Diet therapy for diabetics

The most important part of treating diabetes is diet. Since it is the patient who decides what to choose and how much to eat, the patient’s full understanding and active participation in the diet results in good treatment.

It may seem difficult, but if you think about it from a different perspective, a diabetes diet is also a diet that is commonly recommended for health. Even if you don’t have diabetes, practicing a diabetes diet can help you maintain your normal weight, prevent chronic diseases, and keep you healthy.

Table of Contents

Specific Goals of a Diabetic Diet

The specific goal of a diabetic diet is to improve health by keeping weight, blood sugar, cholesterol and blood pressure normal, preventing and delaying complications.

Fasting blood sugar: 90 mg / dL to 130 mg / dL
Blood pressure: 130 / 80mmHg
Low Density Cholesterol: More than 100mg / dL
High Density Cholesterol: More than 40mg / dL
Triglycerides: Less than 150mg / dL

1. Eat the right amount of food regularly and at regular times every day.

Proper calorie intake and regular meals help control blood sugar.

2. Have a low fat diet

The most common complications of diabetes are stroke and heart disease caused by atherosclerosis. Therefore, diabetics need to keep their blood sugar normal with their blood sugar control.

Reduce intake of greasy meats, eggs, processed meats, internal organs and fish and shellfish, especially those that are high in heart fat, high in trans and saturated fats and cholesterol.

But among the fats, omega-3 fatty acids, unsaturated fatty acids, lower triglycerides, a type of cholesterol, and prevent cardiovascular disease. Therefore, it is helpful to eat more blue fish (mackerel, saury, mackerel, sardines, herring, etc.) at least twice a week.

Specific methods of low fat diet

Meat: Remove visible fat and start cooking. See recipes to remove oil rather than frying and cooking. Keep your daily intake below 60-90g.
Poultry: Peel and eat before and after cooking. Keep your daily intake below 60-90g.
Oil: Vegetable oil is used for cooking. Choose cooking methods that use less oil, such as steaming, roasting, or stewed foods.
Milk and dairy products: Buy low-fat, nonfat products. Check the content of fats and saturated fats in the Nutrition Facts table and buy products with low content.

3. Reduce your salt intake.

Excessive salt intake can increase your blood pressure, so make sure you have a healthy diet. Even if your blood pressure is not high, it is better to eat foods freshly. In diabetics, high blood pressure is often accompanied, and even without high blood pressure, blood pressure may increase with age. If you have diabetes, you should control your blood pressure lower than people without diabetes.

Natural foods contain small amounts of salt, but processed foods contain large amounts of salt. Foods such as soy sauce, seasoned salt, pickles, salted fish, grilled salt, ramen soup, dried snacks and cheese should be eaten as little as possible. Fruits and vegetables are good because they contain less salt than other food groups. However, high sugar fruits raise blood sugar, so you should eat the right amount.

How to reduce salt in your daily life

Choose low or no salt foods or condiments.
Avoid canned foods, smoked or processed (such as bacon or ham).
Use other spices instead of salt.
Season the food with herbs, spices, lemons, and vinegar when cooking or eating.
Eat less food with a lot of seasoning.

4. Eat fiber-rich meals.

Dietary fiber lowers blood sugar and blood fat levels, which helps control blood sugar and prevent cardiovascular disease. Fiber is mainly found in grain and brown rice or vegetables and fruits, legumes and nuts. In particular, grain rice contains 2-3 times more fiber than rice, reducing glucose and cholesterol absorption in the intestines after meals, thereby increasing blood sugar and cholesterol. However, nuts such as peanuts and walnuts are also high in fat, so if you eat a lot of them, you can exceed your planned total calories.

5. Do not drink alcohol as much as possible.

Alcohol does not contain nutrients and is high in calories, increasing body fat and making blood sugar unstable. If your blood sugar is well-controlled, you can only have two drinks per day for men and less than one for women. If your blood sugar is not under control, you should refrain from alcohol.

6. Be careful of ingesting simple sugars such as sugar and honey.

Simple sugar is a concentrated calorie source, and its digestive absorption is quick to promote blood sugar rise.

