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Diabetes nutrition: what to look out for

by Josephine Andrews
Published: Last Updated on 379 views

The right diabetic diet depends in part on the type of diabetes: Type 1 diabetics can basically eat in a similar way to non-diabetics. However, type 2 diabetics should reduce their overall energy intake if they are overweight. In both forms of diabetes, it is important that the energy supply and the usable amount of insulin are optimally coordinated. Find out here what you should pay attention to when it comes to diabetic nutrition.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

E11 E10 E13 O24 H36 E12 E14

Proper nutrition for type 1 diabetes

The first thing that patients with type 1 diabetes need to learn is to correctly estimate the proportion of carbohydrates in a planned meal. Only then can they inject the right amount of insulin , which is necessary for nutrient utilization. If too little insulin is injected before a meal, it can lead to high blood sugar (hyperglycaemia). If the insulin dose is too high, the blood sugar drops too much – there is a risk of hypoglycaemia. Both over and under sugar can be dangerous.

The correct dose of insulin depends on the type and amount of carbohydrates ingested. For example, whole grains contain more long-chain or complex carbohydrates, which require less high insulin levels than short-chain carbohydrates, which appear more quickly in the blood. The latter are found, for example, in white flour products and sweets.

The term carbohydrate unit (KHE) was introduced to make it easier to estimate the proportion of usable carbohydrates in a food . 1 KHE corresponds to 10 grams of usable carbohydrates and increases blood sugar by 30 to 40 mg/dl. Especially in the past, the so-called bread units (BE) were used instead of carbohydrate units. The following applies here: 1 BE corresponds to 12 grams of carbohydrates. You can read more about this in the article on bread units .

By the way: Every patient is recommended diabetes training and individual nutritional advice after the diagnosis. There, in addition to other content, everything important about the right diabetes diet is conveyed.

Type 2 Diabetes Diet Tips

In type 2 diabetes mellitus , the body cells only respond to a reduced extent to the blood-sugar-lowering hormone insulin. This insulin resistance is favored by obesity. That means: The right diabetic diet for overweight type 2 diabetics aims at weight loss . Regular physical activity helps to achieve this goal. Losing excess pounds can also reduce insulin resistance. In this way, the existing amount of insulin can work better again.

The diabetes mellitus diet in overweight people should therefore be low in calories. How many calories are “allowed” per day, patients learn from their nutritionist. Regardless of weight, every diabetic should take part in diabetes training after diagnosis and receive individual nutritional advice (just like type 1 diabetics).

What can or should diabetics eat?

First of all: The food for diabetics should (as in general for all people) be balanced, varied and wholesome. It is designed to provide adequate amounts of macronutrients (carbohydrates, fats and proteins) as well as vitamins and minerals. Experts are discussing the ideal percentage composition of the diet from the three main nutrients. In general, the following recommendations apply to a healthy diet:

  • 45 to 60 percent carbohydrates
  • 30 to 35 percent fat
  • 10 to 20 percent proteins (proteins)
  • 40 grams of fiber
  • maximum 6 grams of table salt
  • maximum 50 grams of pure sugar (glucose, sucrose)

The nutritionist will provide appropriate recommendations for each patient, which may differ from those above. In the diet plan for diabetics, he must take into account, among other things, the patient’s age, body weight and any accompanying and secondary diseases (such as obesity, kidney damage, high blood lipid levels, etc.).

Almost more important than the exact percentage of the various macronutrients is their type and source. For example, whole grain products are cheaper than white flour products, and vegetable fats are healthier than animal ones.

Diabetes Diet: Carbohydrates

Carbohydrates are sugar molecules linked to more or less long chains. They are very important suppliers of energy for the human organism, especially for the muscles and brain . One gram of carbohydrate has about four calories.

A distinction is made between short- and long-chain carbohydrates. Short-chain carbohydrates , such as those found in white bread and sweets, cause the blood sugar to rise very quickly and significantly and also only satisfy the craving for sugar for a short time. Long-chain (complex) carbohydrates , on the other hand, must first be broken down in the intestine before they can enter the bloodstream. As a result, the blood sugar level rises more slowly and less strongly after consumption. Complex carbohydrates are found in legumes and whole grain products, for example.

So, the type of carbohydrate source has a direct impact on insulin requirements. 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 can happen if the dose or timing of the insulin injection doesn’t exactly match the carbohydrate intake. In type 2 diabetics, whose body still produces some insulin, it takes longer for the excess sugar to enter the cells (prolonged hyperglycaemia).

Diabetes patients should therefore cover their carbohydrate requirements as much as possible with long-chain carbohydrates, such as those found in whole grain products, potatoes and legumes.

Diabetes Diet: Fat

The ideal diet prefers dietary fats that contain many monounsaturated or polyunsaturated fatty acids. This applies primarily to vegetable fats and oils. Cold-pressed vegetable oils such as rapeseed oil, linseed oil, olive oil or walnut oil are therefore recommended. Fish is also considered a healthy source of fat in the diabetic diet (and also for non-diabetics). In contrast to other animal fat sources, it contains many healthy fatty acids.

Since diabetes drastically increases the risk of arteriosclerosis (“hardening of the arteries”), the diet plan for diabetics should limit cholesterol intake. All animal products (milk, butter, cream, eggs, meat, etc.) contain cholesterol. These products should therefore be consumed sparingly. In addition, regular blood tests at the family doctor are useful, since an elevated cholesterol level can only be detected through a blood test.

Diabetes Diet: Proteins

About 10 to 20 percent of the daily energy requirement should be covered by proteins. This recommendation applies if a diabetic patient shows no signs of kidney damage (diabetic nephropathy). However, if you have kidney weakness, you should consume a maximum of 0.8 grams of protein per kilogram of body weight per day.

