Diabetes and diet - the basics

One of the most important things to remember if you have diabetes, is that you need to consult a clinical dietitian to have an individual diet worked out for you, here is certain basic information about diabetes that may prove useful.

What is diabetes?

Individuals who suffer from diabetes all have raised blood sugar or glucose levels. The cause of these high blood sugar levels is either an inability to produce enough insulin (a hormone produced by the pancreas), or a decrease in the sensitivity of body cells to insulin, so-called insulin resistance.

The food we eat is digested and broken down into simple components. One of these simple components is called glucose which is obtained from carbohydrate breakdown.

Glucose is the main source of energy in the body and this is why it is so important to be able to transport the glucose from the digestive tract via the blood to each and every cell in the human body. The hormone insulin is responsible for carrying glucose over the “wall” of the cell membrane into the cell.

If your body doesn’t produce sufficient insulin or if you have insulin resistant cells in your body, you will not be able to transport glucose over the cell membrane and your body cells will literally “starve” due to a lack of glucose as an energy source. At the same time, the glucose levels in the blood will rise because glucose is not being removed from the blood and transported into the cells, hence the high blood glucose levels.

Two kinds of diabetes

People suffering from diabetes are usually divided into two categories, namely:

1) Insulin-dependent diabetes mellitus, or type 1 diabetes

These patients do not make sufficient insulin to meet the needs of the body. Type I diabetes is most often diagnosed in children and adolescents. Treatment consists of taking insulin injections, combined with a special diet and controlled amounts of exercise.

2) Non-insulin-dependent diabetes mellitus, or type 2 diabetes

Patients with Type II diabetes often produce some insulin but in insufficient quantities to meet the need of their bodies and/or have become resistant to the insulin their bodies produce. This type of diabetes is more common in adults and older people. In some cases Type 2 diabetes can be controlled by diet alone, while a combination of oral medications, diet, weight loss and exercise is used in other cases.

How do I know if I have diabetes?

The following symptoms tend to occur when you have diabetes:

a) Symptoms associated with uncontrolled, high blood sugar levels

• weight loss (can occur even if you are eating well and have a good appetite)
• uncontrollable thirst
• increase in urination (without having a bladder or kidney infection)
• blurred vision
• bad abdominal pains
• tendency to develop infections and sores that do not heal quickly or well
• feelings of exhaustion
• inability to concentrate

On the other hand, blood sugar levels can also drop too low when a diagnosed diabetic does not stick to her/his diet, or skips meals, does physically exhausting exercise, is exposed to various stresses, or uses more insulin medication that is required.

b) Symptoms associated with low blood sugar levels

• trembling
• sweating
• pallor
• fatigue
• headache
• loss of concentration

This list of symptoms is very similar to the ones that may occur when you suffer from a condition called hypoglycaemia (low blood sugar). In both cases, these symptoms are caused by blood sugar levels that are too low, and treatment aims to raise the blood sugar to normal levels again.

Treatment of diabetes

As mentioned above, insulin-dependent diabetics need to inject themselves with insulin every day to provide the body with the insulin that is lacking. Insulin therapy has to be combined with a special diet and controlled amounts of exercise.

Non-insulin-dependent diabetics take oral medications, together with a special diet and controlled exercise.

Obesity is a complicating factor that needs to be treated, says dietician, Dr Ingrid van Heerden. If a diabetic is overweight then he or she must try and lose weight by following the instructions of a clinical dietitian and doing a certain amount of exercise. The idea is NOT to starve yourself or exercise to exhaustion, as such drastic approaches to weight loss can endanger your health.

Basic dietary guidelines for diabetics

The basic principles of the diabetic diet are as follows:

• eat a balanced diet
• try and achieve your ideal body weight
• avoid large quantities of sugar and highly processed carbohydrates (cakes, pies, pastries, white rice)
• eat plenty of dietary fibre (brown rice, wholewheat bread, oats, unsifted maize meal, fresh, unpeeled, raw fruits and vegetable, and legumes, such as cooked, dry beans, peas and lentils and meat substitutes made from legumes like soya)
• cut down on fat intake (eat less butter, margarine, oil and mayonnaise, use nonstick pans and nonstick spray for cooking, avoid all fatty food)
• eat less salt (use less salt in cooking, replace salt with other herbs and spices, cut out commercial soups and gravies which have a very high salt content, use a salt substitute)

However, you must keep in mind that the details of the diabetic diet that you are going to use have to be worked out by a clinical dietitian who will take into consideration:

• your age and sex, (young people and men usually need to take in more energy)
• level of activity (people who are physically active have increased energy requirements)
• the type of diabetes you have (type I or type II)
• the type of medication you are taking (insulin injections or oral medication)
• body weight (over- or underweight)
• other complicating factors (kidney disease, hypertension)
• the stresses you are exposed to (both physical and psychological)
• growth phases (childhood, adolescence, pregnancy, lactation)
• short-term complications (infections, taking part in athletic events, writing exams, etc)

With the correct medication, diet, and exercise, all diabetics should be able to live perfectly normal and happy lives.

For more information on care and support of diabetes visit Diabetes South Africa or phone them on 011 886 3721 / 3765.