How much sugar a day for diabetics: Sugar & diabetes – Diabetes Canada
Added Sugar in the Diet | The Nutrition Source
Your body doesn’t need to get any carbohydrate from added sugar. That’s why the Healthy Eating Pyramid says sugary drinks and sweets should be used sparingly, if at all, and the Healthy Eating Plate does not include foods with added sugars.
An important fact to keep in mind when reading nutrition labels:
4 grams of sugar = 1 teaspoon
The average American consumes 22 teaspoons of added sugar a day, which amounts to an extra 350 calories. (27) While we sometimes add sugar to food ourselves, most added sugar comes from processed and prepared foods. Sugar-sweetened beverages and breakfast cereals are two of the most serious offenders.
The American Heart Association (AHA) has recommended that Americans drastically cut back on added sugar to help slow the obesity and heart disease epidemics. (27)
- The AHA suggests an added-sugar limit of no more than 100 calories per day (about 6 teaspoons or 24 grams of sugar) for most women and no more than 150 calories per day (about 9 teaspoons or 36 grams of sugar) for most men.
- There’s no nutritional need or benefit that comes from eating added sugar. A good rule of thumb is to avoid products that have a lot of added sugar, including skipping foods that list “sugar” as the first or second ingredient. However, the growing use of alternative sweeteners can make it difficult to determine which ingredients count as sugar, because there are multiple sources of sugar with different names.
By law, The Nutrition Facts Label must list the grams of sugar in each product. But some foods naturally contain sugar, while others get theirs from added sweeteners.
Soft drinks are a prime source of extra calories that can contribute to weight gain and provide no nutritional benefits. Studies indicate that liquid carbohydrates such as sugar-sweetened beverages are less filling than the solid forms (28)– causing people to continue to feel hungry after drinking them despite their high caloric value. They are coming under scrutiny for their contributions to the development of type 2 diabetes, heart disease, and other chronic conditions.
- The average can of sugar-sweetened soda or fruit punch provides about 150 calories, almost all of them from sugar – usually high-fructose corn syrup. That’s the equivalent of 10 teaspoons of table sugar.
- If you were to drink just one can of a sugar-sweetened soft drink every day, and not cut back on calories elsewhere, you could gain up to 15 pounds over three years. (31)
Cereals and other foods
Choosing whole, unprocessed breakfast foods – such as an apple, or a bowl of steel-cut or old fashioned oatmeal – that don’t have lengthy ingredient lists is a great way to avoid eating added sugars. Unfortunately, many common breakfast foods such as ready-to-eat breakfast cereals, cereal bars, instant oatmeal with added flavoring, and pastries can contain high amounts of added sugars.
Some ingredient lists mask the amount of sugar in a product. To avoid having “sugar” as the first ingredient, food manufacturers may use multiple forms of sugar– each with a different name – and list each one individually on the nutrient label. By using this tactic, sugars are represented separately in smaller amounts, which makes it more difficult for consumers to determine how much overall sugar is in a product.
- So don’t be fooled – your body metabolizes all added sugars the same way; it doesn’t distinguish between “brown sugar” and “honey.” When reading a label, make sure you spot all sources of added sugars even if they’re not listed as the first few ingredients.
Sweet treats can be enjoyed in moderation, but make sure you’re aware of added sugars elsewhere in your diet, such as breads, drinks and cereals.
Industry-sponsored labeling programs can also be confusing. One such program, called Smart Choices, drew scrutiny from the U.S. Food and Drug Administration in 2009 for calling one popular cereal —which is 41 percent sugar—a “Smart Choice.” (The Smart Choices program has since been suspended.)
How to spot added sugar on food labels
Spotting added sugar on food labels can require some detective work. Historically, food and beverage manufacturers in the U.S. have been required to list a product’s total amount of sugar per serving on the Nutrition Facts Panel, but they didn’t need to disclose how much of that sugar is added versus naturally occurring. However, this is set to change with the rollout of the updated Panel, which (by 2020 or 2021) will include a line disclosing “added sugars,” along with a corresponding 10 percent-Daily Value—representing a limit of 50 grams (roughly 12 teaspoons) of added sugar towards the daily 2,000 calories recommended for most adults. In the meantime, you’ll need to scan the ingredients list of a food or drink to find the added sugar. (29)
- Ingredients are listed in descending order by weight (30), so where sugar is listed in relation to other ingredients can indicate how much sugar a particular food contains.
- Added sugars go by many different names, yet they are all a source of extra calories.
Food makers can also use sweeteners that aren’t technically sugar—a term which is applied only to table sugar, or sucrose—but these other sweeteners are in fact forms of added sugar. Below are some other names for sugar that you may see on food labels:
|Agave nectar||Evaporated cane juice||Malt syrup|
|Brown sugar||Fructose||Maple syrup|
|Cane crystals||Fruit juice concentrates||Molasses|
|Cane sugar||Glucose||Raw sugar|
|Corn sweetener||High-fructose corn syrup||Sucrose|
|Crystalline fructose||Invert sugar|
27. Johnson RK, Appel LJ, Brands M, et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009;120:1011-20.
28. Pan A, Hu FB. Effects of carbohydrates on satiety: differences between liquid and solid food. Curr Opin Clin Nutr Metab Care. 2011;14:385-90.
29. U.S. Dept. of Health and Human Services. U.S. Dept. of Agriculture. Dietary Guidelines for Americans. 2005. Chapter 7:Carbohydrates. Accessed on April 5, 2009.
30. U.S. Food and Drug Administration. 2008. A Food Labeling Guide: Chapter 4:Ingredient Lists. Accessed April 10, 2009.
31. Malik VS, Hu FB. Fructose and Cardiometabolic Health: What the Evidence From Sugar-Sweetened Beverages Tells Us. J Am Coll Cardiol. 2015 Oct 6;66(14):1615-24
The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products.
Finding the Hidden Sugar in the Foods You Eat
Are you skipping cookies, cake or other sweet treats to reduce your sugar intake? Give yourself an A for effort, but you’re probably still eating more sugar than you realize. The average American eats 22 teaspoons of added sugar per day, according to the American Heart Association. You’re likely not adding that much sugar to food yourself, so could you really be eating that much? Well, yes, says Erin Gager, R.D., L.D.N., a dietitian at The Johns Hopkins Hospital, because sugar is in a lot more foods than you may think.
Health Risks of Excess Sugar
This extra sugar may be adding to your waistline as well as putting your heart at risk. Research shows that excess sugar consumption can be associated with an increased risk of cardiovascular disease. The American Heart Association recommends limiting added sugar consumption to 25 grams (about six teaspoons) per day for women and 36 grams (nine teaspoons) per day for men. Knowing where sugar may be hiding can help you meet these goals and beat added sugar at its game of hide and seek.
Know the Names for Sugar
The nutrition facts label is required to inform you how much sugar is in a food. However, the label does not separate the amounts of naturally occurring sugar from added sugar, Gager explains. Sugar is found naturally in many nutritious foods, such as fruits and vegetables. But, you have to be a bit more savvy with locating foods that contain added sugar. There are more than 60 names for added sugar.
To identify added sugars, look at the ingredients list. Some major clues that an ingredient is an added sugar include:
- it has syrup (examples: corn syrup, rice syrup)
- the word ends in “ose” (examples: fructose, sucrose, maltose, dextrose)
- “sugar” is in the name (examples: raw sugar, cane sugar, brown sugar, confectionary sugar)
Other examples of added sugar include fruit nectars, concentrates of juices, honey, agave and molasses.
4 Foods With Hidden Sugar
Most people are able to identify desserts and candy as having added sugar, but what about less obvious sources? Some foods that most people would consider “healthy” may actually have a lot of added sugar in them, such as:
Be sure to talk to your doctor or a dietitian if you make changes to your diet.
Healthy Snack Suggestion: Do-It-Yourself Trail Mix
Try this trail mix recipe for a sweet-tasting, healthy treat.
1 cup wheat cereal
1/4 cup dried fruit: raisins, blueberries, cranberries, chopped apricots, plums, or peaches, or a mixture
1/4 cup cashews (1 ounce)
Mix ingredients, split into two servings, and store in sandwich-sized plastic bags. Each serving contains about 192 calories, 5 g protein, 9 g fat, 28 g carbohydrates, 3 g fiber, and 115 mg sodium.
This article is written by Erin Gager, R.D., L.D.N., a dietitian at The Johns Hopkins Hospital.
Demystifying Sugar :: Diabetes Education Online
In the past, people with diabetes were told to avoid sugar as a way to control diabetes. And even today, you may hear someone you know tell you the same information. But the truth is, research has shown that people with diabetes can enjoy sugar and sugar-containing foods, in the context of a balanced diet. This section demystifies sugars.
In this section, you will learn about:
Contrary to popular opinion, people with diabetes can eat sugars and still meet their blood sugar goals. Research shows that the total amount of carbohydrate you eat has the biggest effect on your blood sugar level. So how does sugar fit in the picture?
Sugar is found in:
- Table sugar
- Brown sugar
- Powdered sugar
- Cane sugar
- Raw sugar
- Agave nectar
- Syrups, like corn syrup and maple syrup
- Other names of sugar you might read are glucose, fructose, dextrose, maltose and sucrose
Sugar, like all carbohydrates, contains food energy. Every gram of carbohydrate has about 4 calories.
One teaspoon of sugar has about 5 grams of carbohydrate, and 20 calories. One tablespoon of sugar has about 15 grams of carbohydrate, and 60 calories. So it may be no surprise that sugar and sugar-containing foods still have an impact on your blood sugar and body weight, just like other carbohydrate foods.
Can I include sugar in my meal plan?
