Carbohydrate Guidelines for Type 2 Diabetes

Carbohydrates are an essential part of a healthy diet. But carbs also raise your blood sugar. When you have type 2 diabetes, it’s important to aim for a balanced carb intake. It can seem confusing and a little overwhelming at first, but don’t be discouraged. Your doctor, diabetes educator, or dietitian can help you find a meal plan that works for you.

By setting limits on your carb intake—and tracking what you eat to make sure you stay within those limits—you can improve your blood sugar control. To get started, here are some basic facts you need to know.

Foods that contain carbohydrates include:

• Grains, such as breads, cereals, pasta, and rice

• Fruits and fruit juices

• Starchy vegetables, such as potatoes and corn (nonstarchy vegetables also contain carbs, but usually very little)

• Dried beans and peas

• Dairy foods, such as milk and yogurt

• Sweets, such as cookies, pastries, cakes and candy

• Snack foods, such as potato chips

To find the carb content of a food, check the amount of total carbohydrate on the food label. Be sure to look at the serving amount as well. If you’re eating twice as much as the listed serving, you’ll need to double the total carbs.
If a food doesn’t have a label, there are many apps and books available to help you track carbs. One great free tool is MyFoodAdvisor from the American Diabetes Association. At first, you may need to look up almost everything. But with time, you’ll start to learn how many carbs are in your favorite foods and dishes.

The American Diabetes Association recommends getting about 45% of your total calories from carbs. You should spread out your carb consumption throughout the day. Typically, that works out to about 45 to 60 grams of carbs per meal and 10 to 25 grams per snack, eaten twice a day between meals. But ask your healthcare provider for guidance on more specific goals for you.

Achieving those goals doesn’t happen by accident. You’ll need to plan your meals more carefully than someone without diabetes. Fortunately, there are several methods of meal planning to make the process easier. Your healthcare provider can help you choose the best method for you, based on your preferences and needs.

These are three techniques for planning meals so you get the right amount of carbs:

1. Carb counting. This method is the most straightforward. You work with your healthcare provider to set a limit for how many carbs you’ll consume at each meal. Then you track the grams of carbohydrate in the foods you eat.

2. Exchange lists. This method categorizes foods into groups, such as carbohydrates, meat/meat alternatives, and fats. The plan spells out how many servings you can have from each group at a meal. Within each group, the plan also specifies how much of each food equals one serving, based on its nutrient content. You can exchange a serving of one food for another within the same group.

3. Glycemic index(GI). This method lets you refine carb counting. It considers not only the quantity of carbs in the foods you eat, but also the quality. Foods with a high GI value raise blood sugar more than those with a low GI. So the goal is to choose your carbs from foods with a lower GI value, such as many whole grain foods, most fruits, nonstarchy vegetables, and dried beans and peas.

Some people with type 2 diabetes use a less formal method of gauging how many carbs to eat. Called the plate method, it doesn’t require any counting at all. Instead, you simply imagine dividing your plate in half. Then divide one side in half again.

Fill the large section with nonstarchy veggies. Fill one small section with grains, starchy veggies, or cooked beans and peas, and the other with meat or another protein food. Add a cup of low-fat milk and a piece of fruit, and you’ve got a balanced meal.

• Although carbohydrates are part of a healthy diet, they raise your blood sugar. If you have type 2 diabetes, you need to aim for a balanced carb intake.

• Carbs are found in a variety of foods. You can check food labels to find the carb content, or use a website, app, or book to help you.

• The American Diabetes Association recommends getting about 45% of your total calories from carbs.

• There are several methods to help you plan meals, including carb counting, exchange lists, glycemic index, and the plate method.

How to Count Carbs for Your Diabetes Diet

Carbohydrates are a great source of energy for your body, but they affect your blood sugar too. If you have diabetes, keep track of how many you eat with a few simple tricks.

Know your carbs. It’s a lot more than just pasta and bread. All starchy foods, sugars, fruit, milk, and yogurt are rich in carbs, too. Make sure you count them all, not just the obvious ones.

Put together a meal plan. Figure out the amount of carbs, protein, and fat you can eat at meals and snacks throughout the day to keep your blood sugar levels steady. Most adults with diabetes aim for 45-60 grams of carbs per meal and 15-20 grams per snack. That number may go up or down, depending on how active you are and the medicines you take, so check with your doctor or a registered dietitian.

Look at labels. They make counting carbs easy. Find the “Total Carbohydrate” number listed on a package’s “Nutrition Facts” panel. Then, check the serving size and confirm the amount you can eat. Repeat this step with other foods you plan to eat. When you add all the grams of carbs, the total should stay within your meal budget.

Continued

Starch, fruit, or milk = 15. Fresh foods don’t come with a label. You may have to guess the number of carbs they have. A good rule of thumb: Each serving of fruit, milk, or starch has about 15 grams. Vegetables don’t have a lot, so you can eat more of them. Two or three servings of veggies usually equal 15 grams of carbs.

Pay attention to portion sizes. The size of one serving depends on the type of food. For instance, one small (4-ounce) piece of fresh fruit, 1/3 cup of pasta or rice, and 1/2 cup of beans are each one serving. Buy a pocket guide that lists carb counts and portion sizes. Or download an app on your smartphone. Measuring cups and a food scale when you eat at home will help you be accurate.

Continued

Adjust your insulin. Your doses may change, depending on the amount of carbs you ate at a meal and the difference between your target blood sugar level and your actual reading. You’ll need to know your “insulin-to-carbohydrate ratio,” or the number of carbs one unit of insulin will cover. Generally, one unit of fast-acting insulin covers 12-15 grams of carbohydrates.

Continued

Your body can also be more sensitive to insulin changes throughout the day. Stress or how much you exercise also has an impact. It’s important to work out a plan with your doctor for how to change your treatment if you need to.

Make healthy choices. Carb counting focuses on the number of them you eat at every meal, not what types. Still, pick healthy options when you can. Foods and drinks with added sugar are often high in calories and low on nutrients. Healthy carbs like whole grains, fruits, and veggies will give you energy and the vitamins, minerals, and fiber that can help control your weight.

How many carbs per day for a diabetic? Factors to consider

Monitoring carbohydrate intake is one of the key ways people with diabetes can manage their blood sugar levels. People living with type 1 or type 2 diabetes should aim to get 45% of their daily calories from carbohydrates.

This advice comes from the Centers for Disease Control and Prevention (CDC).

Carbohydrates occur in many different foods, including whole grains, fruit, vegetables, and baked goods. By eating a safe amount of carbohydrates, a person with diabetes can:

• stay healthier for longer
• improve their quality of life
• reduce the risk of diabetes complications

In this article, we look at the number of carbohydrates a person with diabetes needs per day, the factors affecting this, and how to eat a suitable amount.

Share on PinterestA person living with diabetes may benefit from getting most of their carbohydrates from unprocessed carbohydrate sources.

According to the CDC, people living with diabetes should get about 45% of their total calories each day from carbohydrates.

For females, they recommend 3–4 servings of carbohydrates, at 15 grams (g) per serving. For males, they recommend a slightly higher amount of 4–5 servings. This is equivalent to 45–75 g each meal.

According to a 2019 article, a low carbohydrate diet may work well for people living with type 2 diabetes, as it can reduce their need for diabetes medication.

However, various other factors can influence how many carbohydrates a person with diabetes needs per day at an individual level.

Other lifestyle factors that influence how many carbohydrates a person with diabetes needs include:

• physical activity level
• age
• weight
• diabetes medications

The more active a person is, the more calories they need for energy. This can have an impact on their blood sugar levels, as well as how many carbohydrates they will need on a given day.

Weight and body fat also has an impact. According to the Obesity Action Coalition, excessive body fat can cause a person at risk of developing type 2 diabetes to have less effective insulin, which can raise blood sugar levels. As a result, people who have obesity may need fewer carbohydrates.

People with prediabetes may also benefit from lowering their carbohydrate intake. The National Institute on Aging (NIA) says that millions of older people in America live with prediabetes. Making dietary changes can help someone prevent or delay the onset of type 2 diabetes.

According to the American Diabetes Association (ADA), eating too many carbohydrates causes hyperglycemia (high blood sugar) in people with diabetes. Hyperglycemia causes symptoms such as:

• increased thirst
• frequent urination
• high blood sugar readings

If someone with diabetes continues to have high blood sugar levels, they may develop ketoacidosis. Ketoacidosis is a severe and life-threatening condition that requires immediate treatment. The symptoms include:

• shortness of breath
• breath that smells fruity
• nausea and vomiting
• a very dry mouth

A person should seek emergency help from a doctor if they notice signs of ketoacidosis.

People with diabetes can also develop complications if their blood sugar levels fall too low, which causes hypoglycemia. According to the National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center (NIDDK), this can happen if someone:

• uses too much diabetes medication or insulin
• does not eat enough carbohydrates
• skips or delays meals
• increases their physical activity
• drinks alcohol without enough food
• vomits

Hypoglycemia can cause mild or no symptoms, so it is essential that people check their blood glucose levels regularly. The symptoms of hypoglycemia include:

• hunger
• feeling shaky or dizzy
• sweating
• headaches
• tiredness
• weakness
• fast or irregular heartbeat
• personality changes
• seizures or convulsions
• loss of consciousness

Hypoglycemia requires quick treatment. Severe hypoglycemia can be life-threatening. To avoid hypoglycemia, a person should make sure their medication and carbohydrate intake match each other, that they eat regularly, and that they take any exercise and illness into account.

Many foods contain carbohydrates. According to the CDC, some common sources of carbohydrates include:

• grains and foods that contain grains, such as bread, cereal, and pasta
• fruits and fruit juice
• dairy including yogurt, milk, and cheeses
• starchy vegetables, such as potatoes and corn
• beans, legumes, and peas
• soft drinks and sports drinks
• snack foods and desserts

However, some types of carbohydrates are more beneficial than others for people with diabetes. According to the ADA, there are three broad types of carbohydrate that deserve particular attention:

• Sugar: This includes sugar from sugar cane, honey, fruits, and dairy products. Sugars can occur naturally in food, or manufacturers may add sugar to foods.
• Starch: Foods high in starch include starchy vegetables, beans, and refined and whole grains.
• Fiber: Foods that are high in fiber include fruits, vegetables, whole grains, nuts, beans, and legumes.

The ADA recommend that people get most of their carbohydrates from unprocessed carbohydrate sources, such as whole grains and vegetables, rather than white bread or baked goods.

By contrast, fiber can actively reduce blood sugar levels, aid digestion, and reduce the risk of heart disease. As such, people with diabetes should avoid foods containing added sugar and refined carbohydrates and focus on vegetables, fruits, and whole grain sources.

A person can find out the most suitable amount of carbohydrates for them by counting them. According to the NIDDK, counting carbohydrates can help someone understand how many carbohydrates they need to eat to reach their target blood sugar level.

To count carbohydrates, a person needs to:

1. learn which foods contain carbohydrates
2. take note of the carbohydrates on the food label, or look them up online
3. add the gram measurements together to calculate the total for each meal and each day

A dietitian can also help someone find the best balance of carbohydrates, exercise, and medication, and create a plan based on their needs and preferences.

