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Are you suffering from diabetes? When someone asks this, a lot of things start bothering: “what will be my lifestyle modifications from now onwards?”, “Can I even survive without taking insulin?” and the list goes on. Here we will discuss some practical guidelines for managing diabetes
According to WHO, diabetes killed around 1.5 million people and became the ninth leading cause of death in 2019.
Diabetes can be a managed by:
1. A good diet plan.
2. Maintaining a healthy weight.
3. Exercise or physical activities.
A healthy diet for diabetes helps prevent cardiovascular diseases, and chronic complications associated with diabetes. A healthy meal plan for diabetes includes balanced portions of carbohydrates, protein, and fats in each meal. It will reduce blood sugar levels, improve blood pressure, and lowers cholesterol levels.
Carbohydrate intake for diabetic patients:
Carbohydrates affect the blood sugar level most so, take into consideration the carb count to measure the insulin to blood sugar ratio to manage and promote a healthy blood sugar level.
A smart or a balanced carb diet promotes a healthy nervous system and improves the kidney, brain, and heart functions.
Select carbs rich in fibers, required for a healthy digestive system. They also improve blood glucose and cholesterol levels like oats, whole grains, barley, legumes, brown rice, non-starchy vegetables, etc.
RECOMMENDED CARBOHYDRATE PORTION PER MEAL-GRAMS
For Women:
For Losing Weight: 2–3 (30–45 grams)
For Maintaining Weight: 3–4 (45–60 grams)
For the Energetics: 4–5 (60–75 grams)
For Men:
For Losing Weight: 3–4 (45–60 grams)
For Maintaining Weight: 4–5 (60–75grams)
For the Energetics: 4–6 (60–90 grams)
Protein intake for diabetic patients:
Protein constitutes a vital part of the diet and does not impact blood sugar levels as they have a low glycemic index. They are the building blocks of muscles, blood, and body tissues. It keeps your stomach full for a long time.
The richest source of protein is animal sources such as fish, chicken, cottage cheese, milk, and Greek yogurt. Plant-based proteins include whole grains, legumes, beans, lentils, nuts, etc.
Approximately 15–20% of protein needs to be a part of both diabetic and non-diabetic person’s diets.
Fats intake for diabetic patients:
People with diabetes are at a greater risk of developing heart diseases thus correct type of fats will improve your heart health by managing your blood sugar levels. Fats are necessary for a healthy heart and brain and aid in the absorption of vitamins in the body.
The healthiest form of fats is unsaturated fats. They help improve HDL or good cholesterol levels commonly found in nuts, olive oil, fish, and avocados. Omega-3 fatty acids are found in fish, promote brain and heart health, and fight inflammation. Saturated fats are found in full-fat dairy products, animal products like red meat, oils like coconut oil, and fried food, and consumed in moderate amounts as they raise LDL or harmful cholesterol levels.
According to American Diabetes Association, you should not take more than 15 grams of saturated fats per day. Trans fat found in cookies, margarine, and crackers, avoid as they will reduce your good cholesterol levels and raise harmful cholesterol levels.
Obesity is a risk factor for type 2 diabetes, if you lose even 5% of your weight it will help in lowering cholesterol levels and high blood pressure leading to cardiac diseases. Fat accumulation around the waist might surround the liver and pancreas which leads to insulin resistance. Knowledge of healthy waist size helps to maintain a healthy weight.
For women:
It should be less than 31.5 inches (80cm)
For men:
It should be less than 37 inches (94cm)
Calories and weight loss:
· For men, to maintain a healthy weight it should be 2,500 kcal per day.
· For women, to maintain a healthy weight it should be around 2,000 kcal per day.
Best weight loss diets for diabetes:
A healthy diet will offer more nutritional value that is low in fat and calories maintaining weight and blood sugar levels. These include:
· DASH Diet
· Mediterranean Diet
· Low carb Diet
· Vegetarian Diet
DASH Diet:
American National Heart, Lung, and Blood Institute recommends DASH (Dietary Approaches to Stop Hypertension) diet. It is a diet pattern to improve health conditions associated with high blood pressure, and high blood sugar levels.it also helps weight loss and improves insulin resistance
DASH diet limits food with high sodium levels and saturated fats and sugars.
It encourages the consumption of:
· Whole grains
· Fat-free dairy products as they are a good source of calcium and vitamin D
· Fruits but with moderation
· Vegetables rich in fiber, vitamins, and minerals such as potassium and magnesium
· Poultry, fish
· Nuts
Mediterranean Diet:
The Mediterranean diet is according to the diet pattern of people living near the Mediterranean Sea.
The Mediterranean diet encourages:
· High consumption of olive oil which is an edible fat, vegetables, Pulses, beans, chickpeas, whole grains, fruits, nuts, and seeds
· Moderate consumption of poultry and fish
· Low utilization of Full-fat dairy products and red meat.
This diet plan is particularly rich in fiber and monosaturated fat which improves high blood sugar and cholesterol. It is also anti-inflammatory as it limits processed foods and sugar which decreases inflammatory markers in the blood reducing the risk of heart diseases and high blood sugar levels.