Diet using food exchange table

1. Calculation of required calories

The total calories you need will depend on your obesity level and your daily activities. The recommended total calorie intake for normal diabetics is 30 calories per kilogram of normal body weight for adults with little physical activity, 35 calories for normal active adults and 40 calories for those with severe physical activity. People who are overweight and obese eat less than normal weight to help them lose weight.

Calories needed per kilogram of body weight, depending on activity and obesity.

Light activity
- Overweight / Obesity: 20-25
- Normal: 30
- Low weight: 35
Moderate activity
- Overweight / Obesity: 30
- Normal: 35
- Low weight: 40
Severe activity
- Overweight / Obesity: 35
- Normal: 40
- Low weight: 40-50

2. Allocation of Three Major Nutrients

Carbohydrates, fats and proteins are energy nutrients. It is important to keep the ratio of each nutrient intake, as either should not be short or overfilled.

1) Carbohydrate

Carbohydrates produce 4 calories per gram. It is mainly found in grain foods such as rice, bread, noodles, rice cakes, potatoes, sweet potatoes, corn and sweets. It is often called sugar. The sweetest ingredient in food is one kind of carbohydrate. It can be a direct cause of blood sugar, but it helps keep your organs functioning smoothly.

2) Protein

Protein, like carbohydrates, produces four calories per gram. It constitutes body tissue and is a major component of immune cells. Meat and fish are the main protein foods, and they are also high in soy and tofu.

3) Fat

Fat, which is 9 calories per gram, consumes twice the calories than carbs and protein. Saturated fats that cause atherosclerosis are found primarily in animal foods, while most oils from plants are unsaturated fats.

Palm and coconut oils are vegetable but rich in saturated fats. Foods high in unsaturated fats, known as healthy fats, include nuts such as blue fish, olive oil and walnuts.

3. Diet planning using food exchange table

1) Food Exchange Table

The Food Exchange Table is a table that divides the foods we eat in our daily lives into six food groups that have similar nutrient composition.

The six food groups are cereals, fish meats, vegetables, fats, milk and fruit, and they are set to be freely exchanged within the same group. To eat a balanced diet, you need to eat six different food groups. Grains are good for stocks, fish and vegetables, side dishes, fats for cooking oil, milk and fruits for snacks.

2) Exchange unit

Determining the weight of foods with the same nutrient content is called ‘1 exchange unit’. The exchange units in a food group are interchangeable because they have similar calories and similar nutrients. For example, one-third of the rice, one medium grain of potato, one medium of potato, and 23 grams of carbohydrates, 2 grams of protein, and 100 calories of calories, each of which is equivalent to one exchange unit of grain group. Similar.

3) Diet planning using Food Exchange Table

First, calculate the standard weight.

For men, standard weight (kg) = height (m) x height (m) x 22
For women, standard weight (kg) = height (m) x height (m) x 21

Second, calculate the calories you need per day.

Third, the number of exchange units for each food group is determined according to the calories required.

Fourth, the number of exchange units is appropriately distributed for each meal.

Fifth, food is selected using the food exchange table.

Sixth, calculate the amount of food you will actually eat.

Food distribution is not absolute and may vary slightly depending on your lifestyle and preferences.

If you have dyslipidemia or have atherosclerosis, low fat milk is recommended rather than regular milk to strictly limit saturated fat.
If you replace 1 milk group with 1 low-fat milk, you can add 1 nut.
1800kcal or more If you want to take only one milk group exchange, you can replace 1 milk group exchange with 1 medium exchange + fruit group 1 exchange.
Getting up a little early and having breakfast slowly is the basis of healthy living as well as diabetes.

4. Food to eat freely and food to watch out for

1) Relatively free food

Beverages: water, black tea, green tea, tonic water
Vegetables: Most vegetables are classified as free food.
Green leaf vegetables (cucumbers, Chinese cabbage, lettuce, lettuce, mushrooms, etc.) and seaweeds (seaweed, seaweed, kelp, radish, agar, etc.)
Vegetables with more than 6g of sugar per exchange unit (pepper leaves, mugwort, sweet pumpkin, green garlic, carrots, lotus root, burdock, mackerel, etc.) are excluded from free food because they have higher sugar content than other vegetables.
Others: Clear greasy broth, vegetable soup, mustard, vinegar, cinnamon, pepper, lemon, low-calorie sweetener

2) Foods to watch out for

Sugar, candy, honey, fucked, jam, liquor, sweet cookie, pie, cake, chocolate, yokan, jelly, medicine, canned fruit, syrup, syrup, honeydew, quince tea, yoghurt tea, colored milk, sweetened condensed milk, sweetened yogurt , Icing flakes etc

5. Glycemic Index

Many factors affect blood sugar control, such as the amount of sugar, the type of sugar, the cooking process, and other food components. However, even if you eat foods that contain the same amount of sugar, your blood sugar response may vary depending on the food.

