Diabetes Diet
and Martina Feichter, medical editor and biologist Updated onDr. med. Julia Schwarz is a freelance writer in the medical department.
More about the expertsMartina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
More about the experts All content is checked by medical journalists.
The correct diet for diabetes depends in part on the type of diabetes: Type 1 diabetics can basically eat similarly to non-diabetics. Type 2 diabetics should reduce their overall energy intake if they are overweight. With both forms of diabetes, it is important that the energy supply and the usable amount of insulin are optimally coordinated. Find out here what to look for in a diabetic diet.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. E11E10E13O24H36E12E14
Proper nutrition for type 1 diabetes
Patients with type 1 diabetes must first learn to correctly estimate the carbohydrate content of a planned meal. Only then can you inject the right amount of insulin, which is necessary for nutrient utilization. If too little insulin is injected before a meal, it can lead to high blood sugar levels (hyperglycaemia). If the insulin dose is too high, the blood sugar drops too much - there is a risk of hypoglycaemia. Both high and low sugar can be dangerous.
The correct dose of insulin depends on the type and amount of carbohydrates you are consuming. Whole grain products, for example, contain more long-chain or complex carbohydrates, which require less high insulin levels than the short-chain carbohydrates that appear more quickly in the blood. The latter are found in white flour products and sweets, for example.
In order to be able to more easily estimate the proportion of usable carbohydrates in a food, the term carbohydrate unit (KHE) was introduced. 1 carbohydrate corresponds to 10 grams of usable carbohydrates and increases blood sugar by 30 to 40 mg / dl. In the past, in particular, the so-called bread units (BE) were used instead of carbohydrate units. The following applies here: 1 BE corresponds to 12 grams of carbohydrates. You can find out more about this in the article Bread Units.
By the way: After diagnosis, diabetes training and individual nutritional advice are recommended to every patient. In addition to other content, everything important about the correct diet for diabetes is conveyed there.
Tips for the Type 2 Diabetes Diet
In type 2 diabetes mellitus, the body's cells respond only to a reduced extent to the blood sugar-lowering hormone insulin. This insulin resistance is favored by being overweight. This means that the right diabetes diet for overweight type 2 diabetics aims at weight loss. Regular physical activity helps to achieve this goal. If you manage to shed the excess kilos, the insulin resistance can also decrease. In this way, the existing amount of insulin can work better again.
The diabetes mellitus diet for overweight should therefore be reduced in calories. Patients can find out how many calories are "allowed" per day from their dietitian. Regardless of weight, every diabetic should take part in diabetes training after diagnosis and receive individual nutritional advice (like type 1 diabetics).
What can or should diabetics eat?
First of all: The food for diabetics should (as in general for all people) be balanced, varied and wholesome. It is said to provide sufficient amounts of macronutrients (carbohydrates, fats and proteins) as well as vitamins and minerals. What the ideal percentage composition of the diet from the three main nutrients looks like is discussed among experts. In general, the following recommendations for a healthy diet apply:
- 45 to 60 percent carbohydrates
- 30 to 35 percent fat
- 10 to 20 percent proteins
- 40 grams of fiber
- a maximum of 6 grams of table salt
- maximum 50 grams of pure sugar (glucose, sucrose)
The nutritionist will give each patient appropriate recommendations that may differ from the above. In the diet plan for diabetics, he must take into account, among other things, the patient's age, body weight and possible accompanying and secondary diseases (such as obesity, kidney damage, high blood lipid levels, etc.).
Almost more important than the exact percentage of the various macronutrients is their type and source. Whole grain products, for example, are cheaper than white flour products, and vegetable fats are healthier than animal fats.
Diabetes Diet: Carbohydrates
Carbohydrates are sugar molecules linked to form more or less long chains. They are very important suppliers of energy for the human organism, especially for muscles and the brain. One gram of carbohydrate has about four kilocalories.
A distinction is made between short-chain and long-chain carbohydrates. Short-chain carbohydrates, such as those found in white bread and sweets, cause blood sugar to rise very quickly and significantly and also only satisfy cravings for sugar for a short time. Long-chain (complex) carbohydrates, on the other hand, must first be broken down in the intestine before they can enter the bloodstream. As a result, the blood sugar level rises more slowly and less strongly after consumption. Complex carbohydrates are found in legumes and whole grain products, for example.
