What is diabetes?
Diabetes is a lifelong condition caused by a failure of the blood sugar regulation mechanism in the body. This is controlled by a hormone called insulin. Diabetes results when the pancreas does not secrete enough insulin or cells of the body become resistant to insulin so blood sugar levels are not controlled as they should be. Without the proper function of insulin, sugar cannot enter muscle or fat cells, causing serious secondary complications such as heart disease, stroke, kidney disease, neuropathy and other complications.
How many types of diabetes are there?
Recent research has suggested that diabetes could be seen as five separate diseases, with the potential for treatment to be tailored to each of the different forms. The study was published in The Lancet Diabetes and Endocrinology and looked at 14,775 Scandinavian patients. However, while experts saw the results as promising, they cautioned that further research would be necessary before changes could be made to treatment.
The NHS still classifies diabetes in two types.
Type 1 diabetes
Insulin dependent, less common and usually develops before the age of 30.
Type 1 diabetes occurs when the pancreas stops producing insulin. The exact cause is unknown but some believe that it is an autoimmune response in which the body attacks its own pancreatic cells. People with Type 1 diabetes must take insulin for life.
Type 2 diabetes
Non-insulin dependent, used to be most common in later life but is becoming increasingly more prevalent in younger generation largely due to an increase in obesity.
In Type 2 diabetes, the pancreas still produces insulin, but either it is not producing enough or the body does not respond to it properly. The most common cause of type 2 diabetes is obesity. In many cases, Type 2 diabetes can be avoided through eating a healthy, balanced diet and taking regular exercise and often can be controlled in the same way if diagnosed. However, some cases will require medication and your doctor should be the one to determine whether this is necessary.
Recent research has reported interesting evidence to support the reversal of type 2 diabetes. Research funded by Diabetes UK and performed by a team at Newcastle University reported that type 2 diabetes can be reversed by an extremely low-calorie diet (600 kcals per day).
This diet is extreme and Diabetes UK strongly recommends that such a drastic diet is only undertaken under professional medical supervision. People with diabetes who want to lose weight should consult their GP before undertaking any new eating plan.
…a note on gestational diabetes
Gestational diabetes is a type of diabetes that affects women during pregnancy, when some women have slightly higher than normal levels of glucose in their blood and their body cannot produce enough insulin to transport it all into the cells.
Read more from the NHS on gestational diabetes.
Symptoms of diabetes can include tiredness, thirst, frequent urination and skin infections. A full list of symptoms can be found at diabetes.co.uk . Diabetes must always be controlled under the management of a doctor. For further advice and information see: diabetes.org.uk
People with diabetes of either Type 1 or 2 have a higher chance of developing a range of health conditions including heart disease, stroke, high blood pressure, circulation problems, nerve damage and damage to the kidneys and eyes. If you are overweight then losing this excess weight healthily and steadily can have a very positive effect on blood sugar levels and can reduce the risk of developing Type 2 diabetes. It’s also particularly important to build up a good exercise routine as this will help the body maintain good blood sugar levels.
Food choices for diabetics
Dietary modification is fundamental to the successful management of both Type 1 and Type 2 diabetes, though making sensible choices will mean you can continue to enjoy a wide range of foods. It’s imperative that weight is kept within the normal range. The dietary guidelines are very similar to those recommended for a healthy lifestyle: eat less sugar and fat, include more fibre-rich starchy foods and more fruit and vegetables with moderate amounts of meat, fish, milk and dairy. Choosing the right foods can make a big difference and eating regularly helps to ensure blood sugar levels do not fluctuate too much.
Foods to eat
– Starchy carbohydrates provide energy and help maintain and control blood glucose levels so should factor in every meal, though portion sizes and carb intake should be discussed with a dietitian to ensure you are eating to your individual needs. Look for wholemeal or wholegrain breads, high fibre breakfast cereals, wholemeal pasta and brown rice.
– Fibre can slow the rate at which the starch and sugar in foods enter the bloodstream. It can also help manage cholesterol levels as part of a balanced diet. This kind of soluble fibre is found in oats, pulses, fruit and vegetables.
– Whether you are taking insulin or not, stick to low GI foods (see below for suggestions).
– Magnesium, chromium, zinc and vitamin B3 all help to stabilise blood sugar. Eat plenty of green vegetables, whole grains, dairy foods, brewer’s yeast, seafood and pulses to ensure adequate amounts of these micronutrients.
– Maintain your hydration levels with water, herbal teas etc. but avoid squash and sugary drinks.
Foods to avoid
– Diabetes is linked to a higher risk of cardiovascular disease so the same heart friendly healthy eating principles apply. See our Spotlight on heart disease article.
– If you decide to drink alcohol, avoid drinking more than the recommended amount, and never drink alcohol on an empty stomach. Men and women are advised not to reguarly drink more than 14 units a week. Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia). Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.
– Minimise refined carbohydrates and enjoy more foods with a low GI instead. When buying processed or packaged foods check labels and be sure to understand those ingredients which may influence blood sugar levels – these include ingredients ending in ‘-ose’ as well as additives like maltodextrin.
Moderate your intake of the following:
- Over-ripe bananas
- Fruit yogurts and desserts high in sugar
- Fruit juices
- Dried figs & dates
- White bread, baguettes and bagels
- Cream crackers & white rice cakes
- Iced cakes & pastries
- Scones, crumpets and waffles
- Sweet pies
- Fruit canned in syrup
- Breakfast cereals containing sugar
- Baked & mashed potatoes & chips
- White rice
- Corn & rice pasta
- High sugar jams & jellies
- Crisps & other potato & corn snacks
- Fruit drinks containing added sugar
- Fizzy drinks containing sugar
- Sweets & chocolate bars
- Thickened soups
- Table sugar
- Ice cream containing glucose syrup or high levels of other sugars
Swap higher GI foods for lower GI foods:
- Swap refined sugary cereal for oatmeal porridge, All Bran or muesli
- Swap white bread sandwiches for whole grain or granary bread sandwiches
- Swap white rice for basmati rice or wholegrain rice
- Swap biscuits or cookies for a small handful of nuts
- Swap sugary fizzy drinks for water
- Swap sweets or sugar candy for raw vegetable sticks with cheese or low-GI fruit
- Swap milk chocolate bar for plain dark chocolate (70% or more cocoa solids)
- Swap jam or marmalade on toast for avocado or nut butter on toast
- Swap curry with rice for curry with chickpeas or lentils
- Swap rice cakes for oatcakes
- Swap pretzels for walnuts
Simple salads to keep those blood sugar levels in check:
Mexican bean salad
Chickpea & roasted pepper salad
Salmon & soya bean salad
Use beans and pulses in chillis and stews and serve with brown rice:
Spicy meatballs with chilli black beans
Spicy root & lentil casserole
Slow cooker chicken casserole
Managing your weight can help control Type 2 diabetes. Check out some of our favourite low-fat recipes which don’t compromise on taste:
Zesty haddock with crushed potatoes & peas
Superhealthy Singapore noodles
For further advice or information regarding the diagnosis or management of diabetes please consult your doctor.
This article was last reviewed on 27 June 2019 by Kerry Torrens.
A qualified nutritionist (MBANT), Kerry Torrens is a contributing author to a number of nutritional and cookery publications including BBC Good Food magazine. Kerry is a member of the The Royal Society of Medicine, Complementary and Natural Healthcare Council (CNHC), British Association for Applied Nutrition and Nutritional Therapy (BANT).
Jo Lewin is a registered nutritionist (RNutr) with the Association for Nutrition with a specialism in public health. Follow her on Twitter @nutri_jo.
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