You can occasionally eat sugar and sugar-containing foods. Just like other carbohydrate foods, count the grams of carbohydrates in your sweets, and be sure to stay within your carbohydrate budget for the meal or snack. Sweets or desserts will need to replace another carbohydrate choice in order to meet your blood sugar and body weight goals. Because sugar-containing foods may also be high in calories and fat, aim for small portions of sweets.
How do I read food labels for sugar?
When you read food labels, the grams of sugar are already included in the total carbohydrate amount, so you do not need to count this sugar amount separately. The grams of sugar listed include both natural sugars, from fruit or milk, and added sugars. To learn more about label reading, view our Nutrition Facts Label example.
A word on treating a low blood sugar (Hypoglycemia)
Simple sugars are easy to digest, and can raise blood glucose levels quickly if eaten alone. That’s why these are the types of sugars suggested for treating hypoglycemia, or low blood sugar. But when sugar is mixed with fat, digestion is delayed. Foods that contain nuts, peanut butter, or fat such as chocolate, candy bars, ice cream or cookies don’t raise the blood sugar quickly enough. So if you have a low blood sugar, stick with fat-free sugar choices like jelly beans, fruit juice, or glucose tablets. Learn more about hypoglycemia.
View our printer-friendly Guide to Sweeteners.
Sugar alcohols are a type of reduced calorie sweetener and may be found in products that are labeled “sugar-free” or “no sugar added.” This can include sugar-free candies, desserts, and energy bars. But don’t be fooled – sugar alcohols are still a form of carbohydrate, and they still affect your blood sugar levels.
Examples of sugar alcohols include:
- Hydrogenated Starch Hydrolysates
Here’s what you need to know:
Because sugar alcohols are harder for the body to digest, the effect on blood sugar levels is less than sugar. Sugar alcohols have about half the amount of calories compared with sugar and other types of carbohydrates. When counting carbohydrates for products made with sugar alcohols, subtract half of the grams of sugar alcohol listed on the food label from the total grams of carbohydrate.
Remember that because sugar alcohols are harder for your body to digest, eating too many sugar alcohols may cause digestive complaints like gas, cramping and diarrhea. So while it is safe to eat products with sugar alcohols, it is best to limit the amount.
Now let’s practice counting carbohydrates using the sample food label shown here:
- Locate the total carbohydrate in one serving. You will see that the total carbohydrate is 29 grams.
- The amount of sugar alcohol is 18 grams per serving.
- Calculate half the grams of sugar alcohol (18 grams of sugar alcohol divided by 2 equals 9 grams).
- Subtract only half of the grams of sugar alcohol from the total carbohydrate Count this product as 20 grams of carbohydrate (29 grams total carbohydrate minus 9 grams sugar alcohol equals 20 grams of carbohydrate).
View a printer-friendly Guide to Sweeteners.
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Diabetes Diet, Eating, & Physical Activity
In this section:
Nutrition and physical activity are important parts of a healthy lifestyle when you have diabetes. Along with other benefits, following a healthy meal plan and being active can help you keep your blood glucose level, also called blood sugar, in your target range. To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine, if you take any. What you choose to eat, how much you eat, and when you eat are all important in keeping your blood glucose level in the range that your health care team recommends.
Becoming more active and making changes in what you eat and drink can seem challenging at first. You may find it easier to start with small changes and get help from your family, friends, and health care team.
Eating well and being physically active most days of the week can help you
- keep your blood glucose level, blood pressure, and cholesterol in your target ranges
- lose weight or stay at a healthy weight
- prevent or delay diabetes problems
- feel good and have more energy
What foods can I eat if I have diabetes?
You may worry that having diabetes means going without foods you enjoy. The good news is that you can still eat your favorite foods, but you might need to eat smaller portions or enjoy them less often. Your health care team will help create a diabetes meal plan for you that meets your needs and likes.
The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts your meal plan outlines.
The food groups are
- nonstarchy: includes broccoli, carrots, greens, peppers, and tomatoes
- starchy: includes potatoes, corn, and green peas
- fruits—includes oranges, melon, berries, apples, bananas, and grapes
- grains—at least half of your grains for the day should be whole grains
- includes wheat, rice, oats, cornmeal, barley, and quinoa
- examples: bread, pasta, cereal, and tortillas
- lean meat
- chicken or turkey without the skin
- nuts and peanuts
- dried beans and certain peas, such as chickpeas and split peas
- meat substitutes, such as tofu
- dairy—nonfat or low fat
Learn more about the food groups at the U.S. Department of Agriculture’s (USDA) ChooseMyPlate.gov.
Eat foods with heart-healthy fats, which mainly come from these foods:
- oils that are liquid at room temperature, such as canola and olive oil
- nuts and seeds
- heart-healthy fish such as salmon, tuna, and mackerel
Use oils when cooking food instead of butter, cream, shortening, lard, or stick margarine.
Choose healthy fats, such as from nuts, seeds, and olive oil.
What foods and drinks should I limit if I have diabetes?
Foods and drinks to limit include
- fried foods and other foods high in saturated fat and trans fat
- foods high in salt, also called sodium
- sweets, such as baked goods, candy, and ice cream
- beverages with added sugars, such as juice, regular soda, and regular sports or energy drinks
Drink water instead of sweetened beverages. Consider using a sugar substitute in your coffee or tea.
If you drink alcohol, drink moderately—no more than one drink a day if you’re a woman or two drinks a day if you’re a man. If you use insulin or diabetes medicines that increase the amount of insulin your body makes, alcohol can make your blood glucose level drop too low. This is especially true if you haven’t eaten in a while. It’s best to eat some food when you drink alcohol.
When should I eat if I have diabetes?
Some people with diabetes need to eat at about the same time each day. Others can be more flexible with the timing of their meals. Depending on your diabetes medicines or type of insulin, you may need to eat the same amount of carbohydrates at the same time each day. If you take “mealtime” insulin, your eating schedule can be more flexible.
If you use certain diabetes medicines or insulin and you skip or delay a meal, your blood glucose level can drop too low. Ask your health care team when you should eat and whether you should eat before and after physical activity.
How much can I eat if I have diabetes?
Eating the right amount of food will also help you manage your blood glucose level and your weight. Your health care team can help you figure out how much food and how many calories you should eat each day.
If you are overweight or have obesity, work with your health care team to create a weight-loss plan.
The Body Weight Planner can help you tailor your calorie and physical activity plans to reach and maintain your goal weight.
To lose weight, you need to eat fewer calories and replace less healthy foods with foods lower in calories, fat, and sugar.
If you have diabetes, are overweight or obese, and are planning to have a baby, you should try to lose any excess weight before you become pregnant. Learn more about planning for pregnancy if you have diabetes.
Meal plan methods
Two common ways to help you plan how much to eat if you have diabetes are the plate method and carbohydrate counting, also called carb counting. Check with your health care team about the method that’s best for you.
The plate method helps you control your portion sizes. You don’t need to count calories. The plate method shows the amount of each food group you should eat. This method works best for lunch and dinner.
Use a 9-inch plate. Put nonstarchy vegetables on half of the plate; a meat or other protein on one-fourth of the plate; and a grain or other starch on the last one-fourth. Starches include starchy vegetables such as corn and peas. You also may eat a small bowl of fruit or a piece of fruit, and drink a small glass of milk as included in your meal plan.
The plate method shows the amount of each food group you should eat.
You can find many different combinations of food and more details about using the plate method from the American Diabetes Association’s Create Your Plate.
Your daily eating plan also may include small snacks between meals.
- You can use everyday objects or your hand to judge the size of a portion.
- 1 serving of meat or poultry is the palm of your hand or a deck of cards
- 1 3-ounce serving of fish is a checkbook
- 1 serving of cheese is six dice
- 1/2 cup of cooked rice or pasta is a rounded handful or a tennis ball
- 1 serving of a pancake or waffle is a DVD
- 2 tablespoons of peanut butter is a ping-pong ball
Carbohydrate counting involves keeping track of the amount of carbohydrates you eat and drink each day. Because carbohydrates turn into glucose in your body, they affect your blood glucose level more than other foods do. Carb counting can help you manage your blood glucose level. If you take insulin, counting carbohydrates can help you know how much insulin to take.
Carbohydrate counting is a meal planning tool for people with diabetes who take insulin, but not all people with diabetes need to count carbohydrates. Your health care team can help you create a personal eating plan that will best meet your needs.
The amount of carbohydrates in foods is measured in grams. To count carbohydrate grams in what you eat, you’ll need to
- learn which foods have carbohydrates
- read the Nutrition Facts food label, or learn to estimate the number of grams of carbohydrate in the foods you eat
- add the grams of carbohydrate from each food you eat to get your total for each meal and for the day
Most carbohydrates come from starches, fruits, milk, and sweets. Try to limit carbohydrates with added sugars or those with refined grains, such as white bread and white rice. Instead, eat carbohydrates from fruit, vegetables, whole grains, beans, and low-fat or nonfat milk.
Choose healthy carbohydrates, such as fruit, vegetables, whole grains, beans, and low-fat milk, as part of your diabetes meal plan.
In addition to using the plate method and carb counting, you may want to visit a registered dietitian (RD) for medical nutrition therapy.
What is medical nutrition therapy?
Medical nutrition therapy is a service provided by an RD to create personal eating plans based on your needs and likes. For people with diabetes, medical nutrition therapy has been shown to improve diabetes management. Medicare pays for medical nutrition therapy for people with diabetes If you have insurance other than Medicare, ask if it covers medical nutrition therapy for diabetes.
Will supplements and vitamins help my diabetes?
