Nutrition and diet in diabetes. Allowed and prohibited products. Sample menu for diabetes: nutritional features, diet and recommendations Proper nutrition for suspected diabetes

Studying an important medical topic: "Nutrition for diabetes", it is important to know which foods are prohibited for a diabetic already at the initial stage of the disease, and which, on the contrary, are recommended to ensure a long period of remission. If you limit yourself to fractional meals and strictly adhere to the prescribed diet therapy, you can not be afraid of extremely undesirable spikes in blood glucose. Therapeutic diet for patients with diabetes is adjusted individually, is part of the complex treatment of this dangerous chronic disease.

What is diabetes

This incurable disease is considered an extensive pathology of the endocrine system, while it provokes systemic complications in the body. The main goal of effective treatment is the control of blood glucose by medical methods, the timely normalization of fat and carbohydrate metabolism. In the latter case, we are talking about proper nutrition, which, after a detailed diagnosis and a series of laboratory tests, is prescribed by the attending physician. A diet for a diabetic should become the norm of everyday life, as it contributes to a full-fledged metabolism.

Nutrition for diabetes

Overweight patients are at risk, so it is important to control body weight in a timely manner and avoid obesity. If we are talking about the nutrition of an already diabetic patient, portions should be small, but it is desirable to increase the number of meals to 5-6. By changing the daily diet, it is important to protect blood vessels from destruction, while losing 10% of your real weight. The presence of food ingredients rich in vitamins in the menu is welcome, but you will have to forget about the excessive use of salt and sugar. The patient will have to return to a healthy diet.

General principles of nutrition

Progressive obesity in humans of the abdominal type is corrected by therapeutic nutrition. When creating a daily diet, the doctor is guided by the patient's age, gender, weight category and physical activity. With a question about nutrition, a diabetic should contact an endocrinologist, undergo a series of laboratory tests to determine the hormonal background and its disorders. Here is a note from experts:

and hunger strikes are contraindicated, otherwise the norm of sugar in the blood is pathologically disturbed.
The main measure of nutrition is the "bread unit", and when compiling a daily diet, it is required to be guided by data from special tables for a diabetic.
Breakfast, lunch and dinner should account for 75% of the daily diet, the remaining 25% are snacks during the day.
Preferred alternative foods should match the calorie content, BJU ratio.
As an appropriate method of cooking for diabetes, it is better to use stewing, baking or boiling.
It is important to avoid cooking with vegetable fats, limit the total calorie content of food.
It is necessary to exclude the presence of sweet foods in the daily diet, otherwise, to achieve an acceptable level of glucose, it will be necessary to use hypoglycemic drugs.

Diet

Food in diabetes mellitus reflects the internal state of health of the patient. Therefore, it is important to develop a regimen and, without violating it, avoid extremely undesirable relapses. Daily nutrition should be fractional, and the number of meals reaches 5-6. It is recommended to eat based on the prevailing body weight, if necessary, reduce the total caloric content of meals. The medical advice is:

with normal weight - 1,600 - 2,500 kcal per day;
in excess of normal body weight - 1,300 - 1,500 kcal per day;
with obesity of one of the degrees - 600 - 900 kcal per day.

Products for diabetics

A diabetic should eat not only tasty, but also healthy. Below is a list of recommended food ingredients that support acceptable blood sugar levels while significantly prolonging the period of remission of the underlying disease. So:

Name of food	Benefits for diabetics
berries (all except raspberries)
	are a source of healthy fats, but are high in calories
unsweetened fruits (the presence of sweet fruits is prohibited)	have a positive effect on the heart and blood vessels, fiber slows down the absorption of glucose into the blood.
skimmed milk	an inexhaustible source of calcium necessary for bones.
natural yoghurts	normalize the microflora in the intestines and help cleanse the body of toxins.

What kind of sausage can be eaten with diabetes

The diet for diabetics provides for homemade food, excludes the use of preservatives and semi-finished products. This also applies to sausages, the choice of which must be treated with special selectivity. It is important to take into account the composition of the sausage, the prevailing level of the glycemic index. Favorites for diabetics are boiled and diabetic sausages of different brands with a specified indicator ranging from 0 to 34 units.

