Beta cells of the pancreas are destroyed in DM1, thus there is a decline and subsequent absence in the secretion of insulin. This leads to a high blood glucose level (hyperglycemia) due to failure in the regulation of glucose. Once diagnosed with diabetes, patients start making necessary adjustments to help keep blood glucose levels stable. These include insulin replacement therapy (injection of insulin) and Medical Nutrition Therapy (MNT). Medical Nutrition therapy is the individual counseling of patients about healthy eating habits that will keep blood glucose at target levels, and also prevent conditions like obesity, hypoglycemia, and hypertension. When medical nutrition therapy focuses on the management of patient’s diets, it plays a major role in the regulation of type 1 DM. people with type 1 diabetes are required to make healthy food choices with fewer fats, less salt, and less sugar. Health diets will help to
- Control blood sugar
- Control blood pressure
- Control blood fats
- Maintain a healthy and steady weight
Making these dietary adjustments gradually and consistently will eventually turn into a healthy and successful lifestyle.
In effect, this can help to reduce the risk of diabetes complications including heart diseases and stroke. As with any lifestyle changes, making gradual and realistic changes over a longer period is more likely to lead to success. See a registered dietitian for specific advice and an eating plan that is tailored to your needs.
The importance of diet in type 1 diabetes control
When healthy food choices are made and eaten in consistent amounts, they help in keeping blood sugar levels stable. Diet can also help to lower the chances of diabetes-related problems like heart disease and kidney disease.
What to Eat
Previously, experts thought there were specific diets for diabetics. They assumed that that diabetes patients had to avoid eating sugary foods or carbohydrates in general. However, people with type one diabetes can eat the same healthy food as everyone else, including their favorites, as long as they follow these general guidelines:
- Eat less of unhealthy fats: Cut back on the saturated fats you find in high-fat meats like beef, pork, and chicken skin, as well as a full-fat dairy like whole milk and butter. Unhealthy fats increase the chances of heart disease, and being diabetic makes the chances even higher. Smart food choices can lower this risk.
- Eat enough fiber: Fiber may help to control blood sugar levels. It can be gotten from whole grains, beans, fruits, and vegetables. These high fiber foods are preferred for diabetics than their low fiber counterparts such as white rice, refined grains, and sugary foods
- Substituting high-glycemic-index foods for low-glycemic index foods: Glycemic index (GI) is the ranking of carbohydrates in foods according to how they affect glucose levels (blood glucose-raising potential). Carbohydrates with low glycemic index are more slowly digested, absorbed, and metabolized. Hence they cause a slower rise in blood glucose levels. Low glycemic index foods (GI lower than 55) are healthier for diabetics, they include apples (39), pears (38), and grapefruit (25). High GI foods increase blood glucose levels faster and should be avoided. Examples are white bread (71), millet (71), white rice (89) and cereals (76)
The body’s main source of energy is carbohydrates that are consumed in the form of simple sugars such as glucose, sucrose, and fructose, or as complex sugars such as starch. They can be gotten from foods such as maize, rice, fruits, and dairy products. Carbohydrates raise blood sugars faster than other macronutrients like fats and proteins will. The quantity and quality of carbohydrates you eat will affect the process of diabetes management.
Counting carbs helps the patient to keep track of the carbohydrate intake. Dieticians will help you figure out how many grams of a particular carbohydrate you should eat, depending on the glycemic index and glycemic load of the food. This, together with insulin therapy will help keep blood glucose at target levels.
Dietary fiber, especially soluble fiber is useful in the management of type 1 diabetes. High fiber diets are said to reduce plasma glucose concentration in diabetic patients by slowing the process of glucose absorption. This is one of the reasons why most diabetes associations encourage high fiber diets for patients. Fibers also can reduce weight and disturb carbohydrates and fat metabolism. Intake of insoluble dietary fibers can be increased by replacing refined foods with whole grains and cereals. as found in whole-grain cereal products are considered to be especially effective in the prevention of type 2 diabetes mellitus. High consumption of fruits, vegetables, and pulses also shows these health-promoting properties. Type 1 diabetes patients are recommended to consume between 15 g to 35 g per day of fiber.