Glycemic index is a numerical value that can be used to compare the quality of sugar after ingesting the food containing sugar, and reflecting the absorption rate of sugar. If the sugar index is 55 or less, the glycemic index is low. Are classified as high food. In other words, even with the same amount of sugar, foods with a low glycemic index have a lower rate of glucose absorption after ingestion, resulting in relatively less change in postprandial blood sugar. Therefore, eating brown rice with a low glycemic index is a better choice for blood sugar control than eating white rice with a high glycemic index.

However, since there are not many foods with known glycosides and some foods with low glycemic index, which are high in fat or unhealthy, it is important to eat a diet that lowers the glycemic index rather than choosing foods with low glycemic index. It is recommended to eat a balanced meal regularly to meet the daily meals you need.

Meals to lower your sugar index

Choose grain rice rather than white rice, whole wheat bread than white bread, and non-glutinous rice.
Choose foods high in fiber, such as vegetables, seaweed, and burdock.
Take raw fruit and raw vegetables rather than juice.
Avoid ripe fruits and high sugar fruits (eg tropical fruits).
Often use lemon juice or vinegar when cooking.
When eating, eat more than just one food.
Chew slowly and tightly.

Why is Diet Difficult and How to Overcome It?

1. Dining out

As life became busy, eating out increased and it is now part of everyday life. While there is an advantage to simply choosing a variety of foods, there are many foods high in calories and nutrients are not balanced.

The right way to eat out

Keep daily meals constant with the type of food and the amount you eat before meals.
Eating out a lot of sugar and oil, so high calories can be consumed in excess salt, so try to only once a day.
Eating out is not more than 1 hour away from the scheduled time, and eat on time.
Do not skip meals before eating out.
Choose a meal that is balanced with cereals, fish, vegetables, and fats, according to your meal plan.

2. Seasonal Management

Summers are hot and humid and easily get tired. You’ll want to have more cool drinks, ice cream, watermelons, and shaved ice than meals. However, at such times, a well-planned meal can help you control your blood sugar and keep you in good shape.

Seasonal foods like cucumbers, barley, lettuce, and garland chrysanthemum are good for midsummer. Digestion is less in summer, so eat less oily foods or cooked foods that use a lot of oil. If you sweat a lot, drink plenty of fluids to prevent dehydration.

Cold weather also stresses the human body. Because of the weather, the time in the house is longer and the amount of snacks is likely to increase. As your activity decreases, you gain weight and raise your blood sugar. Balance nutrition and avoid overeating.

On cold days, it is necessary to avoid outdoor exercises and to develop and maintain exercises that can be done indoors.

3. Diabetes and Drinking

Even when you’re not eating, your blood sugar stays constant because your liver makes glucose. But when blood alcohol levels rise, the liver stops making glucose and first breaks down the alcohol. Therefore, it is often observed that blood sugar is lower than usual after drinking. In severe cases, hypoglycemia may occur.

It is undesirable to have a drop in blood sugar due to alcohol, which means an instability of the overall blood sugar.

Since drinking affects blood sugar management, please consult with your doctor.
You can drink 1-2 glasses only if your blood sugar is well controlled.
Don’t drink alcohol if you have liver disease, hyperlipidemia and obese diabetes.
Do not drink alcohol on an empty stomach or immediately after exercise.
Do not skip your blood sugar test and breakfast as you may experience low blood sugar after drinking alcohol.
Sugar-rich liquor (fruit wine, grain wine, cocktail, fermented wine, etc.) is counted as a grain group.
When drinking alcohol, drink slowly, and dilute high alcohol.
Don’t take some drugs and alcohol at the same time.

4. Sweet foods and artificial sweeteners

The use of artificial sweeteners instead of sugar can increase the limited food choices of diabetics. Artificial sweeteners are several times or even hundreds of times more sweet than sugar. Therefore, it does not raise blood sugar because it is added in very small amounts.