A person with diabetes should see their doctor if they are struggling to control their blood sugar levels or frequently experience the symptoms of high or low blood sugar.

Someone with diabetes should also speak to their doctor before making lifestyle changes that could affect their blood sugar levels, such as a new diet or exercise program.

If a person has symptoms of severe hyperglycemia or hypoglycemia, they must seek emergency medical attention.

In general, people with diabetes should get about 45% of their daily calories from carbohydrates. However, this may change depending on factors, such as age, weight, exercise, and the severity of their condition. People with prediabetes may benefit from a low carbohydrate diet, for example.

It is important that people talk to a dietitian or doctor to find the best balance of carbohydrates for their lifestyle.

Understanding Carbs | ADA

Get smart on carbs.

When you eat or drink foods that have carbohydrate—also known as carbs—your body breaks those carbs down into glucose (a type of sugar), which then raises the level of glucose in your blood. Your body uses that glucose for fuel to keep you going throughout the day. This is what you probably know of as your “blood glucose” or “blood sugar.” When it comes to managing diabetes, the carbs you eat play an important role. After your body breaks down those carbs into glucose, your pancreas releases insulin to help your cells absorb that glucose.

When someone’s blood glucose—or blood sugar—is too high, it is called hyperglycemia. There are a few causes for “highs,” including not having enough insulin in your body to process the glucose in the blood or the cells in your body not effectively reacting to the insulin that is released, leaving extra glucose in the blood. A low blood glucose is known as hypoglycemia. “Lows” can sometimes be caused by not consuming enough carbohydrates, or an imbalance in medications. In short, the carbs we consume impact our blood sugar—so balance is key!

There are three main types of carbohydrates in food—starches, sugar and fiber. As you’ll see on the nutrition labels for the food you buy, the term “total carbohydrate” refers to all three of these types. The goal is to choose carbs that are nutrient-dense, which means they are rich in fiber, vitamins and minerals, and low in added sugars, sodium and unhealthy fats. When choosing carbohydrate foods:

• Eat the most of these: whole, unprocessed, non-starchy vegetables. Non-starchy vegetables like lettuce, cucumbers, broccoli, tomatoes and green beans have a lot of fiber and very little carbohydrate, which results in a smaller impact on your blood sugar. Remember, these should make up half your plate according to the Plate Method!
   
• Eat some of these: whole, minimally processed carbohydrate foods. These are your starchy carbohydrates, and include fruits like apples, blueberries, strawberries and cantaloupe; whole intact grains like brown rice, whole wheat bread, whole grain pasta and oatmeal; starchy vegetables like corn, green peas, sweet potatoes, pumpkin and plantains; and beans and lentils like black beans, kidney beans, chickpeas and green lentils. If you’re using the Plate Method, foods in this category should make up about a quarter of your plate.
   
• Try to eat less of these: refined, highly processed carbohydrate foods and those with added sugar. These include sugary drinks like soda, sweet tea and juice, refined grains like white bread, white rice and sugary cereal, and sweets and snack foods like cake, cookies, candy and chips.

The Diabetic Diet: How Diabetics Count Calories and Plan Their Diets.

The mainstays of diabetes treatment are:

1. Working towards obtaining a healthy body weight 
2. Establishing a diabetes diet plan; no one diabetic diet fits all
3. Fitting in daily physical activity, even walking is enough
4. Medication, if needed

Note: Type 1 diabetes must be treated with insulin; if you have type 2 diabetes, you may not need to take insulin. This involves injecting insulin under the skin for it to work. Insulin cannot be taken as a pill because the digestive juices in the stomach would destroy the insulin before it could work. Scientists are looking for new ways to give insulin. But today, shots are the only method. There are, however, new methods to give the shots. Insulin pumps are now being widely used and many people are having great results.

In this Article

Working towards obtaining ideal body weight
An estimate of ideal body weight can be calculated using this formula:

For women:
Start with 100 pounds for 5 feet tall. Add 5 pounds for every inch over 5 feet. If you are under 5 feet, subtract 5 pounds for each inch under 5 feet. This will give you your ideal weight.

If you have a large frame, add 10%. If you have a small frame, subtract 10%. A good way to decide your frame size is to look at your wrist size compared to other women’s.

Example: A woman who is 5′ 4″ tall and has a large frame
100 pounds + 20 pounds (4 inches times 5 pounds per inch) = 120 pounds.
Add 10% for large frame (in this case 10% of 120 pounds is 12 pounds).
120 pounds + 12 pounds = 132 pounds ideal body weight.

For men:
Start with 106 pounds for a height of 5 foot. Add 6 pounds for every inch above 5 foot.

For a large frame, add 10%. For a small frame, subtract 10%. (See above for further details.)

Learn More about Treating Type 2 Diabetes

The Diabetic Diet
Diet is very important in diabetes. There are differing philosophies on what is the best diet but below is a guideline with some general principles.

Patients with type 1 diabetes should have a diet that has approximately 35 calories per kg of body weight per day (or 16 calories per pound of body weight per day). If you have a child who has type 1 diabetes, we encourage you to read our article about meal planning for children with type 1 diabetes.

How much do you know about the diabetic diet?

Patients with type 2 diabetes generally are put on a 1,500 to 1,800 calorie diet per day to promote weight loss and then the maintenance of ideal body weight. However, this may vary depending on the person’s age, sex, activity level, current weight, and body style.

More obese individuals may need more calories initially until their weight is less. This is because it takes more calories to maintain a larger body, and a 1,600 calorie diet for them may promote weight loss that is too fast to be healthy.

Men have more muscle mass in general and therefore may require more calories. Muscle burns more calories per hour than fat. (Thus also one reason to regularly exercise and build up muscle!) Also, people whose activity level is low will have less daily caloric needs.

Generally, carbohydrates should make up about 50% of the daily calories (with the accepted range 40% to 60%). In general, lower carbohydrate intake is associated with lower sugar levels in the blood.

However, the benefits of this can be canceled out by the problems associated with a higher fat diet taken in to compensate for the lower amount of carbohydrates. This problem can be improved by substituting monounsaturated and polyunsaturated fats for saturated fats.

Most people with diabetes find that it is quite helpful to sit down with a dietitian or nutritionist for a consult about what is the best diet for them and how many daily calories they need. It is quite important for diabetics to understand the principles of carbohydrate counting and how to help control blood sugar levels through proper diet. Below are some general principles about the diabetic diet.

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Understanding Food Groups
There are 3 basic food groups: fats, proteins, and carbohydrates. The carbohydrates are the foods that can be broken down into sugar. It is essential to have all 3 food groups in your diet to have good nutrition.

1. Why Count Carbohydrates?
Carbohydrates make your blood glucose level go up. If you know how much carbohydrates you’ve eaten, you have a good idea what your blood glucose level is going to do. The more carbohydrates you eat, the higher your blood sugar will go up.

2. Which Foods Contain Carbohydrates?
Most of the carbohydrate we eat comes from 3 food groups: starch, fruit, and milk.

Vegetables also contain some carbohydrates, but foods in the meat and fat groups contain very little carbohydrates. Sugars may be added or may be naturally present (such as in fruits).

The nutrient term for sugars can also be identified by looking for -ose at the end of a word ( ie, glucose, fructose, and sucrose are all sugars). Look for these on food labels to help identify foods that contain sugar.

Below are some examples of the grams of carbohydrate contained in a sampling of common food products:

To make things easy, many people begin to carbohydrate count by rounding the carbohydrate value of milk up to 15.

In other words, one serving of starch, fruit, or milk contains 15 grams carbohydrate or one carbohydrate serving. Three servings of vegetables also contain 15 grams. Each meal and snack will contain a certain total number of grams of carbohydrate.

For example: Each gram of carbohydrate provides 4 calories. A person with diabetes on a 1,600 calorie diet should get 50% of these calories from carbohydrates. This would be a total of 800 calories of carbohydrates (at 4 calories per gram) spread out over the day. At 15 grams per exchange, this would be about 13 exchanges of carbohydrates per day.

The amount of food you eat is closely related to blood sugar control. If you eat more food than is recommended on your meal plan, your blood sugar goes up. Although foods containing carbohydrates (carbs) have the most impact on blood sugars, the calories from all foods will affect blood sugar.

The only way you can tell if you are eating the right amount is to measure your foods carefully. Also, it is important to space your carbohydrates out throughout the day to avoid sugar “loading.” Measuring your blood sugar regularly also provides important feedback on how high your sugar went based on what you ate and your level of activity.

Where Do You Get Carbohydrate Information?
The “Nutrition Facts” label on most foods is the best way to get carbohydrate information, but not all foods have labels. Your local bookstore and library have books that list the carbohydrate in restaurant foods, fast foods, convenience foods and fresh foods. You will still need to weigh or measure the foods to know the amount of grams of carbohydrates present.

How Do You Count Carbohydrates?
Carbohydrates can be counted in number of grams or can be counted as exchanges. One carbohydrate exchange equals 15 grams of carbohydrates.

Free Foods
These are foods that you can eat without counting. A free food or drink is one that contains less than 20 calories and 5 grams or less of carbohydrates per serving. If your serving of a food contains more than 5 grams of carbohydrates, you should count it in your meal plan.

Examples of free foods:

• Bouillon or broth
• Carbonated or mineral water
• Club soda
• Coffee or tea
• Diet soft drinks
• Drink mixes, sugar-free
• Tonic water, sugar free
• Sugar-free hard candy
• Sugar-free Jell-O
• Sugar-free gum
• Jam or jelly, light or low-sugar, 2 tsp
• Sugar free syrup, 2 tsp

 You should spread out free foods throughout the day and not eat them in one sitting.

Fitting Sugar in Your Meal Plan
It is commonly thought that people with diabetes should avoid all forms of sugar. Most people with diabetes can eat foods containing sugar as long as the total amount of carbohydrates (carbs) for that meal or snack is consistent.

Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carbs, the blood sugar levels will go up.

Can I Eat Cake and Not Worry About It?
No! A slice of white cake with chocolate icing (1/12 of a cake or 80 grams weight) will give you about 300 calories, 45 grams of carbs, and 12 grams of fat. That is 3 starch servings and over 2 fat servings.

Before you have a slice of cake, ask yourself the following questions: Will that small piece of cake be satisfying or will I still be hungry? How will it fit into my meal plan? Do I have 300 calories to “spend” on this? Are there other choices I could make which would contribute less fat?

A 1/12 slice of angel food cake has less than 1 gram of fat and only 30 carbs. This may be a better choice.

Controlling All Carbohydrates
It is important to realize that sugar is not the only carbohydrate that you have to “control.” The body will convert all carbohydrates to glucose, so eating extra servings of rice, pasta, bread, fruit, or other carbohydrate foods will make the blood sugar rise.

Just because something doesn’t have sugar in it doesn’t mean you can eat as much as you want. Your meal plan is designed so that the carbohydrate content of your meals remains as consistent as possible from day to day.

A Word of Caution
Although sugar does not cause the blood sugar to rise any higher than other carbohydrates, it should be eaten along with other healthy foods. If you choose to drink a 12-ounce can of a sugar-sweetened soft drink, that would use up about 45 grams of carba, and you wouldn’t have gotten any nutrition (protein, vitamins, or minerals). What a waste of calories!