10 steps to planning a healthy diabetic diet
Although balancing carbohydrate and insulin is most important in diabetes management, the role of eating a healthy cannot be underestimated too as it helps put your weight, blood fats, and blood pressure under control. The following steps can help in planning a healthy diabetic diet:
Eat three meals a day.
Avoid skipping meals and space out your breakfast, lunch, and evening meal over the day. This will help control your appetite and blood glucose levels.
Include starchy carbohydrates in meals.
At each meal include starchy carbohydrate foods such as bread, pasta, potatoes, yam, noodles, rice, and cereals. The high fiber varieties of starchy foods will also help to maintain the health of your digestive system and prevent problems such as constipation. The amount of carbohydrate consumed is important in controlling your blood glucose levels.
Reduce fat intake.
Cut down particularly on saturated fats intake. Choose unsaturated fats or oils, especially such as olive oil as these types of fats are better for your heart. Eating fewer fats will help in weight loss since fat is a great source of calories.
Eat more fruits and vegetables.
As much as five portions of low GI fruits a day will provide you with vitamins, minerals, and fiber to help balance your overall diet. One portion is, for example, a banana or apple, a handful of grapes, a tablespoon of dried fruit, a small glass of fruit juice or fruit smoothie, three heaped tablespoons of vegetables, or a cereal bowl of salad. Increase consumption of vegetables like lettuce and cabbages.
Eat more beans and lentils.
Include kidney beans, butter beans, chickpeas, or red and green lentils in the diet. These have little effect on blood glucose levels and may help with the control of blood fats too. They can be added to stews, soups, and salad.
Limit sugar and sugary foods.
This does not mean you need to eat a sugar-free diet. Sugar can be used in foods and baking as part of a healthy diet. Using sugar-free, no added sugar or diet fizzy drinks/squashes instead of sugary versions can be an easy way to reduce the sugar in your diet. Sugary drinks are best used as a treatment for hypoglycemia
Eat less salt.
Reduce salt in your diet to 6g or less a day. More than this can raise your blood pressure, which can lead to stroke and heart disease. Limit the number of processed foods you eat (as these are usually high in salt) and try flavoring foods with herbs and spices instead of salt.
Drink alcohol in moderation only.
A maximum of 2 units of alcohol per day for a woman and 3 units per day for a man. Never drink on an empty stomach, as alcohol can make hypoglycemia (low blood glucose levels) more likely to occur. Remember, alcohol contains empty calories so think about cutting back further if you are trying to lose weight.
Consume at least two portions of oily fish weekly.
Oily fish contain a type of polyunsaturated fat called omega 3 which helps protect against heart disease. Examples include mackerel, sardines, salmon, and pilchards.
Do not use diabetic foods or drinks.
They contain just as much fat and calories as ordinary forms. Also, they can have a laxative effect and are expensive. Diabetic foods or drinks, therefore, do not offer any benefit to people with diabetes.
Blood glucose control is very vital in the management of type 1 DM. Making healthy food choices will help you control your diabetes and protect long-term health. People with type one diabetes can eat the same healthy food as everyone else, including their favorites, as long as they follow the general guidelines in planning their diets. Upon diagnosis, diabetics are advised to meet a dietician for counseling and guidance on eating habits that will keep blood sugar at target levels.
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Reynolds AN, Akerman AP, Mann J (2020) Dietary fiber and whole grains in diabetes management: Systematic review and meta-analyses. PLoS Med 17(3):e1003053.https://doi.org/10.1371/journal.pmed.1003053
Susana R. Patton, (2011). Adherence to Diet in Youth with Type 1 Diabetes J Am Diet Assoc. 2011 April; 111(4): 550–555. doi:10.1016/j.jada.2011.01.016.