Forbidden foods for diabetes

It is very important not to exceed the daily calorie intake, otherwise one of the forms of obesity progresses, and the level of glucose in the blood rises pathologically. Moreover, experts stipulate a number of prohibited foods that need to be excluded from their daily menu for diabetes. These are the following food ingredients:

Forbidden foods	Health risks for diabetics
	contribute to an increase in glucose levels, relapse.
fatty meats	increase the concentration of bad cholesterol in the blood.
salted and pickled vegetables	violate the water-salt balance.
from cereals - semolina, pasta	reduce the permeability of the vascular walls.
first broths
fatty dairy products, such as full-fat cottage cheese, cream, sour cream	increase the concentration of lipids, an indicator of glucose in the blood.

What can replace forbidden foods

To preserve the palatability of the food consumed, the diabetic is advised to choose alternative food ingredients. For example, it is advisable to replace sugar with honey, and instead of semolina, eat buckwheat porridge for breakfast. In this case, we are talking not only about replacing cereals, but to replace forbidden foods with the following food ingredients:

Food Processing Methods for Diabetic Patients

It is better not to eat fried and canned food for diabetics, since there is a high probability of a dangerous relapse. Health food should be low-fat, rather lean. Of the acceptable processing methods, doctors recommend boiling, stewing, processing in their own juice. So food ingredients retain more useful properties, exclude the undesirable formation of harmful cholesterol.

Menu for diabetics

With obesity of one degree, you need to eat right, otherwise the number of attacks in diabetes only increases. In addition to limiting carbohydrates, it is important to control the total calorie content of meals. Other recommendations and features of the daily menu are presented below:

Alcohol, vegetable fats and oils, sweets are extremely rare, and it is better to completely exclude from the daily menu.
Allowed the use of dairy products, lean meat and poultry, legumes, nuts, eggs, fish in the amount of 2 - 3 servings per day.
Fruits are allowed to eat 2-4 servings, while vegetables can be eaten per day up to 3-5 servings.
The rules of clinical nutrition include bread and cereals with a capacious fiber content, which can be consumed up to 11 servings per day.

Weekly menu for diabetics

The daily diet of a diabetic should be useful and varied, it is important to properly distribute the ratio of BJU. For example, sources of vegetable proteins are bread, cereals, beans, beans, soybeans. Carbohydrates allowed for a diabetic patient predominate in unsweetened fruits. An example patient menu is shown below:

Monday: for breakfast - fat-free cottage cheese, for lunch - cabbage soup from sauerkraut, for dinner - baked fish.
Tuesday: for breakfast - buckwheat porridge with skim milk, for lunch - steamed fish, for dinner - unsweetened fruit salad.
Wednesday: for breakfast - cottage cheese casserole, for lunch - cabbage soup, for dinner - stewed cabbage with steam cutlets.
Thursday: for breakfast - wheat milk porridge, for lunch - fish soup, for dinner - stewed vegetables.
Friday: for breakfast - oatmeal porridge, for lunch - cabbage soup, for dinner - vegetable salad with boiled chicken.
Saturday: for breakfast - buckwheat porridge with liver, for lunch - vegetable stew, for dinner - stewed vegetables.
Sunday: for breakfast - cheesecakes, for lunch - vegetarian soup, for dinner - boiled squid or steamed shrimp.

Nutrition for type 2 diabetes

the energy value of daily nutrition should be 2400 kcal;
you need to replace foods with simple carbohydrates for complex ones;
limit daily salt intake to 6 g per day;
remove their diet food ingredients that contain bad cholesterol;
increase the amount of fiber, vitamins C and group B.

Diet for type 2 diabetes for a week

Nutrition in the presence of diabetes should be fractional with a minimum intake of salt and spices. In addition, it is important to observe the drinking regimen up to 1.5 liters of free liquid. Here is the recommended menu and healthy recipes for every day:

Monday: breakfast - oatmeal and unsweetened tea, lunch - borscht in meat broth, dinner - cabbage cutlets.
Tuesday: breakfast - low-fat cottage cheese with dried apricots, lunch - stewed cabbage with lean boiled meat, dinner - kefir with bran bread.
Wednesday: breakfast - barley porridge, lunch - vegetable soup, dinner - cabbage schnitzel, cranberry juice.
Thursday: breakfast - buckwheat porridge, lunch - fish soup, dinner - fish cakes with egg.
Friday: breakfast - cabbage salad, lunch - stewed vegetables with chicken, dinner - cottage cheese casserole.
Saturday: breakfast - protein omelet, lunch -

For many, diet is one way to lose weight. But there is a category of people who are simply forced to limit themselves in food. For them, diet is an integral part of complex treatment. Diabetes is a disease that requires special attention. In the fight against it, various methods are used - doctors prescribe medications to patients, limit physical activity, adhere to an established diet, and so on.

