Diabetes

Diabetes is a condition in which the amount of glucose in the blood is too high because the body cannot use it properly. It is due to an insulin resistance or a deficient pancreas.

Insulin is a hormone produced by the pancreas, which helps the glucose to enter the cells where it is used as fuel by the body.

The two types of diabetes

Type 1 diabetes develops if the body is unable to produce insulin. It is usually treated by insulin injections, diet and regular exercise

Type 2 diabetes develops when the body can still produce some insulin but not enough, or when the insulin produced does not work properly (known as insulin resistance)

The importance of nutrition in diabetes

It is essential to permanently adopt eating habits that will enable you to stabilise your  glycemia as well as your weight and to avoid complications. Your diet will therefore be an integral part of your treatment. It has to be varied and balanced and in fact very similar to a “normal / healthy “ diet, with  just more rigorous meals times.

The calorific content of your food intake should be the same everyday and should also be evenly spread out throughout the day.

Main principles of a good nutritional routine in case of diabetes

You can eat everything as long as you make sure you respect the quantities calculated and planned by your dietician for each food category.  This will ensure that all your needs in nutrients, vitamins and minerals are covered  ;

Losing weight can improve your glucose control as well as your blood pressure but keep realistic targets

Sugar intake and diabetes

Never have more than the allowed quantity of sugars in order to maintain your  glycemia between 4 and 7 mmol (= 72 to 123 mg/dl) before meals

and below 10 mmol (= below 180 mg/dl)  afterwards.  

Which sugars in case of diabetes

Avoid « fast / simple » sugars (found in sweets, cakes, biscuits, fruits) as well as products with a high « Glycemic Index » - especially in the evening. Never eat them on their own  ;

Importance of the glycemic index in case of diabetes

The Glycemic Index corresponds to the rapidity of absorption of sugars

Sugar Equivalents :

1 bowl of milk = 2 yoghurts = 10g of sugar

15 g of sugar  = 75g de banana or grapes or = 100g of nectarines or cherries, or pears or almonds  = 130g of apricots or kiwis or pineapple or orange or clementines = 200g of strawberries or raspberries or melon or watermelon or grapefruit

20g of sugar = 40 g of bread (1/6 of a baguette)  = 3 biscottes = 2 toasts

= 30g of breakfast cereals

= 125 g of potatoes (2 the size of an egg) ou 2 table spoons (=25g = 2/3 of a glass) of pasta,  rice, uncooked semolina = 30g of legume

= 1 slice of take away quiche or pizza = 1 « croque-monsieur ”

= 1 fruit (medium size) small apple, medium orange, ½ a grapefruit, 1 mango, 2      kiwis, 1 small banana, 4 apricots 15 cherries, 20 grapes, 200g strawberries/raspberries

= 2 small pancakes

25g of sugar = 50g of bread = 1 brioche = 1 croissant = 5 biscottes

 = 150g of cooked carbs (ie 3 potatoes the size of an egg  = 130g of peas = 7 table spoons of rice or lentils, 5 table spoons of pasta, semolina, beans…)

= 35g of flour

50g of sugar = 100g of bread

                        = 65g of uncooked rice, pasta

                        = 60g of uncooked tapioca

                        = 65g of biscottes

                        = 80g of pulses / legumes

                        = 315g of potatoes 

Action Plan to stabilise your weight, your glycemia and your diabetes :

Include : Starchy carbohydrates at each meal to help control your blood glucose levels – preferably those with a low Glycemic Index (GI) : pasta, grainy bread, potatoes, oats, bran… Aim at regular amounts at each meal ;

Reduce  : Foods rich in calories (cereals, sauces, hard cheeses, salamis, creamy sauces, fried dishes ; try and choose low fat options in all the food groups …)

Avoid : foods that contain saturated fats  like butter, ghee, coconut milk, palm oil, lard, or trans fats (found in biscuits, cakes, ready meals, take away) ; Use unsaturated fats  like soya oil, sunflower oil, olive oil,  rapeseed oil,  ground nut oil. 

Watch out for hidden fat in products such as pork pies, sausage rolls, hot dogs, samosas, kebabs, burgers ;

Choose lean cuts of meat and trim off any visible fat ; remove the skin of poultry ;

Have fish at least 3 times a week as they contain a type of polyunsaturated fat called omega 3 which help protect against heart diseases by reducing the levels of triglycerides in the blood. They also have an anti-inflammatory effect ;

Replace some of the meat in recipes with beans, pulses and alternatives ;

Cut down salt as too much can raise your blood pressure (it is better to flavour your food with herbs and spices)

 Eat high fibre food which are good for your digestive system and help prevent constipation.

Drink lots of water ; avoid sweet drinks and alcohol (2 units a day maximum) as it can lower your blood glucose quite suddenly ;

Eat at regular times and never skip a meal (3 main meals and 2 snacks) to stabilise your glycemia, avoid tiredness, and hypos

Risks of hypoglycemia and diabetes

In case of a hypoglycemia (medical name for low blood glucose level – less than 4 mmol/l) immediately take quickly absorbed carbohydrates such as 5 jelly babies, a small glass of Lucozade, 3 glucose tablets ; then follow this with slowly absorbed carbohydrates such as : a bowl of cereals or a banana

Choose healthier cooking techniques to improve your diabetes:

Steaming, grilling, baking, cooking in the micro-wave, using non-stick pans

Make sure butter/oil is not cooked and added only if necessary just before serving ; for salad dressings, you can use yoghurt + herbs instead of oil ; avoid sauces that use fat+flour as thickening agents

Lifestyle and diabetes

 Adopt a healthier lifestyle :

Exercise even if moderately but every day to burn more calories, maintain the weight loss, improve blood pressure,  increase the action of insulin, relieve stress. Aim for 30 minutes physical activity at least 5 days a week, building up gradually. If you have not exercised for a while check with your doctor which activity is most suitable for you.

Exercise and diabetes

When you exercise, your muscles take up more sugar from the blood to provide extra energy. To revent your blood sugars from dropping too low, you may need to take extra carbohydrate before and after exercise. Always carry an “emergency” supply of quick acting carbohydrate (eg : a sweet) in case you do have a hypo.

-       Remember that stress and lack of sleep increase gain weight