High sugar foods are more concentrated in carb. Therefore the volume would be smaller than a low sugar food. High sugar foods might not be a good choice if they will just tempt you to eat more. If you would rather eat larger portions, select low sugar choices.

Look at the differences in portion size you get for equal amounts of carbohydrate in these cereals!

In addition, many sugar-containing foods also contain a lot of fat. Foods such as cookies, pastries, ice cream and cakes should be avoided largely because of the fat content and because they don’t contribute much nutritional value. If you do want a “sweet,” make a low-fat choice, such as low-fat frozen yogurt, gingersnaps, fig bars, or graham crackers and substitute it for other carbohydrates on your meal plan.

Updated on: 04/02/19

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How Many Carbs Per Day Should Diabetics Eat? No More Than 4 Servings

• Experts recommend that people with diabetes get 45% of their daily calories from carbohydrates.
• People with diabetes should consume more complex carbs from high-fiber foods than simple carbs like from fruit and milk.
• Limiting carbs more than the recommended 45% of daily calories may provide even better results in controlling blood sugar levels.
• This article was medically reviewed by Samantha Cassetty, MS, RD, nutrition and wellness expert with a private practice based in New York City.
• This story is part of Insider’s guide to Diabetes. 

People with

diabetes
have a complicated relationship with carbohydrates. While carbs are part of a healthy diet, they can also contribute to high blood sugar levels, which makes managing diabetes much more challenging. Many experts recommend that people with diabetes limit or even drastically reduce their carbohydrate intake.

Carbs drive blood sugar levels

Compared with proteins and fat, carbohydrates have the biggest impact on blood sugar levels, which is why keeping tabs on carb intake is so important for managing diabetes. 

The digestive system breaks carbs down into glucose, or blood sugar, which is a main source of energy for the body. When sugar enters the blood, the pancreas usually releases the hormone insulin, which allows cells to process and absorb that sugar. As they do, blood sugar levels fall. 

However, diabetes affects how people are able to produce or use insulin. In people with

type 1 diabetes
, their pancreas is unable to make insulin. People with

type 2 diabetes
can’t make enough insulin, or their cells have stopped responding to it effectively, so glucose builds up in the blood.

In both types of diabetes, this can lead to dangerously high blood sugar levels if not treated. Consistently high blood sugar levels can damage blood vessels, eyes, feet, kidneys, and the heart.

Healthy carb intake for people with diabetes

The Centers for Disease Prevention and Control recommends that people with diabetes get about 45% of their daily calories from carbohydrates. Put another way, for a 2,000 calories diet that equates to about three or four servings of carbohydrates.

For those with diabetes, eating well is not just a matter of counting grams and calories, though. Choosing nutritious foods is key, says Jennifer Smith, Director of Lifestyle and Nutrition at Integrated Diabetes Services in Madison, Wisconsin. 

There are two main types of carbs:

1. Complex carbohydrates, which are found in foods like potatoes, whole grains, and corn, provide nutrients and fiber which take longer to digest. 
2. Simple carbohydrates, which are found in fruit and milk, and in refined foods such found in snacks, candy, soda, and desserts. 

Simple carbs hit the bloodstream quickly and can lead to a higher spike in blood sugar levels compared to complex carbs. 

“If you’re doing 45% carbohydrates because that’s what you’ve been told to do, but it’s all white rice and white bread and Fruit Loops, that’s not healthy,” Smith says. “Simple sugars have a big impact on blood sugar, while more complex carbohydrates like grains, beans, and legumes have more fiber in them, which slows blood sugar impact once your body takes it into your system. “

Lower-carb diets help stabilize blood sugar levels 

While the 45% rule for total daily calories from carbohydrates is a general clinical guideline, there’s evidence that eating fewer carbs has better results for controlling diabetes – and the fewer, the better.  

Related

6 months on a low-carb diet linked to remission from type 2 diabetes, study finds

The American Diabetes Association used to recommend that people eat at least 130 grams of carbs per day, but changed their position in 2019, saying that low-carb diets are a promising way to manage diabetes.

One way to do that is by following a low-carb, high-fat ketogenic diet, which is generally defined as eating no more than 50 grams of carbohydrates per day. When the body lacks carbs,  you have less glucose in the blood for energy. To survive, your body enters a state called ketosis, where the body produce ketones that allow it to use fat as an alternate source of energy in place of glucose. 

People on the

ketogenic diet
eat mainly meat, shellfish, eggs, nuts, salad, vegetables, and cheese. The key is to consume more fat than carbs so your body uses ketones for energy, which does not spike blood glucose levels. 

The diet has had impressive results in research trials and in patients, says William Yancy, associate professor of medicine and director of the Duke Diet and Fitness Center at Duke University.

“Studies have shown that if you feed people food with a large fat content, it doesn’t raise their blood sugar or insulin levels hardly at all. You can see from several studies that people’s blood sugar improves to the point that they can cut back on their medicines. That’s really rewarding to the individual. It’s empowering for our patients,” he says.

Smith says at least a third of her patients with diabetes aim to take in fewer than 120 grams of carbohydrates per day. “It can take out some of the up-down swings of blood sugar management, so mentally it’s much less stressful for them.” 

However, it may be tough for some people to follow such a restrictive diet long-term.”We’ve seen good health with much lower carb intake in many people. If you can stick with it, it will work. But we also have to work with what people are willing to do,” Smith says.

There are some risks associated with following the ketogenic diet, including dehydration or a sudden and potentially dangerous drop in blood sugar levels. People with diabetes should follow a ketogenic only under the guidance of an experienced clinician, Yancy says.

How Many Carbs Are Right for Me: Managing Diabetes

Carbohydrates, which include any type of sugar, starch, or fiber, are a primary source of energy (along with the two other macronutrients, protein and fat). But not all carbs are created equal. Some bring vitamins, minerals, and other nutritional value to the table while others are, for the most part, just a source of empty calories.

 fcafoto digital / Getty Images

People with diabetes have trouble managing excess levels of glucose (sugar), so carbohydrate intake can be a fraught issue regardless of nutritional value. During digestion, the body breaks down carbs into glucose which then floods the bloodstream where it can cause potentially life-threatening damage if not kept in check.

For this reason, the recommendations for daily carbohydrate intake is somewhat different for people with diabetes than for those who do not have this disease.

According to the Centers for Disease Control and Prevention (CDC), people with diabetes should get approximately 45% of calories from carbohydrates. 

People with diabetes should skip or limit refined carbohydrates (consisting mostly of processed and packaged foods) in favor of complex carbohydrates, which are slower-burning starches like whole grains such as brown rice or oats, or veggies like squash or potatoes, in portion-controlled amounts. 

The carbohydrate count, fiber, and added sugars of all packaged foods can be found by reading the Nutrition Facts label. For foods without a label, a food journal app in which you input specific foods and portion size can determine the approximate number of carbs you’re consuming. Carbohydrate counting can be helpful to keep an eye on your overall intake, especially if you have been diagnosed with diabetes.

How Many Carbs Are Right for Me?

Guidelines from the American Diabetes Association suggest that there is not an ideal percentage of calories from carbohydrate, protein, and fat for people with diabetes. Registered dietitians, nutritionists, and certified diabetes educators (CDEs) can create individualized meal plans based on eating patterns, goals, food preferences, lifestyle, and culture, etc. 

Recommended Amount of Carbs For People With Diabetes

Most people with diabetes are advised to get no more than 45% of daily calories from carbohydrates. On a 1600-calorie diet, for example, that would mean 135 grams to 180 grams per day. Broken down into three meals and two snacks, this comes to 45 grams and 60 grams per meal and 15 grams to 30 grams per snack. This may change depending on your specific calorie needs.

Additionally, some people benefit from eating a consistent carbohydrate diet. For example, eating the same amount of carbohydrates per meal daily (especially when taking fixed doses of insulin) can help take the guesswork out of managing medication at mealtimes. Others practice estimated guess carbohydrate counting or eat low-carb diets. 

Recommended Amount of Carbs for People Without Diabetes

The daily recommended intake of carbohydrates for adults ranges from 45% to 60% of calories. On a 1600-calorie diet, that comes to around 180 grams to 240 grams per day or 60 grams to 80 grams per meal. On a 2000-calorie diet, that looks like 225 grams to 325 grams of carbs per day or 75 to 108 grams of carbs per meal.

Factors Determining Your Individual Carb Count

Figuring out the ideal number of carbohydrates you should eat daily needs to be a collaborative effort between your healthcare provider, a dietitian or certified diabetes educator, and you. Specific factors that influence your carbohydrate intake include:

• Age
• Sex
• Weight
• Activity level
• Blood sugar numbers

How you divide total carb intake throughout the day also will depend on a variety of conditions, including:

• Diabetes medication (some must be taken with food)
• Insulin, for anyone on insulin, the timing of carb intake is important)
• Eating patterns
• Blood glucose response
• Exercise

A good way to determine your ideal carb intake is to test your blood sugar before and after you eat. If it’s within target range two hours after a meal, then you know your meal plan is working for you.

The American Diabetes Association recommends the following glycemic targets 2 hours after eating a meal (postprandial)

Sample Meal Plan

Another way to keep track of your carbohydrate intake is by creating a meal plan with your dietitian. Mapping out your daily meals can provide a helpful framework for making sure you’re balancing your carb intake to just 45 grams to 60 grams per meal (or less). When planning your meals, pair any carbs with a protein and fat to slow the uptake of glucose uptake by your bloodstream.

Here are a few things to consider when creating a meal plan:

• Studies have shown that eating a lower-carbohydrate breakfast may help to improve weight and blood sugars. In addition, other studies suggest that a high-fat, high-protein breakfast can help reduce blood sugars throughout the day.
• Focusing on a high-fiber lunch with plenty of veggies and whole grains will help sustain you through any afternoon slumps.
• A dinner packed with lean protein, green veggies, and a complex carb side is filling and nutrient-dense, meaning you’ll be less likely to reach for a carb-heavy dessert later.
• Juice, milk, soft drinks, and alcoholic drinks are usually high in carbs. If you’re limiting your carb intake, these beverages can count for a lot. Stick to water, sparkling water, coffee, and tea for a healthy, no-carb option.

The following sample meal plan provides roughly 45 to 60 grams of carbohydrates per meal and 15-30 grams of carbohydrates per snack.

Breakfast: 

• 3 eggs with two slices of whole grain toast (30g carbohydrate), lettuce, tomato
• 1 small piece of fruit (15 g carbohydrate)
• Total carbohydrate: 45 g carbohydrate 

Lunch: 

• Salad with lettuce, cucumber, carrot, 1/4 avocado (~5 g carbohydrate) 
• 1 cup low-sodium lentil soup (30 g carbohydrate)
• 3 cups air-popped popcorn (15 g carbohydrate)
• Total carbohydrate: ~50 g carbohydrate

Snack:  

• 1 small apple (15 g carbohydrate)
• 1 tablespoon peanut butter 
• Total carbohydrate: ~15 g carbohydrate 

Dinner: 

• 4 oz grilled salmon
• 1 cup roasted asparagus with 1/2 cup cannellini beans (20 g carbohydrate )
• 1 large sweet potato (35 g carbohydrate)
• Total carbohydrate: ~55 g carbohydrate

Snack: 

• 1 nonfat plain Greek yogurt (7 g carbohydrate)
• 3/4 cup blueberries (15 g carbohydrate)
• Total carbohydrate: ~22 g carbohydrate 

How Many Added Sugars Are Right for You

While sugar can have a place in a lower-carbohydrate diet, it’s important to be aware of the fact that sugar has zero nutrient density, meaning no vitamins or minerals are present. Keep an eye on added sugars in packaged foods, which can be the biggest culprit of empty carbs. Current dietary guidelines recommend that no more than 10 percent of calories come from added sugar. That specifically looks like:

• No more than 6 teaspoons or 25 grams of added sugar for adult women without diabetes
• No more than 9 teaspoons or 37.5 grams of added sugar for adult men without diabetes

There are no current recommendations for added sugars for adults with diabetes. If you have diabetes, work with your care provider and dietitian, nutritionist, or CDE to determine the daily amount of added sugar that’s right for you.