Each patient must follow the recommendations of a specialist. Anyone who thinks that a diet for diabetes does not help in the treatment of this disease is greatly mistaken. Proper nutrition provides the sick body with the nutrients that are required for its normal functioning.

Diabetes. Description of the disease, how to deal with the disease

Treatment is prescribed only by a doctor. It is necessary to visit a specialist as soon as the first signs of the disease manifest themselves. Symptoms of diabetes can be the following: frequent urination (the number of urination per day exceeds the norm), fatigue for no reason, sudden and significant weight loss, severe thirst, poor eyesight, and so on. If the diagnosis is confirmed by the doctor, he also prescribes complex treatment. The patient is prescribed medication (including hormones), a diet, and a daily regimen is established. All doctor's recommendations must be strictly followed. Its purpose is a pass to a normal life without diseases.

The action of drugs gives the body the opportunity to establish a balance of components that are important for its work. A diet for diabetes helps to facilitate the treatment process, sufficient rest and sleep help maintain a good emotional state. Ignoring the doctor's recommendations leads to unforeseen negative consequences.

Rules to be followed in nutrition

People with diabetes should eat 5 to 6 times a day. It is desirable that the menu be as balanced as possible. Meals should be taken at the same time. The diet can be like this:

Breakfast - 8-00.
Lunch - 11-00.
Lunch - 14-00.
Afternoon snack - 17-00.
Dinner - 20-00.

When a person eats at the same time, his body gets used to it. The work of the digestive system is getting better, the metabolism returns to normal, unpleasant sensations disappear - bloating, a feeling of a full stomach, belching, and so on. The diet for diabetes, which the patient must follow, contributes to a uniform intake of carbohydrates in the body. If you do not adhere to the established diet, the level of glucose in the blood will constantly fluctuate, and very sharply.

Sweets (cakes, sweets, chocolate), grapes of any variety, sugar should be excluded from the diet. These products for diabetic patients are hazardous to health, they can significantly worsen the condition, as well as cause an attack.

Fats in food should be present, but in limited quantities. The body spends a lot of time and effort on their processing. In order not to overload it, but to help, it is necessary to add a lot of fiber to the menu - vegetables, cereals, bread. These foods are quickly digested and provide a lot of energy.

A diabetic diet should be designed in such a way that a person gets the same amount of calories every day. More nutritious foods are best eaten in the first half of the day, lighter foods in the second.

Diet number 9 for diabetics

This diet is not suitable for people who are obese. Diet number 9 is prescribed for type 2 diabetics.

The peculiarity of nutrition is the maximum restriction of the consumption of easily digestible carbohydrates, as well as animal fats. The energy value of the daily diet is 2300-2600 kcal. This is quite enough for the body to function normally and receive a sufficient amount of nutrients.

Diet 9 for diabetes mellitus allows you to add the following foods to the diet: rye and wheat bread, cereals (buckwheat, barley, wheat, oatmeal), low-fat milk, as well as cottage cheese and cheese, vegetables, fish and meat.

Recipes for good nutrition during treatment

You can follow the following menu:

Breakfast:

The total calorie content of breakfast is 400 kcal.

Snack:

Yogurt - 250 ml. It is desirable that the fermented milk product be without additives.
Fruit compote - 200 ml. The drink must be sugar-free. Take 1 kg of fruit, remove stones, cut into medium pieces, pour into a saucepan and pour 4 liters of water. Bring all this to a boil. The main thing is that the fruits are not digested. Therefore, it only takes 5 minutes to boil.

Dinner:

The total calorie content of lunch is 600 kcal.

Snack:

Green tea - 200 ml.
Lean cookies - 75 grams.

The total calorie content is 250 kcal.

Dinner:

The total calorie content of dinner is 400 kcal.

A diet for diabetes, the menu of which is rational and balanced, provides a feeling of satiety for the whole day. If you eat this way, you won't be hungry. You can make a menu yourself, adhering to the recommendations of your doctor, or contact an experienced nutritionist. The specialist will describe in detail the nutrition for the entire period of treatment.

The French diet is an effective way to improve the normal functioning of the body

This diet helps improve metabolism. Due to the wrong lifestyle, the work of internal organs is disrupted, which entails a lot of problems. The French Type 2 Diabetes Diet helps cleanse the body and keeps it running smoothly. Nutrition according to this method takes place in four stages:

This diet for diabetes, the menu of which is limited to a minimum, allows you to quickly lose weight without harm to the body. This helps to improve the general standing of the patient.

