Proper, rational and carefully balanced diet in diabetes mellitus is a key factor in maintaining systemic stable compensation of carbohydrate metabolism. Unfortunately, at this time there are no effective medications that could completely rid a person of diabetes, so diet, with the right daily regimen and, if necessary, taking medication, can help the patient live comfortably and without fear for health.
Doctors have long known about the need for diet in diabetes mellitus - it was the pre-insulin medical diet that was the only effective mechanism to combat the problem. Nutrition is especially important for patients with type 1 diabetes mellitus, where there is a high probability of coma with decompensation and even death. For diabetics with another type of disease, nutritional therapy is usually prescribed for weight correction and for a more predictable stable course of the disease.
- The basic concept of a therapeutic diet for any type of diabetes is the so-called unit of bread - a theoretical measure equivalent to ten grams of carbohydrates. Modern nutritionists have developed special sets of tables for all types of products, indicating the amount of XE per 100 grams of product. Every day a patient with diabetes is recommended to take a product with a total "value" of 12-24 XE - the dosage is chosen individually, depending on the body weight, age and degree of physical activity of the patient.
- Keep a detailed food diary. All food consumed must be recorded so that, if necessary, the nutritionist can correct the nutrition system.
- Number of moves. Diabetics are recommended to eat 5-6 times. At the same time, breakfast, lunch and dinner should make up 75 percent of the daily meal, the remaining 2-3 snacks - the remaining 25 percent.
- Individualization of medical nutrition. Modern science recommends individualization of classic diets, adapting them to the patient's physiological preferences, regional factors (set of local dishes and traditions) and other parameters, while maintaining the balance of all components of a balanced diet.
- Replacement equivalence. If you change your diet, the selected alternative products should be as interchangeable in terms of calorie content, as well as the ratio of protein, fat, carbohydrates. The main groups of components in this case include products that contain predominantly carbohydrates (1), proteins (2), fats (3) and multicomponent (4). Substitutions are only possible within these groups. If substitution occurs in (4), then nutritionists make adjustments to the composition of the overall diet, while substituting the elements from (1), equivalence in terms of glycemic index needs to be considered - the XE tables described above can help.
Foods that are strictly forbidden in diabetes
Modern dietetics, armed with advanced diagnostic methods and research into the effects of substances and products on the body, has significantly narrowed the list of absolutely forbidden foods for patients with diabetes in recent years. At the moment, dishes based on refined carbohydrates, sweets and sugars, as well as products that contain refractory fats and a lot of cholesterol, are absolutely contraindicated.
There is a relative ban on white bread, rice and semolina, as well as pasta - they can be used strictly limited. In addition, regardless of the type of diabetes, alcohol is completely contraindicated.
In some cases, strict adherence to a diet for type 2 diabetes helps to fully compensate for carbohydrate metabolism and not use medications. For diabetics with type 1 diabetes and other types of diabetes, nutritional therapy is considered and is an important element of complex problem therapy.
Types of diabetic diet
- Classic.This type of nutritional therapy was developed back in the 30s and 40s of the twentieth century and represents a balanced, albeit strict type of diet. Its striking representative in domestic dietetics is “Table No. 9” with numerous, later variations. This type of therapeutic diet is suitable for almost all diabetics with type 1 and type 2 diabetes.
- Modern.The principles of individualization and peculiarities of the mentality of certain social groups have spawned various menus and modern diets, with less strict bans on certain types of products and taking into account new properties discovered in the latter, which allowed the introduction of previously banned products in everyday diet. The main principles here are the factor of using "protected" carbohydrates, which contain a sufficient amount of dietary fiber. However, it should be understood that this type of medical diet is selected strictly individually and cannot be considered a universal mechanism to compensate for carbohydrate metabolism.
- Low carb diet.Designed primarily for overweight type 2 diabetics. The main principle is to exclude the highest possible consumption of foods high in carbohydrates, but not to the detriment of health. However, it is contraindicated for children and also cannot be used by people with kidney problems (late-stage nephropathy) and diabetics with type 1 diabetes and severe hypoglycemia.
- Vegetarian diet.Experimental studies at the turn of the 20th and 20th centuries have shown that a vegan diet with an emphasis on significantly reducing the intake of high-fat foods not only contributes to weight loss, but also lowers blood sugar. A large amount of whole vegetation, rich in dietary fiber and fiber, in some cases turns out to be even more effective than the recommended specialized diets, especially since a vegetarian diet involves a significant reduction in the total calories in the daily diet. This in turn significantly reduces the risk of metabolic syndrome in pre-diabetic conditions, can act as an independent prophylactic agent and effectively combat the onset of diabetes.