Types of Fat and Proteins to Include

High-quality sources of fat and protein play a big role in diabetes management, as they can slow the entry of glucose into the bloodstream and be used for energy when you’re limiting carbs.

Proteins to include as part of your healthy diet:

• Meat, such as poultry, fish, and lean red meats
• Eggs
• Beans and legumes
• Soybeans, tempeh, and tofu
• Nuts and seeds

Fats to include as part of your healthy diet:

• Avocado and avocado oil
• Olive oil and olives
• Nuts and nut butters
• Seeds, such as sesame seeds, pumpkin seeds, sunflower seeds, etc.
• High-quality full-fat, grass-fed dairy

When planning your meals, keep a mental checklist of a plate complete with complex carbs, protein, and healthy fats, which will help you keep your glucose levels in better balance than by eating simple or refined carbs alone.

A Word From Verywell

Everyone with diabetes, especially those who are recently diagnosed, should receive diabetes self-management education (DSME) on an ongoing basis. DSME has been proven to help diabetes outcomes through individualized education. If you have not received this type of education, ask your primary doctor about where you can find a certified diabetes educator.

Until then, you can start by implementing a modified, consistent carbohydrate diet. The American Diabetes Association recommends starting with about 45 to 60 grams of carbohydrate per meal. You may ultimately end up on a lower carbohydrate diet, but testing your blood sugar before and after meals can help you to see if your current meal plan is working. Ideally, two hours after eating, your blood sugar should be less than 180mg/dL. If it is higher, you may need to adjust your meal plan by reducing your carbohydrate intake.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Centers for Disease Control and Prevention. Diabetes and carbs. Updated September 19, 2019.

2. Harvard T.H. Chan School of Public Health. Carbohydrates and blood sugar.

3. American Diabetes Association. 5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S48-S65. doi:10.2337/dc20-S005

4. EndocrineWeb. Treatment of diabetes: The diabetic diet. Updated April 2, 2019.

5. American Diabetes Association. 6. Glycemic targets: Standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S66-S76. doi:10.2337/dc20-S006

6. American Diabetes Association. Meal planning.

7. Chang CR, Francois ME, Little JP. Restricting carbohydrates at breakfast is sufficient to reduce 24-hour exposure to postprandial hyperglycemia and improve glycemic variability. Am J Clin Nutr. 2019;109(5):1302-1309. doi:10.1093/ajcn/nqy261

8. Harvard T.H. Chan School of Public Health. Sugary drinks.

9. American Heart Association. Added sugars. Updated April 17, 2018.

10. American Diabetes Association. Diabetes self-management education.

11. dLife. Blood tests for diabetes: two-hour postprandial glucose test. Updated September 2017.

Additional Reading

• American Diabetes Association. Carbohydrate counting. October 25, 2015: 

• Centers for Disease Control and Prevention. Diabetes and carbohydrates. 2019.

Verywell Health is part of the Dotdash publishing family.

Diet for type 2 diabetes

According to the WHO, it is only thanks to special dietary nutrition that it is possible to maintain normal levels of glucose in a person’s blood. In order to achieve normal pancreatic function and glucose levels, it is important to know which foods can be consumed without restriction and which ones should be limited.

Type 2 diabetes – nutritional guidelines

The ratio of nutrients in the diet plays an important role in the presence of diseases such as type 2 diabetes. A special diet that helps maintain acceptable blood sugar levels should be 25% fat, 60% carbohydrate, and 15% protein. In addition:

• It is necessary to completely exclude refined carbohydrates from the menu, replacing them with sweeteners of natural origin.
• Limit the amount of animal fats.
• It is necessary to calculate the caloric content of the daily diet taking into account energy consumption, age, sex, body mass index and profession of a person with diabetes.
• The daily menu should contain vitamins, dietary fiber and trace elements.
• A person suffering from this ailment should not overeat or feel hungry.

If a person is diagnosed with type 2 diabetes, he is recommended to eat fractionally (4-5 times a day) with strict adherence to the diet (meals at the same time).

Distinctive features of nutrition in type 2 diabetes

Patients with diabetes should adhere to the following rules:

• Calculate the amount of carbohydrates consumed.
• Limit the consumption of animal fats by 50%.
• Enter vegetable and coarse fiber foods in the menu.
• Give up sugar, giving preference to sugar substitutes.
• Reduce consumption of foods high in salt.
• Eliminate alcohol consumption.
• Do not eat excessively cold or hot food.
• Do not arrange fasting days.
• Give preference to steamed dishes.
• Observe the drinking regime.

Also, the diet should include foods that contain simple carbohydrates, such as berries and fruits.

Foods that normalize sugar in type 2 diabetes

Heat treatment significantly increases the glycemic index of many foods, so nutritionists recommend consuming as many raw vegetables as possible. This will help improve glucose uptake and pancreatic function.

Foods recommended for type 2 diabetes:

It is also allowed to use special diabetic products, which include sugar substitutes (breads, bars, etc.)

What foods are not recommended for type 2 diabetes

In the presence of this pathology, the following products should be excluded from the diet:

In addition, marinades and canned vegetables / fruits should be excluded from the diet.

Sweeteners

It is believed that artificial sweeteners are absolutely harmless and are a substitute for traditional sugar. However, it is not. According to nutritionists, only natural products can be used as sweeteners and only in strictly limited quantities. Natural sugar substitutes include honey, fructose, and stevia.

Honey

Natural honey is rich in fructose, glucose and sucrose. Moreover, it does not matter what kind of honey a person with diabetes is going to use.The sucrose content in this product is so insignificant (no more than 5%) that its presence in the body does not in any way affect the production of insulin. However, those who decide to include honey in their diet should know that the daily intake should not exceed 2 teaspoons.

Fructose

Insulin is not involved in the metabolism of fructose, which is why its use is absolutely safe for people with type 2 diabetes. Fructose has a low glycemic index, several times less high in calories than ordinary sugar, and at the same time 1.5 times sweeter than sugar.No more than 40 g of fructose per day is allowed, if this rule is neglected, then it is possible to reduce the sensitivity of the liver to the production of insulin, which can lead to negative consequences. Fructose is available on the market in the form of tablets and powder.

Stevia

This perennial plant was approved by WHO experts as a sugar substitute in 2004 and since then people with type 2 diabetes have added stevia to cooking or to ready-made meals. Stevia synthesizes stevioside (a sweet glycoside), making it taste almost 20 times sweeter than our usual sugar.According to nutritionists, stevia promotes the production of its own insulin and restores the functioning of the pancreas.

In diabetes, the daily intake of stevia is limited to 1 tablespoon per day, because if it is abused, a toxic effect can develop, which will lead to an increase in glucose levels. Stevia is produced in the form of syrups, powder, liquid extracts.

Benefits of diet

A properly formulated diet helps not only to stabilize glucose levels and improve the functioning of the pancreas, but also improves metabolism.Also, overweight people notice that following a special diet promotes gradual weight loss. Weight loss is one of the important conditions in the treatment of diabetes mellitus. You can take the most effective drugs for treating this disease, but without dieting, the effect of their use will be minimal.

Diet No. 9 is indicated for patients with diabetes for life. It has a beneficial effect on the body, prevents drops in blood sugar levels, improves the functioning of the pancreas and helps to avoid serious complications associated with this disease.

Everyone with type 2 diabetes should know that the path to health and longevity is only possible if three rules are followed: diet, weight loss and increased physical activity.

90,000 How to count XE in type 1 and 2 diabetes mellitus?

Due to numerous requests, we begin to cover more often the issues of counting bread units (XE).
And first of all, let’s figure out how XE can be considered. If you are new to diabetes, this information will probably come in handy!

In Russia, it is customary to consider food in units of bread (XE).This is easier than counting in grams of carbohydrates, and allows you to count carbohydrates by eye in situations where weights are not at hand.

For 1 XE you can take 10, 11 or 12 g of carbohydrates. Your choice will greatly affect the calculation of the final dose.
For example, you want a bar that contains 18 g of carbs. If your bread unit contains 10 g, then the bar comes out almost 2 XE; if 12 g – then for you it contains exactly 1.5 XE and a completely different dose of insulin.

What is the correct way to count XE in foods and dishes?

Method 1: Good old-fashioned calculation of XE by eye

In the hospital, when you are discharged, they often give tables where it is indicated that 1XE is a piece of bread, 12 cherries, 2 tablespoons of porridge or a glass of milk.Those who have had diabetes for a long time will probably remember that such tables have long been almost the only way to count food that is not sold in a package with an exact indication of carbohydrates.

Counting by eye is convenient when there are no scales at hand (at a party or in a cafe), but in general it is too approximate to rely on it constantly. One and the same cereal can be cooked so that in two spoons there will be much more than 1 XE, and a piece of bread or a “small apple” – the concepts are so vague that the dose can be greatly missed.

Method 2: Count carbohydrates by weight of a single product. This method is already more accurate.

You weigh the same bread or boiled buckwheat and calculate XE based on the weight, not the approximate portion size. For ready-made portioned products such as cereal bars, snacks (chips, crackers), cookies and drinks, calculations are even easier – we know exactly how much the product weighs in a pack and count XE without any problems.

For calculation we use the usual formula of proportions.
Example: 100 g of Chokopai contains 73 g of carbohydrates; one Chocopai weighs 30 g. Substitute the formula:
(73/100) * 30 = 21.9 g.
You can quickly count in your head, removing the extra zeros. For example, like this:
7.3 * 3 = 21.9, where 7.3 are carbohydrates in 10 g of chocopai, and 3 is the number of times 10 grams in one chocopai. You can also count like this: 73 * 0.3 = 21.9. In general, consider what is more convenient for you 🙂

Sometimes caring manufacturers indicate the amount of carbohydrates not only per 100g, but also per 1 serving, which makes it completely easier to calculate the insulin dose.We really appreciate such care, so we are pleased to add to our range of snacks such brands as Bombbar and Dary Pamir, which indicate the amount of carbohydrates per serving.

Method 3: Count the dry ingredients of the future dish (suitable only for homemade dishes)
You weigh the initial products, count the amount of carbohydrates in each in Method 2, add up and divide the amount by the portions of the finished dish.

For example, you are preparing morning porridge. You have got 35 grams of dry oatmeal, 100 ml of milk and water per eye.The amount of water can affect the weight of the finished porridge and the final dose, if counted in spoons. But you are not afraid, because you already know the amount of carbohydrates in a serving.

