Diet and Diabetes: Generalities and Carbohydrates

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Introduction

The high diabetes diet is a diet indicated for restoring or maintaining blood sugar balance; Let's start immediately by saying that the strategy can have a variable efficacy depending on the triggering cause and predisposing factors, and that dietary therapy must be modeled on them.

Blood glucose refers to the amount of diluted glucose in the blood plasma, which is measured in milligrams per deciliter (mg / dL) or millimoles per liter (mmol / L).

Note: In this article we will cover the diet for type 1 and type 2 diabetes mellitus; with regard to gestational diabetes, many of the nutritional principles applied to type 2 treatment can be considered valid.

Diabetes

What is diabetes?

Diabetes refers to a syndrome that includes a group of metabolic diseases characterized by a defect in insulin secretion and / or action, the presence of hyperglycemia and the long-term appearance of chronic complications in various organs, especially eyes. , kidney, nerves, heart and blood vessels.

Diabetes classification

• Type I diabetes: characterized by the destruction of the beta cells of the pancreas, resulting in an absolute defect of insulin (also called juvenile diabetes);
• Type II diabetes: characterized by the defect in insulin secretion associated with insulin resistance (also called senile diabetes);
• Gestational diabetes - GDM: any form of impaired glucose tolerance that occurs during pregnancy.

Any form of diabetes may require insulin therapy at any stage of the disease. The use of insulin by itself does not classify the patient or the condition.

Diabetes tasteless it has nothing to do with glucose metabolism and affects the secretion of vasopressin hormone (ADH or antidiuretic hormone).

Differences between the various types of diabetes

Type 2 and gestational diabetes mellitus (also thanks to certain drugs) can stabilize, improve and even heal (depending on the case) if treated in the correct way and if the genetic predisposition or the anatomical-functional defect are not prevalent causes; however, they need a fairly specific and effective dietary therapy.

Among the main causes of "variable" origin we recognize: overweight and obesity, with emphasis on abdominal storage, sedentary lifestyle and absence of desirable motor activity, and nutritional imbalance. All three of these elements begin the disease process by complicating glucose and insulin sensitivity, up to insulin resistance and chronic hyperglycemia.

Let's not forget that worse it is the metabolism of glucose (which causes hyperglycemia), plus severe becomes diabetes and the greater the chances of serious complications (protein glycation, neuropathies, vasculopathies, atherosclerosis, etc.).

Type 1 diabetes mellitus, on the other hand, cannot be cured, simply requires you to calibrate the amount of insulin (to be injected) according to the carbohydrates taken from the diet.

Symptoms of type 2 diabetes mellitus

Type 2 diabetes mellitus does not always have obvious symptoms, at least in principle. Due to severe hyperglycemia, various general feelings of malaise may appear (fatiguedry mouth frequent urination etc).

The first specific clinical signs are generally associated with nerve and blood circulation complications; this indicates that the disease has been present for a long time or that it is very serious.

Causes of type 2 diabetes mellitus

We have already made a small introduction and now let's go into detail.

Different types of diabetes have different causes.

• Everyone can have a hereditary genetic basis, even if of a specific and different type;
• Type 1 diabetes mellitus is characterized by the loss of some specific cells of the pancreas gland. It is typically autoimmune, but there are sporadic cases of surgical induction, mechanical injury, poisoning, etc;
• Type 2 diabetes mellitus often has lifestyle causes. Particularly:
  • Overweight and especially visceral obesity;
  • The sedentary lifestyle;
  • An excessive and / or unbalanced diet, particularly rich in foods with a high content of carbohydrates, especially refined and with a high glycemic index;
• Gestational diabetes also has a very important dietary and behavioral component; are more exposed to this dysmetabolism (which can cause serious damage to the fetus and become chronic even after childbirth):
  • Obese women and / or
  • who feed without control in pregnancy.

Importance of diet for the treatment of type 2 diabetes

Diet

The diabetes diet is an appropriate nutritional regimen that meets current guidelines on the matter.

The diet for diabetes is one of the fundamental cornerstones in the therapy of type 2 mellitus. The role of nutrition in the treatment of this diabetes is so important that in this regard doctors prefer to talk not about diet, but about real "medical nutritional therapy for diabetes"(diet therapy).