Below we will consider the classic diet menu for type 1 and type 2 diabetics, which is optimal for patients with mild to moderate forms of diabetes. In the event of severe decompensation, predisposition, and hyper- and hypoglycemia, the nutritionist should develop an individualized diet regimen taking into account human physiology, current health problems, and other factors.
- Protein - 85-90 grams (sixty percent of animal origin).
- Fat - 75-80 grams (one third of vegetables).
- Carbohydrates - 250-300 grams.
- Free liquid - about one and a half liters.
- Salt - 11 grams.
The food system is fractional, five to six times a day, the daily maximum energy value does not exceed 2400 kcal.
Prohibited Products:Meat / culinary fats, sharp sauces, sweet juices, pastries, lush soups, cream, pickles and marinades, fatty meats and fish, canning, salty and saturated cheeses, pasta, semolina, rice, sugar, jams, alcohol, sugar-based ice cream and sweets, grapes, all raisins and bananas with dates / figs.
Allowed food / dishes:
- Flour products are allowed - rye bread and bran bread, as well as tasteless flour products.
- Soups - optimal for medical nutrition are borscht, cabbage soup, vegetable soups, as well as stews in low-fat soup. Sometimes okroshka.
- Meat. Varieties of beef, veal, pork with reduced fat. Restricted chicken, rabbit, lamb, boiled tongue and liver allowed. From fish - any variety with little fat, cooked, steamed or baked without vegetable oil.
- Dairy products. Low-fat cheeses, fermented dairy products without added sugar. Limited - 10% sour cream, low-fat or semi-fat cottage cheese. Eat eggs without yolks, in the last resort, in the form of an omelet.
- Cereals. Oatmeal, pearl barley, beans, buckwheat, barley, millet.
- Vegetables. Carrots, beets, cabbage, pumpkin, zucchini, eggplant, cucumbers and tomatoes are recommended. Potatoes are limited.
- Snacks and sauces. Fresh vegetable salads, tomato and non-fatty acid sauces, horseradish, mustard and pepper. Limited - zucchini or other vegetable caviar, vinaigrette, jelly, fish, seafood dishes with the least vegetable oil, beef jelly with little fat.
- Fats - limited vegetables, butter and ghee.
- Miscellaneous. Sugar-free drinks (tea, coffee, rosehip soup, vegetable juices), jellies, mousses, fresh sweet and sour non-exotic fruits, compotes. Very limited - honey and sweets with sweeteners.
Indicative weekly menu for diabetes mellitus
The individual components of the lower menu are subject to replacement in accordance with the principles of equivalent replacement within the above groups.
- We will have breakfast with two hundred grams of low-fat cottage cheese, to which you can add a little berry fruit.
- The second time we have breakfast with one glass of 1% kefir.
- We have lunch with 150 grams of roast beef, a plate of vegetable soup. For decoration - stewed vegetables in the amount of 100-150 grams.
- In the afternoon, snack on a salad of fresh cabbage and cucumbers, seasoned with a teaspoon of olive oil. The total volume is 100-150 grams.
- Dinner with grilled vegetables (80 grams) and one medium-roasted fish weighing up to two hundred grams.
- We will have breakfast with a plate of buckwheat porridge - no more than 120 grams.
- The second time we have breakfast with two medium-sized apples.
- We have lunch with a plate of vegetable borscht, 100 grams of cooked beef. You can drink food with compote without adding sugar.
- Drink afternoon tea with a glass of rosehip soup.
- We have dinner with a bowl of fresh vegetable salad in the amount of 160-180 grams, as well as one cooked lean fish (150-200 grams).
- We have breakfast with a cheese casserole - 200 grams.
- You can have a glass of rosehip soup before lunch.
- Lunch with a bowl of cabbage soup, two small fish cakes and a hundred grams of vegetable salad.
- Afternoon snack with one boiled egg.
- We have dinner with a plate of stewed cabbage and two medium-sized meat pâtés, cooked in the oven or steamed.
- Breakfast with two egg omelette.
- Before lunch, you can eat a cup of minimally fatty or unsweetened yogurt.
- We have dinner with cabbage soup and two units of stuffed peppers based on lean meat and allowed cereals.
- In the afternoon, snack on two hundred grams of low-fat cottage cheese and a carrot casserole.
- We have dinner with stewed chicken (a piece of two hundred grams) and a plate of vegetable salad.
- We will have breakfast with a plate of millet porridge and one apple.
- Eat two medium-sized oranges before lunch.