No clear proof exists that taking dietary supplements such as vitamins, minerals, herbs, or spices can help manage diabetes.1 You may need supplements if you cannot get enough vitamins and minerals from foods. Talk with your health care provider before you take any dietary supplement since some can cause side effects or affect how your medicines work.2
Why should I be physically active if I have diabetes?
Physical activity is an important part of managing your blood glucose level and staying healthy. Being active has many health benefits.
- lowers blood glucose levels
- lowers blood pressure
- improves blood flow
- burns extra calories so you can keep your weight down if needed
- improves your mood
- can prevent falls and improve memory in older adults
- may help you sleep better
If you are overweight, combining physical activity with a reduced-calorie eating plan can lead to even more benefits. In the Look AHEAD: Action for Health in Diabetes study,1 overweight adults with type 2 diabetes who ate less and moved more had greater long-term health benefits compared to those who didn’t make these changes. These benefits included improved cholesterol levels, less sleep apnea, and being able to move around more easily.
Even small amounts of physical activity can help. Experts suggest that you aim for at least 30 minutes of moderate or vigorous physical activity 5 days of the week.3 Moderate activity feels somewhat hard, and vigorous activity is intense and feels hard. If you want to lose weight or maintain weight loss, you may need to do 60 minutes or more of physical activity 5 days of the week.3
Be patient. It may take a few weeks of physical activity before you see changes in your health.
How can I be physically active safely if I have diabetes?
Be sure to drink water before, during, and after exercise to stay well hydrated. The following are some other tips for safe physical activity when you have diabetes.
Drink water when you exercise to stay well hydrated.
Talk with your health care team before you start a new physical activity routine, especially if you have other health problems. Your health care team will tell you a target range for your blood glucose level and suggest how you can be active safely.
Your health care team also can help you decide the best time of day for you to do physical activity based on your daily schedule, meal plan, and diabetes medicines. If you take insulin, you need to balance the activity that you do with your insulin doses and meals so you don’t get low blood glucose.
Prevent low blood glucose
Because physical activity lowers your blood glucose, you should protect yourself against low blood glucose levels, also called hypoglycemia. You are most likely to have hypoglycemia if you take insulin or certain other diabetes medicines, such as a sulfonylurea. Hypoglycemia also can occur after a long intense workout or if you have skipped a meal before being active. Hypoglycemia can happen during or up to 24 hours after physical activity.
Planning is key to preventing hypoglycemia. For instance, if you take insulin, your health care provider might suggest you take less insulin or eat a small snack with carbohydrates before, during, or after physical activity, especially intense activity.4
You may need to check your blood glucose level before, during, and right after you are physically active.
Stay safe when blood glucose is high
If you have type 1 diabetes, avoid vigorous physical activity when you have ketones in your blood or urine. Ketones are chemicals your body might make when your blood glucose level is too high, a condition called hyperglycemia, and your insulin level is too low. If you are physically active when you have ketones in your blood or urine, your blood glucose level may go even higher. Ask your health care team what level of ketones are dangerous for you and how to test for them.
Ketones are uncommon in people with type 2 diabetes.
Take care of your feet
People with diabetes may have problems with their feet because of poor blood flow and nerve damage that can result from high blood glucose levels. To help prevent foot problems, you should wear comfortable, supportive shoes and take care of your feet before, during, and after physical activity.
What physical activities should I do if I have diabetes?
Most kinds of physical activity can help you take care of your diabetes. Certain activities may be unsafe for some people, such as those with low vision or nerve damage to their feet. Ask your health care team what physical activities are safe for you. Many people choose walking with friends or family members for their activity.
Doing different types of physical activity each week will give you the most health benefits. Mixing it up also helps reduce boredom and lower your chance of getting hurt. Try these options for physical activity.
Add extra activity to your daily routine
If you have been inactive or you are trying a new activity, start slowly, with 5 to 10 minutes a day. Then add a little more time each week. Increase daily activity by spending less time in front of a TV or other screen. Try these simple ways to add physical activities in your life each day:
- Walk around while you talk on the phone or during TV commercials.
- Do chores, such as work in the garden, rake leaves, clean the house, or wash the car.
- Park at the far end of the shopping center parking lot and walk to the store.
- Take the stairs instead of the elevator.
- Make your family outings active, such as a family bike ride or a walk in a park.
If you are sitting for a long time, such as working at a desk or watching TV, do some light activity for 3 minutes or more every half hour.5 Light activities include
- leg lifts or extensions
- overhead arm stretches
- desk chair swivels
- torso twists
- side lunges
- walking in place
Do aerobic exercise
Aerobic exercise is activity that makes your heart beat faster and makes you breathe harder. You should aim for doing aerobic exercise for 30 minutes a day most days of the week. You do not have to do all the activity at one time. You can split up these minutes into a few times throughout the day.
To get the most out of your activity, exercise at a moderate to vigorous level. Try
- walking briskly or hiking
- climbing stairs
- swimming or a water-aerobics class
- riding a bicycle or a stationary bicycle
- taking an exercise class
- playing basketball, tennis, or other sports
Talk with your health care team about how to warm up and cool down before and after you exercise.
Do strength training to build muscle
Strength training is a light or moderate physical activity that builds muscle and helps keep your bones healthy. Strength training is important for both men and women. When you have more muscle and less body fat, you’ll burn more calories. Burning more calories can help you lose and keep off extra weight.
You can do strength training with hand weights, elastic bands, or weight machines. Try to do strength training two to three times a week. Start with a light weight. Slowly increase the size of your weights as your muscles become stronger.
You can do strength training with hand weights, elastic bands, or weight machines.
Do stretching exercises
Stretching exercises are light or moderate physical activity. When you stretch, you increase your flexibility, lower your stress, and help prevent sore muscles.
You can choose from many types of stretching exercises. Yoga is a type of stretching that focuses on your breathing and helps you relax. Even if you have problems moving or balancing, certain types of yoga can help. For instance, chair yoga has stretches you can do when sitting in a chair or holding onto a chair while standing. Your health care team can suggest whether yoga is right for you.
 American Diabetes Association. Foundations of care and comprehensive medical evaluation. Diabetes Care. 2016;39(suppl 1):S26 (Table 3.3).
 National Institutes of Health, Office of Dietary Supplements. Dietary supplements: what you need to know.
ods.od.nih.gov/HealthInformation/DS_WhatYouNeedToKnow.aspx. Reviewed June 17, 2011. Accessed June 21, 2016.
 U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Physical Activity Guidelines for Americans, 2nd edition.
Washington, DC: U.S. Department of Health and Human Services; 2018. https://health.gov/paguidelines/second-edition/. Updated January 14, 2019. Accessed January 14, 2019.
 Yardley JE, Sigal RJ. Exercise strategies for hypoglycemia prevention in individuals with type 1 diabetes. Diabetes Spectrum. 2015;28(1):32–38.
 Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065–2079.
Pears and Diabetes – USA Pears
Pears: A Sweet You Can Eat
Type 2 Diabetes: Overview
We naturally have sugar in the bloodstream that provides energy to every body cell. Healthy levels of this sugar, glucose, are maintained by insulin, a hormone secreted when blood sugar rises too high. Type 2 diabetes happens when your body doesn’t make enough insulin or your body’s cells don’t respond normally to insulin, called insulin resistance. This causes high blood sugar and immediately starts to starve cells of energy. Over time, high blood sugar damages sensitive tissues, such as those in the extremities, eyes, and kidneys.
What Should I Eat?
Following a regular meal plan, being active, taking medications, and tracking your blood sugar levels will help you manage your diabetes. Indeed, you may be able to control your diabetes just by eating healthfully and exercising regularly. Most people benefit from 3 meals plus 2 to 3 snacks every day. For easy snacking ideas, click here.
What are Carbohydrates?
Carbohydrates provide energy, and every cell needs energy. Carbohydrates are found in fruits, vegetables, grains, nuts, seeds, beans, and dairy and come in three forms, sugars, starches, and fiber. Sugars are the simplest, most easily absorbed carbohydrates and include glucose needed to sustain energy. Starches are longer chains of sugars. Fiber is the indigestible part of a plant. While it is generally not digested, it may offer cardiovascular and digestive benefits.
Everyone’s digestive system needs carbohydrates, and it is best to balance them with fiber, protein, or fat at every meal. Balancing carbohydrates decreases the rate of absorption of glucose, so your blood sugar won’t spike as dramatically. Good carbohydrate choices are those that already contain these nutrients, such as fiber-rich fruits and vegetables.
Pears pack a nutritional punch! Each medium pear contains 6g of fiber, 21% of the recommended daily value, and they are contain vitamin C. Eating two pears every day meets your fruit needs as outlined by the Dietary Guidelines for Americans. What could be sweeter?
But Doesn’t Fruit Contain Sugar?
Sometimes people think that since fruit naturally contains sugar, eating fruit is not appropriate for managing diabetes. This is not true! Fruit is full of vitamins, minerals, water, and fiber – all important nutrients – and most fruits are considered low GI foods. Indeed, foods high in fiber, such as pears, taste sweet without having the deleterious effect of spiking blood sugar.
For those counting carbohydrates, a small piece of fruit contains about 15g, or one serving, of carbohydrates.
For more information on including fruit in your diet, visit the American Diabetes Association website.
The Glycemic Index:
Many practitioners suggest following the glycemic index (GI). The GI is a scale from 1 to 100 that ranks how foods affect blood sugar. Foods that contain carbohydrate naturally increase blood sugar; the lower a food is on the GI, the less that food increases blood sugar. According to Diabetes Care, a medium-sized pear ranks 38 on the glycemic index and is considered a low glycemic food. 