The same is true for pies, pancakes and other baked goods – you simply divide the total amount of carbohydrates in the dough by the number of pieces or pieces.

Method 4: Using special scales for calculating XE in products

This method is very convenient for those who have recently got sick and have difficulty in calculating.It is also convenient to use the scales for children with diabetes. In order to find out the amount of XE in a certain product, you just need to put the product on the scale and enter the digital product code. The screen will show the amount of XE in the product that is on the scales.

It must be borne in mind that manufacturers accept 1XE = 12 gr. carbohydrates. If your bread unit contains 10 carbohydrates, then the scales will also be convenient to use, since you can look at the “Carbohydrates” window. You can choose a scale for every taste – flat scale with a touch screen Beurer DS61 or scales with a bowl and simple buttons Sanitas SDS64

There are many services for calculating carbohydrates in complex dishes.But as our subscribers tell us, they can fail. So keep a close eye on your sugars and make adjustments if necessary next time.

Finally, we note that in reality we use all three methods, depending on the situation and our capabilities.

Although weighing products is the most accurate method, there is nothing wrong with sometimes counting by eye. The more often you weigh, the more accurately you will count by eye over time.

We wish you precise doses and good sugars 🙂

Principles of healthy eating in type 2 diabetes – Nutritional advice – Information – For patients – OKDC PJSC Gazprom

In non-insulin dependent diabetes (type 2 diabetes), in addition to problems with elevated blood sugar , patients often have overweight .

The basis for the treatment of type 2 diabetes mellitus, in addition to drug therapy, is diet , the main goal of which is to maintain optimal blood sugar levels, normalize fat metabolism, achieve and maintain the patient’s optimal weight. The diet should be consistent with the principles of good nutrition.

Basic principles of nutrition in type 2 diabetes mellitus

Diabetes »In type 2 diabetes, the daily intake of carbohydrates

Diet in type 1 and 2 diabetes mellitus body gurus – weight loss without garbage

Hello,

If type 2 diabetes mellitus and the person is being treated as:

1. diet correction
2. physical activity
3. plus antihyperglycemic tablets

to Diabetes Diet involves the following: limit the consumption of foods containing easily digestible carbohydrates and eat food that meets your daily calorie intake.

I am decoding the above. Type 2 diabetes mellitus is often associated with obesity or overweight. Therefore, with regard to the diet for diabetes mellitus, the main task of a patient with type 2 diabetes mellitus is to lose weight, or, which is equally important, not to gain weight, or to maintain weight in case of successful weight loss.

This is only possible if:

• kcal consumed
• number of kcal consumed = number of kcal spent per day

How to calculate your daily calorie intake?

Let me give you a very rough formula.Error + – 150kcal.

• For women: Your weight in kg * 28 = Your daily allowance kcal
• For men: Your weight in kg * 30 = Your daily allowance kcal

Other formulas, more precise, require a separate article. We will analyze it next time.

Foods that contain easily digestible carbohydrates traditionally include sweets, breads, grapes and raisins, melon, watermelon, honey, sweet waters, etc. – a list of them is easy to find in any brochure for people with diabetes.

However, I would like to dwell on this issue in more detail. Often, after people read such “lists of prohibited foods”, getting acquainted with the diet for diabetes mellitus, one has to hear desperate exclamations: “ So now I have nothing to eat? “or” Whatever you take – nothing is wrong! “.

This would not be a big deal if, after that, a refusal to adhere to a diet for diabetes mellitus in general did not follow.

But the diet in diabetes mellitus is the most important thing in the treatment.Ignoring its observance deprives a person of a simple and effective way to improve control over blood sugar, cholesterol in the blood, over weight and other serious risk factors.

How can you decide what is possible and what is impossible?

Based on your conscientiousness and ability to analyze, regarding the diet for diabetes mellitus, I would recommend the following.

Your head judge is your personal meter. If you want to understand the permissibility of the product, eat what you want, and 2 hours after eating, check your blood sugar level.If blood sugar is below 9 mmol / l 2 hours after eating (ideally 8), you can eat this product.

BUT ONLY IN THE AMOUNT YOU ARE IN 2 HOURS OF MEASUREMENT!

And now, run at me to burst everything. Joke

Don’t be alarmed. You won’t have to experiment for a long time: the usual set of products in the daily diet is no more than 15. Thus, you will understand the mass of information that the literature on diabetes is full of, as well as select a diet for diabetes mellitus that individually suits you.

And more …

I highly recommend understanding the glycemic index of foods. What is it and how to apply it.

You can download the table of glycemic indices (+ other bonuses) under this Video tutorial 38

If type 1 diabetes mellitus or type 2 diabetes mellitus and the person receives treatment in the form of:

1. diet correction
2. physical activity
3. plus insulin on an intensive scheme (possibly plus pills), the approach to diet therapy for her is different

In this case, to correct the sugar level, insulin should be injected after 2 hours after eating, which means that the amount of carbohydrates eaten must correspond to the amount of injected insulin.Conversely: the amount of carbohydrates eaten should be injected with the appropriate dose of insulin.

Therefore, first of all, the number of eaten carbohydrates and kcal should be considered. Why the focus on carbohydrates? Because it is carbohydrates that increase blood sugar? That is, nibels and fats do not raise blood sugar if the amount eaten at a time does not exceed 300 g.

How to calculate the amount of carbohydrates eaten?

Option No. 1. You can refer to the label, where it is noted how many grams of carbohydrates are contained in 100 g of the product and knowing how much you have eaten, recalculate the dose of insulin you need.

Option No. 2. To simplify calculations, a system of so-called “grain units” was invented. What is this system? The system of bread units is a good help in drawing up a diet for diabetes mellitus, as it is a more accessible way of calculating the amount of carbohydrates in food.

Its purpose is to give a diabetic patient such a way of calculating the amount of carbohydrates in food, so that you can already look at a portion of food in a plate to say how much carbohydrates it contains.

What is a bread unit?

If you take a loaf of bread (the so-called “brick”, it does not matter – black or white) and cut a piece 1 cm thick across, then divide this square piece in half as it is done in the dining room, then we get a piece of bread weighing 25 g. It is estimated that such a slice of bread contains 10-12 g of carbohydrates. Conventionally, 10-12 google-growers were taken as one grain unit.

Thus, 1 unit of bread (XE) of carbohydrates is contained, for example, in a piece of bread weighing 25 g.In order to assimilate 1 unit of bread contained in one piece of bread, colotinsulin should be calculated: for each unit of bread – 1-4 units of short insulin (the dose may vary for different people, but the average statistically is 2 units of insulin per 1 XE).

Now let’s move on to other foods that contain carbohydrates. So 1XE is in 1 tablespoon of any porridge or pasta, 1 glass of milk (kefir, ryazhanka), 1 medium apple, 5 crackers, etc.

Download conversion table XE 28

A few words about foods containing hidden carbohydrates.These include, for example, cutlets (contain bread) – one medium cutlet is equal to 1 XE, boiled sausages and sausages (contain soy and starch).

Let me remind you once again that this approach to diabetes mellitus diet is applicable only to people with type 1 diabetes or type 2 diabetes who are on intensive insulin therapy, i.e. those who inject short insulin with food.

For those patients who use a special device to administer insulin, an insulin pump, especially the latest models, a dose of short insulin with meals will help to calculate a samapump.

That’s all. I briefly tried to clarify the situation.

Write in the comments what type of diabetes do you have? If you have any questions, just write them in the comments.

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Diabetes mellitus – healthy-food.ru

Diabetes mellitus is an endocrine disease characterized by a syndrome of chronic hyperglycemia, which is a consequence of insufficient production or action of insulin, which leads to disruption of all types of metabolism, primarily carbohydrate, vascular damage (angiopathy), nervous system (neuropathy), and other organs and systems.

According to the WHO definition, diabetes mellitus is a state of chronic hyperglycemia caused by exposure to genetic and exogenous factors.

The prevalence of diabetes mellitus among the population of different countries ranges from 2 to 4%. Currently, there are about 120 million patients with diabetes mellitus in the world.

There are two main types of diabetes mellitus: insulin-dependent diabetes mellitus (IDDM) or type I diabetes and non-insulin-dependent diabetes mellitus (NIDDM) or type II diabetes.With IDDM, there is a pronounced insufficiency of insulin secretion by B (b) cells of the islets of Langerhans (absolute insulin deficiency), patients need constant, lifelong insulin therapy, i.e. are insulin dependent.

In NIDDM, insulin deficiency comes to the fore, peripheral tissue resistance to insulin develops (relative insulin deficiency). Insulin replacement therapy for NIDDM is usually not performed.Patients are treated with diet and oral hypoglycemic agents. In recent years, it has been established that with NIDDM there is a violation of the early phase of insulin secretion.

Diabetes mellitus is one of the most common endocrine diseases. With this disease, due to a lack of pancreatic hormone – insulin – in the body, disorders of all types of metabolism, especially carbohydrate ones, develop.

In the origin of the disease, along with a hereditary predisposition, the leading role is played by systematic overeating, excessive consumption of foods containing easily digestible carbohydrates.In diabetic patients, carbohydrates absorbed from the digestive tract are not completely absorbed and accumulate in the blood in an increased amount. Hyperglycemia (high blood sugar) is a characteristic sign of diabetes mellitus. Sugar can also appear in the urine. In a practically healthy person, the blood sugar level usually does not exceed 6.66 mmol / L, and there should be no sugar in the urine at all.

The main symptoms of diabetes: excessive thirst (the patient drinks a lot of tea, water), frequent and profuse urination, an insatiable feeling of hunger, itching of the skin, general weakness.

The main therapeutic goal of measures for diabetes mellitus is to normalize metabolic processes in the body. An indicator of normalization is a decrease in blood sugar levels. At the same time, the patient’s general well-being improves: thirst decreases, efficiency increases.

In order to normalize the level of sugar in the blood of a patient with diabetes, doctors try first of all to limit the amount of carbohydrates in his diet, and, if necessary, prescribe special medications for him.

In some forms of diabetes, you can do without medication, you just need to strictly follow the diet prescribed by your doctor. Scientists believe that more than a third of all diabetics can be improved through diet alone.

The basic rules of diet therapy are: limiting the amount of carbohydrates, primarily easily digestible, reducing the calorie content of the diet, especially with excess body weight, sufficient fortification of food, adherence to the diet.
We must strive to eat daily at the same hours, 5-6 times a day, avoiding overeating.

The attending physician, when prescribing a diet to a patient, in each case takes into account his body weight, the presence or absence of obesity, concomitant diseases and, of course, the blood sugar level. The nature of production activity, that is, the energy consumption of the patient, the peculiarities of the course of his illness, are necessarily taken into account. The body’s tolerance of certain food products and dietary meals is taken into account.

Which foods should be limited in diabetes mellitus in the first place?

First of all, those that contain in excess of easily digestible and quickly absorbed carbohydrates – sugar, sweets, jam, confectionery, as well as raisins, grapes, figs – since the glucose in large quantities, like sucrose, is quickly absorbed from the intestines into the blood , which leads to a sharp rise in blood sugar levels.