Strict diet

From the name it is clear that it will not be easy.

It is important to prepare yourself psychologically, because on a physical level, well-being will become much better. During the diet, sugar is completely excluded from the diet. Nothing can be sweetened. In rare cases, you can treat yourself to a sweetener, but in very moderate amounts. The number of meals per day - from 8 times. All portions should be small. For one, consume about 300 kcal. A strict diet for diabetes limits the amount of fat. They can be eaten, but not much. No more than thirty grams are allowed per day.

Recipes for a strict diet

If food restrictions are set, this does not mean that a person should starve. There are many healthy nutritious foods that you can eat with a strict diet.

Recipe number 1. Steamed chicken sausage. Cooking time - 40-50 minutes. Take 500 grams of chicken meat, cut into medium pieces and pass through a meat grinder. Pour the minced meat into a large bowl. Add 1 egg and 2 tbsp. l. semolina. Mix everything well. Leave the resulting mass for 5 minutes until the semolina swells. Take a medium carrot, boil until fully cooked and cut into cubes. Add to mince. Also add green peas (300 g) and broccoli (200 g) to the meat. For a spicy taste, you can add 2 minced garlic cloves to the minced meat. Mix everything again. Add some salt. Put the resulting mass on a cling film and form a sausage. Steam for 30 minutes. Cool the mass under pressure. After that, remove the cling film. A strict diet for diabetes mellitus allows you to eat 100 g of this sausage in the morning (you can with a slice of bread).

Recipe number 2. Onion soup with cabbage. Cooking time - 30 minutes. We take ten medium onions, peel them and finely chop. Next, you need to take one small head of cabbage and cut it into strips. Pour 2-3 tbsp into a saucepan. l. vegetable oil, bring it to a boil and pour the onion. It should brown slightly. Then pour cabbage into it. Mix the whole mass and pour water into the pan to the top. Bring to a boil. While all this is being cooked, take a medium carrot, peel and rub. Next, you need to also pour it into the pan. To make the soup thicker, you need to add a little flour to it, about 2 tbsp. l. So the dish will be more nutritious. Pour 1 tbsp into the pan. l. vegetable oil and add 2 tbsp. l. flour. Bring to readiness. Do not let the flour burn and turn black. This will only spoil the dish. When the flour is ready, add it to the pan with the rest of the products. Boil. Cook for a few more minutes. Turn off the stove and let the soup cool down a bit. You can eat the dish for lunch. One serving - two hundred and fifty milliliters.

A lot of delicious food allows a diet for diabetes. Recipes are amazing in their variety. It may come as a surprise to you, but proper nutrition is simple, inexpensive and very tasty.

Diet Kornelyuk

The famous musician was able to lose those extra pounds thanks to this diet. That is why in our country this diet has such a name - the Kornelyuk diet. But in fact, its founder is nutritionist Pierre Dukan. That is, this food is the same French diet, only under a different name. By adhering to the established rules in food, you can get rid of extra pounds quickly enough. The Kornelyuk diet for diabetes is not too strict. Almost everyone can follow it. But you should not assign it to yourself. Let a specialist do it. In order for the weight to go away more rapidly, it is not enough just to eat right, it is also necessary to provide the body with moderate physical activity.

Diabetes diet for pregnant women

In rare cases, women who are in an interesting position develop dangerous diseases.

Diabetes mellitus that has occurred in a pregnant woman, but has not previously been observed in her, is called gestational diabetes. The causes of the development of the disease are heredity, unfavorable environmental conditions, overweight, age over forty years.

Diet for gestational diabetes involves eating five to six times a day. At the same time, a pregnant woman needs to give up fatty and fried foods and fast food. The diet should include foods rich in fiber. They stimulate the bowels. You need to eat moderately, at the same time, avoid overeating. Eating once a day and in large quantities provokes a rise in blood sugar much higher than normal. This can cause many negative consequences.

Those women who already had diabetes before pregnancy should definitely consult a doctor as soon as they find out about their situation. For each patient, individual treatment is prescribed, taking into account the fact that she is expecting a child. Diet for pregnant women with diabetes should not be scary. All healthy foods remain in the diet in sufficient quantities. Every day it is worth eating meat, fish, porridge on the water (buckwheat, oatmeal or barley), wheat bread.