Products sweetened with artificial sweeteners are also free to diabetics. Commercial sweeteners on the market include saccharin, aspartame, acesulfame potassium, sucralose, and sugar alcohols such as zyritol. Aspartame consumes 4 calories per gram, but it’s 200 times more sugar than sugar, so it’s extremely low. Saccharin is the longest and safest sweetener with no calories and 300-400 times sweeter than sugar. Cooking does not lose sweetness. However, in pregnant women, it is not recommended to overdose. Acesultam potassium is safe even when heated and is excreted and safe from metabolism by the body. It is 200 times sweeter than sugar.

5. Processed food

Processed food intake has become an inevitable choice in modern life. Here are some things to keep in mind when choosing which product to buy from a number of processed foods that look similar:

Choose low or no trans fats. Eat as few confections, bakers, and fritters as high in trans fats, such as shortening and margarine.
Choose foods high in fiber.
Select the products with low carbohydrate content by considering the total amount of sugar and carbohydrate content.
Unsweetened products can also increase sugar. An unsweetened product means no sugar is added, it does not mean there is no sugar. Higher sugar content, like grapes, increases blood sugar.
You can rest assured that it is fat free. Products that do not contain fat often contain more carbohydrates to taste. Therefore, it is advisable to refer to the ingredient labeling in detail, not unconditionally selecting a nonfat product.

Diet in Diabetes Complications

1. Hypoglycemia

Hypoglycemia is when your blood sugar is lower than the minimum level that your blood sugar can normally change. It usually means your blood sugar is below about 70 mg / dL.

1) The patient is unconscious

If unconscious, intravenous injection of glucose solution is required.

2) The patient is conscious

Eat about 15 grams of glucose or sugar. Individuals vary, but this amount of sugar increases blood sugar by 50 mg / dL after 15 minutes. After 15 minutes, your blood sugar should be measured and if your blood sugar doesn’t rise above 80 mg / dL, try eating foods that contain about 15 grams of sugar.
Even if your blood sugar is more than 80 mg / dL, if you still have an hour or more between meals, try eating foods containing 15 grams of sugar.
After 15 minutes, check your blood sugar again to see if your hypoglycemic reaction is over.
Other forms of carbohydrates, including glucose and sugar, sweets, bread, milk, juice, and candy can help raise your blood sugar. However, fatty foods are recommended to avoid, as they slow down the digestion and absorption of carbohydrates in the gastrointestinal tract.

3) Correcting the cause of hypoglycemia

You must identify the cause of your hypoglycemia and take steps to prevent it from happening again.

First Aid Measures for Hypoglycemia.

The patient is unconscious
- Intravenous injection of glucose infusion (visit emergency room).
The patient is conscious
- Eat about 15 grams of glucose or sugar
  - Food equivalent to 15 g of glucose
    - 2/3 cup apple or orange juice
    - 1/2 cup grape juice
    - 1.5 cups of milk
    - 5~6 candies
    - 1 spoon of sugar
    - 5 slices of biscuits
  - After 15 minutes, if your blood sugar is less than 80 mg / dL, take another 15g of sugar.
  - Even if your blood sugar is over 80 mg / dL, if you have more than 1 hour left until your next meal, take another dose.
  - Check your blood sugar again after 15 minutes to see if your hypoglycemic response is over.

* Low blood sugar generally means blood sugar below 70 mg / dL.

2. Diabetic Nephropathy

Eating more protein is believed to increase the burden on the kidneys and worsen nephropathy. However, diabetic patients with normal kidney function do not need to be restricted and eat like normal people.

If you have microproteinuria, it is recommended to reduce protein intake to about 2/3 of the general public. As nephropathy progresses, protein intake should be further reduced, but it is better to limit your nutritional status and quality of life rather than absolute recommendations.

If kidney function is reduced, calcium intake should be increased with diet and nutrition. If terminal renal failure worsens swelling and high blood pressure, salt intake is further restricted.

3. Diabetic Gastric Paralysis

In about 20% of people with diabetes, stomach movement is off. These symptoms occur more often in insulin-dependent diabetes. Symptoms include anorexia, premature satiety, post-prandial bloating, abdominal discomfort, nausea, vomiting, constipation, belching and weight loss. If you have diabetic gastroparesis, you will need the following nutritional therapy along with medication.