Low carb or A Smart carb Diet:
Proteins, Carbs, and Fat constitute macronutrients. Out these carbs are found to produce a major effect on blood sugar levels because they break down into smaller units of glucose-raising blood sugar levels. Usually, insulin is released from the pancreas which absorbs glucose from the blood thereby maintaining blood sugar levels whereas a diabetic patient does not have enough insulin to process glucose for maintaining blood sugar levels. A Smart or a low carb diet emphasizes on intake of food that has high nutritional value and is particularly rich in fiber, aids in weight loss, and maintains blood sugar levels allowing moderate to low intake of sugar and starches as they breakdown into glucose elevating blood sugar levels.
A carb intake of 20–90 grams per day is recommended for a diabetic patient.
A carb diet encourages the consumption of:
A good intake of non-starchy vegetables like having low glycemic indexes like lettuce, cucumber, broccoli, cabbage leaves, cauliflower, eggplant, asparagus, tomatoes, etc. Green beans are rich in fiber, Omega-3 enriched or pastured eggs. Whole intact grains like brown rice, whole wheat bread, and oatmeal. Beans, lentils, and chickpeas.
A moderate to low intake of starchy fruits and vegetables like apples, blueberries, strawberries, corns, sweet potatoes, green peas, etc.
Processed carbohydrates and added sugars like soda, sweet tea, juice, cake, candy, cookies, and chips must be avoided.
Plants-based or Vegetarian Diet:
The vegetarian or plant-based diet is beneficial in the treatment of type 2 diabetes and aids in weight loss making our body responds to insulin. This diet is usually low in calories and rich in fiber, antioxidants, folate, and phytochemicals. A vegetarian diet is based on the consumption of whole grains, vegetables, fruits, nuts, seeds, beans, and legumes.
Vegetarians are common of three main types:
Lacto Vegetarians-They exclude meat, fish/seafood, poultry, and eggs, from their diet but include dairy products in their diet
Lacto-Ovo Vegetarian-They excludes meat, fish/seafood, and poultry from their diet but include dairy products as well as eggs in their diet.
Ovo-vegetarians-They excludes meat, fish/seafood, and dairy products from their diet and include eggs in their diet.
Vegan-They doesn’t take meat or animal products excluding meat, fish/seafood, poultry, eggs, dairy, honey, etc, and only take plant-derived foods.
Commonly vegetarians replace the animal source of protein with plant-based proteins like beans, nuts, and grains.
Exercise and physical activities are effective for the management of diabetes as well as obesity. There are several benefits associated with exercise. It can control and maintain diabetes in the following ways:
· Increases insulin sensitivity by improving the body’s use of insulin
· Increases strength and flexibility of bones and joints.
· Maintains blood pressure preventing the risk of diabetes complications.
· Prevents heart diseases by lowering LDL cholesterol.
· Promotes weight loss by burning fat.
· Reduces stress levels and anxiety and promotes relaxation by releasing endorphins-a hormone that creates a feeling of well-being.
· Boost up the energy level and improves blood circulation.
During exercise, your body needs more energy so insulin is released to absorb excess glucose from the blood, lowering blood sugar levels and increasing insulin sensitivity.
What type of exercise people with diabetes should do?
Moderate aerobic activities promote heart health by improving heart rate and helping you breathe faster. These include:
· Brisk walking
· Yoga
· Dancing
· Swimming
According to Physical Activity Guidelines for Americans, an adult needs 150 minutes of physical activity per week and strengthening muscle activities for at least 2 days per week.
Things to consider when a diabetic patient performs physical activity or exercise:
Test your blood sugar level 15 to 30 minutes before exercise
· If it is lower than 100 mg/dL then you take some snacks containing 15–30 grams of carbs before starting your exercise. Blood sugar levels between 100–250 mg/dL are good to go for exercise.
· If your blood sugar level is above 250 mg/dL, you should test your urine for ketone bodies, as it might cause ketoacidosis in which the body breaks down fats for energy instead of sugar due to lack of insulin leading to death or coma.
· Keep yourself hydrated by drinking plenty of water and don’t exercise if your sugar level is 70 mg/dL or below. Quickly eat something like candy, jelly beans, drinks, or fruit juices, or take glucose tablets to maintain your blood sugar level.
Diabetes can contribute to many serious complications but a healthy meal plan, maintaining weight, and performing physical activities can help to manage diabetes by controlling blood glucose levels, improving heart health, and increasing insulin sensitivity.
REFERENCES:
“Diabetes Meal Plan”, Centers for Disease Control and Prevention, March 11, 2021
https://www.cdc.gov/diabetes/managing/eat-well/meal-plan-method.html
“Mediterranean Diet Voted Best for 2022: What Do Diabetes Experts Say?”, diatribe.org, February 22, 2022
https://diatribe.org/mediterranean-diet-voted-best-2022-what-do-diabetes-experts-say
“What You Should Know About Unexplained Weight Loss and Diabetes”, health.clevelandclinic.org, January 24, 2022,
https://health.clevelandclinic.org/what-you-should-know-about-unexplained-weight-loss-and-diabetes
The importance of exercise when you have diabetes”, health.harvard.edu February 3, 2021
https://www.health.harvard.edu/staying-healthy/the-importance-of-exercise-when-you-have-diabetes
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