Diet number 8 for diabetics

This diet is suitable for people who are obese. Salt, all seasonings are completely excluded from the diet. The menu should include steamed dishes, in the oven, boiled in water. You can not eat flour products. Bread (wheat or rye) is allowed in moderation. Diet 8 for diabetes spares the digestive organs. If you follow its rules, you can lose excess weight to normal levels and fix the result for a long time. Poultry meat (chicken, goose, duck, turkey), fish, eggs (boiled only), dairy products (low-fat cottage cheese, yogurt, etc.) are allowed.

conclusions

For those who are sick, food restriction becomes a real punishment. But do not despair. There are many foods that can be eaten with diabetes. All of them are tasty and healthy. Regardless of which diet for diabetes is prescribed by a doctor, in any case, it is aimed at restoring the normal functioning of the digestive organs and maintaining an acceptable level of glucose in the blood. If the patient has a desire to lose weight and alleviate the general condition, he should adhere to the established rules in nutrition. The result will not keep you waiting.

It is important to remember that excess weight has not helped anyone yet, it only complicates the situation. Therapeutic diet for diabetes (table number 9) is the most effective. Subject to the established rules, there is no discomfort in the stomach and intestines, normal metabolism is established. Foods that are included in the diet menu are rich in vitamins. They can be bought in the market or in any store at an affordable price. From these products it is recommended to prepare meals for the whole family. They are quickly absorbed by the body. Almost all diets for diabetes do not allow you to eat at night. It is advisable to eat at least two hours before bedtime. Be healthy!

FROM diabetes mellitus is a disease of the endocrine system caused by absolute or relative insufficiency of the pancreatic hormone insulin in the body and manifested by profound disorders of carbohydrate, fat and protein metabolism. Diabetes mellitus is one of the most common diseases, but rarely diagnosed, as it has many "masks". The prevalence of diabetes in the population is currently 6%. Every 10-15 years the total number of patients doubles.

There are two main forms of the disease: type 1 (insulin-dependent) and type 2 (insulin-independent).
Our clinic deals with the treatment of diabetes of any type.
The main factors provoking the occurrence of type 1 diabetes (insulin-requiring) with a genetic predisposition to it are viral infections.
The reasons for the development of type 2 diabetes (non-insulin dependent) are: genetic predisposition; obesity, often associated with overeating, as well as diseases of the endocrine system: pathology of the pituitary gland (hypo- and hyperfunction), adrenal cortex. Diabetes mellitus can also occur as a complication of viral diseases (influenza, viral hepatitis, herpes virus, etc.), cholelithiasis and hypertension, pancreatic tumors.

Despite the fact that at present there are many drugs that reduce blood sugar, nevertheless, in diabetes mellitus, therapeutic nutrition is of decisive importance. With mild and even moderate form of diabetes, mainly dietary treatment is required. In a severe form, therapeutic nutrition should be combined with treatment with insulin or other drugs.

Basic principles of therapeutic nutrition in diabetes mellitus:

1) frequent (at least 4-5 times) and regular meals;
2) more or less the same amount of carbohydrates and calorie main meals (breakfast, lunch, dinner);
3) dietary diversity: wide use of a range of products that do not contain large amounts of sugars;
4) replacement of sugar with sorbitol or xylitol, as well as saccharin, which are added to prepared foods and drinks. For overweight diabetics, to increase the feeling of fullness, you need to include in the diet vegetables such as fresh and sauerkraut, lettuce, spinach, green peas, cucumbers, tomatoes.
To improve liver function, which suffers significantly in diabetes, it is necessary to introduce foods containing lipotropic factors (cottage cheese, soy, oatmeal, etc.) into the diet, as well as limit meat and fish broths and fried foods in the diet.

