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Norfolk & Norwich University Hospital NHS Trust Kate Gudgeon chief community dietician
Diet and diabetes
The number of people with diabetes is set to double by 2010 because of the increase in obesity, which itself has trebled over the last 20 years. So what is diabetes? Diabetes occurs when the body stops producing insulin [a hormone produced by the pancreas], in the case of type I diabetes. In the case of type II diabetes the amount of insulin produced is reduced or the insulin produced cannot work effectively. Insulin enables sugar from the blood stream to be transported to our muscle cells where it is used for energy. The sugar reaches the blood when we eat and digest certain foods. Some foods cause a faster rise in blood sugar levels than other foods. Ideally foods that cause a rapid rise in blood sugar levels should be eaten less often in people with diabetes. When blood sugars are high in the case of poorly controlled diabetics or people with undiagnosed diabetes, then often tiredness is a symptom, because the muscles are not getting the energy they need. Rapid weight loss may occue and individuals often feel very thirsty and therefore drink more, which may result in passing more urine. High blood sugar may result in poor wound healing so any cut, or injury make take longer to heal or there maybe an increase in problems like thrush. Vision can become blurred and sometimes sight does not return to normal even when blood sugar levels stabilise.
Type II diabetes often occurs in overweight people [hence the rise in incidence of diabetes is mirrored by the rise in the obesity rate] but, this is not always the case. Also there is an increased likelihood if your parents have diabetes that you may develop it. Type II diabetes can be treated with diet alone, diet and tablets or diet and insulin. But no matter what medication you are on, whether you have type I or type II diabetes, then diet is the cornerstone of your treatment. If you are overweight the key aim of any dietary treatment is weight loss. A five–to–10 per cent reduction in weight can help improve blood glucose levels. Regular meals that contain regular amounts of carbohydrate foods is one of the key messages for people with diabetes to follow. That is each meal should contain either bread, pasta, rice, potato or a form of unsweetened breakfast cereal. The sugar content of the diet should be reduced. Sugar in drinks and on cereals should be cut out or replaced with artificial sweetener, for example, Splenda, Canderel. Squash and fizzy drinks should be ‘diet’ or no added sugar versions. Fancy cakes, biscuits and chocolates should be limited but, if consumed, small amounts would be permitted occasionally at the end of a meal that contains some carbohydrate. Aim for five portions of fruit and vegetables per day. Fruit is a good food to eat but it does need to be spread evenly throughout the day. Fruit has a natural sugar content and if more than one portion of fruit at a time is eaten then blood sugars could increase.
If fats are eaten then generally it is better to use monounsaturated fats, for example, olive oil and olive oil spreads or rapeseed oil rather than saturated fats. But remember, all fats are high in calories so need to be limited. Oily fish is one of the exceptions in this group. They have beneficial properties, for example, help to keep the blood thin, so reducing risk of clot formation. A serving of oily fish, for example, pilchards, sardines, mackerel, salmon is recommended at least once a week. Fresh tuna does contain the beneficial fatty acids but tinned tuna does not. There has been press coverage of glycaemic index and the role of it may have in improving blood sugar levels in people with diabetes. Foods with a low glycaemic index, for example, pulses, oat–based cereals, noodles and pasta can help to lower blood sugar levels thereby improving blood sugar control. It makes sense to encourage the use of these foods but in conjunction with a healthy balanced diet. Diabetic products are expensive, can be quite high in fat and may contain a sugar substitute that has a laxative effect. For these reasons the use of diabetic products are discouraged. Pasta salad What you need150g [6oz] pasta shells, Small tin sweetcorn [drained], Small tin tuna [drained], Low calorie mayonnaise or salad cream. EquipmentMixing bowl. How to make it1: Cook pasta according to packet and leave to get cold. 2: Put all ingredients into a bowl and mix in the mayonnaise. 3: Chill. From your browser | Email the page | Email the page link | Print the page | Add page to favourites Handy guide to wellbeing series | For you, family and friends
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There are 1.4 million people in the United Kingdom with diabetes and it is estimated that there are a further one million people who have diabetes but do not know it yet.
People diagnosed with type I diabetes are usually under 35. The reason type I diabetes occurs is not clear, genetics may play a role, the body for some reason stops producing insulin and without taking regular daily injections death would immediately occur.
Foods high in fat are also high in calories. Since 80 per cent of people with type II diabetes are overweight then an overall reduction in high fat foods, for example, cheese, cream, pastry, fried chips and crisps should be encouraged.