Life with diabetes
Quick links to our articles on the topic:
The way to prevent type 2 diabetes and its later development is to change bad eating habits and exercise regularly, i.e. lifestyle changes before the onset of the disease. This is based on the normalization of body weight. Ask the help of a dietician to prepare your diet, and exercise intensively for 3x30 minutes a week so that you work up a sweat. With a suitable lifestyle, nearly 70% of people with type 2 diabetes could prevent or delay the development of the disease.
Metabolic syndrome develops in 30-35% of patients already suffering from carbohydrate metabolism disorders. They gain weight, blood fat abnormalities appear, and their blood pressure rises, for which the only effective solution is a personalized diet , precisely defined medication or insulin dosage, and regular exercise. The diet, also known as medical nutrition therapy, includes all the information and guidelines regarding the use of macro- and micronutrients, dietary fibers, pleasure agents, sugar substitutes and sugar substitutes.
In type 1 diabetes, insulin treatment and nutrition together ensure the appropriate blood sugar level - glycemic control. In type 2 diabetes, it is only necessary to supplement the therapy with medication - oral antidiabetics and/or insulin if lifestyle management alone is not satisfactory.
Dietary recommendations, carbohydrate control
Diabetic patients should primarily not eat "diet" foods, but should compose their diet from general foods recommended for everyone. Following the nutritional anamnesis, we determine the individual's energy needs, which also depends on age, body mass index, physical activity and metabolic characteristics. It is necessary to comply with the amount of carbohydrates to be consumed per day prescribed by the experts. Instead of the "pseudo-scientific" fad diets that appear from time to time recommending a low carbohydrate intake, we recommend a diet containing 50-55% carbohydrates, however, it does not matter what type of carbohydrates or in what distribution the diabetic consumes. There are many options available to replace the sweet taste.
For type 2 diabetics, who are mostly overweight, we recommend energy-free sweeteners and sugar substitutes with a lower energy content. The difference between sweeteners lies in their sweetening power, possible side-taste-causing effect, and thermal stability. Due to their carbohydrate and energy content, sugar substitutes can only be consumed in moderation, included in the prescribed daily amount of carbohydrates. Some varieties also cause unwanted flatulence in larger quantities.
Important in the life of a diabetic:
- tracking and calculating the amount of carbohydrates consumed, planning the value of the energy content of food specified by a specialist/doctor, which is a defining element of treatment in all stages of type 2 diabetes,
- it is advisable to avoid foods that cause a rapid increase in blood sugar (Glycemic index - GI),
- knowing the concept of GI, learning the glycemic index (low, medium, high) of frequently consumed foods and taking it into account when planning a diet,
- it is recommended to divide the daily meal into several, usually three to five meals.
Physical activity
Part of the lifestyle change/treatment is regular physical activity and exercise, which is very important in the development of diabetes, as well as in the effective treatment of pre-existing diabetes. Exercise has a direct and indirect role in improving carbohydrate metabolism, as it can directly reduce blood sugar levels without the use of insulin, and it also contributes to weight loss. A 5-10% reduction in body weight already results in a measurable improvement in metabolism. It is worth choosing the type, intensity and frequency of the form of movement on a personalized basis, leave this to a specialist, your treating doctor, physiotherapist.
It is worth measuring your blood sugar during physical activity to avoid possible hypoglycemia (low blood sugar). Among diabetics receiving medical treatment, hypoglycemia caused by exercise is quite rare, however, those receiving insulin therapy should be aware of this possibility and, if necessary, adjust their insulin dosage.
Blood sugar self-check
On the one hand, regular blood sugar measurement helps the patient learn about the reactions of his own body, the extent of the increase in blood sugar level (glycemic index) caused by different foods, and other external conditions (physical activity, fever, menstrual cycle, weather fronts, etc.) how they affect your blood sugar levels. On the other hand, it provides the attending physician with information about the diabetic patient's metabolic state, the effectiveness of the drug and/or insulin therapy used, the patient's possible dietary errors, and overall the achievement of the set goals.
It is important that patients measure their blood sugar using the appropriate technique and on the basis of the doctor's instructions - at the appointed times - otherwise the data obtained will not be sufficiently informative regarding carbohydrate metabolism.
Regular self-monitoring of blood sugar levels is recommended for type 1 and type 2 diabetics, as well as expectant mothers with gestational diabetes.
The composition of the diet
In both types of diabetes, we recommend a diet low in fat and protein and rich in carbohydrates. Accordingly: 50–55% complex, high fiber content (>30g dietary fiber/day) carbohydrates, 15–20% protein (0.8–0.9g per kilogram of body weight), the remaining portion is recommended to be taken as fat.