There are several options for diets for diabetics, but almost at home, you can use one (diet No. 9), which can be easily adapted to the treatment of any patient, excluding or adding certain dishes and products. It is allowed to include in the diet: bread and bakery products - mainly black bread (200-300-350 g per day - as directed by the doctor); soups - on vegetable broth; on a weak meat and fish broth with a small amount of vegetables 1-2 times a week; meat and poultry dishes - from beef, veal, lean pork, poultry, rabbit in boiled and aspic form; fish dishes - mainly from lean fish (perch, cod, pike, navaga, carp, etc.), boiled and aspic (up to 150 g per day); fish can be replaced with meat in a ratio of 1.5: 1; dishes and side dishes from leafy green vegetables - from white cabbage, cauliflower, lettuce, swede, radish, cucumbers, zucchini, potatoes, beets, carrots in boiled, raw and baked form; dishes and side dishes from cereals, legumes and pasta - in limited quantities, occasionally, while reducing the amount of bread in the diet; egg dishes - no more than 2 pcs. per day in the form of an omelette or soft-boiled, as well as for adding to other dishes; sweet dishes, sugar, fruits and berries - sugar with a doctor's permission, sour and sweet and sour varieties of fruits and berries (apples - Antonov, lemons, oranges, red currants, cranberries, etc. - up to 200 g per day), raw , in the form of compotes on xylitol or sorbitol; with the permission of the doctor, you can use sweet dishes and specially prepared diabetic products; milk, dairy products and dishes from them - milk with the permission of a doctor, kefir, yogurt (only 1-2 glasses per day), cottage cheese (50-200 g per day) in its natural form or in the form of cottage cheese, cheesecakes and puddings; cheese, sour cream, cream in limited quantities; sauces and spices - mild sauces based on vegetable broth with vinegar, tomato puree, roots, as well as dairy; appetizers - salads, vinaigrettes, low-fat fish (100 g); drinks - tea with milk, weak coffee, tomato juice, fruit and berry juices from berries and fruits of acidic varieties (total liquids along with soup, milk, yogurt, compote, drinks - up to 5 glasses a day); fats - butter, vegetable oil (only 40 g per day - in free form and for cooking). The food of a diabetic patient should be rich in vitamins, therefore it is useful to introduce vitamin carriers into food: baker's yeast, beer yeast, rosehip broth, etc.

The following foods and dishes are prohibited: sweets, chocolate, confectionery, muffins, jam, honey, ice cream and other sweets; sugar is allowed only in a small amount with the permission of a doctor; lamb and pork fat; spicy, spicy, smoked and salty snacks and dishes, pepper, mustard; alcoholic drinks; grapes, bananas, raisins.

Approximate one-day diet menu number 9
For the whole day: wheat bread 150 g, rye bread 250 g.
First breakfast (before work): buckwheat porridge (40 g of cereals, 5 g of butter); meat pate - 60 g; xylitol milk tea, bread, butter.
Second breakfast (at lunchtime): cottage cheese - 100 g; 1 glass of kefir, bread, butter, tea.
Lunch (after work): vegetable soup (50 g potatoes, 100 g cabbage, 25 g carrots, 20 g tomatoes, 10 g sour cream, 5 g butter); boiled meat with potatoes (100 g of meat, 150 g of potatoes, 5 g of butter); apple - 200 g.
Dinner: carrot zrazy with cottage cheese (75 g carrots, 50 g cottage cheese, 1 egg, 10 g sour cream, 8 g semolina, 100 g crackers); boiled fish with cabbage (100 g of fish, 10 g of vegetable oil, 150 g of cabbage), tea.
Before going to bed: kefir - 1 glass.

Diet therapy for patients receiving insulin

Particular attention should be paid to the diet of patients receiving insulin. In the domestic reference literature on dietetics, diet No. 9b was previously recommended for such patients.

The chemical composition of diet No. 9b: proteins - 100 g, fats - 80-100 g, carbohydrates - 400-450 g, energy value 2700-3100 kcal kcal.

If we compare the chemical composition of this diet with the norms of the physiological need for nutrients and energy (Appendix 2), it will be clear that it is excessive for almost all women, as well as for men engaged in mental work. This once again proves the need for individualization of nutrition of patients. The same foods and dishes are allowed on diet No. 9b as on diet No. 9. Instead of sugar, various sweeteners are used, but every patient receiving insulin should have sugar with them to stop possible hypoglycemia.

Currently, in healthcare facilities, patients with diabetes are advised to use a diet with a high protein content (high-protein diet) during insulin treatment.

Brief description: a diet with a high protein content, a normal amount of fats, complex carbohydrates and a restriction of easily digestible carbohydrates. Refined carbohydrates (sugar) are excluded. Salt is limited (6-8 g / day), chemical and mechanical irritants of the stomach and biliary tract. Dishes are cooked in boiled, stewed, baked, steamed, mashed and non-mashed.

Temperature of hot dishes - no more than 60-65°С, cold dishes - not lower than 15°С. Free liquid - 1.5-2 liters. Diet - 4-6 times a day.

Chemical composition: proteins - 110-120 g (animals - 45-50 g), fats 80-90 g (vegetable - 30 g), carbohydrates - 250-330 g (simple - 30-40 g), energy value: 2080- 2690 kcal.

Note that not all patients on insulin treatment have such a high protein requirement. Such a diet is more suitable for patients with infectious complications and diabetic nephropathy with nephrotic syndrome.

