Currently, diabetes is a global problem. In the last ten years, the number of people suffering from diabetes has more than doubled to 425 million. According to forecasts, in 2045 their number could reach 629 million.
Diabetesis a group of endocrine diseases associated with impaired glucose absorption and developing as a result of an absolute or relative deficiency of the hormone insulin, resulting in the development of hyperglycemia, a persistent increase in blood glucose levels. 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 reasons for the development of this disease. Type 1 diabetes is characterized by the destruction or destruction of pancreatic cells. This usually leads to absolute insulin deficiency. The development of type 1 diabetes involves both genetic and environmental factors: viral infections, nutrition, toxins and hygiene. Type 2 diabetes mellitus is characterized by the development of insulin resistance and a relative, rather than absolute, insulin deficiency and is manifested by persistent hyperglycemia. The main problem of any type of diabetes is increased blood glucose levels and lack of carbohydrates from the cells, since glucose cannot enter, but floats inactively in the blood.
The treatment of diabetes mellitus is based on diet therapy. The general principles of nutrition, regardless of the type of diabetes, are that the patient is advised to reduce the carbohydrate load in the diet to 5-7% and increase the consumption of vegetable fats. Previously, diabetics were recommended to completely eliminate simple carbohydrates, but today more and more emphasis is placed on personalized diets with individual selection of food baskets and calorie calculations. Currently, the slogan: "With diabetes there are no restrictions, there is only the right lifestyle" is very popular.
The diet of patients with diabetes is based on the glycemic index. Basically, this index reflects the speed with which their sugar is absorbed into the blood. Products with a high index (jams, cookies, cakes) have a high absorption rate. Products with a low index (cereals, fruits) have a lower index. The slower the absorption rate, the easier it is for the pancreas to cope with the load. Thus, foods with a GI of up to 55 are broken down gradually and almost do not cause an increase in sugar.
Also, do not forget about the food insulin index, which reflects the increase in the amount of insulin in response to food consumption. It is important to take into account the insulin index of foods so that people with diabetes can predict the body's reaction to consuming specific foods and correctly calculate the doses of insulin preparations (short-acting and long-acting) to be used for injection after of the food.
Any food, even protein, causes a large release of the hormone insulin. And the more insulin swings you have during the day, the more likely you are to develop insulin resistance, which will subsequently lead to type 2 diabetes. Everyone's favorite snacks in the form of dairy and fermented milk products, such as cottage cheese, kefir and yogurt, have a very, very high insulin index, which means that the insulin swing will vary very strongly along with your mood and your irritability.
Let's consider different options and features of diets depending on the type of diabetes.
Basic nutrition rules for type 1 diabetes.
with the first typePatients are completely dependent on insulin injections and the diet is designed with insulin administration in mind. Diabetics need to study the presence of carbohydrates (bread units) in food to determine the dose of the hormone that will help absorb them. A unit of bread is a conventional concept that implies a certain amount of any product that contains 12 grams of carbohydrates. It is recommended to consume no more than 12 units of bread per day. Insulin is administered half an hour before meals, so it is important to know exactly what you will eat and how much to absorb carbohydrates from food. For each main meal it is not necessary to eat more than 5 to 6 units of bread and 2 to 3 additional ones.
You should almost completely avoid foods containing easily digestible (simple) carbohydrates. These are sweets, jams, condensed milk, marshmallows, jam, halva, pies, jams, etc. , as well as oatmeal and semolina porridge, mashed potatoes. Reducing the amount of carbohydrates in the diet, which increase blood sugar, reduces the need for medications. Consuming the same doses as before switching to a low-carb diet can cause hypoglycemia. It is necessary to measure your blood sugar level regularly when starting this diet and adjust your medication dosage accordingly.
The daily caloric intake is distributed throughout the day in 4-5 meals. According to the BJU ratio, the distribution looks like this: proteins make up 20-25% of the total diet, fats - 30%, of which saturated no more than 10%, carbohydrates - 45-50%.