Low GI Foods: <55
Pears and most fresh fruits, non-starchy vegetables, sweet potatoes, rolled oats, quinoa, beans, nuts, seeds, milk
Medium GI Foods: 56 -69
Whole wheat bread, brown rice, quick oats
High GI Foods: >70
White bread, sugary cereals, white potatoes, pretzels, candy, cookies, pineapple, melons
How Much Sugar Should A Diabetic Have In One Day
Daily sugar intake for diabetics. Health for all prediabetes how many carbohydrates per day for a pre diabetic.
How Much Sugar Can A Person With Diabetes Have
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How much fruit should we have a day are natural sweeteners like honey healthy and whats the overall daily sugar intake limit.
How much sugar should a diabetic have in one day. For instance if youre currently consuming about 250 grams of carbs per day reducing your intake to 150 grams should result in significantly lower blood sugar after meals. The other carb to count. There are no particular regulations on sugar consumption for diabetics but someone with type 2 diabetes should not have more than 30 60 grams of carbohydrate per meal and 15 30 grams per snack according to registered dietician amy campbell.
To answer all your natural sugar related questions huffpost australia spoke to chloe mcleod accredited practising dietitian and sports dietitian. In that case you should not be consuming sugar every day more like once per week or once every two weeks at most. Carbohydrates and not sugar cause blood glucose levels to rise and can be harmful to diabetics.
For example if youre having a meal with bread half a potato grilled chicken and asparagus and you want to have two cookies swap out one of the carbs the bread or. If you are overweight obese or diabetic you should probably avoid sugar as much as possible. For its part the world health organization who recommends a threshold of no more than 5 percent.
For a 2000 calorie diet that would translate to 50 grams of total sugar from all sources per day. For any other person who is or is diabetic how many grams of sugar and carbohydrates should i prepare here. But if you want to be as healthy as possible you really shouldnt be consuming foods that have sugar added to them.
Reducing daily intake of sugar can improve. Monitoring sugar intake is a critical dietary strategy for managing diabetes. Counting carbohydrates is a way to control the amount of carbs you eat each day.
This equates to less than 50 grams of added sugar per day. If you are borderline diabetic how much sugar can you have per day. This is the same amount suggested for a balanced non diabetic diet.
Having 45 to 60 grams of. This means that by the end of the day you should consume roughly 135 to 180 grams of carbohydrates in all. How many grams of sugar per day can a diabetic have.
This includes all sugars both natural and added as well as starch. Protein itself does not have much of an effect on blood sugar levels though the food the protein is in may. You will need to work with your healthcare provider to determine how much protein you need each day.
Working closely with a physician and dietician can ensure the appropriate dietary plan is in place. Conditions content t2 diabetic carbohydrates per day recommendations meal plans with diabetes. If you dont have diabetes your daily intake of sugar should represent no more than 10 percent of your total calories.
How many carbs should a pre diabetic have in a day. That said a severely restricted intake of 2050 grams of carbs per day appears to produce the most dramatic results going so far as to reduce or even eliminate the need for insulin or diabetes medication. Too much protein might be bad for your kidneys.
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Managing your diabetes | BOOST®
Nutrition plays a significant role in the overall management of diabetes. It is possible to take good care of yourself, eat foods you enjoy, and manage your diabetes if you understand what to eat, how much to eat, and when to eat. Choosing nutrient-rich foods in appropriate portion sizes and healthy sources of carbohydrates can help keep your blood sugar levels in your target range. Frequent self-monitoring of blood glucose can also be used (with proper instruction) to keep track of the effects of meals and physical activity on your blood sugar levels.1
Carb counting is key
Carbohydrates turn into glucose in the body and affect blood glucose levels more than fat or protein. This does not mean that you have to give up all carbs; however, monitoring your total carbohydrate intake is essential. Choose carbs that come from nutrient-dense sources like fruit, vegetables, dairy, legumes, and whole grains, along with controlled portion sizes. If these foods are not handy or if you have a hard time selecting balanced food choices, nutritional drinks like BOOST Glucose Control® Drink can be a convenient way to manage your carb intake while getting protein and other essential nutrients. Each bottle contains 16 g carbs (including 4 g sugars), 16 g high-quality protein, and 25 vitamins & minerals. Lastly, consider working with a Registered Dietitian Nutritionist (RDN) for a plan that fits your needs, preferences and goals.1-3
Choose sources of lean protein
Protein is an essential nutrient that is needed every single day, and unlike carbohydrates and fats, protein cannot be stored in the body. As we get older, experts recommend we consume higher amounts of protein to help maintain muscle. Protein can also help manage hunger and promote satiety. Protein is found in a variety of foods that are either animal- or plant-based, including chicken, beef, eggs, milk, legumes, nuts, soy, and whole grains like quinoa.4-7
Focus on healthy fats
When incorporating fat into a diabetes meal plan, you should focus on foods that supply “healthy fats” while limiting “unhealthy fats” such as trans fats. Choose from mono- and polyunsaturated fats, and foods rich in omega-3 fatty acids. Examples of healthy fat food sources include avocado, oils (olive and flaxseed), olives, nuts (almonds, cashews, pecans, peanuts, walnuts), seeds (pumpkin, sunflower, flaxseed), and fatty fish such as salmon and albacore tuna.8
People with diabetes are more likely to have high blood pressure, which can be affected by sodium intake. Aim to consume less than 2,300 mg of sodium per day (equivalent to 1 teaspoon of salt) by limiting processed foods high in sodium. Some examples of high-sodium foods include canned soups and vegetables, cold cuts, pizza, savory snacks, salted nuts, cereals, and condiments such as soy sauce, ketchup, mustard, and pickles.2,9
Simple steps to help lower your risk of diabetes
While you can’t change the genes you inherit and how that influences your risk of developing diabetes, you can make some positive behavioral and lifestyle changes. If you are overweight, make a plan to lose weight and get moving. Achieving a 7% weight loss goal and taking a brisk walk for 30 minutes each day can significantly reduce your risk in developing type 2 diabetes. Also, if you smoke, quit, as smokers are up to 40% more likely to develop diabetes compared to nonsmokers. Finally, getting too little or too much sleep is associated with increased risk for diabetes, so aim for 7-8 hours of sleep each night.1,10-12
Set an action plan
When you have type 1 or type 2 diabetes, it is important to test your blood sugar regularly, have an action plan and set small goals with your healthcare team. Talk with your doctor and meet with an RDN regularly to help keep your meal plans in check, maintain your blood sugar levels in your target range, and provide encouragement to achieve a healthy lifestyle.1,2
1. American Diabetes Association. Standards of Medical Care in Diabetes 2020. Diabetes Care 2020;43(S1):S1-S212.
2. Evert AB et al. Diabetes Care 2019;42:731-754.
3. National Institute of Diabetes and Digestive and Kidney Diseases. Carbohydrate Counting. 2016.
4. Hamdy O, Horton ES. Curr Diab Rep. 2011;11(2): 111-9.
5. Campbell AP, Rains TM. J Nutr 2015;145:164S-9S.
6. Bauer J et al. JAMDA 2013;14:542-559.
7. American Diabetes Association. Healthy Food Choices Made Easy – Protein. 2020. https://www.diabetes.org/nutrition/healthy-food-choices-made-easy/protein
8. American Diabetes Association. Healthy Food Choices Made Easy – Fats. 2020. https://www.diabetes.org/nutrition/healthy-food-choices-made-easy/fats
9. Franz MJ et al. JAND. 2017; 117(10): 1659-1679.
10. Harvard School of Public Health, The Nutrition Source. Simple Steps to Preventing Diabetes. 2020.
11. Maddatu J et al. Transl Res 2017;184:101-107
12. Shan Z et al. Diabetes Care 2015;38:529-537.
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 mellitus are diagnosed in people who are overweight and obese. 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 capital’s 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 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 to use reliable methods of contraception and take a responsible approach to the issue of planning pregnancy.
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, 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 must 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.
90,000 What is type 1 diabetes?
What Causes Type 1 Diabetes
Entering the body, food is broken down into glucose (blood sugar), which is then used by the body to regulate metabolism and obtain energy. The glucose then travels through the bloodstream to each cell.At this stage, the pancreas plays a vital role, and it is at this stage that you can tell if you have type 1 diabetes, since the amount of glucose in your bloodstream is controlled by the insulin produced by the pancreas. If the pancreas is unable to produce enough insulin to regulate blood sugar levels, doctors diagnose type 1 diabetes.
For more information, see the Type 1 Diabetes Causes page.
How to prevent type 1 diabetes
As of 2016, there is still no cure for type 1 diabetes. Despite this, diabetes is a condition that can be controlled and treated, making it possible for most people with diabetes to lead healthy, successful and productive lives.
Type 1 diabetes is a lifelong autoimmune disease that destroys the insulin-producing beta cells of the pancreas. Without enough insulin to control the situation, glucose will remain in the bloodstream and levels will continue to rise.Therefore, type 1 diabetes requires regular injection of insulin or with an insulin pump. Insulin delivery, dietary changes, and regular exercise can help maintain optimal blood sugar
Type 1 diabetes control
Every day, blood sugar levels in people with diabetes change in a very different way than in other people. Typically, changes in blood sugar levels are a response to food intake or exercise. In healthy people, the changes are regulated by insulin, which is produced in the body.If insulin is not produced, the diabetic is faced with the need to control the level of insulin in the bloodstream. To keep track of what’s going on in the body, a person with diabetes needs to constantly check their blood sugar levels with a glucometer. Ideally, blood sugar should be in the range of 4-7 mmol / L (72-126 mg / dL) before meals and about 5-9 mmol / L (90-162 mg / dL) 90 minutes after meals. Checking blood glucose levels is an integral part of a diabetic patient’s daily routine. In addition, it is important to understand your body and recognize in time its signals that the blood sugar level is high or low – this will allow you to react faster to any situation.
The diabetic is at risk of hypoglycemic (low blood glucose) and hyperglycemic (high blood glucose) reactions. Below is information on how these states differ.
This term is used to describe a condition in which there is a drop in blood sugar levels below 4 mmol / L (72 mg / dL). Some of the main reasons why hypoglycemia can occur:
- Giving too much insulin
- Skip meal
- Insufficient carbohydrate intake
- Excessive physical activity
- Unplanned physical activity
- Use of prohibited substances (such as ecstasy or cocaine)
For more information, see the What is Hypoglycemia page.
This term is used to refer to a condition in which blood sugar levels rise above 7 mmol / L (126 mg / dL). Some of the main reasons hyperglycemia can occur:
- Inserting too little insulin
- Eating too many carbohydrates
- Physical activity is less than planned
- Drinking alcohol
For more information, see the What is Hyperglycemia page.
90,000 Gestational diabetes during pregnancy – treatment and diagnosis of pregnancy diabetes in Moscow, Clinical Hospital on Yauza
Specialists of the Clinical Hospital on Yauza diagnose and treat pregnancy diabetes and its complications. For a comfortable pregnancy and the safety of the expectant mother and baby, we carry out strict control over the blood sugar level of a pregnant woman, if necessary, we prescribe a specially developed diet and medications.
Make an appointment with a gynecologist
- About 7% of pregnant women have manifestations of gestational diabetes mellitus. In 50% of cases, the disease is asymptomatic 90 108
- Gestational diabetes in pregnant women significantly increases the risk of complications during pregnancy, both for the mother and the fetus
- Perinatal mortality with a combination of diabetes mellitus and pregnancy increases by 2-3%
Diabetes in pregnancy (gestational diabetes) is an increase in blood glucose that first occurs during pregnancy, but does not reach a level sufficient to make a diagnosis of diabetes mellitus.These are hidden disorders of carbohydrate metabolism that threaten to develop into diabetes mellitus.
Norm of the level of glucose in the blood of a pregnant woman
During pregnancy, all women experience changes in insulin sensitivity and glucose tolerance. This is fine. The difference between norm and pathology is the degree of change.
Blood tests for diabetes during pregnancy – norm and pathology
- If the analysis of venous blood taken on an empty stomach shows a glucose level of more than 5.1 mmol / l, this is the norm for pregnant women.
- From 5.1 to 7.0 mmol / L – gestational diabetes.
- If 7.0 mmol / L or more – diabetes mellitus.
- Fingertip capillary blood testing is not recommended for the diagnosis of gestational diabetes mellitus.
- If during the oral glucose tolerance test (when during the study 75 g of glucose is taken orally) after an hour the glucose level is more than 10.0 mmol / L, and after two hours the blood glucose is in the range of 7.8-8.5 mmol / L – then for pregnant women this is a normal indicator.
To better understand what gestational diabetes is, or pregnancy diabetes, you need to talk a little about hormonal changes in the body in pregnant women.
Causes of pregnancy diabetes
Hormonal changes that occur during pregnancy are associated with increased production of large amounts of steroid hormones. Some of them, such as cortisol and progesterone, have a significant effect on the receptors of cells, increasing their insulin resistance.
This leads to an increase in blood glucose levels and requires a significant increase in the production of insulin by the pancreas. In cases where the compensatory capacity of the pancreas is insufficient, sugar metabolism gets out of control and a condition called pregnancy diabetes or gestational diabetes develops.
This condition occurs quite often. Between 3% and 10% of pregnant women develop pathological insulin resistance leading to gestational diabetes.
Unlike diabetes mellitus diagnosed before pregnancy, abnormal insulin resistance developed during pregnancy is not a cause of fetal malformations and, in most cases, does not require insulin treatment. But, nevertheless, uncompensated gestational diabetes can significantly complicate the course of pregnancy.
Specialists of the Clinical Hospital on Yauza diagnose, treat and prevent diabetes during pregnancy and its complications, such as impaired intrauterine growth of the fetus.Doctors of the Clinical Hospital on Yauza strictly control the blood sugar level of a pregnant woman, and, if necessary, prescribe a specially developed diet. This ensures a comfortable pregnancy and the safety of the expectant mother and baby.
Diabetes in pregnancy – consequences for the child
Large disproportionate fruit. The most important and frequent complication of pregnancy diabetes is impaired growth of the intrauterine fetus. Developing in conditions of increased blood glucose levels, which penetrates the fetoplacental barrier, the fetus is forced to compensate for the increased sugar level with the help of its own insulin.Due to the fact that the structure of insulin and growth hormone is very similar, high insulin levels stimulate the growth of the fetus. The problem is that a large fruit is developing. In such a fetus, the proportions of the body differ from the proportions of correctly developing newborns, in which the volume of the head is greater than the volume of the shoulder girdle. In fetuses with uncompensated gestational diabetes, the size of the shoulder girdle prevails, the size of the abdomen increases. This leads to the fact that during childbirth, after the fetus’s head passes through the birth canal, the shoulders can get stuck (shoulder dystocia) and the child and the mother can be severely injured or die.
Polyhydramnios or low water. In addition, with gestational diabetes, the balance of the amount of amniotic fluid may be disturbed and either polyhydramnios or oligohydramnios develops. This is a serious risk factor for intrauterine fetal death or premature birth.
Lung underdevelopment. With diabetes of pregnant women, the fetal lungs mature later, since the production of surfactant is impaired (a special lubricant of the inner walls of the alveoli, where oxygen is exchanged in the lungs).Therefore, preterm birth with gestational diabetes is especially dangerous.
Hypoglycemia and metabolic disorders in the fetus. Due to the constant increased production of its own insulin during pregnancy, immediately after childbirth, the child is in a state of hypoglycemia with electrolyte metabolism disorders, which threatens his life.
All this dictates the need for early detection of gestational diabetes in pregnant women, blood sugar levels of a pregnant woman and to prevent the development of complications.
Diagnosis of diabetes in pregnant women at the Clinical Hospital on Yauza
Signs of diabetes mellitus in pregnant women
Gestational diabetes in pregnancy is not usually associated with the classic symptoms of diabetes mellitus, such as thirst or excess urine output (polyuria).
Tests of pregnant women for diabetes mellitus
First phase. At the first visit of a pregnant woman to a doctor at any time, she undergoes a study of the level of glucose in the venous blood – determination of glucose on an empty stomach, regardless of food intake, glycated hemoglobin.This is the first phase of research to detect diabetes mellitus or gestational diabetes in pregnant women. If diabetes is detected, the patient is sent for observation and treatment to an endocrinologist.
Second phase. At a period of 24-28 weeks, all patients who did not show detected disorders of carbohydrate metabolism during the first study are called for a glucose tolerance test (OGTT) to detect “latent diabetes”. This is because the onset of pregnancy diabetes is associated with the development of insulin resistance under the influence of hormones produced by the placenta.Therefore, in the vast majority of cases, gestational diabetes develops in the second half of pregnancy after 24 weeks, when there is a peak in the production of placental hormones.
Glucose Tolerance Test
Conducted to identify the pathological insulin resistance characteristic of latent diabetes in pregnant women. Pregnant women undergo a two-hour test, only in the laboratory.
During the 3 days preceding the test, the woman should eat her usual way, including carbohydrates (> 150 g of carbohydrates per day), and maintain the usual physical activity.On the evening before testing, dinner should include 30-50 g of carbohydrates.
On the day of the study, before the analysis, you should not smoke and take medications that can affect the level of glucose (vitamins, glucocorticoid hormones, iron preparations, which include carbohydrates, beta-adrenomimetics, beta-blockers). You can drink water.
Venous blood is taken on an empty stomach (after 8-14 hours of hunger, usually in the morning, before breakfast).
Then the patient takes a glucose solution (75 g).
And they take blood in an hour and two after the sugar load. Normally, the level of glucose in the blood after a sugar load should not exceed an hour later – 10 mmol / l, after 2 hours – 8.5 mmol / l.
When a manifest diabetes mellitus is detected, the patient is referred to an endocrinologist, gestational diabetes mellitus is treated by an obstetrician-gynecologist or therapist.
Contraindications to glucose tolerance test
- Strict bed rest prescribed for a pregnant woman (until approved by the doctor).
- Severe toxicosis of pregnant women (with nausea and vomiting).
- Acute infectious or inflammatory disease.
- Exacerbation of chronic pancreatitis.
- Dumping syndrome (resected stomach syndrome).
nutrition, diabetic menu, what ration for treatment for the week
Diabetes mellitus is a group of diseases characterized by a persistent increase in blood sugar levels.These diseases lead to the development of severe complications, primarily vascular: coronary heart disease, myocardial infarction, stroke, as well as renal failure and even gangrene. Diabetes is common in pregnant women and is referred to as gestational diabetes. But a diet is not prescribed, as it usually goes away after childbirth.
Photo: towfiqu999 / freepik.com
People who eat a lot of sugar are more likely to get fat. This is facilitated by the modern rhythm of life and the peculiarities of work – the way to work is sitting in the car, and the work itself is sedentary, office.Lack of physical activity contributes to the development of physical inactivity. Naturally, body weight begins to increase. Metabolic disorders develop.
Why you need a diet for diabetes
A person with diabetes is prescribed a specific diet. Many people mistakenly believe that they have to give up sweets. In fact, in the diet of a person with diabetes mellitus, half of the diet should be taken by carbohydrates, but carbohydrates are “harmless”. It should be remembered that the so-called “fast” carbohydrates – sugar, donuts, buns, bagels, white bread cause a peak increase in human blood sugar and therefore are not recommended for patients with diabetes.
Most people with diabetes will find it easier to control their blood glucose levels if they can lose weight. The diet should serve two purposes: normalizing blood sugar levels and reducing caloric intake. There are no universal recommendations for people with type 1 and 2 diabetes, since there is a risk that a person will go from a state of hyperglycemia to hypoglycemia (too low blood glucose levels), and this is fraught with serious complications up to the development of coma.
Features of the diet for diabetics
If we talk about the nutrition of a patient with type 2 diabetes mellitus, it is interesting to start with a story about vodka.Vodka is a very high-calorie product. One gram contains approximately 7 kilocalories, one gram of fat contains 9 kilocalories. If we compare with proteins and carbohydrates, there are about two to three times less kilocalories.
Many people believe that vodka lowers blood sugar levels. So it really is, but in a pathological, abnormal, harmful way. Blood sugar levels drop, but appetite increases immediately. A person wants to have a bite of this vodka, and once he has had a bite, he added more calories to himself.
Photo: newfabrika / freepik.com
Calorie: the stronger the drink, the more calorie it is. A bottle of wine has about three times less calories than vodka, beer – even less.
Strictly speaking, a patient with diabetes mellitus should first of all minimize alcohol consumption.
Carbohydrates are of two types: easily digestible (fast) and the so-called slow. Slowly digestible includes cereals, pasta, potatoes. In the diet of a dibetics, carbohydrates must be present.If you take a plate and divide it into four parts, about half should be carbohydrates, a quarter of fats and a quarter of proteins.
Animal fats are extremely dangerous. Therefore, it is more useful to give preference to fish over meat. If you eat chicken, then naturally, skin it off and remove fat. If we talk about beef, pork, you need to reduce the calorie intake and the volume of consumption of these fats itself. Fish and meat are also excellent sources of protein. However, you should not focus only on them – plant foods like soy and wheat also have a lot of protein, sometimes even more than animal sources.
Important! Food should be measured, moderate, five to six times a day, a little bit, once every three hours, full, but in no case three times a day.
Photo: towfiqu999 / freepik.com
It is also recommended to devote time to the main meals – breakfast and lunch for at least 30 minutes. If he eats too quickly, an excess amount of insulin enters the bloodstream, and since there is a lot of it, he needs more food. And, without noticing, the person eats more. Therefore, it is important to eat without distraction, not to rush.
You may have heard something about numbered diets for people with diabetes. We also heard, and decided to invite an expert, professor, head of the endocrinology department of the A.K. Eramishantsev of the Moscow Department of Health “- Leonid Yulievich Morgunov.
“In Soviet times, diabetic tables, the so-called numbered diets, were actively used. Since then, dietetics and all science in general have made great strides forward. Therefore, the diabetic table number 9 is an outdated concept, it is no longer used.»
Nutritional differences in type 1 and type 2 diabetes
It is important for all people with diabetes, regardless of age, to eat healthy food, just like people without diabetes. The diet must include fiber-rich foods: fruits, vegetables, legumes and whole grains.
A person with diabetes does not need to take insulin as many times as he has eaten. For example, a patient with type 2 diabetes mellitus on pill therapy does not need insulin – even if necessary, eat six times a day, in small portions.
But if a person receives insulin, then it should be done only before the main meals. No need for three small snacks.
What is the Glycemic Index
Calories is the energy that can be obtained from food. In the store, on the packaging of any food product, the number of kilocalories in one hundred grams of the product, the amount of proteins, fats, carbohydrates is indicated.
But the products are different, they have a different glycemic index – the rate of absorption of carbohydrates in the body.The index is ranked on a scale from zero to one hundred. There are foods that slowly raise sugar levels, and there are foods that quickly, and this does not depend on calorie content. The higher the index, the more the sugar level rises after eating the product.
Figure 1. Table of foods with different glycemic index. Source: CC0 Public Domain
What is a Bread Unit
Bread units is a parameter developed by German endocrinologists for patients with type 1 diabetes mellitus.We are talking about the amount of carbohydrates, which roughly corresponds to 12.5 grams of bread. Each patient calculates the approximate number of bread units for himself, how much he needs. If one person weighs 100 kilograms, and another 60, then they need a different number of bread units. But in this case we are talking about carbohydrates, how many carbohydrates to eat.
The approximate required number of grain units individually. It depends on how much a person weighs, does sports, or maybe plans a long trip or a trip to the club.In this case, a simple calculation of XE will not help. It is necessary to understand both the size of the portions and the composition of the products – for this there is a school of patients with diabetes.
According to the data provided to us by our expert: “Bread units are an approximate concept. We understand that the amount of carbohydrates for patients with diabetes should be approximately 50–55% of the amount of food. Therefore, the calculation is a fairly simple thing, but it still requires some kind of training. ”
In diabetes mellitus, sweets can only be replaced with sweets – sweeteners, fruits.You can, for example, eat two or three peaches, two oranges, or three apples. Or you can eat something made with sweeteners. The fact is that foods for people with diabetes, including sweet foods, differ, in fact, in only one thing – they are more expensive.
The menu should contain healthy carbohydrates, foods rich in fiber, fish and “good” fats. During digestion, complex carbohydrates and disaccharides in the intestine are broken down into simpler ones. In particular, sugar breaks down into glucose and fructose, after which glucose is absorbed from the intestines into the blood.Avoid foods and drinks high in fat, sugar, and salt.
Foods rich in healthy fats help lower cholesterol levels. These include: avocados, nuts, olive and peanut oils. Remember that, like all fats, they are high in calories. It is important that a diabetic’s diet contains a lot of foods high in fiber. Fiber slows down the body’s digestion, release and absorption of glucose. Vegetables, fruits, nuts, mushrooms and whole grains are rich in fiber.
Choose fish over meat. Eat it at least twice a week. For a complete list of preferred and not so preferred fish, visit the FDA website.
If possible, exclude easily digestible carbohydrates and alcohol. Such carbohydrates mean a rapid rise in blood sugar, and if a person is on insulin, and quickly tries to reduce this jump, sudden changes in sugar levels are dangerous for the body due to the risk of developing acute cardiovascular pathology.
Diabetes increases the risk of heart disease and stroke, accelerating the development of atherosclerosis.
In case of diabetes, you need to limit:
- Saturated Fat (NS). Eat less animal fats and avoid fatty dairy products. Most of all NF is found in butter, fatty beef, sausages, sausages and some types of oil – coconut and palm;
- Trans fat. They are formed when the food industry turns liquid oils into solid fats, like margarine is made.Most of them are found in fast food, pastries, cakes, pastries. It is best not to consume trans fats at all, whether you have diabetes or not;
- Cholesterol. Best of all – no more than 200 mg of cholesterol per day. About so much is contained in one chicken egg.
- Salt. Optimally, no more than 2,300 mg of sodium per day will be. This is about one teaspoon of salt, 6 grams.
- Otherwise, there are no special restrictions on food intake. You can also cook yourself more often.So you will know exactly what calorie content the dish has, how much protein, fat, carbohydrates it contains.
They are different, synthetic and natural. These substances contain practically no calories, but they are sometimes hundreds of times sweeter than sugar. There have been a lot of studies that have not proven their harm.
Therefore, sweeteners can be used in moderation. The list of FDA-approved sweeteners includes saccharin, neotame, acesulfame, aspartame, sucralose, advantam, stevia, and lo-han-go.
It is not worth using them in excess. Four to five tablets a day.
Important! Many people mistakenly believe that sugar can be replaced with honey. Honey contains a huge amount of calories and is an easily digestible carbohydrate. It needs to be limited as much as possible. It is, of course, very useful, but people with diabetes should avoid it.
You can read more about sugar substitutes allowed in Russia in the list of Rospotrebnadzor here.
Menu compilation rules
For 1 type
The most important thing for people with type 1 diabetes is to get all the essential nutrients in the same amount as healthy people.If there is no tendency to be overweight, then in terms of calorie content, the diet should not differ from the norm. It is vital for people with CD-1 to know exactly how many carbohydrates they eat.
On average, one unit of insulin helps you absorb 15 g of carbohydrates. This is a commonality, and it is important for every person with type 1 diabetes to know their individual insulin to carbohydrate ratio. The ratio can vary depending on how long the person has had diabetes, weight, and level of physical activity.
The insulin dosage is adjusted for the pre-meal blood glucose level.If your blood sugar is above the target level, additional units of insulin are added to lower it.
The meal plan should include healthy proteins, fats and small amounts of complex carbohydrates, with a low glycemic index. It is best if proteins and fats come from plant sources. According to most foreign recommendations for diabetes, the diet is most accurately and fully represented in the Mediterranean nutrition plan.
For type 2
There is currently no clear evidence of the benefits of a specific meal plan for people with type 1 and type 2 diabetes.Regardless of whether you have diabetes, your diet should always be rich in non-starchy vegetables, whole grains, and minimally processed foods. But this does not mean that you have to eat everything raw. You should limit foods with free sugar, processed grains and processed meats. Sometimes a doctor may recommend a low-carb diet for people with type 2 diabetes – it is better not to switch to it on your own, but to consult a dietitian.
The diet in each case is selected individually and implies taking into account the general state of health, food preferences, and individual characteristics of a person.
Important! If people with type 2 diabetes have been on a diet for a long time, they may periodically need consultations with a dietitian to update their meal plan.
Unlike a style, a meal plan is a specific guideline that helps people plan when, what, and how much to eat each day based on the recommendations of the chosen style.
The Diabetic Plate Method is widely used as a basic nutritional guide and provides a visual, visual approach to calorie management.
Figure 2. Diabetic plate method (22-23 cm diameter). Source: CDC
Knowing how many carbs you ate makes it much easier to calculate the correct insulin dose. How and what to count correctly in accordance with the diet, you will always be taught in a diabetic school.
Weekly Menu Examples
There is one trick when making a menu and serving a portion of food. You can put the same amount of food on a large plate and on a small one. On a small one it seems that there is a lot of it, but on a large one it is not enough, but the number will be the same.You only need to eat from small plates.
Here’s the menu, it is about 2000-2500 calories. Depending on weight and other individual characteristics, you may need a different number of calories.
- Breakfast: poached egg, half an avocado, a slice of bread, an orange.
- Lunch: beans with spinach and tomatoes, cheese.
- Dinner: whole grain pasta with tomato sauce and turkey.
- Breakfast: oatmeal with berries and nuts.
- Lunch: spinach, chicken breast, carrot and avocado salad; Strawberry.
- Dinner: boiled whole wheat couscous, fried zucchini, cucumber and tomato salad with fresh basil.
- Breakfast: vegetable omelet with herbs, mushrooms, bell pepper and avocado; beans, blueberries.
- Lunch: whole grain bread sandwich with unflavored Greek yogurt, mustard and tuna; grated carrot, cucumber, apple.
- Dinner: a mixture of beans and corn, chicken breast, asparagus, a quarter of pineapple.
- Breakfast: whole grain bread toast with cheese and spinach.
- Lunch: stewed cabbage with chicken, strawberries, banana.
- Dinner: salad of tomatoes, cucumbers, herbs and cheese.
- Breakfast: breakfast cereals, blueberries, a glass of almond milk.
- Lunch: salad of spinach, tomatoes, hard cheese, eggs, with yoghurt dressing; grapes, pumpkin seeds.
- Dinner: baked salmon with potatoes and asparagus.
- Breakfast: a glass of low-fat Greek yogurt, strawberry-banana puree.
- Lunch: brown rice with beans, low-fat cheese, avocado, cabbage and cucumber salad.
- Dinner: lean beef with potatoes and broccoli, strawberries.
- Breakfast: pearl barley porridge on low-fat milk.
- Lunch: whole grain bread, cucumber, tomato, herbs and cheese salad.
- Dinner: shrimps, green peas, boiled beets with olive oil, grapefruit.
This is an approximate meal plan, but it gives a general idea of the composition of a diabetic diet and may provide direction in your search for recipes.
Diabetes Nutrition Myths
The most important myth is that diabetes is caused by the fact that people eat sugar. It is called sugar not because people eat sugar, but because diabetes increases sugar.And sugar levels rise for a variety of reasons. Apples and bread can also raise blood sugar levels, although they seem harmless. There are a lot of carbohydrates, and they are found not only in sugar.
There is a theory of the viral origin of type 1 diabetes mellitus: it is possible that the Coxsackie virus, influenza virus, rubella virus and some other viruses cause type 1 diabetes mellitus. That is, after the disease, antibodies are formed, which by mistake begin to attack the beta cells of the pancreas.Whether this is so or not, it is necessary to prove, but, unfortunately, the disease appears and develops.
Another myth – you can get type 1 diabetes and it will go on to type 2 diabetes. This will never happen, these are completely different diseases that have the same onset of the disease called “diabetes mellitus”.
It is impossible to recover from diabetes mellitus. Among the ineffective and unhelpful treatments for diabetes, there are: ice diving, withdrawal of insulin therapy, endless exercise and nutritional supplements.All this worsens the prognosis of the disease and increases the risk of complications. Get treated with real doctors. The second type can be prevented, but there is no cure.
Ready meals for diabetics (delivery services)
If you have diabetes, carefully read the labels of all products and compare them with other similar products, look for the best balance of carbohydrates, fats, proteins and fiber, as well as the optimal amount of calories.
Fructose is often found in products “for diabetics”.Drinking it will not raise your blood glucose levels – because you won’t be getting it at all.
There are commercial food delivery services in Russia for people with diabetes. Consult with your dietitian and review the menus and calorie intake provided by these services.
All people diagnosed with prediabetes or diabetes should follow the dietary advice of a healthcare professional. Nutrition for diabetes mellitus should be developed individually, it can be adjusted by a nutritionist, in accordance with changes in the course of the disease, or when concomitant diseases appear.It is important that the diet is consistent with the overall treatment plan, and the history and medications that the person is taking should be taken into account. Not all obese people have diabetes. However, they have a higher risk of developing diabetes in the future. It is best not only to follow a diabetes diet, but also to start playing sports, quit smoking, and limit alcohol.
We have compiled several popular science books in which you can learn more about diet and the digestive system in general.Knowledge of the mechanisms occurring in the body makes it possible to better understand how everything is arranged in it. This means it will protect against charlatans and improve the quality of life.
Elena Motova – My best friend is my stomach. One of the country’s leading nutritionists explains how to eat and stay healthy. Along the way, the book explains the basic psychological and physiological mechanisms related to hunger and satiety.
If you have diabetes, you probably already know so much about it. And for those who want to get a deeper understanding of the topic, we recommend the book The Sugar Man.Everything you wanted to know about type 1 diabetes.
- American Diabetes Association. // Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. // Diabetes Care 2002. // p. 202-212.
- UK National Health Service – Diabetes.
- United States Centers for Disease Control and Prevention – Diabetes Meal Planning.
- Mayo Clinic – Diabetes diet: Create your healthy-eating plan.
Endocrinologist explained why diabetes is extremely dangerous with COVID-19 – Russian newspaper
Of all chronic diseases, the most dangerous with coronavirus is diabetes mellitus. This was stated by the head of the Ministry of Health Mikhail Murashko and a group of international scientists who published their research in the journal Science Advances. In Russia, more than five million cases of diabetes mellitus have been registered in the adult population and almost 50 thousand in children. What happens when two dangerous diseases overlap? The highest category endocrinologist Irina Presnyakova told Rossiyskaya Gazeta about this.
Jumps of dangerous sugar
Irina Valerievna, why are patients with diabetes at risk?
Irina Presnyakova : In my opinion, there are two main reasons. First: at risk are people with poorly compensated diabetes mellitus. That is, a person constantly lives with high blood sugar levels, or he “jumps” from low to high values (which is even worse). And it affects almost all organs and systems, including suppressing the immune system.Therefore, it is easier for such people to become infected, and complications of infections are more common in them.
Second reason: any infection, especially with fever and symptoms of intoxication (weakness, lack of appetite, muscle pain) or diarrhea, can lead to diabetes decompensation. That is, it is much more difficult for people with diabetes to maintain normal blood glucose levels during illness. Hence the risks of developing acute complications of diabetes – ketoacidosis, diabetic coma, severe hypoglycemia.
How does the virus affect the weakened body of a diabetic?
Irina Presnyakova : Any viral infection is stress for the body, a kind of “test of the strength of the defenses.” To counteract the causative agent of the infection, the body produces in an increased amount of stress hormones, cortisol and adrenaline.
These hormones interfere with the action of insulin and activate the production of glucose in the liver. Under these conditions, it is much more difficult for even a person with well-compensated diabetes to keep glucose within target levels.In addition, lack of appetite, vomiting, or diarrhea also affect blood glucose levels and require dose adjustments of antidiabetic drugs.
If carbohydrates are not supplied with food, then the body quickly depletes their reserves in the liver and begins to burn fat for energy. When fat breaks down, ketone bodies (acetone) are formed and their level in the blood rises. If this situation lasts long enough, and insulin therapy is inadequate, then a person with type 1 diabetes may develop ketoacidosis and even ketoacidotic coma.Hyperosmolar diabetic coma can develop in people with type 2 diabetes, especially in the elderly and old age. Both of these acute complications of diabetes are very dangerous.
If COVID-19 nevertheless overtook
If a diabetic does catch the coronavirus, advise how people should behave during illness.
Irina Presnyakova : Blood glucose levels can change dramatically during illness. Therefore, you should more often monitor blood sugar levels in order to take timely measures when it rises or falls.
Do not stop insulin therapy during an acute illness, even if you eat less than usual. To lower blood sugar levels in coronavirus infection, a temporary increase in the dose of insulin (both long-acting and short-acting) may be required. And additional injections of (ultra) short insulin “to reduce” without food.
Patients with type 2 diabetes who do not receive insulin sometimes need to increase the dose of some drugs and, conversely, temporarily stop taking others.And sometimes they may need temporary insulin administration.
What is the best way to eat during illness? This is a very important point for diabetics.
Irina Presnyakova : If possible, you should eat enough carbohydrates and drink more fluids. Try to eat more often and in small portions. Save fast carbohydrates (sweets, honey, jams, juices) only in case of hypoglycemia or a rapid drop in blood sugar. If vomiting occurs, food should be replaced with carbohydrate-containing liquids (diluted juice, compote) – if blood glucose is low.And non-carbohydrate salt solutions (still mineral water) – if blood sugar is high.
Patients with type 1 diabetes on the background of an acute infectious disease should determine the level of ketones in the urine using test strips several times a day. This is especially important when blood glucose rises above 13-15 mmol / l. With the appearance of ketones in the urine and high blood sugar levels in any type of diabetes mellitus, additional injections of short insulin “without food” and an increase in the use of non-carbohydrate fluids are necessary.
At the peak of two diseases
When should you sound the alarm and call an ambulance?
Irina Presnyakova : When the patient cannot cope with high blood sugar and high levels of ketones in the urine. When he has constant nausea and vomiting and cannot drink for more than 4-6 hours.
When it is difficult for the patient to breathe, or breathing is rapid and difficult. When he feels severe weakness, drowsiness, he cannot think clearly. In such cases, you need to immediately call an ambulance.
How can diabetics not get coronavirus infection? In addition to the well-known preventive measures, what does he need to know, are there any special rules for them in a pandemic?
Irina Presnyakova : In fact, the rules are elementary – you need to follow all the precautions that have now been introduced.
The best way to cope with an acute viral illness is to know these rules and be prepared to deal with the problem ahead of time. Wash your hands often, especially before eating, after using the toilet, during and after visiting crowded places (airports, train stations, shops, hospitals).
Carry an alcohol-based hand sanitizer, or at least wet alcohol wipes, in case you have nowhere to wash your hands. Wash your hands thoroughly. It is not enough just to rinse them under running water. Lather your hands (on all sides and between your fingers) for 20 seconds. Then rinse off under running warm water and close the tap (preferably with an elbow or a napkin).
Keep your distance, wear masks. Wipe with an antiseptic solution those objects and surfaces that you take with your hands: doorknobs, mobile phones, control panels, keys.Ventilate the room in which you are, and do not forget about wet cleaning.
In your diet, try to adhere to a healthy, correct menu, eat more vegetables, fruits with a low glycemic index, whole grains, nuts, lean meats, fish and drink plenty of fluids. Don’t forget about physical activity.
Discuss in advance with your doctor what to do if your blood sugar is too low or too high, as well as if you develop any illness or cannot eat normally.Do not be afraid and do not be alarmed, do not escalate problems, maintain a healthy mind in yourself – so that the body is healthy!
All materials of the plot “COVID-19. We can handle it!” read here .
Nutrition for diabetes – it is better to eat less often and more
Photo author, AP
Two full meals a day reduce blood sugar
that limiting the number of meals to two meals a day is more beneficial for diabetics than the usual six meals a day.
Researchers in Prague examined a group of 54 volunteers, half of whom ate twice a day and half ate six times, and the nutritional value of their diets in terms of the number of calories was the same.
It turned out that the participants of the first group lost weight faster and stronger, and the sugar content in their blood decreased.
According to the researchers, this result confirms the existing evidence that sparser diets are more rational choices for people with diabetes.
How many times to eat
Diabetes mellitus is associated with insulin deficiency, which occurs due to not very clear reasons. This metabolic disorder leads in acute forms to vascular lesions, increases the risk of stroke and heart attack, diseases of the nervous system and kidneys.
In Britain, about 2.9 million people suffer from diabetes, 90% of whom have type II diabetes, or diabetes mellitus.
Currently, doctors recommend that such patients eat three times a day, occasionally snacking between main meals.
Scientists from the Institute of Clinical and Experimental Medicine in Prague worked with two groups of volunteers aged 30 to 70, 27 people each.
For 12 weeks, one group received six meals a day (diet A-6), and the other two meals a day (diet B-2). Currently, in the Czech Republic, such patients are recommended to adhere to the A-6 diet.
Each diet averaged 1,700 calories per day.
Results are encouraging
Diet B-2 group ate from 6 am to 10 am and 10 am to 4 pm, and group A-6 received meals throughout the day at regular intervals.
Participants in group B-2 lost an average of 1.4 kg of weight more than volunteers from group A-6, and their waist circumference decreased by 4 cm more.
The head of the research team, Dr. Hana Kahleova, said she was very pleased with the results.
“At first, the patients were afraid that they would be severely hungry in the evening, but in fact it turned out that if they were given plenty of food in the first half of the day, such hunger did not occur. But those who ate little by little six times a day, no they didn’t enjoy the food, ”she says.
New research is needed
According to scientists, the data obtained may be useful for those who do not suffer from diabetes, but simply want to lose weight.
Dr. Richard Ellis, who works as a public relations officer for Diabetes UK, notes that these results support the earlier belief that sparse and abundant meals are healthier than frequent meals.
However, he says new studies in more patients are needed to finally confirm these findings.
Required frequency of self-monitoring of glucose level in T2DM
Diabetes mellitus is a chronic disease, that is, it cannot be cured at all, but it can and should be controlled! It is necessary to adhere to proper nutrition, regularly play sports or just walk, light gymnastics, if necessary, take medication, but only as directed by a doctor.
Sounds good, but how do you know if this treatment helps? Is all this enough? Or maybe, on the contrary – excessive efforts lead to a decrease in blood glucose below normal, but there are no symptoms…
After all, as you know, diabetes mellitus is dangerous for its formidable complications.
To find out if you really control your diabetes, it is worth using a very simple method – self-control of blood sugar. It is carried out using a glucometer device and allows you to find out what the blood sugar level is at a given moment. But when and how to measure it?
Many patients with diabetes mellitus believe that measuring blood is unnecessary, and that you only need to use a glucometer when you go to the doctor, he will certainly ask “Do you measure blood sugar? What sugar was on an empty stomach today? At another time?”And the rest of the time you can do it – there is no dry mouth, you do not go to the toilet often, so it means “sugar is normal”.
Just remember when you were diagnosed with diabetes, how did it happen? Did you recognize the symptoms and come to donate blood for sugar yourself? Or did it happen by accident?
Or even after a thorough examination and a special “hidden sugar” test – a test with a load of 75g glucose? (see here).
Do you feel bad with fasting blood sugar, for example, 7.8-8.5 mmol / l? And this is already a fairly large sugar, which damages blood vessels, nerves, eyes and kidneys, disrupts the work of the whole organism.
Think what is important to you? Your health, wellness and fulfilling life?
If you really want to learn how to manage your diabetes on your own, to prevent the development of complications, then it is important to start regularly monitoring your blood sugar! And not at all in order to once again see a good figure and think “it means you don’t need to measure more / drink pills” or see a bad one and get upset, give up. No!
Competent control of sugar will be able to tell you a lot about your body – how this or that food that you have taken affects the level of glucose in the blood; physical activity – whether it is cleaning the apartment or working in the garden, or playing sports in the gym; tell you how your medications work, maybe it is worth changing them or changing the regimen / dosage.
Let’s analyze to whom, when, how often and why it is necessary to measure blood sugar.
Most people with type 2 diabetes measure their blood glucose levels only in the morning before breakfast – on an empty stomach.
Here are just state “on an empty stomach” speaks only of a small interval of the day – 6-8 hours, that you sleep. What happens during the remaining 16-18 hours?
If you still measure your blood sugar level before going to bed and the next day on an empty stomach, then you can estimate whether the blood glucose level changes overnight , if it does, then how.For example, you take metformin and / or insulin at night. If fasting blood sugar is slightly higher than in the evening, then these drugs or their dose are insufficient. If, on the contrary, the blood glucose level is low or excessively high, then this may indicate a dose of insulin greater than required.
It is also possible to measure before other meals – before lunch and before dinner . This is especially important if you have recently been prescribed new drugs to lower your blood sugar or are on insulin treatment (basal and bolus).So you can evaluate how the blood glucose level changes during the day, how physical activity or lack of it, snacks during the day, etc., has affected.
It is very important to evaluate how your pancreas works in response to food intake . It is very easy to do this – use the meter before and 2 hours after a meal. If the “after” result is much higher than the “before” result – more than 3 mmol / l, then it is worth discussing this with your doctor.It may be worth making nutritional adjustments or changing drug therapy.
When is it worth to additionally measure the level of glucose in the blood:
- when you are not feeling well – you feel the symptoms of high or low blood glucose levels;
- when you are sick, for example, you have a high body temperature;
- before driving a car;
- before, during and after physical activity. This is especially important when you are just starting to practice a sport that is new to you;
- before bedtime, especially after drinking alcohol (better after 2-3 hours or later).
Surely you will argue that doing so much research is not very enjoyable. Firstly, it is painful, and secondly, it is quite expensive. And it takes time.
But you don’t have to take 7-10 measurements a day. If you are on a diet or receive pills, then measurements can be taken several times a week, but at different times of the day. If the diet has changed, medications, then in the beginning it is worth measuring more often in order to assess the effectiveness and significance of the changes.
If you are on bolus and basal insulin treatment (see the appropriate section), your blood glucose should be checked before each meal and before bed.
What are the goals of blood glucose control?
They are individual for everyone and depend on the age, presence and severity of complications of diabetes mellitus.
Average target glycemic levels are as follows:
- on an empty stomach 3.9 – 7.0 mmol / l;
- 2 hours after meals and before bedtime up to 9-10 mmol / l.
Frequency of glucose control during pregnancy is different . Since an increased blood glucose level adversely affects the development of the fetus, its growth, and the course of pregnancy itself, it is extremely important to keep under strict control! It is necessary to take measurements before meals, one hour after it and before going to bed, as well as in case of feeling unwell, symptoms of hypoglycemia .Target blood glucose values during pregnancy also differ (more ..).
Using self-control diary
Such a diary can be either a specially designed notebook or any notebook or notebook convenient for you. In the diary, mark the measurement time (you can designate a specific number, but it is more convenient to just make notes “before meals”, “after meals”, “before bedtime”, “after a walk.” entered, if you accept it, what food you ate.If it takes too long, mark foods that may have affected your blood glucose levels, for example, you ate chocolate, drank 2 glasses of wine.
It is also useful to note blood pressure numbers, weight, physical activity.
Such a diary will become an irreplaceable assistant for you and your doctor! With him, it will be easy to assess the quality of treatment, to carry out, if necessary, correction of therapy.
Of course, it is worth discussing what exactly you need to write in your diary with your doctor.
Remember that a lot depends on you! The doctor will tell you about the disease, prescribe medications for you, but then you decide on control, whether to stick to a diet, take prescribed medications, and most importantly, when and how many times to measure blood glucose levels.
You shouldn’t treat this as a heavy duty, a grief of responsibility that suddenly fell on your shoulders.