Particularly recommended sources of protein are legumes (such as peas, lentils or beans), fish and low-fat meat.

diabetes and alcohol

The combination of alcohol and diabetes is problematic: the alcohol blocks the formation of new sugar (gluconeogenesis) in the liver for several hours. However, this new formation is included in the calculation of the required amounts of insulin.

Diabetes patients should therefore only consume alcohol in moderation and always in combination with a carbohydrate-rich meal (maximum 10 grams per day for women and 20 grams per day for men, as a guide: half a liter of beer (5% by volume) contains around 20 grams Alcohol). In this way, low blood sugar (hypoglycaemia) can be avoided.

There is another reason why alcohol is unfavorable for overweight diabetics: one gram of alcohol has a calorific value of around 7.2 kilocalories per gram, which is similar to that of fat. This makes it a real calorie bomb. However, obesity increases the body’s insulin requirements due to the increasing insulin resistance of the cells and has a negative impact on diabetes.

Alcohol can also lead to nerve damage (polyneuropathy). An existing diabetic polyneuropathy can be aggravated by alcohol consumption.

Sweets for diabetics

The same applies to diabetics as to healthy people: sweets should only be eaten occasionally. It is also important to pay attention to the hidden sugars in food and finished products. For example, ketchup, fruit yoghurt and muesli 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 confectionery products is the combination of sugar and fat : the body cannot metabolize sugar and fat at the same time. First, therefore, the sugar is converted into energy and burned, while the fat is stored in the tissues and promotes obesity.

There are now many “sweet” special products for diabetics on the market , for example diabetic chocolate or diabetic ice cream. However, experts advise against such mostly expensive diabetes products. Although these products often contain no cane or industrial sugar, they do contain large amounts of fructose (and fat).

The fruit sugar (fructose) increases the formation of uric acid , which is often increased in diabetics anyway. Too high a uric acid level can provoke a gout attack. In addition, fructose promotes obesity (obesity), promotes the metabolic syndrome and increases blood lipid levels.

By the way: Instead of expensive and questionably healthier diabetic chocolate, you can use chocolate with a very high cocoa content (at least 60 percent). The higher the cocoa content, the less sugar the chocolate usually contains.

diabetes and cinnamon

According to some nutritionists, diabetes could be favorably influenced by the effects 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) can improve the effect of insulin on the cells.

Scientists were able to demonstrate an anti-diabetic effect of cinnamon in various animal experiments. Some human studies have also suggested that cinnamon may lower blood sugar and cholesterol levels. Other studies, on the other hand, did not produce any significant effect. Before therapeutic use, further studies are necessary to provide reliable evidence of the effect and, among other things, to shed light on a suitable amount of cinnamon and the duration of treatment.

Also good to know: Cinnamon or the coumarin contained in cassia cinnamon in particular can be harmful to health in large quantities (especially for the liver). The Federal Office for Risk Assessment recommends that an adult weighing 60 kilograms should not eat more than a maximum of two grams of cinnamon per day. Pay attention to this when buying concentrated preparations, such as capsules.

So far, cinnamon has not played a 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 more or less large amounts of fruit sugar (fructose). This has long been considered healthier than regular sugar. That is why many foods for diabetics contain fructose instead of conventional sugar. The same applies to numerous “normal” products (for non-diabetics).

However, diabetics (and people with a healthy metabolism) are advised not to supply the body with too much fructose. This can have a negative effect on health: According to studies, a high fructose intake can promote obesity (obesity) and increase blood lipid levels.

That’s why you shouldn’t consume too many industrially produced foods that contain fructose, such as lemonade sweetened with fructose or diabetic foods with fructose. However, daily fruit consumption is harmless and even desirable for diabetics (and others): The German Society for Nutrition recommends eating two portions of fruit and three portions of vegetables every day – according to the motto “5 a day”. This corresponds to about 250 grams of fruit and 400 grams of vegetables daily (1 serving = about a handful).

Sweeteners (like Stevia) & Diabetes

There are some alternative sweeteners that are often recommended in diabetics’ diets – instead of refined sugar – because they don’t raise blood sugar levels, or raise them less. Sweeteners include sugar substitutes and sweeteners.

Examples of sugar substitutes are sorbitol, mannitol, isomalt and xylitol . They contain fewer calories than sugar and cause blood sugar levels to rise only slightly. In contrast, sweeteners (such as acesulfame-K, aspartame, stevia) provide no calories and do not increase blood sugar.

The sweetener stevia has been particularly popular with diabetics for some time. The contained steviol glycosides are responsible for its sweetening power. According to the European Food Safety Authority (EFSA), stevia does not promote tooth decay or be carcinogenic, does not damage genetic material and does not affect fertility or the development of an unborn child.

There is also no evidence to date that sweeteners such as stevia can be “addictive” and trigger hunger pangs – and thus possibly lead to weight gain . However, experts point out that products sweetened with stevia sometimes contain additional sugar.

Also, be careful not to overindulge in stevia. The EFSA recommends a maximum of four milligrams of steviol glycosides per kilogram of body weight (ADI value) per day. This amount is considered safe. The consequences of a possible overdose are unclear.

In general, the following applies: No more than the recommended amounts of sweeteners or a maximum of 50 grams of sugar should be consumed per day. Eating less sweet also makes it easier for yourself: the body does not get used to the taste and has less desire for sweets.

By the way: Diabetes patients who also suffer from the rare metabolic disease phenylketonuria should not take aspartame. The sweetener contains phenylalanine . This protein building block (amino acid) cannot be broken down in phenylketonuria, so that symptoms of poisoning appear. However, other sweeteners (including stevia) do not contain phenylalanine. They are therefore a good alternative in diabetic nutrition for phenylketonuria.

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