Basic nutrition rules for type 2 diabetes
More serious restrictions are needed for non-insulin-dependent variants of the disease. This is due to the fact that this form usually appears against the background of obesity, and not only high levels of glucose, but also insulin are found in the blood. However, it very often happens that insulin resistance, which can subsequently lead to type 2 diabetes mellitus, does not manifest itself in any way for a long time, and even people with insulin resistance are not always overweight, but the Blood glucose level remains constantly at a high level and this situation has very sad consequences. Diet nutrition for type 2 diabetes helps restore the cells' ability to absorb sugar and helps restore cellular sensitivity to insulin.
Diabetes mellitus type 2It is mainly a disorder of carbohydrate metabolism. But at the same time, other types of metabolism suffer: lipids, proteins and minerals. Treatment for type 2 diabetes mellitus includes diet, moderate exercise, stress management, and medications (diabetes drugs).
The type 2 diabetes diet is based on key principles:
- Abundance of vegetables– The amount of vegetables consumed may depend on age, sex, and frequency of exercise per week. As a general rule, women who exercise up to 30 minutes a day are recommended to consume at least 500 grams of vegetables a day. For more intense exercise, it is recommended to increase the amount of vegetables to 800 grams. For men, the recommended amount of vegetables is 600 and 1000 grams, respectively.
- Unsaturated fats– The presence of an adequate amount of polyunsaturated and monounsaturated fats in the diet helps maintain cholesterol levels within normal limits and reduces the risk of developing cardiovascular diseases, one of the most common long-term complications of diabetes. Unsaturated fats are found in many foods, including nuts, avocados, fatty ocean fish, and olive oil.
- Avoid processed foods– Nutritionists and doctors agree that avoiding processed foods has a positive effect on health. Because of the substances added to ensure long shelf life, processed foods tend to have a high glycemic index. Regular consumption of these foods can negatively affect the health of a diabetic.
Healthy foods for diabetes.
Green leafy vegetables
Spinach, cabbage, and bok choy are low in calories but rich in nutrients such as vitamin C, beta-carotene, and magnesium, which help prevent diabetes. One serving (about 106 g) per day reduces the risk of developing type 2 diabetes by 14%.
legumes
These high-fiber foods can help stabilize your blood sugar levels. Legumes are low in saturated fat, which can be harmful to the heart.
Fish
Omega-3 fatty acids– great helpers in the prevention of diabetes, reducing the risk of cardiovascular diseases. The body needs omega 3 for the synthesis of red blood cells and cell membranes, it helps in the absorption of other vitamins by the body and, most importantly, it suppresses 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 amounts in nuts) are important in preventing diabetes by helping the body effectively control blood sugar levels.
Walnuts
As a source of monounsaturated fatty acids, nuts are rich in magnesium, another important nutrient. Global research shows that people who eat nuts regularly have lower rates of diabetes.
Citrus
All citrus fruits contain antioxidants, which are of great help in maintaining the balance of insulin in the blood.
whole grains
Eating whole wheat bread, quinoa and brown rice reduces the risk of developing diabetes. Whole grains are rich in fiber, which helps the body control blood sugar levels. Complex carbohydrates are a kind of buffer that protects us from high blood glucose spikes, so if you want to eat a product with a high glycemic index, combine it with complex carbohydrates.
Cinnamon
This tasty spice helps the body regulate insulin levels. Cinnamon is a kind of insulin sensitizer, that is, it helps improve the sensitivity of cells to insulin. The spice helps with hypertension (chronically high blood pressure), reduces blood sugar concentration when used systematically in the required doses, 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 coagulation indicators. Recommended for fresh daily consumption as a condiment or base for tea.
Prohibited foods for diabetes.
Today, doctors try not to strictly limit patients with diabetes and not force them to adhere to strict limits regarding permitted and prohibited foods. Even with type 2 diabetes, in which diet plays an important role, you can eat a varied diet, but there are a number of foods that people with this disease will still have to eliminate from the diet. In fact, it is recommended that anyone who cares about their health exclude the following list from their diet.
Sweet
The black list includes sugar and all products that contain excess sugar. We must forget about ice cream, chocolate, jams, jams, sweets, preserves, halva and other sweets.