Without a sharp restriction, you can eat vegetables, carbohydrates of which are absorbed in the intestines much more slowly than sugar: fresh cucumbers, tomatoes, cauliflower and white cabbage, lettuce, zucchini, pumpkin, eggplant. It is useful to include parsley, dill, and onions in your daily diet. More often, you need to eat carrots and beets in the amount agreed with your doctor (taking into account the daily intake of carbohydrates).

One of the sugar substitutes recommended for diabetes is xylitol. In its sweetness, it is approximately equal to ordinary sugar, but its intake, unlike sugar, does not have a significant effect on the blood sugar level of patients with diabetes.
Xylitol is obtained by processing plant raw materials – the husks of cotton seeds and corn cobs. The calorie content of 1 g of xylitol is 4 kcal.

Xylitol has choleretic and laxative properties. The daily dose of xylitol should not exceed 30-35 g, otherwise intestinal upset may occur.

Can people with diabetes eat fruit sugar? Fruit sugar (fructose) is one of the natural sugars. It is found in all sweet berries, fruits and vegetables, in bee honey.So, apples contain (on average) 7.3% fructose, watermelon – 3%, pumpkin – 1.4%, carrots – 1%, tomatoes – 1%, potatoes – 0.5%. Especially there is a lot of fructose in honey – up to 38%. In industrial production, beet and cane sugar is used as raw material for fructose production.

Fructose can be used in mild to moderate diabetes mellitus as a sugar substitute, but only in limited quantities. For example, in a mild form of diabetes mellitus, the attending physician may allow the inclusion of up to 40-45 g of fructose in the diet, provided it is well tolerated by the body.Eating large amounts of fructose can raise blood sugar levels.

Note: products manufactured for diabetics, such as sweets and other confectionery, are not contraindicated for healthy people. However, the long-term use of these products is hardly justified, since the body of a healthy person must receive in sufficient quantities all the necessary nutrients, including ordinary sugar, which is absent in products intended for patients with diabetes.

Both rye and white wheat bread can be included in the diet of patients with diabetes. If the attending physician recommends a diet containing, for example, 300 g of carbohydrates, then in this case, about 130 g of them can be obtained with bread (rye and wheat), and the rest of the carbohydrates with vegetables and cereal dishes.

Patients should give preference to bakery products with a reduced carbohydrate content. These include protein-wheat and protein-bran bread.The main raw material for its preparation is raw gluten (one of the protein substances found in the grain). When baking protein-bran bread, wheat bran is added to its composition.

Many are interested in whether patients with diabetes mellitus are allowed to eat honey. The attending physician usually does not object to the use of honey in a small amount by patients with diabetes: a teaspoon 2-3 times a day. Diabetic sufferers should make sure that their diet includes sufficient amounts of all the necessary vitamins.

Apples, fresh herbs, vegetables, black currants, rosehip broth, yeast drink, as well as natural fruit juices prepared on xylitol are useful. The consumption of a strictly defined amount of fruit or berry juice prepared with sugar can be allowed by your doctor.

Composition of the diet

Composition: meat, fish, poultry, animal and vegetable oil, eggs, cheese, cottage cheese, lactic acid products, vegetables and herbs, sour varieties of fruits and berries.Limit carbohydrates, increase protein content. Vitamins A, E, group B, C are added. Food intake every 3 hours. In severe diabetes with the development of acidosis, the diet is strictly individualized.

How to eat with diabetes: diet for type 2 diabetes

By choosing the right diet for diabetes, with a mild (and often moderate) form of type 2 diabetes mellitus, drug treatment can be minimized, or even completely dispensed with. Therefore, the question of how to eat properly with diabetes worries most patients.

Foods containing simple carbohydrates are not recommended for diabetics, but this restriction is not due to the high sugar content in the product, but to the fact that it contains instant sugar, which very quickly raises blood glucose levels.

These are sugar, honey, preserves and jams, sweets, pastries and other sweets, sweet fruits and berries: grapes, bananas, raisins, dates.

There are even recommendations to completely eliminate these foods from the diet, but this is really necessary only for severe diabetes.With mild to moderate type 2 diabetes, with regular monitoring of blood sugar levels, the use of small amounts of sugar and sweets is quite acceptable.

As a result of a number of studies, it was found that an increased content of fats in the blood makes a large contribution to the progression of diabetes mellitus. Therefore, limiting the use of fatty foods in the diet for diabetes is no less important than limiting sweets.

The total amount of fat consumed in free form and for cooking (butter and vegetable oil, lard, cooking fats) should not exceed 40 grams per day; it is also necessary to limit as much as possible in your diet other foods containing a large amount of fat (fatty meat , sausages, sausages, sausages, cheeses, sour cream, mayonnaise).

The diet for type 2 diabetes mellitus limits to a minimum or completely excludes fried, spicy, salty, spicy and smoked foods, canned food, peppers, mustard, and alcoholic beverages.

And foods that contain a lot of fats and carbohydrates at the same time are not at all good for those suffering from diabetes: chocolate, ice cream, cream pastries and cakes & It is better to exclude them from the diet completely.

Recommended food for type 2 diabetes

Foods permitted for type 2 diabetes mellitus:

• Bread up to 200 grams per day, mainly rye or special diabetic.

Why is rye bread recommended? If we eat black bread, then sugar begins to rise in 20-30 minutes, and this increase is gradual, since black bread is processed longer in the stomach and intestines for about two to three hours. Thus, rye bread is a typical slow sugar product.
If we have consumed a piece of bread, absorption will begin in 10-15 minutes, it will go faster, and blood sugar will rise sharply.

• Soups, mainly vegetable. Soups cooked in a weak meat or fish broth can be consumed no more than twice a week.
• Lean meat, poultry (up to 100 grams per day) or fish (up to 150 grams per day) in boiled or jellied form.
• Dishes and side dishes from cereals, legumes, pasta can be afforded occasionally, in small quantities, reducing the consumption of bread these days. Of the cereals, it is better to use oatmeal and buckwheat; millet, pearl barley, and rice cereals are also acceptable. But it is better to exclude semolina.

Porridge made from buckwheat, millet and oatmeal are comparable in absorption rate to black bread, i.e.That is, they contain slow sugar. Semolina porridge contains almost no fiber, absorption is too fast.

• Vegetables and herbs. Potatoes, beets, carrots are recommended to be consumed no more than 200 grams per day. But other vegetables (cabbage, lettuce, radishes, cucumbers, zucchini, tomatoes) and greens (except spicy) can be consumed almost without restrictions raw and boiled, occasionally baked.
• Eggs, no more than 2 pieces per day: soft-boiled, in the form of an omelet or using in the preparation of other dishes.
• Fruits and berries of sour and sweet-sour varieties (Antonovka apples, oranges, lemons, cranberries, red currants &) up to 200-300 grams per day.
• Milk is included in the diet for diabetes mellitus with the permission of a doctor. Fermented milk products (kefir, yogurt, unsweetened yogurt) 1-2 glasses a day. Cheese, sour cream, cream occasionally and a little bit.
• Cottage cheese with diabetes mellitus is recommended to be consumed daily, up to 100-200 grams per day in natural form or in the form of curds, cheese cakes, puddings, casseroles.

Cottage cheese, as well as oat and buckwheat porridge, bran, rosehip improve fat metabolism and normalize liver function, prevent fatty changes in the liver. These products are recommended to be included in the diet for diabetes mellitus.

• Drinks. Green or black tea is allowed, it is possible with milk, weak coffee, tomato juice, juices from berries and sour fruits (it is recommended to dilute the juices with half water).

When making a menu for type 2 diabetics who are receiving insulin, you should count the amount of carbohydrates in your food.For this, there is a system of grain units (XE). For 1 XE, the amount of a food product containing 10-12 g of carbohydrates is taken.
It is not recommended to eat more than 7 bread units at one meal.

Approximate amount of product for 1XE:

Bread 1 piece
Flour 1 tbsp. spoon
Pasta 1.5 tbsp. spoons
Boiled cereals 2 tbsp. spoons with a slide
Dried beans 1 tbsp. spoon
Boiled beans – 3 tbsp. spoons

Milk 1 glass
Granulated sugar 1 tbsp.spoon
Refined sugar 2.5 pieces

Potatoes 1 pc. the size of a large egg
Carrots 3pcs.
Beetroot 1pc.

Grapes 3 berries
Grapefruit 0.5 pcs
Banana 0.5 pcs.
Maize 0.5 pcs
Apples
Pear 1 pc.
Peach 1pc.
Orange 1pc.
Persimmon 1pc.
Watermelon 1pc.
Melon 1pc.
Mandarins 3 pcs.
Apricots 3 pcs.
Plums 3 pcs.
Handful of cherry
Handful of cherry
Handful of strawberries
Handful of raspberries
Handful of currants

Grape juice 1/3 tbsp.
Apple juice 1/3 tbsp.
Kvass 1 st.
Beer 1 tbsp.

In diabetes, it is recommended to follow the principles of fractional nutrition. Take food at least 4 times a day, and preferably 5-6 times, at the same time.

Food products for diabetes mellitus should be rich in vitamins, micro- and macroelements, choose natural food. Try to diversify your diet as much as possible, because the list of foods allowed for diabetes is not at all small.

Important:

diet for diabetes should be recommended by a doctor.Only your doctor, knowing the medical history, seeing the test results and your current condition, can correctly assess the situation and give nutritional recommendations that are most suitable for you and right now.
The above recommendations are for guidance only.

Diabetes mellitus – endocrinology – medportal.ru

Diabetes mellitus is associated with metabolic disorders, it is based on insufficient absorption of glucose by the body. Type 2 diabetes often occurs with obesity.

In any type of diabetes mellitus, proper nutrition plays an important role. For mild type 2 diabetes, diet is the main treatment. With an average and severe form of the disease, the diet should be combined with the intake of antihyperglycemic drugs or insulin.

What is a unit of bread?

How to correctly determine the required rate of carbohydrate products? All of them differ significantly in their physical properties, composition, calorie content.It is impossible to measure all these important parameters of food in any one familiar home way with the help of a spoon or glass. It is no less difficult to determine the required volume of the daily norm of products without special knowledge and without seeing the guidelines that are clear to oneself. To facilitate the task, nutritionists introduced the conditional concept of a bread unit.

Bread unit is a kind of measuring spoon for calculating carbohydrates. Regardless of the type and quantity of the product, be it bread or an apple, one bread unit contains 12-15 grams of digestible carbohydrates.It raises blood sugar levels by the same 2.8 mmol / L and requires 2 units of insulin to be absorbed by the body.

The bread unit was introduced specifically for diabetic patients receiving insulin. Indeed, it is very important for them to observe the daily daily intake of carbohydrates corresponding to the injected insulin. Otherwise, they may experience an increase or decrease in blood sugar, hyper or hypoglycemia. Thanks to the introduction of the concept of a bread unit, patients with diabetes mellitus were able to correctly compose a menu, competently replacing some carbohydrate-containing foods with others.

So for example, 1 bread unit corresponds to 25-30 grams of white or black bread, or 1/2 cup of buckwheat or oatmeal, or 1 medium-sized apple, or 2 pieces of prunes, etc.