On an outpatient basis, patients receiving short-acting and intermediate-acting insulin must strictly adhere to two rules:

1. The amount of foods rich in carbohydrates should be constant from day to day. In order to diversify the carbohydrate part of the diet, you can use the carbohydrate interchangeability table.

2. These products must be properly distributed throughout the day in accordance with the action curve of the insulin used.

Failure to comply with the rules can lead to hypo- or hyperglycemia. Consider the nutritional patterns of patients receiving different types of insulin in terms of duration of action:

a) regular insulin

8.00 - protein breakfast (egg, cottage cheese, meat), insulin injection
9.00 - carbohydrates (porridge or potatoes)
11.30 - carbohydrates (bread)
14.00 - lunch without bread
17.00 - insulin injection
18.00 - carbohydrates (porridge or potatoes)
20.30 - carbohydrates (bread)

As can be seen from the diagram, before the first injection of insulin, the patient is given a small protein breakfast to avoid hypoglycemia by the end of the first hour of the drug.

b) insulin with a duration of action up to 24 hours

8.00 - insulin injection
9.00 - carbohydrates
11.30 - carbohydrates
14.00 - carbohydrates
18.00 - carbohydrates
22.30-23.00 - carbohydrates

Here, a nutritional feature is the provision of carbohydrates (usually bread) before bedtime to prevent nocturnal hypoglycemia.

c) insulin with a duration of action of 30-36 hours

7.00 carbohydrates
8.00 insulin injection
9.00 carbohydrates
11.30 carbohydrates
14.00 carbohydrates
18.00 carbohydrates
22.30-23.00 carbohydrates

In this scheme, in contrast to the previous one, carbohydrates are provided early in the morning immediately after getting up before the administration of insulin in order to avoid morning hypoglycemia.

With the threat of diabetic coma, the amount of fat in the diet is limited to 30 g, and proteins - up to 50 g, since ketone bodies can be synthesized from fats and ketogenic amino acids in the body. The amount of carbohydrates in this case is 300 g, mainly due to easily digestible ones. During this period, the patient is allowed foods and dishes that were prohibited in everyday nutrition (sugar, jam, semolina and rice porridge, etc.) due to the antiketogenic effect of carbohydrates. In precome, only carbohydrate foods are recommended, fats and proteins are completely excluded.

On the first day after the elimination of the diabetic coma and the use of rehydration, detoxification and hypoglycemic therapy, alkaline mineral waters, potassium-rich vegetable and fruit juices, compotes, kissels are indicated. From the second day, they give vegetables and fruits in a pureed form (potato, carrot, apple puree), crackers, pureed soups, semolina, rice and oatmeal, kefir. From the 5th day, protein dishes are included in the diet: cottage cheese, boiled fish, protein omelet, minced meat and chicken, and only from the 10th day are free fats (butter and vegetable oil) introduced into the diet.

Feeling good with high glycemia is a deceptive symptom. Feeling good readaptation to lower glucose levels occurs in 1-2 weeks. Therefore, it is necessary to constantly strive for these lower rates.

Abrupt transitions to normoglycemia, especially in decompensated diabetic patients with complications, are usually not achieved due to the possibility of irreversible consequences (loss of visual acuity, cardiovascular complications). It is necessary to achieve compensation in such patients very gradually.

Even more stringent should be the indicators of glycemia in pregnant women with diabetes and in women with diabetes and about to become a mother. Normoglycemia should be throughout pregnancy and for 3 months before conception. In this case, the risk of complications for the mother and child is sharply reduced, perinatal morbidity and mortality are reduced.

The exact volume of physical activity in diabetes has not been determined, but it is known that they normalize metabolic processes and thereby increase sensitivity to endogenous and administered insulin, that is, reduce insulin resistance. Large physical activity or skipping meals can lead to the development of hypoglycemia. Occasional physical activity requires an additional carbohydrate intake of 10-15 g every 30-45 minutes during additional exercise or a reduction in insulin dose with or without additional food intake.

Intensified insulin therapy is more physiological, but in practice it is feasible only with regular self-monitoring and daily appropriate adaptation of the insulin dose, depending on the results of sugar determinations.

Any treatment makes sense only when, along with the lengthening of life expectancy, its quality also improves. Most patients are unable to maintain the regimen that they are usually prescribed. The task of the doctor is to teach the patient to help himself. Education is the basis of the treatment of patients with diabetes mellitus. In contrast to patients with type II diabetes, the main treatment for patients with type I diabetes is not diet, but injections of a certain dose of insulin. Therefore, it is advisable to give them dietary restrictions only when their insulin replacement therapy is far from physiological insulin secretion. Proper training allows the patient, depending on physical activity, performance, to vary food intake and insulin administration, to weaken strict dietary recommendations ("liberalized diet").