Bakery
Sweet baked goods are prohibited: muffins, cookies, buns, white loaf and bread.
Fatty foods
These dishes can considerably increase your 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.
Semi-finished products
They contain a large amount of aromas, stabilizers and flavor enhancers. You should not eat fish fingers, industrially prepared cutlets, meatballs, sausages and sausages.
Trans fat
Its consumption will harm not only a diabetic, but also a healthy person. Prohibited products include margarine, confectionery fat, spreads, French fries, hot dogs and hamburgers.
fruit
It is not recommended to consume certain fruits and nuts that cause a sharp increase in blood sugar. These include dried apricots, dates, figs, raisins, persimmons, melons, grapes and bananas.
Table No. 9 for diabetes
This diet was developed by scientists specifically for diabetics and has long been used in treatment both in the hospital and at home.Table No. 9 includes:
- 300 g of fruit;
- 80 g of vegetables;
- 100 g mushrooms;
- 1 tablespoon. natural fruit juices;
- 300 g of meat or fish;
- 200 g of low-fat cottage cheese, 500 ml of fermented milk products;
- 100-200 g of bran, rye, wheat bread mixed with rye flour or 200 g of cereals (prepared), potatoes;
- 40-60 g of fat.
Main courses
- soups: vegetable soup, cabbage soup, beet soup, borscht, vegetable and meat okroshka, light fish or meat broth, mushroom soup with cereals and vegetables.
- Bird meat: rabbit, beef, chicken, stewed, chopped, boiled, turkey.
- Fish: pike perch, navaga, cod, pike and lean seafood, stewed, steamed, boiled, baked in juice.
- Appetizers: mixed vegetables, vinaigrette, dietary fish and meat gelatin, vegetable caviar, unsalted cheese, seafood salad with butter.
- sweets:desserts made with red fruits, fresh fruits, red fruit mousses, sugar-free fruit jellies, sugar-free jams and jams.
- egg dishes: soft-boiled eggs, white omelette, on plates.
Other dietary strategies for diabetes
Of course, we must not forget that all diets are prepared strictly individually, taking into account the age, sex of the patient and his level of physical activity.
Thus, today there are several options for dietary strategies for diabetes. If it is necessary to normalize body weight in a patient with type 2 diabetes mellitus, it has proven effective.Mediterranean diet, which is based on daily physical activity.
The basic principles of the diet are:
- fractional meals 5 times a day: 3 main meals and 2 snacks;
- breakfast should be richer in carbohydrates, mainly complex carbohydrates;
- light dinner based on lean proteins and vegetables;
- During the day it is necessary to consume more than 1 kg of various vegetables and herbs;
- It is important to observe a drinking regimen: at least 7-8 glasses of water per day.
The main sources of fat in the diet are– unrefined olive oil, sometimes sesame, rapeseed and peanuts can be used. Animal fats are limited in the Mediterranean diet.
Special attention is paid to omega-3 fatty acids and oleic acid, which are found in oils, fatty fish and shellfish. These fatty acids have a great impact on preventing atherosclerosis, improving insulin sensitivity, and helping immune cells detect inflammation and suppress it.
The carbohydrates of the Mediterranean diet are predominantly complex and with a low glycemic index: durum wheat pasta, beans, rice, lentils, whole wheat bread, seasonal vegetables and fruits.
Protein comes in the form of low-fat soft cheeses, eggs, fish, shellfish and, rarely, poultry.
Another diabetes diet option islow calorie CHFand ketogenic diet. The essence of this dietary strategy is to consume low amounts of carbohydrates and high amounts of fat. Carbohydrates in fatty diets are limited to 50 grams per day, and in the ketogenic diet the restriction is even more severe: no more than 10 grams of carbohydrates.
The following foods are completely excluded from the ketogenic diet::
- sugar, honey, artificial sweeteners;
- sweet carbonated drinks;
- leavened bread, pastries;
- cereals, porridges, flakes and breakfast cereals;
- skimmed milk, kefir, yogurts;
- sweet curds;
- margarine.