- Lunch with meat stew (no more than one hundred grams), a plate of fish soup and a plate of barley.
- Lunch with a plate of fresh vegetable salad.
- We have dinner with a good portion of stewed vegetables with lamb, total weight up to 250 grams.
- We will have breakfast with a plate of bran-based porridge, you can eat one pear bite.
- Eat one soft-boiled egg before dinner.
- We have dinner with a large plate of vegetable stew with the addition of lean meat - only 250 grams.
- Have lunch with a few permitted fruits.
- We have dinner with a hundred grams of stewed lamb and a plate of vegetable salad in the amount of 150 grams.
- We will have breakfast with a bowl of low-fat cottage cheese with a small amount of berries - only up to a hundred grams.
- For the second breakfast - two hundred grams of grilled chicken.
- We have lunch with a plate of vegetable soup, a hundred grams of stew and a bowl of vegetable salad.
- Afternoon snack with a plate of berry salad - up to 150 grams.
- We have dinner with one hundred grams of cooked beans and two hundred grams of steamed shrimp.
Questions and Answers
Is it possible to eat: diabetes fruits, nuts, beets, rice, khaki, pomegranate and pumpkin?
Rice is not allowed. Nuts (walnuts, peanuts, almonds, pine nuts) - it is possible, but in limited quantities (up to 50 grams per day), previously peeled from the shells and other elements. You can use beet for diabetes in cooked form, using it, for example, as a component of vinaigrette - no more than 100 grams per day.
Khaki is a food with a high glycemic index, but it contains a huge amount of nutrients and at the same time does not significantly affect sugar levels, because it contains mainly fructose. You can use it, but in strictly limited quantities, no more than one fruit every few days.
Pumpkin is on the green list for diabetes and can be eaten without any special restrictions (the only threshold is the total calories in the menu). Pomegranate can be eaten by a type 2 diabetic, no more than 50 grams a day.
Is it possible to use honey for diabetes?
Until the 1990s, nutritionists attributed honey to an absolutely forbidden type of food for all types of diabetes. Recent research shows that in type 2 diabetics, a small amount of honey (5-7 grams per day) does not cause an increase in blood sugar levels due to the presence of a large amount of fructose in honey. Therefore, you can use it, but in limited quantities.
How much fruit can you eat for this disease?
Eat them in moderation, carefully choosing fruits for your diet - therefore, grapes are absolutely contraindicated, while apples, oranges or persimmons can be included in the diet, of course, in limited quantities - no more than 1-2 fruits per day.
Is there a low carb diet for type 2 diabetes?
The low-water diet is intended for diabetics with type 2 diabetes who have problems with being overweight. Its main direction is to reduce carbohydrate intake and reduce the total daily energy value of the diet. As an alternative, modern nutritionists often offer a vegetarian diet - in some cases they are even more effective than the classic therapeutic diet foods usually recommended by doctors.
Do I have to follow a diet?
It is necessary to support the compensation of carbohydrate metabolism. A 6-course meal plan with a maximum daily energy threshold of 2400 kcal for adults is the best option used everywhere.
Do you need a strict diet for diabetes?
Modern science has significantly expanded the limits of permitted foods for diabetes, allowing patients to diversify their daily diet. The total weight of the diet consists in calculating the amount of carbohydrates consumed, as well as the total calorie content and frequency of meals, while individual components of the diet must be replaced in the same way within their groups.
The baby was born with diabetes. How to feed him?
It's not entirely clear what kind of diabetes we're talking about. If your child has transient neonatal diabetes, then it can be treated and, as a rule, you can get rid of it forever. If we are talking about permanent neonatal diabetes, then the whole life of the baby requires the appointment of insulin and, therefore, lifelong therapy. Both types of disease are quite rare and are a genetic abnormality, sometimes leading to type 1 diabetes in the future.
Did you mean type 2 diabetes acquired in childhood? Either way, your child needs a physiological diet that is absolutely balanced in all respects, meeting the energy needs of the growing body. The diet of a child with diabetes is systemically indistinguishable from the diet of a healthy baby of the same age with identical parameters of physical development - only obviously harmful foods based on refined refined carbohydrates, sweets and sugars, as well as foods containing refractory fats and lots of cholesterol are prohibited. There is a relative ban on white bread, rice and semolina porridge, as well as pasta - they can be used strictly limited.
Of course, we are not talking about the most serious forms of the disease in the decompensation phase. In any case, to develop an individual diet for a child, you need to consult a nutritionist who will take into account the type of diabetes of your child, the characteristics of his body and other factors.