Eat small, low-fiber and low-fat meals often. The nutritional status is assessed and if calorie intake is insufficient, a high calorie formula is supplemented. Patients with dry mouth are recommended to drink juicy or juicy foods. If necessary, medications such as gastrointestinal motility modifiers are combined. If you have gastric palsy, keep in mind that taking low blood sugar foods will take longer to return to normal blood sugar.

Frequently Asked Questions

1. Do not eat sugar or sweet foods?

You can also eat sweet food. However, you should eat less other carbohydrate foods in consideration of the exchange unit. Most sweet foods, such as sugar, honey, red beans, and chocolate, are high in calories and low in other nutrients. Frequently choosing sweet foods will eat less nutritious foods, which can lead to unbalanced nutrition.

Therefore, it is recommended to eat as little as possible. On the other hand, sweet foods using artificial sweeteners can be served with confidence.

You can also eat sugar. However, it is not advisable to consume sugar by itself or drinks containing sugar alone, and it is recommended to eat as part of a meal or snack.

Sugar has no nutritional value except sugar, so you should eat as little as possible and eat less carbohydrate foods in consideration of the exchange unit.

2. How much fruit can I eat?

Fruits are high in carbohydrates, which can raise blood sugar levels when consumed in excess.

On the other hand, fruits contain a lot of vitamins, minerals, and fiber, so it is important to eat them properly.

It is good to eat about one exchange unit of fruit at a time. For example, apples are medium sized 1/3 (100 grams), melon or half orange (100 grams), watermelon large (250 grams), pear Eat 1/4 quarter, 10 strawberries, 1 large tomato (350 grams), and half a glass of fruit juice.

It is better to eat fresh fruits than to juice or canned food. When you drink juice, choose what is labeled as unsweetened.

3. What should I keep in mind when I eat meat?

Choose areas with less fat to remove oily areas and crusts. Also refrain from high cholesterol. Steam or lightly boil meat to remove any remaining oil. Removing fat can reduce calories by as little as 15% and as much as 35%. When cooking chicken or pork, immerse them in lukewarm water and remove the water and cool them in the refrigerator to separate fat. At this time, remove the visible fat and cook.

4. Is the glycemic index important?

The glycemic index is a measure of the glycemic response after ingestion of each food. Foods with a high glycemic index, based on 100 grams of white bread, raise blood sugar faster than foods with a low glycemic index. You can’t eat foods with low sugar content in peace.

The glycemic index is not easy to measure and the individual differences are so large that the total amount of carbohydrates consumed is still more important than the glycemic index. Moreover, low glycemic index is not necessarily good food. This is because the glycemic index is low even when food is digested slowly due to the high content of fat.

5. How often should I measure blood sugar at home?

The number of times you check your blood glucose depends on how much you take, how much insulin you use, or how well you control your blood sugar.

However, blood sugar should be measured more often when the first drug or insulin is started, when the treatment method is changed, when the body is ill or pregnant, or when the blood sugar is undulating.

6. How much should I eat nuts?

Nuts contain high levels of healthy unsaturated fatty acids, but they are high in fat and can increase your calorie intake when consumed in excess. It is recommended not to eat more than one spoonful (10) a day.

7. Can eating chromium supplements help with diabetes?

Chromium plays an important role in sugar metabolism by helping insulin work. Lack of chromium causes symptoms similar to diabetes. If you give chromium supplements to people with low chromium intake, your diabetes will improve. However, chromium is a nutrient that is found in many kinds of foods, which is not lacking in general meals. Therefore, not all diabetics need chromium supplementation.

8. Can I eat unsweetened foods without any worries?

It’s not like that. Unsweetened orange juice is similar to fruit with no added sugar when making the product. Since there are sugars in the fruit itself, you should eat according to your meal plan. You can drink half a glass if you have one exchange unit per day, or one drink if you have two exchange units per day.

9. What foods are good for diabetes?

No food is particularly good for diabetes. In obese patients, a successful diet can improve diabetes or mild diabetes can help normalize blood sugar, but you can’t get better by eating more food. Occasionally, companies that produce supplements advertise that diabetes improves, but most of them have no basis. It is best to eat regularly according to the interwoven diabetes diet.

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