Diabetes

What is Diabetes?
Diabetes occurs when the amount of glucose in the blood is too high, and the body is not able to use it properly. Glucose is derived mainly from food. Insulin, a hormone produced by the pancreas, is needed to convert glucose into the energy the body requires. If the pancreas does not produce enough insulin, or if thebody cannot use the insulin it has, then diabetes occurs. There are 2 different kinds of diabetes: Insulin Dependent Diabetes (type 1) which is usually diagnosed before the age of 40 and is treated by insulin injections and diet. The second kind is Non-Insulin Dependent Diabetes (type 2) which is usually diagnosed after the age of 40 and is treated by either diet alone, or diet and tablets or, sometimes, diet and insulin injections. Diabetes, however, can affect anyone at anytime.
General Dietary Recommendations
The diet advocated for diabetics is not a 'special diet'. It is a healthy diet which is recommended for everyone. Everyone with diabetes has different dietary requirements depending on age, weight, activity. It is suggested that your GP refer you to the state registered dietition at your local hospital who will be able to give you more specific advice.
A summary of dietary recommendations made by the British Diabetic Association is as follows:
· Avoid being overweight. It is more difficult to control diabetes if you are overweight.
· Eat regular meals and a wide variety of foods. It is important to eat regular meals so that your blood glucose level does not swing from one extreme to another. This is particularly important if you are taking tablets or insulin for your diabetes.
· Eat high fibre carbohydrate foods. e.g. brown rice, wholemeal pasta, wholemeal bread, oats, vegetables, fruit, beans and lentils. This will help control your diabetes.
· Reduce your intake of sugar and sweet foods e.g. sweet cakes, chocolate and sugary drinks.
· Reduce your intake of fried and fatty foods which are very high in calories.
· Avoid special diabetic products e.g. diabetic sweets, diabetic chocolate, diabetic biscuits. These are not necessary, contain the same amount of fat and are not signifcantly lower in calories than their non-diabetic counterparts.
· Use salt in moderation for good general health.
· Drink alcohol in moderation.
The following is a list of more detailed suggestions with regard to day to day eating patterns.
Fruit & Vegetables
Most people do not eat enough fruit and vegetables. So make sure you eat enough to obtain fibre, vitamins and minerals as well as maintaining a healthy digestive system. There is no fibre in animal products like meat, cheese and eggs. Fibre is also removed from foods as they become more refined so try to eat unrefined products such as wholegrain bread, brown rice, etc. Don't just add bran to refined foods because it does not contain the wholegrain nutrients. Try to eat at least 3-4 pieces of fruit per day. If you are eating tinned fruit buy the ones in fruit juice rather than syrup. Sweeten stewed fruit with artificial sweeteners. Eat small amounts of dried fruit as it is a concentrated form of sugar and it should be eaten in small amounts. Grapes and mangoes are quite sweet and if you eat them in large amounts this may affect your blood glucose level.
Carbohydrates
The basic foods themselves will mostly be those you have always probably eaten. it may be that you have heard that you should cut down on starchy carbohydrates such as bread, pasta, potatoes and chapatis. This is not true. It is the refined carbohydrate foods e.g. sugary cakes, that you should be careful about. Starchy foods, often known as complex carbohydrates, should form the basis of your meals. Eat these types of foods at every meal and make it the main part of the meal. Aim to eat the same amount of starchy foods each day. Eat more potatoes (boiled and baked rather than fried or roasted).Choose rice and pasta for a change. There are many breakfast cereals to choose from.
Protein
Make use of pulses (beans, peas and lentils). Add them to stews and casseroles. Vegans should ensure eating low fat protein foods e.g. pulses (soya bean products such as tofu are a good choice). Nuts are nutritious but high in fat and therefore calories so if eating nuts as part of a main meal do not use them as snacks especially if you are overweight.
Fats
If you need to use oil or fat, choose an unsaturated one e.g. olive, rapeseed, sunflower or corn oil. Use reduced fat spreads and non-hydrogenated reduced fat margarines. Granose produce a vegan low fat margarine and all their margarines are made with non-hydrogenated fats. Most saturated fats and hydrogenated fats tend to raise the blood cholesterol level. Saturated fats are usually found in animal foods such as butter, lard, dripping, fatty meat and full fat dairy products. Use less oil in recipes than suggested. Where possible do not use oil for cooking but cook by boiling, casseroling, baking, grilling, steaming or microwaving. The British Diabetic Association recommends making meat, fish and cheese the smaller part of meals (which is easy for vegans!) and filling up on starchy foods and vegetables instead.
Added Sugar
Do not panic about the added sugar in savoury foods such as baked beans or tomato ketchup. It will not be enough to affect your blood glucose levels. Eating healthy regular meals will help to stop you getting too hungry and resorting to sweet foods. As long as your day to day eating patterns are healthy and your blood glucose levels are good, the occasional celebration meal or little bit of chocolate cake will do no harm. If you are going to eat something which is very sugary then do so after a meal. However, if you are overweight, the fewer sweet cakes and biscuits you eat the better.
Eat reduced sugar or no added sugar jams and pure fruit spreads. Use fresh fruit for snacks. Plamil sugar free rice pudding or sugar free soya milks are useful.
Fluid (including alcohol)
Drinking lots of fruit juice, even if unsweetened may make your blood sugar level rise too high. If you like juice, take it with a meal rather than on its own. If drinking because you are very thirsty then dilute it with water or better still drink the water on its own. Drink at least 6-8 cups of fluid a day. Avoid sugary drinks and use the sugar-free ones where you can. Men should have no more than 3 units of alcohol a day, women should have no more than 2 units. Don't save up all your units and binge at the end of the week. Alcohol can cause hypoglycaemia (low blood sugar level). Drinking alcohol also makes it harder to recognise a hypo and recover from it.
e.g. 1 unit = 1/2 pt beer, lager, cider or
1 pub measure of sherry or
1 standard glass wine or
1 pub measure spirit
Try to ensure the following:
· don't drink on an empty stomach or miss a meal so you can have a drink
· If you drink beer or lager, choose ordinary ones preferably with an alcohol content of less than 5%. low sugar 'diet' beers and lagers tend to be higher in alcohol and are best avoided.
· Use sugar-free or slimline mixers
· Choose medium/dry varieties of wines or sherry
You may also be at risk of having a hypo up to several hours after drinking alcohol. It is therefore important to have something to eat with your drink or shortly afterwards.
Further information on Diabetes:
British Diabetic Association, 10 Queen Anne Street, London W1M OBD. Tel: 020 7323 1531. Fax 020 7637 3644.