In the concept of low carbohydrate diet, insulin is a dangerous thing, because after eating something rich in carbohydrates, carbohydrates are broken down into glucose, the blood sugar level begins to rise sharply and, consequently, the level of Insulin increases considerably to transport glucose to the muscles, liver and fat cells, that is, insulin is "responsible for our obesity. "Additionally, protein can increase insulin levels just as well as carbohydrates. And fats do not increase insulin at all, which promotes insulin resistance and, if necessary, improves the sensitivity of cells to insulin.
Diabetes mellitus in children
Diabetes mellitus in children can be caused by a hereditary predisposition, poor diet, including excessive consumption of simple carbohydrates and sweets, and the disease can also occur as a result of physical or mental trauma. The treatment of diabetes in children, as well as in adults, consists of a therapeutic diet and the administration of insulin for type 1 diabetes.
The diet of children with diabetes should be rich in vegetables such as white and cauliflower, onion, spinach and garlic. You can eat fruits, meats, poultry and fish without sugar. It is advisable to give milk and cottage cheese those that have a small percentage of fat content, as long as the child does not have an intolerance to cow's milk protein. When cooking meat or fish, you can use spices to promote better protein absorption.
All confectionery products, sweets, grapes, apricots, rice, baked goods, cookies and plums should be excluded. Parents of a child with diabetes should learn to calculate the consumption of units of bread when feeding the child and calculate the necessary dose of insulin. The child himself also needs to learn these skills as early as possible.
Gestational diabetes mellitus
Othertype of diabetes– gestational diabetes mellitus in pregnant women, which is quite common today.
Increased blood sugar during pregnancy.and it is one of the most common metabolic disorders in an expectant mother. The so-called gestational diabetes mellitus or diabetes of pregnant women is diabetes that appears during pregnancy and is limited to its duration. During pregnancy, the production of sex hormones (estrogen and progesterone, hCG) and the hormone cortisol, which suppresses the action of insulin, dramatically increases. As a result, blood glucose levels increase in pregnant women. High blood sugar levels during pregnancy negatively affect both the health of the woman herself and the health of the fetus and therefore require timely diagnosis and subsequent correction.
Women are at special risk:
- overweight or obese (BMI greater than 25 kg/m²– the risk doubles, above 30 – it triples);
- with multiple pregnancy;
- after IVF;
- with polycystic ovaries;
- with large weight gain during actual pregnancy;
- with glucosuria (glucose in the urine);
- having close family members with diabetes;
- with a previous burdened pregnancy: GDM, birth of a large fetus, intrauterine fetal death.
Gestational diabetes is dangerous not only for the mother, but also affects the health of the fetus. Therefore, at the age of 4-5 years, these children are much more likely to be overweight and obese, at 10-11 years old - increased blood pressure, in adolescence the risk of developing diabetes is 20 to 11 years old. 40%, the risk The risk of developing non-alcoholic fatty disease increases significantly.
If GDM is not detected in time or the expectant mother does not take any measures to treat it, thenthe risk increases significantly:
- premature aging of the placenta and, as a result, delay in fetal development;
- premature birth;
- polyhydramnios;
- formation of a large, disproportionate or edematous fetus;
- increased blood pressure, preeclampsia;
- the need for a cesarean section;
- traumatization of women and children during childbirth;
- hypoglycemia (low blood sugar) and breathing problems in a newborn;
- The most serious complication of untreated GDM is stillbirth.
Therefore, it is important to understand that diabetes is not a kind of life sentence, but only imposes certain obligations on the person regarding diet and physical activity. Adequate and balanced nutrition is of utmost importance for any type of diabetes. And although reducing carbohydrates and saturated fats in the diet contributes to weight loss, an excess that type 2 diabetics often suffer from, it is very important to change one's own lifestyle and eating habits. And if in type 2 diabetes a good effect in reducing blood sugar levels is achieved not only with properly selected foods, but also with a series of physical exercises that help improve the function of glucose transport to cells muscles, then in type 1 diabetes nutrition plays an important role. a leading role.