Diabetes is a chronic disease for which an increasing number of people get sick every year. This is a huge challenge for both doctors and s ///. Symptoms of diabetes mellitus include primarily persistent hyperglycaemia (increased blood glucose levels) as well as elevated sugar levels on an empty stomach as well as between meals and immediately after them. The cause of the disease is insulin deficiency (type 1 diabetes) or insulin resistance (type 2 diabetes).
Nutritional treatment in diabetes is necessary, regardless of its duration and type. It can be used as the only method to improve health or combined with the administration of oral medications or insulin. The type of diet used depends on many factors, including the severity of the disease, the value of glycemia, the presence of complications or other diet-related diseases. Properly selected diet will allow you to level blood glucose and will prevent complications.
What is a carbohydrate exchanger (WW)?
The term means the mass of a given food product in which there is 10g easily digestible carbohydrates. The unit is used in the nutritional treatment of diabetes for the rotation of products on the menu during the day. Suitable replacement tables are used for this. It is important to replace products only within the same group, that is, exchange cereal products for other cereal products, and fruit for other fruits. 1WW is for example 15g oatmeal, 70g potatoes, 200g pumpkin or 80g pear.
The association of the glycemic index with the nutritional treatment of diabetes
Products with a low glycemic index (ie below 55) should be the basis for the menu of all people who want to eat healthy. However, the most attention should be paid to those suffering from diabetes. The glycemic index of a given product means the rate at which blood glucose levels rise after ingestion. The value is compared to the rate at which it increases after consuming the same amount of glucose derived from pure glucose. The term refers primarily to food products that are sources of sugars in the diet. The lower the glycemic index, the less rapid increase in postprandial glucose. Rapid increases and decreases in glucose levels in people with diabetes can cause unpleasant symptoms and even fainting. Failure to follow the principles of nutritional management in diabetes in the long term can lead to serious complications such as kidney damage, brain damage or even loss of vision.
What products to choose for the nutritional treatment of diabetes?
The glycemic index of products should be guided by. Among the permitted carbohydrate foodstuffs, there are mentioned above all wholegrain cereal products. You should choose not only popular rye bread or graham. It is also worth paying attention to other products abundant in carbohydrates – pasta made from wholemeal flour, oatmeal, bran, brown rice and thick groats (buckwheat, pearl barley). Thanks to the high content of fiber and the low glycemic index they will also make the feeling of satiety after a meal eaten longer. The menu should also include raw vegetables and fruits, with a predominance of vegetables.
What affects the value of the glycemic index?
The glycemic index is influenced not only by the amount of carbohydrates in the product, but also by their type. The greater the advantage of simple sugars over complex ones, the higher its value. The presence of fiber in a meal will result in lower postprandial glycemia . The degree of fruit and vegetable maturity is also significant. These overrides will cause a more rapid increase in the level of glucose in the blood. The type of product processing and thermal treatment also affect the glycemic index. The more fragmented and overcooked food, the higher its value. The amount and form of starch present in the product as well as the content of other ingredients are also important. It is worth combining carbohydrate products with protein and fat, because it will slow down the increase in blood glucose.
Impact of heat treatment on the glycemic index
Thermal treatment of carbohydrate-containing products also affects the glycemic index value. Always the best choice in the nutritional treatment of diabetes will be eating them raw. This mainly applies to fruit and vegetables. Vegetables whose glycemic index increases particularly after cooking are carrots and beets. For a raw carrot it is about 30, but after cooking, its value increases almost three times (85)! Instead of a cooked carrot to dinner, a better choice will be preparing a salad. It is also important that the cereal products cook al dente. Consumption of overcooked pasta, rice or porridge will make postprandial glycemia higher.
The glycemic index is not everything
However, the glycemic index is not enough to accurately assess postprandial glycemia. In the nutritional treatment of diabetes, a glycemic charge should also be taken under the microscope, which takes into account the carbohydrate content in the mass of food ingested. This means that the consumption of a small portion of a product with a high glycemic index will similarly affect the level of glucose in the blood as the intake of large amounts of food with a low glycemic index. The glycemic load allows to more accurately predict how the level of glucose in the blood will increase after consumption. An example is eating 100g grapes and 300g grapes. The glycemic index of both fruit portions is the same, although after a three-fold higher amount, postprandial glycemia will be higher due to the higher glycemic load.
What is sweetened in the nutritional treatment of diabetes?
For people with diabetes and those who can not live without sweet taste, there is also a solution. In health food stores and supermarkets are generally available, popular sugar substitutes that can be successfully used in the nutritional treatment of diabetes. They are characterized by very low caloricity and a low or even zero glycemic index as well as a sweet taste. The use of stevia will be a good choice. This extraordinary plant is more than 300 times sweeter than white sugar, so be careful not to overdo it with its amount. The sweet properties of xylitol and erythritol, whose sweetness is close to sucrose, can also be used. Fructose, despite the low glycemic index, will not be a good choice. Its excess will adversely affect the lipid metabolism. You can, however, consume products that contain fructose, in other words vegetables and fruits.
Gestational diabetes – a threat only for the future mother?
Gestational diabetes (GDM) is a disorder of glucose tolerance that occurs during pregnancy. The dominant group of women with GDM are those in whom diabetes was induced by pregnancy. However, they are also people with existing diabetes that has been diagnosed during pregnancy. Abnormal glycemic control in pregnant women is particularly dangerous, because it threatens the health not only of the future mother, but also the child. The fetus developing in the mother’s womb is very sensitive to fluctuations in the level of glucose in its body. Complications of abnormal diabetes include miscarriage, hypoxia of the developing child or premature delivery. Proper management of diabetes during pregnancy is necessary for the proper development of the child in the first stages of his life. Treatment depends on the severity of diabetes. In some cases, the introduction of a proper diet may be sufficient, but in advanced diabetes it is also necessary to include insulin therapy. By following the dietary recommendations for diabetics, you can reduce your insulin dose or even avoid taking it. The implementation of appropriate eating habits is also not indifferent after the end of pregnancy, because a woman who has had gestational diabetes is in a group of higher risk of its occurrence in the future.
In the nutritional treatment of diabetes, the aim is to make the fluctuations in blood sugar levels as small as possible. Therefore, it is very important that in addition to the selection of products with low index and glycemic load, the amount of carbohydrates in each meal was similar. You should also remember to eat at similar intervals – every 3 hours in an amount of 4 to 6. It should be avoided to drink sugary drinks, especially between meals. This will cause an additional increase in the level of glucose in the blood during the day. Juices should be consumed with a meal. Ideally, they will be vegetable juices and unsweetened fruit juices. The diet should exclude alcohol, especially sweet drinks and beer, which has a higher glycemic index than pure glucose!