So the type of carbohydrate source has a direct impact on insulin requirements. Because high blood sugar levels, such as those caused by white flour products, chocolate, honey, sweet lemonade and cola or other sugary foods, require higher amounts of insulin for a short time to compensate for the fluctuations. This increases the risk of blood sugar levels getting out of control:
In type 1 diabetics, this can happen if the dose or the time of the insulin injection does not exactly match the carbohydrate intake. In type 2 diabetics, whose bodies still produce a small amount of insulin, it takes longer until the large amount of sugar can be smuggled into the cells (prolonged hyperglycaemia).
Diabetes patients should therefore cover their carbohydrate requirements as much as possible with long-chain carbohydrates, such as those found in whole grain products, potatoes and legumes.
Diabetes diet: fat
The ideal diet prefers dietary fats that contain many monounsaturated or polyunsaturated fatty acids. This primarily applies to vegetable fats and oils. Cold-pressed vegetable oils such as rapeseed oil, linseed oil, olive oil or walnut oil are therefore recommended. Fish is also a healthy source of fat in the diabetic diet (and also for non-diabetics). In contrast to other animal fat sources, it contains many healthy fatty acids.
Since diabetes dramatically increases the risk of arteriosclerosis ("hardening of the arteries"), cholesterol intake should be limited in the diet plan for diabetics. Cholesterol is found in all animal products (milk, butter, cream, eggs, meat, etc.). These products should therefore be consumed sparingly. Regular blood tests by your family doctor are also useful, as high cholesterol can only be detected through a blood test.
Diabetes Diet: Proteins
About 10 to 20 percent of the daily energy requirement should be covered by proteins. This recommendation applies if a diabetic patient shows no signs of kidney damage (diabetic nephropathy). However, if you have kidney weakness, you should consume a maximum of 0.8 grams of protein per kilogram of body weight per day.
Particularly recommended sources of protein are legumes (such as peas, lentils or beans), fish and low-fat meat.
Diabetes and alcohol
The combination of alcohol and diabetes is problematic: alcohol blocks the formation of new sugar (gluconeogenesis) in the liver for several hours. However, this new formation is factored into the calculation of the required amounts of insulin.
Diabetes patients should therefore only consume alcohol in moderation and always in combination with a meal rich in carbohydrates (a maximum of 10 grams per day for women and 20 grams per day for men, for guidance: half a liter of beer (5% by volume) contains around 20 grams Alcohol). In this way, hypoglycaemia can be avoided.
Alcohol is unfavorable in overweight diabetics for another reason: one gram of alcohol has a calorific value of around 7.2 kilocalories per gram, which is similar to that of fat. This makes it a real calorie bomb. However, being overweight increases the body's need for insulin through the increasing insulin resistance of the cells and has a negative impact on diabetes.
Alcohol can also lead to nerve damage (polyneuropathies). Pre-existing diabetic polyneuropathy can be exacerbated by alcohol consumption.
Sweets for diabetics
The same applies to diabetics as to healthy people: sweets should only be consumed occasionally. It is essential to pay attention to the hidden sugars in foods and finished products. For example, ketchup, fruit yoghurt and muesli are not primarily classified as sweets, although they often contain a lot of sugar. This must be taken into account in the diabetes diet.
A particular problem with many sweets is the combination of sugar and fat: the body cannot metabolize sugar and fat at the same time. Therefore, the sugar is first converted into energy and burned, while the fat is stored in the tissue and promotes obesity.
There are now many "sweet" specialty products for people with diabetes, for example diabetic chocolate or diabetic ice cream. However, experts advise against such mostly expensive diabetes products. Often these products do not contain cane or industrial sugar, but they do contain large amounts of fructose (and fat).
The fruit sugar (fructose) increases the formation of uric acid, which is often increased in diabetics anyway. A uric acid level that is too high can provoke a gout attack. In addition, fructose promotes obesity, promotes the metabolic syndrome and increases blood lipid levels.