Approximately 18-25 grain units should enter the human body per day. It is advisable to distribute them into six meals: breakfast, lunch and dinner for 3-5 bread units, at mid-morning snacks 1-2 bread units. Most carbohydrate foods should be consumed in the first half of the day.

Principles of Nutritional Care

The diet must be physiologically literate:

• The amount of energy in food should be equal to the energy needs of the patient.
• The amount of proteins, fats, carbohydrates must be balanced.
• Food intake during the day 5-6 times.

For overweight diabetic patients, in order to increase the feeling of fullness, it is necessary to include in the diet such vegetables as fresh and sauerkraut, lettuce, spinach, green peas, cucumbers, tomatoes.To improve the function of the liver, which is significantly affected by diabetes, it is necessary to introduce into the diet products containing lipotropic factors (cottage cheese, soy, oatmeal, etc.), as well as limit meat, fish broths and fried foods in the diet.

There are several options for diets for patients with diabetes mellitus, but almost at home you can use one (diet 9), which can be easily adapted to the treatment of any patient, excluding or adding individual dishes or foods.

It is allowed to include in the diet:

• Bread and bakery products, mainly black bread (200-350 grams per day, as directed by a doctor).
• Soups with vegetable broth, weak meat and fish broth with a small amount of vegetables (1-2 times a week).
• Meat and poultry dishes (beef, veal, lean pork, turkey, rabbit in boiled or aspicated form).
• Fish dishes, mostly low-fat (pike perch, cod, pike, navaga, carp, etc. in boiled or aspicated form).
• Dishes and garnishes from vegetables (leafy greens, cabbage (white, cauliflower), lettuce, rutabagas, radishes, cucumbers, zucchini, potatoes, beets, carrots) in boiled, raw and baked form.
• Dishes and side dishes from cereals, legumes, pasta (in limited quantities, occasionally, while reducing the amount of bread in the diet).
• Egg dishes (no more than 2 pieces per day in the form of an omelet or soft-boiled, as well as for adding to other dishes).
• Sour and sweet-sour varieties of fruits and berries (Antonov apples, lemons, oranges, red currants, cranberries and others) up to 200 grams per day raw, in the form of compotes on xylitol or sorbitol. With the permission of the doctor, you can use sweet dishes and specially prepared diabetic products.
• Milk with the permission of a doctor, kefir, yogurt (only 1-2 glasses per day), cottage cheese (50-200 grams per day) in natural form or in the form of curds, cheese cakes and puddings.
• Mild sauces based on vegetable broth with vinegar, tomato puree, roots, as well as dairy sauces.
• Tea with milk, weak coffee, tomato juice, fruit and berry juices (total liquid with soup up to 5 glasses per day).
• Butter, vegetable oil (only 40 grams per day in free form and for cooking).

The food of a diabetic patient should be rich in vitamins, therefore it is useful to introduce brewer’s and baker’s yeast, rosehip broth into the diet.

Contraindicated:

• sweets, chocolate, confectionery, buns, jam, honey, ice cream and other sweets;
• spicy, spicy, salty and smoked snacks and dishes, lamb and pork fat;
• pepper, mustard;
• alcoholic beverages;
• grapes, bananas, raisins;
• Sugar is allowed only in small quantities with the permission of a doctor.

Diabetes. diet for diabetes, therapeutic diets No. 9, No. 9a and No. 9b

Diabetes diet

In diabetes mellitus, it is extremely important to observe the principles of proper nutrition, which contributes to the normalization of metabolic processes in the body. Diabetes can be prevented by diet and medication can be minimized for those who already have it. Doctor prescribes nutritional rules, taking into account the peculiarities of the disease, individual tolerance of foods, the patient’s weight and type of diabetes mellitus .

Type 1 diabetes mellitus usually affects young people and children, therefore, food should be high in calories, type 2 diabetes is mature people, and, as a rule, overweight. With a therapeutic purpose is recommended the so-called diet for diabetes mellitus No. 9 , its varieties No. 9a and No. 9b regulate the diet for different types of disease . No. 9a involves limiting calorie intake to 1650 kcal per day solely due to carbohydrates (especially easily digestible ones) and fats.All sugary foods and drinks must be prepared exclusively using sweeteners. Meals should be 5-6 times a day with an even distribution of carbohydrates for all meals. Diet No. 9b involves the consumption of carbohydrates depending on the time of taking insulin, and the daily calorie intake can be 2300 kcal with a full intake of all elements.

Nutritional Principles for Type 1 and Type 2 Diabetes:

• Fractional nutrition. The daily calorie intake must be divided into 5-6 parts, exactly as many meals per day should be.
• Maintain water balance in the body. Drink 8 glasses of water a day, as blood glucose rises with dehydration.
• The diet must necessarily contain foods rich in vegetable fiber (these are products made from wholemeal flour, bran, fresh vegetables, unsweetened fruits).
• It is advisable to set up a meal schedule so that meals are taken every day at approximately the same time.
• As a rule, liver function is impaired in type 1 and 2 diabetes mellitus.To prevent its dysfunction, it is advisable to include in the menu products such as soy, oatmeal, cottage cheese and exclude fried, meat and fish broths. If, of course, this does not contradict the prescriptions of the treating doctor.
• If you are overweight, it is important to normalize your weight. This is necessary to improve metabolism. With type 2 diabetes mellitus, with obesity, the dietary supplement Insulat is recommended. Insulate is a natural phytocomplex of medicinal herbs that help lower blood glucose levels by reducing its absorption in the intestine, improve the secretory function of the pancreas, and increase the cellular utilization of glucose.The components of Insulate help to reduce body weight and normalize carbohydrate metabolism, are well compatible with drugs for the treatment and prevention of type 2 diabetes mellitus.

Make a menu for the day, taking into account the doctor’s prescriptions and the calorie table of foods. Calculate your meals like this:

• 1st breakfast at about 8:00 20% of daily calories,
• 2nd breakfast around 10:00 10% of daily calories,
• lunch at about 13:00 30% of daily calories,
• afternoon snack around 16:00 10% of daily calories,
• dinner at about 18:00 20% of daily calories,
• late dinner 20:00 10% of daily calories.

Choose the right products!

To compensate for diabetes mellitus, it is imperative to include the intake of plant fiber in the daily diet, which gives a feeling of fullness with minimal calories. Among other things, fresh berries are also recommended, especially gooseberries, cranberries and cherries, since the fructose contained in them prevents obesity and the development of diabetes. But do not overdo it with sweet fruits containing a large amount of carbohydrates: melons only one slice, grapes only a brush, banana no more than half, potatoes no more than two tubers a day.Limit bread to three slices a day. Give preference to wholemeal breads.

When diagnosed with diabetes mellitus, all refined, that is, purified from fiber, foods are prohibited. For example, white bread, sugar, sweets (jams, jams, syrups, sweet juices, ice cream, cakes, pastries, waffles, cookies, sweets, other confectionery and pastries), honey, dates. Also try to eat as little salt as possible (no more than 4 g per day), eggs, fish roe, animal fats (incl.hours of butter), liver. Instead of sweets, xylitol, fructose and sorbitol are offered. These sweeteners are less sweet and have a positive effect on the metabolic process, which is especially important in type 2 diabetes. For example, xylitol reduces food intake by slowing down the digestion of food. Allowed up to 30 g of sweetener per day.

Thus, , your diet, first of all, should include:

• boiled beans
• lean fish, lean beef and skinless chicken, preferably boiled or oven baked
• cabbage in any form
• firm low-fat cheese
• grapefruits, lemons, oranges, cranberries, gooseberries, cherries
• tomato juice, tea
• gray bread made from coarse flour
• low fat milk and cottage cheese
• buckwheat, oatmeal, barley

Just remember: your individual menu must be coordinated with your doctor. Consult your supervising endocrinologist or dietitian, GP or GP, do not self-medicate.

90,000 Diabetes: counting carbohydrates | Archive

Diabetes is a condition that requires a constant diet. However, diet is not about avoiding food, but about necessary restrictions that do not have to be minimized.

IN DIABETES, the main thing is not to overdo it with carbohydrates, since when they are broken down they turn into sugar.Simple carbohydrates – sugars and sweets – are severely limited, and as a rule, generally excluded. But the body needs carbohydrates. In addition, the diet should be varied.

If you know the composition of the products, then you can replace some products with others, without confining yourself to 3-4 dishes. Some people who monitor their health prefer to use special tables of the chemical composition of foods (proteins, fats, carbohydrates, calories) for this, they can be easily found in dietary guides, special literature.You can calculate your diet in other ways: by calorie intake, by sugar value, by starch units. The most convenient for use in everyday life is the calculation of consumed carbohydrates by bread units (XE). What it is? One bread unit is the amount of food that contains 10-12 g of carbohydrates. Knowing how much XE is contained in certain products, you can, firstly, find it easier to find an equivalent replacement for one product with another and thereby diversify your diet without harming your health, and secondly, more accurately calculate the required amount of insulin.During breakfast for 1 XE, 2.5-2.8 units should be injected. insulin, at lunch – a little less than 2 units, for dinner, as a rule, about 2 units. At first glance, such a system of food replacement seems complicated, but a person very quickly gets used to it, and it becomes easier for him to change foods in his diet, understanding how much carbohydrates he receives. For example, 1 XE is one piece of black bread or bran bread, or 5 medium crackers, or 2 crispbreads, or 1 pancake. Of vegetables, 1 XE will contain, for example, 6 tablespoons of canned peas, 1 potato in a jacket, 2 tbsp.heaped spoons of boiled lentils, 3 large carrots, etc. (see table).

“In any case, no matter what tables and methods of calculating the amount of carbohydrates consumed, the main thing is to follow a diet,” says endocrinologist Alla Petrovna ANDREYCHENKO. “It is necessary to count carbohydrates not only in type 1 diabetes (insulin-dependent), but it is also necessary for type 2 diabetes, the so-called senile, because it is an even more insidious disease.With external well-being, the absence of such severe conditions as in the first type, when almost something is wrong – immediately decompensation, ketoacidosis and, God forbid, coma, the second type of diabetes is dangerous because there are more gross vascular disorders. To avoid them, to maximize the delay in the onset of complications, you need to monitor what you eat. ”

When replacing products, it is necessary to take into account not only the amount of carbohydrates they contain, but also the calorie content and the level of glucose in the blood after taking a particular food (glycemic coefficient).The glycemic coefficient depends not only on the amount of carbohydrates in a particular product, but also on the composition of these carbohydrates (simple or complex). The less fiber in the product, the better carbohydrates are absorbed and the faster the blood sugar level will rise. There are a lot of dietary fiber in berries (strawberries, raspberries, black currants), dried apricots, raisins, dry rose hips, vegetables (carrots, dill), dried white mushrooms, cereals, legumes. Plant fibers help to lower blood glucose and cholesterol levels.

We must try to replace products from the same groups: vegetables – for vegetables, fruits – for fruits, dairy products – for dairy products, etc., but so that all these groups are present in the diet and it is not limited only to cereals or fruits. At the same time, in the diet of young people (namely, they make up the majority in type 1 diabetes), it is necessary to ensure that there is enough protein in the diet, and for the elderly – to make a diet taking into account the fact that atherosclerosis develops with age, which means , it is necessary to limit animal fats and increase the amount of plant fibers.

