, even for people with diabetes mellitus. Diabetics who are treated with insulin or insulinotropic drugs should consume alcohol best only together with a carbohydrate-containing snack. The reason: after alcohol consumption, the new synthesis of glucose in the liver (gluconeogenesis) is inhibited, and the blood glucose level drops. Hypoglycemia is even possible the next morning. Measure your blood glucose again before going to sleep; it should not be below 180 mg/dl. If the values are too low, you should eat one or two additional units before going to bed. You should also check your blood glucose more frequently the day after drinking alcohol. Physical exertion makes the cells of the body more sensitive to insulin, and blood glucose drops. The increased insulin sensitivity lasts for several hours. It is best not to drink alcohol before or after physical exertion. Some drinks, such as liqueurs, sweet fruit wines, port or non-alcoholic beer, are high in sugar and cause blood sugar to rise rapidly. You should avoid such drinks altogether if possible. Suitable drinks include diabetic wines, dry wines, light beer or brandy. In addition, alcohol has a high energy value (1 g = 7.1 kcal) and thus provides many calories. Alcohol consumption also inhibits fat breakdown in the liver, so the body stores the excess energy as extra kilos of body weight.
Special diet products are unnecessary
Special diet products are unnecessary because they sometimes contain large amounts of fat and energy and are often more expensive than regular products. Sugar substitutes or sweeteners are used to sweeten the products. No rationale is found for recommending the consumption of special diabetic products or diet products.
Five tips for diet in diabetes mellitus.
- The diet should include a varied whole foods.
- Overweight should reduce affected with low-fat and low-calorie food.
- Drink enough, at least 1.5 liters a day. Alcohol only in moderation, because hypoglycemia threaten.
- Special diet products are not necessary. These contain no sugar, but often very many calories.
- Physical activity has positive effects on diabetes. Therefore, diabetics should preferably do half an hour of moderate physical activity every day. The amount of exercise should depend on age and level of fitness.
Diabetes mellitus: prevent nutrient deficiencies.
What even experienced diabetics usually do not know: Your body has an increased need for certain micronutrients. An optimal supply of these micronutrients can reduce the risk of secondary damage that occurs due to the increased need. Affected individuals should check with their treating physician to determine whether they are deficient in micronutrients or vitamins and how best to treat it.
- Diabetics often have reduced magnesium levels. Insulin-dependent diabetics who were also deficient in magnesium were more likely to have eye damage. Increased rates of miscarriage as well as birth defects in mothers with diabetes have also been linked to magnesium deficiency.
- Many diabetics are deficient in zinc, which can lead to an impaired immune system. Therefore, experts recommend taking 15-25 mg of zinc daily.
- The vitamin C blood level of a diabetic is also often reduced. Studies showed that taking vitamin C can improve glucose tolerance and protect the kidneys.
- Similar results have been reported for vitamin B6. Measured blood levels were particularly low in diabetic patients with nerve damage. The simultaneous consumption of vitamin B1 and B12 is particularly recommended in diabetics with neuropathy.
- In glucose metabolism, biotin and coenzyme Q10 play a role.Taking 9-16 mg of biotin for at least 1 week was able to significantly reduce fasting blood glucose in diabetics in various studies. A positive effect on pain in nerve damage has also been described. To prevent a possible coenzyme Q10 deficiency, as observed in old-age diabetics, some experts additionally advise the consumption of 50 mg coenzyme Q10 daily.
Fasting also possible with diabetes mellitus?
Many people want to consciously cut back during Lent. Mostly, in the weeks between Carnival and Easter on certain consumer and luxury goods such as meat, alcohol, nicotine or sweets are waived. In principle, fasting is also possible for people with diabetes, as long as they do not have any cardiovascular diseases or problems with their kidneys or liver. However, they must take special care when fasting: Regular measurement of blood sugar and an adjustment of the therapy are inevitable. Any radical change in diet has a strong effect on the metabolic processes in the body. In particular for Diabetiker, which are treated with blood sugar-lowering means or insulin, the risk on Unterzuckerung (Hypoglykämie) increases. In order to regulate the metabolism during fasting, the insulin dose or oral antidiabetic drugs must be individually adjusted to the food intake. To eliminate risks, medical guidance and monitoring of the entire fasting regimen is recommended. People with diabetes should not follow strict fasting cures or juice cures without solid food (zero diet). More gentle is therapeutic fasting, whose purifying and detoxifying effect on the body is to prevent disease. In addition, fasting cures that provide the body with sufficient nutrients and minerals are recommended for diabetes, such as the Schroth cure (7-day grain cure) or the alkaline fasting with legumes, grains, fruits and vegetables, which is also suitable for everyday life.