Diabetes sufferers should therefore strive to scrupulously respect the few rules that we will see below. These recommendations, seen from a preventive point of view, are exactly the same as those indicated in the healthy population to reduce the risk of developing diabetes and many other diseases, such as cardiovascular and some cancers.

This does not mean that, in the event of a pre-existing disease, metabolic benefits can be obtained.

Goals of the Diabetes Diet

Contrary to what many believe, the ideal diet of the diabetic is by no means complex or restrictive. For most people, the diet simply needs to be adapted to the disease, certainly not upset.

Although some foods should be consumed in moderation, there is still a wide range of healthy alternatives that the diabetic can choose from.

The main goals of the diabetes mellitus diet are:

• Body weight control, if excessive;
• Glycemic and lipid control;
• The prevention and treatment of risk factors or complications related to nutrition.

Diet therapy is apparently very similar in the two types of diabetes even though:

• For type 1 diabetics, greater attention must be paid to the intake of food, especially carbohydrates. The diet should limit simple carbohydrates as much as possible and provide regular and fractional intakes of complex carbohydrates. The primary objective is the maximum reduction of the drug units and the normalization of the glycemic picture.
• For type 2 diabetics, often overweight, the diet will be calibrated in such a way as to favor the reduction of body weight to acceptable levels.

Naturally, the diet will have to take into account individual tastes and preferences.

Note: Following a hypoglycemic or low carb diet is essential mistaken, both ketogenic (prevalence of fats) and high-protein types. Both promote the release of compounds that can strain the kidneys, organs already heavily targeted by type 2 diabetes itself.

Pharmacological therapy

Diet-Associated Medicines for Diabetes

The drugs most used in diabetes therapy are:

• For type 1 diabetes mellitus: synthetic insulin, to be injected (or administered automatically by innovative devices);
• For type 2 diabetes mellitus:
  • Insulin stimulants;
  • Insulin tissue sensitizers;
  • Reducers of neoglucogenesis;
  • Reduced intestinal glucose absorption.

Supplements associated with diabetes diet

Dietary supplements for diabetes mellitus are primarily useful for type 2 therapy.

Above all, products with hypoglycemic properties are used, that is (in a different way depending on the active ingredient):

• They reduce the glycemic index (slowing digestion and absorption); for example the fibers of psyllium seeds (mucilage) or guar (gum) or inulin;
• They reduce the glycemic load (hindering the digestion and absorption of carbohydrates); for example acarbose;
• They prevent, as far as possible, the complications of diabetes: omega 3 and in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA);

Insights

Nutritional insights on diabetes

For further information: Diet and Diabetes: How to deal with Fiber, Salt and Alcohol For further information: Diet and Diabetes: How to deal with Fats, Proteins and Cholesterol

What to eat in case of diabetes

Other types of diabetes

For further information: Diet and Gestational Diabetes For further information: Diet and Type I Diabetes Mellitus

What to eat

Importance of carbohydrates

The quantity of carbohydrates and the type of foods consumed at each meal is one of the most important aspects of the diet for type 2 diabetes mellitus.

How many carbohydrates to eat in the diet for type 2 diabetes mellitus?

As anticipated, the total amount of carbohydrates to be consumed during the day must be around 50% of the daily calories.

Those with a low glycemic index should be preferred (even if the importance of this parameter is strongly questioned today), associated with fiber (in this case the share of carbohydrates in the diet can reach 60% of total calories) and water. Generally, it is recommended to keep the percentage of simple sugars (monosaccharides, such as fructose and glucose, and disaccharides, such as sucrose and lactose) below 10-12%, especially of added nature.

Sucrose, that is normal cooking sugar, must absolutely not exceed 5% of the total calories (max 15-20 grams per day). Note: this quantity can be easily exceeded by consuming sweets and / or some packaged products (biscuits, snacks, drinks, etc.), the use of which must therefore be limited or better avoided.

For the same reason it is good to replace sugar with sweeteners with no nutritional value (approved by the FDA) absolutely without risk for the patient.

Which carbohydrate-rich foods are most recommended in the diet for type 2 diabetes mellitus?