By the way: Instead of expensive and questionably healthier diabetic chocolate, you can use chocolate with a very high cocoa content (at least 60 percent). The higher the cocoa content, the less sugar the chocolate usually contains.
Diabetes and cinnamon
According to some nutritionists, diabetes could be positively influenced by the effects of cinnamon. Cinnamon stimulates the metabolism and thus may have a positive effect on blood sugar regulation. In addition, experts are discussing whether a certain component of cinnamon (proanthocyanide) can improve the effect of insulin on cells.
Scientists have been able to demonstrate an anti-diabetic effect of cinnamon in various animal experiments. Some human studies have also suggested that cinnamon can lower blood sugar and cholesterol levels. Other studies, on the other hand, did not show any noteworthy effect. Before therapeutic use, further studies are necessary that reliably prove the effect and, among other things, illuminate a suitable amount of cinnamon and the duration of treatment.
Also good to know: cinnamon or the coumarin contained in cassia cinnamon in particular can be harmful to health in large quantities (especially for the liver). The Federal Office for Risk Assessment recommends that an adult weighing 60 kilograms should not eat more than a maximum of two grams of cinnamon per day. Pay attention to this when buying concentrated preparations such as capsules.
So far, cinnamon has not played a role in evidence-based diet therapy for diabetes.
Fruit for diabetics
Diabetes patients are generally advised to consume enough fruit and vegetables every day. Both provide important vitamins and minerals as well as fiber.
Depending on the variety, fruit also contains more or less large amounts of fruit sugar (fructose). This has long been considered healthier than normal sugar. That is why many foods for diabetics contain fructose instead of conventional sugar. The same applies to numerous "normal" products (for non-diabetics).
However, diabetics (and people with healthy metabolism) are advised not to take too much fructose into their bodies. This can have a negative impact on health: according to research, a high fructose intake can promote obesity (obesity) and increase blood lipid levels, for example.
Therefore, one should not consume too many industrially manufactured foods that contain fructose, such as lemonade sweetened with fructose or diabetic foods with fructose. Daily fruit consumption is harmless and even desirable for diabetics (and others): The German Nutrition Society recommends consuming two servings of fruit and three servings of vegetables every day - according to the motto "5 a day". This corresponds to about 250 grams of fruit and 400 grams of vegetables daily (1 serving = approx. A handful).
Sweeteners (like stevia) & diabetes
There are some alternative sweeteners that are often recommended in the diet of diabetics - instead of refined sugar, because they do not raise the blood sugar level, or do so to a lesser extent. Sweeteners include sugar substitutes and sweeteners.
Sugar substitutes are, for example, sorbitol, mannitol, isomalt and xylitol. They contain fewer calories than sugar and only cause blood sugar levels to rise slightly. In contrast, sweeteners (such as acesulfame-K, aspartame, stevia) do not provide any calories and do not increase blood sugar.
The sweetener stevia has been particularly popular with diabetes patients for some time. The contained steviol glycosides are responsible for its sweetening power. According to the European Food Safety Authority (EFSA), stevia should neither promote tooth decay nor be carcinogenic, nor damage the genetic make-up nor impair fertility or the development of an unborn child.
So far there is also no evidence that sweeteners like stevia can be "addictive" and trigger hunger pangs - and thus possibly lead to weight gain. However, experts point out that products sweetened with stevia sometimes contain additional sugar.
Also, be careful not to consume stevia in excess. The EFSA recommends a maximum of four milligrams of steviol glycosides per kilogram of body weight (ADI value) per day. This amount is considered harmless. The consequences of a possible overdose are unclear.
The general rule is: no more than the recommended amounts of sweetener or a maximum of 50 grams of sugar should be consumed per day. Those who eat less sweet also make it easier for themselves: the body does not get used to the taste and therefore has less desire for sweets.
By the way: diabetes patients who also suffer from the rare metabolic disease phenylketonuria are not allowed to consume aspartame. The sweetener contains phenylalanine. This protein component (amino acid) cannot be broken down in phenylketonuria, so that symptoms of poisoning occur. Other sweeteners (including stevia), on the other hand, do not contain phenylalanine. They are therefore a good alternative in the diabetes diet for phenylketonuria.
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