How many carbohydrates, and therefore bread units, can be consumed daily by a specific person, depends on the degree of development of his diabetes, height, age, body weight, energy consumption. The spread is quite large – from 150 (15 XE) to 250 g (25 XE), so a doctor should help you more accurately.

See also:

Nutrition for diabetes

Diabetes mellitus is associated with metabolic disorders, it is based on insufficient absorption of glucose by the body.Type 2 diabetes often occurs against a background of 91,298 and obesity.

In diabetes mellitus, the patient’s nutrition plays an important role. For mild type 2 diabetes, dietary nutrition is the main treatment. In moderate and severe diabetes , the diet should be combined with the intake of hypoglycemic drugs or insulin . In type I diabetes mellitus, the occurrence of which is associated with the death of beta cells of the pancreas and insulin deficiency, the main method of treatment is insulin replacement therapy.Compliance with the regimen and dietary nutrition in type I diabetes mellitus are auxiliary.

What is a “unit of bread”?

What is the rate of carbohydrate-containing foods per day should be consumed by patients with diabetes mellitus? All carbohydrate-containing foods differ significantly in their physical properties, composition, and calorie content. It is impossible to measure all these important parameters of food in any one familiar home way – with the help of a spoon or glass.It is no less difficult to determine the required volume of the daily norm of products without special knowledge and without seeing the guidelines that are clear to oneself. To facilitate the task, nutritionists introduced a conditional concept used for diabetics – a unit of bread.

The unit of bread is a kind of “measuring spoon” for calculating carbohydrates. Regardless of the type and quantity of the product, be it bread or an apple, one bread unit contains 12-15 grams of digestible carbohydrates. It raises blood sugar levels by the same amount – 2.8 mmol / L – and requires 2 units of insulin to be absorbed by the body.

The bread unit was introduced specifically for diabetic patients receiving insulin. Indeed, it is very important for them to observe the daily daily intake of carbohydrates corresponding to the injected insulin. Otherwise, they may experience an increase or decrease in blood sugar – hyper or hypoglycemia. Thanks to the introduction of the concept of a bread unit, patients with diabetes mellitus were able to correctly compose a menu, competently replacing some carbohydrate-containing foods with others.

So for example, 1 bread unit corresponds to 25-30 grams of white or black bread, or 1/2 cup of buckwheat or oatmeal, or 1 medium-sized apple, or 2 pieces of prunes, etc.d.

Approximately 18-25 grain units should enter the human body per day. It is advisable to distribute them into six meals: breakfast, lunch and dinner, 3-5 bread units, at mid-morning snacks – 1-2 bread units. Most of the carbohydrate foods should be in the first half of the day.

What cannot be eaten with diabetes and how to correctly determine the required rate of carbohydrate-containing foods? To answer all these questions, a diabetic patient needs to complete the appropriate training in special schools for diabetics.

Principles of Nutritional Care

The diet must be physiologically literate:

• The amount of energy in food should be equal to the energy needs of the patient.

• The amount of proteins, fats, carbohydrates must be balanced.

• Food intake during the day – 5-6 times.

For overweight diabetics, in order to increase the feeling of fullness, it is necessary to include in the diet such vegetables as fresh and sauerkraut, lettuce, spinach, green peas, cucumbers, tomatoes.To improve the function of the liver , which suffers significantly in diabetes, it is necessary to introduce into the diet products containing lipotropic factors (cottage cheese, soy, oatmeal, etc.), as well as limit meat, fish broths and fried foods in the diet.

There are several options for diets for patients with diabetes mellitus, but almost at home you can use one (diet 9), which can be easily adapted to the treatment of any patient, excluding or adding individual dishes or foods.

It is allowed to include in the diet:

• Bread and bakery products – mainly black bread (200-350 grams per day, as directed by doctor ).

• Soups with vegetable broth, weak meat and fish broth with a small amount of vegetables (1-2 times a week).

• Meat and poultry dishes (beef, veal, lean pork, turkey, rabbit in boiled or aspicated form).

• Fish dishes, mostly low-fat (pike perch, cod, pike, navaga, carp, etc.)in boiled or jellied form).

• Dishes and garnishes from vegetables (leafy greens, cabbage (white, cauliflower), lettuce, rutabagas, radishes, cucumbers, zucchini, potatoes, beets, carrots) in boiled, raw and baked form.

• Dishes and side dishes from cereals , legumes, pasta (in limited quantities, occasionally, while reducing the amount of bread in the diet).

• Egg dishes (no more than 2 pieces per day in the form of an omelet or soft-boiled, as well as for adding to other dishes).

• Sour and sweet-sour varieties of fruits and berries (Antonov apples, lemons, oranges, red currants, cranberries and others) up to 200 grams per day raw, in the form of compotes on xylitol or sorbitol. With the permission of the doctor, you can use sweet dishes and specially prepared diabetic products.

• Milk – with the permission of a doctor, kefir, yogurt (only 1-2 glasses per day), cottage cheese (50-200 grams per day) in natural form or in the form of curds, cheese cakes and puddings.

• Mild sauces based on vegetable broth with vinegar, tomato puree, roots, as well as dairy sauces.

• Tea with milk, weak coffee, tomato juice, fruit and berry juices (total liquid with soup up to 5 glasses per day).

• Butter, vegetable oil (only 40 grams per day in free form and for cooking).

Nutrition of a diabetic patient should be rich in vitamins , therefore it is useful to introduce brewer’s and baker’s yeast, rosehip broth into the diet.

Contraindicated:

• sweets, chocolate, confectionery, buns, jam, honey, ice cream and other sweets;

• spicy, spicy, salty and smoked snacks and dishes, lamb and pork fat;

• pepper, mustard;

• alcoholic beverages;

• grapes, bananas, raisins;

• Sugar is allowed only in small quantities with the permission of a doctor.

90,019 90,000 Moscow Department of Health has debunked the most popular myths about diabetes

World Diabetes Day is celebrated on 14 November. Mikhail Antsiferov, chief endocrinologist of the Moscow Department of Health, has debunked the most popular myths about diabetes.

“Over the past 10 years, the number of patients with diabetes mellitus in the world has more than doubled. In Russia, according to the federal diabetes register, about 4.5 million people are registered.sick. According to the results of the NATION study, 24% of the adult population of Russia has prediabetes, 5.4% have type 2 diabetes mellitus, and half of them (54%) do not know about the presence of the disease. Thus, the real number of patients with diabetes mellitus in our country may be about 8-9 million people, ”said Mikhail Antsiferov, chief endocrinologist of the Moscow Department of Health. Diabetes mellitus is an endocrine disease characterized by impaired glucose metabolism against a background of insulin deficiency.As a result, hyperglycemia develops – a persistent increase in blood glucose. The disease is characterized by a chronic course and a violation of all types of metabolism.

MYTH 1. Diabetes mellitus develops from excessive consumption of sugar.

Excessive consumption of sugar is harmful to health and can contribute to obesity. This, in turn, is one of the risk factors for developing type 2 diabetes, but it is not a direct cause.

MYTH 2. Diabetes only affects overweight people.

Most cases of type 2 diabetes are diagnosed in overweight and obese people. But, it can also occur with normal body weight.

MYTH 3. Patients with diabetes cannot eat foods containing carbohydrates.

This myth is one of the most popular. In fact, people with diabetes should adhere to the principles of a healthy diet, when carbohydrates account for 50-55% of the daily calorie content of food.At the same time, an important feature is the restriction of foods containing easily digestible carbohydrates (sugar, honey, jam, jam, sugary drinks and juices).

MYTH 4. Having diabetes, the patient immediately feels bad.

The danger of this disease is that at first it does not manifest itself in any way. At risk are people over 40 years old, overweight or obese, as well as those who have this disease, parents, brothers and sisters. Such patients need to measure fasting blood sugar once a year.

Residents of the city will be able to undergo a free comprehensive examination for susceptibility to type 2 diabetes until November 16. The action takes place in all health centers on the basis of city polyclinics of the Moscow Department of Health. It is timed to coincide with World Diabetes Day, which is celebrated annually on November 14.

Doctors will screen for type 2 diabetes mellitus, which includes calculating body mass index, measuring blood pressure, and a rapid test to determine the level of glucose in the blood.After the examinations, the applicants are given a conclusion on the state of their health, as well as recommendations for the prevention of diabetes. If necessary, the doctor can refer the patient to an endocrinologist, ophthalmologist, cardiologist and other specialists.

MYTH 5. Patients with diabetes mellitus sooner or later lose their sight and undergo amputation of limbs.

Loss of vision and amputation of the lower extremities are late complications caused by this disease. However, in non-smokers who maintain target blood sugar, lipids, and blood pressure, the risk of these severe complications is significantly reduced.Modern drugs and new approaches to diabetes therapy are helping to reduce the incidence of diabetes-related complications.

MYTH 6. Diabetes mellitus is contagious.

Infection with diabetes mellitus is impossible under any circumstances and contacts.

MYTH 7. Honey and sweeteners can be consumed in unlimited quantities.

Honey contains equal amounts of glucose and fructose. It raises blood glucose in much the same way as regular dietary sugar.Sugar substitutes in very large quantities are not always harmless, so they need to be consumed in reasonable, standard amounts. Sugar substitutes do not have any therapeutic effect on the body, are not included in diabetes treatment programs and are not required components of the diet.

MYTH 8. Women with diabetes cannot have children.

With planning pregnancy, high-quality preparation for it, very well-controlled diabetes during the entire period of gestation, a woman is able to give birth to a healthy baby without harm to her and her health.The danger is posed by cases of unplanned pregnancy against the background of high blood glucose levels in the first three weeks of pregnancy, when the organs of the unborn child are being formed. That is why it is very important for a woman with diabetes mellitus to use reliable methods of contraception and to approach the issue of pregnancy planning with all responsibility.

MYTH 9. Sports are contraindicated in patients with diabetes mellitus.

People with this disease need regular physical activity and sports to improve their well-being.Of course, when choosing physical activity, one should take into account the presence of contraindications. There are no absolute contraindications to exercise in diabetic patients. However, it is best to consult a doctor before starting classes. It is very important to avoid hypoglycemia!

MYTH 10. Diabetes mellitus can be completely cured.

At present, diabetes mellitus cannot be cured! But, it can and should be controlled in order to live a full life.If you learn about the risk of the disease in a timely manner, then you can try to prevent it. In many cases, lifestyle changes could stop or slow down the development of type 2 diabetes.

MYTH 11. Insulin is harmful and addictive.

A categorical “no”! In type 1 diabetes mellitus, insulin needs to be given several times a day because it is very important for maintaining life and health. In type 2 diabetes mellitus, in the early stages of the disease, the pancreas still copes with the production of insulin.Therefore, during this period of time, special drugs are prescribed to lower sugar (usually in tablets, but there are also in the form of injections). With the progression of the disease, it becomes more difficult for the body to produce insulin, the previous drugs no longer give the desired effect. That’s when you need to start taking insulin. For some reason, some people with diabetes are afraid of administering insulin, most often for unknown reasons. I repeat: when the pills no longer help lower blood sugar, then insulin injections must be added.If this is not done in a timely manner, then blood sugar will remain significantly elevated for a long time. And this, in turn, will cause the development of severe complications.

.