The carbohydrate sources most suitable for the diet against type 2 diabetes mellitus, in addition to being consumed in the right portions, must have the following characteristics:

• Low or medium glycemic load; it is a parameter related to the total amount of carbohydrates in the diet. Let's say that staying on the percentages suggested above, the problem would be relative; it is sufficient not to amass all the carbohydrates in one or two meals;
• Low or at most medium glycemic and insulin index; they are two strongly correlated parameters, but in any case dependent on the glycemic load. A small portion of food with a high glycemic-insulin index is however less harmful than a large portion with a high glycemic-insulin index;
• Richness in fiber, which reduces both the load and the glycemic index (for example, wholemeal flour is better than refined);
• Wealth of water, which reduces the glycemic load (for example, fresh fruit is better than dehydrated fruit);
• Presence of proteins and fats, which tend to reduce the glycemic-insulin index, as long as the portion is reasonable; this is especially true for the entire meal which, in addition to the sources of carbohydrates, must also contain small quantities of other nutrients (for example, for the same calories, better 80 g of pasta seasoned with fish, vegetables and a teaspoon of oil, rather than 120 g of boiled pasta and nothing else).

What to eat and what to avoid in the diet for type 2 diabetes mellitus

What to eat and "how" in the diet for type 2 diabetes mellitus

As for cereals, legumes, pseudocereals and derivatives (flours and recipes), prefer wholemeal ones. Weights should always be less than 100 g (preferably between 60 and 80 g).

Prefer highly hydrated foods; for example pasta cooked with dry baked goods.

In the case of first courses (with pasta, rice or other cereals or pseudocereals), choose simple recipes, combining vegetables (tomato, zucchini, broccoli, etc.), or lean meats or fish products (tuna in brine, cephalopod molluscs, chicken breast , rabbit loin, veal fillet, etc.); occasionally eggs, crustaceans, offal and bivalve molluscs. The use of extra virgin olive oil is allowed in the order of 5-10 g.

Prefer drinks with low carbohydrates (for example grapefruit juice), without added sugars (for example natural fruit juice), preferably light (such as light cola).

In drinks, possibly use non-calorie sweeteners moderating sugar alcohols and fructose.

Consume only fruits and vegetables mentioned in the list of foods not recommended, in the order of 400 g of vegetables per day and no more than 200 g of fruit. Carrots, contrary to what many believe, can be eaten safely.

The most suitable fruits are: apples (especially green), kiwi, oranges, melon, watermelon, peach, apricot, plum, pear, grapefruit, strawberries etc.

What not to eat or what behaviors to avoid

Do not overdo the doses of pasta and rice and avoid elaborate first courses prepared with fatty condiments (lasagna, tortellini, cannelloni, risotto, etc.).

Avoid having two starchy foods (such as bread, pasta and potatoes) in the same meal.

Avoid elaborate pizzas, bread substitutes with added fat and salt (crackers, bread sticks, oil sandwiches, focaccia).

Avoid dehydrated fruit with a carbohydrate content (dates, candied fruit, mustard, dried figs, prunes, dried apricots, etc.), or in any case particularly sweet such as fruit in syrup.

Avoid dried fruit or oil seeds in large doses (walnuts, almonds, pine nuts, hazelnuts, pecans, pistachios, peanuts, macadamia, etc.), because they are very high in calories; alone those who have the ability to control their intake could benefit from the intake of 10-20 g of oil seeds with a prevalence of omega 3 (alpha linolenic acid).

Avoid fruit with a high sugar concentration as much as possible: ripe bananas, mandarins, grapes, pomegranates, figs, persimmons, etc.

Avoid fruit juices and sugary drinks in general.

Limit the addition of granular sugar, the consumption of foods already sweetened, even with fructose or sugar alcohols, honey and various syrups.

Avoid refined confectionery products with a high carbohydrate-lipid and therefore energy content (biscuits, snacks, snacks, ice creams, prepackaged sweets, croissants, pastas), chocolate, jam.

Avoid sugary drinks.

Overweight and Obesity

Overweight and obesity: primary causes of type 2 diabetes mellitus

Like all other metabolic disorders, type 2 diabetes mellitus arises and worsens with overweight, especially severe (BMI> 30).

If necessary, it is necessary to lose weight. A good method of weight loss is the elimination of 30% of calories, to obtain a weight loss of about three kilograms per month.

It has been observed that, in certain cases, the reduction of excess fat can improve metabolic parameters as well more of the compositional correction of the diet. A simple weight loss of 5-10% will improve metabolic control by favoring the reduction of blood sugar, blood pressure and the improvement of the lipid profile.

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