Preference should be given to vegetables with a high fiber content, whole grains, breads and pastries with a high bran content, fruits, and skimmed milk and milk products.
One of the biggest problems in type 2 diabetes is that the secretion of insulin needed to maintain blood sugar levels during meals starts late, and on the other hand, the insulin produced in the pancreas is unable to exert its effect in the tissues due to insulin resistance. Dietary treatment must be adapted to this, i.e. foods that cause a rapid rise in blood sugar levels should be avoided as much as possible, meals should be eaten several times a day, and foods with specific carbohydrate content should be consumed per meal.
Glycemic index
The glycemic index helps you keep your blood sugar in a normal range! When preparing your diet, judge and separate the raw materials based on their carbohydrate content, blood sugar-raising effect (glycemic index), as well as their fat and protein content. The glycemic index is a value that shows the blood sugar-raising effect of foods, meals and drinks. The ability of food to raise blood sugar is compared to dextrose (glucose). The blood sugar-raising effect of 100 g of dextrose is taken as 100%, and the blood-sugar-raising ability of other foods or foods and drinks is compared to it (expressed as a percentage).
Raw materials, foods and drinks with a high glycemic index cause high blood sugar levels in a short time. The body responds to this by secreting a large amount of the hormone responsible for lowering blood sugar (insulin). However, too much insulin leads to a drop in blood sugar and, as a result, a sudden feeling of hunger. In your case, the secretion of insulin in your body is already delayed, and the insulin that has reached the circulation is not able to fully exert its effect. What you can do is to protect your blood sugar from sudden swings, highs and lows by eating foods with a low glycemic index.
Foods with a low glycemic index raise the blood sugar level slowly and evenly and lead to a moderate insulin release. In the long term, they ensure a feeling of satiety and a sense of well-being. That is why a diet that can be followed and that influences blood sugar levels in a positive direction is based on the choice and consumption of raw materials with a low glycemic index. The backbone of your diet is low-glycemic index, low-energy vegetables and fruits, flours, breads and pasta made from whole grains. Cover your protein intake with low-fat milk and milk products, lean meat and meat products, fish, and dry legumes.
Practices
When preparing food, add a little vegetable fat to your raw materials, steam under a lid, use an oven bag or a Roman bowl. The less time you expose your ingredients to the heat transfer process, the more they retain their vitamin and mineral content, as well as their fiber content, which is doubly beneficial for you, since fiber lowers the glycemic index. It is also reduced by food containing protein and fat eaten at the same time. Avoid sugary drinks, foods and preparations rich in fat. In the downloadable table at the bottom of the page, in addition to the food's energy and carbohydrate content, you can also find whether the given product has a low, medium or high glycemic index. When choosing, take into account whether you are choosing raw or processed ingredients!
Consumption of recreational drugs
- Coffee, tea: 1-3 espresso coffee or 2-4 cups of tea can be consumed daily. Caffeine and tea do not raise blood sugar levels.
- The consumption of alcohol by a diabetic patient is only advisable in conjunction with a meal. Two aspects must be considered when consuming alcoholic beverages: alcohol and sugar content. Regarding the alcohol content, a maximum of 1 unit per day for women and 2 units per day for men can be considered. (One unit = 1–1.5 dl of wine; 3 dl of beer; 2–3 cents of spirits, i.e. ~15 grams of pure alcohol.). Moderate alcohol consumption (1-2 dl of dry red wine per day) has a risk-reducing effect in the prevention of cardiovascular diseases. Don't forget the high energy content of alcohol!
- Smoking increases the chance of all late complications that can develop in diabetics - cardiovascular diseases, kidney and eye diseases. In their case, the higher blood sugar level increases the risk of developing vascular diseases by a factor of 2-5, and in the case of diabetics who smoke, this number can be a factor of 6-15.
Foot care
Ulcers, small cuts, abrasions and infections occur more often in people living with diabetes, as the blood supply to the feet decreases due to the disease and even minor injuries are more difficult to notice due to damage to the nerves. For prevention, cut your nails short and wash your feet daily in hand-warm water. Wear comfortable shoes that fit your feet perfectly and, if possible, go to a pedicurist, who not only helps with foot care, but may also notice and draw attention to small injuries on the skin sooner. Check the condition of your feet daily, and if you notice any changes, don't be afraid to share them with your doctor!
Regular eye examination
Untreated, diabetic retinopathy can lead to severe visual impairment or even blindness, as the small vessels of the eye are damaged as a result of the disease. Deterioration of vision is a late symptom, so it is recommended for patients living with diabetes to visit an ophthalmologist annually, who will monitor the condition of their eyes and help identify the possibility of possible treatments (e.g. laser surgery).
Read more about diabetes!
If you have any questions, book an appointment and contact our diabetologists: