What's new in diabetes care
Introduction to diabetes
Types of diabetes
Diagnosis
Risk factors & screening

Dietary therapy

• Introduction
• Dietary therapy
• Tips for healthy eating
• Artificial sweeteners
• Can diabetic patients drink alcohol?

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Introduction

Diet and exercise should form the main stay in managing Type 2 diabetes. Patients should be encouraged to restrict calorie intake, avoid weight gain and involve in regular exercises. Weight management may be the most important therapy for the obese type 2 diabetic patients. Dietary therapy should be individualized.

Dietary therapy

There is no specific “diabetic” diet. However, eating habits should be modified. Indeed, the diet for the diabetic patient differs little from a healthy diet for the population in general. A healthy, balanced diet is low in fat and sugar and high in fibre, with plenty of fruits and vegetables.

The high carbohydrate, low fat and high fibre diet is recommended. Thus, the composition of your diet should consist of 50 – 55% complex carbohydrate, 30% fat (monounsaturated fat is preferable), 15 – 20 % protein and plenty of fibre i.e. fresh vegetables and fruits. The low carbohydrate, high fat diets should be discouraged because they can increase serum lipids (cholesterol and triglycerides) levels.

Tips for healthy eating

It is recommended that you:

• Eat regular meals based on starchy foods e.g. rice (but avoid fragrant rice), bread, chapattis, potatoes, cereals.
• Avoid snacks in between meals (type 2 diabetes)
• Eat less sugar and sugary foods
• Eat more fruits and vegetables
• Cut down the amount of fat consumed
• Reduce salt intake
• Keep alcohol intake moderately low

What fruits can a diabetic individual take? Perhaps one could use the “glycaemic index” of various foods as a guide. The glycaemic index (GI) measures how fast a food is likely to raise your blood sugar. Diabetic individuals have been urged to eat carbohydrate foods with a low “glycaemic index”, i.e. GI <55.

Examples of Glycemic Index (based on 50g carbohydrate samples) of some of the frequently consumed food:

Table below is a listing of the GI of various fruits. Glucose is given an arbitrary value of 100.

* Low GI = 55 or less, medium GI = 56 – 69, High GI = 70 or more

Artificial sweeteners

Artificial sweeteners are widely available and may be used to substitute glucose. There are 2 main groups:

1. Non-nutritive e.g. saccharine, aspartame. They do not provide any calories and can be used freely
2. Nutritive e.g. fructose, sorbitol. They do not raise blood glucose excessively but contain the same number of calories as glucose

Can diabetic patients drink alcohol?

As a general rule, people with diabetes do not have to give up alcohol just because they have diabetes. They are not any more or less sensitive to the effects of alcohol taken in excess than anybody else. Too much alcohol is not good for anyone’s health and the maximum amount you should drink in any one week, whether you have diabetes or not, is 21 units for men and 14 units for women. (1 unit = half pint of beer or a standard glass of wine). It is better to drink less.

However, there are few things you have to remember if you have diabetes:

• Excessive alcohol can cause low blood sugar several hours later – which may be during the night, especially if you are on insulin

• Alcohol tends to be high in calories and intake should be reduced if trying to lose weight