Douglas Twenefour, specialist dietitian and deputy head of care at Diabetes UK, explains what to eat when you have Type 1 or Type 2 diabetes and shares his top 10 tips for managing diabetes.
There are different types of diabetes, and no two people with diabetes are the same. This is why eating to manage diabetes has so many important nuances. There is not a ‘one-size-fits-all’ eating pattern for everyone with diabetes, but below I have suggested tips that can be incorporated into individual healthy eating goals for people who have the condition. However, as everyone is different, it is important to ask for a referral to see a dietitian to discuss your individual needs and preferences.
For people with Type 1 diabetes, the main priority is to estimate how much carbs to eat per meal, and match these with insulin dose (this is known as carb counting). For people with Type 2 diabetes who may be overweight, finding a way to lose weight (including healthy eating, low carb diets, Mediterranean diet or very low calorie diets when supervised by a medical professional) is the priority, as losing excess weight significantly improves diabetes management. However, not everyone with Type 2 diabetes is overweight so maintaining your current weight, or in some instances gaining a little more weight, may be the goal.
These healthy eating tips are general and can help you manage blood glucose, blood pressure, and blood cholesterol levels. They can also help you manage your weight and reduce risk of diabetes complications such as cardiovascular disease (CVD). Eating healthily and maintaining an active lifestyle can also help reduce your risk of other health conditions.
1. Choose healthier carbohydrates
All carbohydrates affect blood sugar levels, so it is important to know which foods contain carbohydrates, choose the heathier sources and be aware of the portions you eat. Healthier sources of carbs include wholegrains, fruit and vegetables, pulses and dairy, so limit your intake of refined carbohydrates such as white bread, white rice and highly processed cereals.
If you have Type 1 diabetes, carb counting can help manage your blood glucose levels. You can ask for advice from a dietitian for help with this, or you may also be referred to a diabetes education programme which will be able to provide information and guidance.
2. Use less salt
Having too much salt increases risk of high blood pressure. This in turn increases your risk of heart disease and stroke, which people with diabetes are already at higher risk of. Aim for a maximum of 6g (1tsp) of salt per day. As many pre-packaged foods already contain salt, try to rely less on processed foods – check food labels if you are not sure how much salt they contain. A good way to cut down on processed foods is to cook from scratch at home. You can also adapt recipes by cooking with herbs, spices and peppers to replace salt.
3. Eat more pulses and fish
Eating too much red and processed meat such as bacon, ham and sausages is associated with various health conditions such as CVD and certain types of cancers. Replace these with pulses, eggs, fish, poultry, and nuts. Beans, peas, lentils and dhal are high in fibre, have little effect on blood glucose levels and can be good alternatives to meat.
Aim for two portions of oily fish a week. They are rich in omega-3 oil (polyunsaturated fat) which helps protect against heart disease, which people with diabetes are at higher risk of. Examples include salmon, mackerel, sardines and pilchards.
4. Include fruit and vegetables
Try to eat more fruit and veg at mealtimes and have them as snacks. This can help you get the range of vitamins, minerals and fibre your body needs. Fruits contain natural sugar, so choose whole fruit instead of fruit juices, and spread your intake through the day rather than eating huge portions at a go. Choose from fresh, frozen, tinned or dried.
5. Choose healthier fats
Foods such as nuts, seeds, avocados, olive oil, and oily fish have good mixtures of healthy fats. Swap saturated fats such as palm oil, coconut oil, ghee, butter and lard for vegetable oils such as olive oil, rapeseed oil, groundnut oil, corn oil and sunflower oil. Grill, steam or bake foods rather than frying.
6. Reduce your intake of sugar
Swap sugary drinks, energy drinks and fruit juices for water, unsweetened milk, unsweetened tea and coffee. Try to reduce sugary foods such as cakes, pastries and biscuits, and foods with added fructose and polyols. Artificial sweeteners may be an option to help you reduce your intake of sugars and calories.
7. Be smart with snacks
If you want a snack, choose yogurts, unsalted nuts, seeds, fruits and vegetables instead of crisps, chips, biscuits and chocolates – and watch your portions.
8. Drink sensibly
If you drink alcohol, limit your intake to a maximum of 14 units a week, avoid binge drinking and go several days a week without alcohol. Remember: 1 unit is a single measure (25ml) of spirits, or half a pint (284ml) of normal strength lager, beer or cider, but a small (125ml) glass of wine is actually 1.5 units. Alcohol is high in calories. To lose weight, consider cutting back. It is not a good idea to drink on an empty stomach, especially if you take insulin or other diabetes medications that put you at risk of hypos, as alcohol can make hypos more likely to happen.
9. Don’t bother with so-called diabetic foods
These products offer no special benefits to people with diabetes and may still affect your blood glucose levels. They may contain as much fat and calories as ordinary versions, are often expensive and can have a laxative effect.
10. Get your minerals and vitamins from foods, not supplements
There is no evidence that mineral and vitamin supplements can help manage diabetes. Unless you’re at risk of deficiency of specific minerals or vitamins, or you require a particular supplement for a medical condition or other reason (e.g. folic acid for pregnancy), supplements are unnecessary. It is better to get your essential nutrients from eating a mixture of different foods. If you think you may have a nutrient deficiency, speak to your healthcare team before you take supplements. This is because some supplements could affect the way your medications work or make some diabetes complications (e.g. kidney disease) worse.
It is also important to keep physically active, if you can. Being more active can help with diabetes management and also reduce your risk of cardiovascular disease. Aim for at least 150 minutes of moderate intensity physical activity a week spread over at least three or more days. This can be broken down into bite-size chunks of at least 10 minutes. Try to spend less time sitting down and have regular, active breaks – just getting up and going for a walk can be beneficial for both body and mind!
This article was last reviewed on 6 June 2018 by Diabetes UK.
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