Prevention of diabetes

Reduce body weight by 5% or more, reduce fat intake to 30% or less of daily calories, reduce saturated fat to 10% or less of daily calories, increase dietary fiber intake, and increase daily moderate-intensity exercise to 30 minutes or more suggests that lifestyle changes in high-risk patients can prevent the development of type II diabetes by more than 2 times.

Clinical studies have shown that recommendations from specially trained consultants and therapy aimed at correcting dyslipidemia and controlling arterial hypertension significantly reduce the risk of adverse cardiovascular outcomes in patients with diabetes, as well as reduce the development of depression and neurocognitive changes in them. The results showed that the use of these regimens and the relatively small assistance of consultants provide improved glycemic control.

In our previous article, we told readers about:. The topic of our conversation today: proper nutrition in diabetes and the diet of a diabetic patient.

Probably, there is no such disease that would not impose certain restrictions on the patient in the diet. Diabetes is no exception. Moreover, the diet for diabetics becomes an independent remedy.

For example, in type 2 diabetes mellitus (in the initial stages of the disease), a stable remission can be achieved with the help of diet therapy alone, without resorting to hypoglycemic drugs or insulin.

Diabetes mellitus: treatment with diet

The main tasks of dietary nutrition:

normalization of carbohydrate and fat metabolism;
maintaining normal blood sugar levels;
weight stabilization;
protection of the pancreas;
you need to eat regularly, at least 4 times a day (preferably 5-6 times), preferably at regular intervals, in small portions;
limit the amount of carbohydrates and fats, especially animals;
increase the content of vegetables and fiber in the diet;
be sure to include dairy products in the menu that stimulate the pancreas;
exclude fried and smoked dishes from the diet, replacing them with boiled, steamed or baked in foil.

Type 1 diabetes diet

Type 1 diabetes (DM-1, insulin-dependent) suggests that the amount of carbohydrates consumed must strictly correspond to the dose of insulin necessary for their safe assimilation. In order for the patient to be able to navigate the calculations, the concept of "bread unit" was introduced.

One bread unit raises blood sugar levels by a certain amount (2.8 mmol / l) and contains the amount of carbohydrates that require 2 units of insulin (approximately 12 - 15 g) to be absorbed.

The diet of a patient with diabetes mellitus is selected based on this formula and against the background of careful control of the ratio of food intake and insulin administered.

Nutritionists-endocrinologists have developed special tables to help determine the number of bread units in a particular product. So, for example, one bread unit will correspond to:

25 - 30 g of bread;
1/2 cup porridge (buckwheat, barley, etc.);
1 pancake;
1 cheesecake;
half a banana;
1 medium sized potato;
1/2 cup fruit juice;
1 cup boiled beets, grated on a coarse grater;
1 ear of corn;
1 cup fresh turnip, grated on a coarse grater;
1 cup strawberries, etc.

It is easy to see that the range of food acceptable for consumption in diabetes mellitus is quite wide and allows the patient to eat varied and tasty. A table with a complete list of products in terms of bread units should be provided to the patient by a doctor.

Diabetes Mellitus: Diet for Type 2

Type 2 diabetes mellitus (DM-2) is not insulin dependent, so the observance of "bread units" in the diet is not so important. If the patient does without insulin, the requirements for his clinical nutrition are even more flexible.

In this case, a person needs to thoroughly learn two lists: allowed (recommended) and prohibited (undesirable) products.

So, with type 2 diabetes, it is recommended to use

Vegetable and mushroom soups;
Wheat bran;
Milk and sour-milk products with low fat content, necessarily cottage cheese, both fresh and in the form of cheesecakes, casseroles, etc.;
Eggs (no more than 1 - 2 per day);
Kashi: buckwheat, oatmeal, wheat, barley;
Low-carb vegetables: cabbage, tomatoes, eggplant, pumpkin, zucchini, cucumbers, lettuce;
Sweet and sour fruits and berries: green apples, grapefruits, lemons, pomegranates, lingonberries, raspberries, strawberries, blueberries, cranberries and others;
Butter, ghee, vegetable oil - use very limited, no more than 40 g of total fat per day (including fat contained in various dishes).
Bread: preferably black, coarse, no more than 300 g per day; if you have stomach problems, you can eat dried white bread.
Drinks: vegetable juices, green tea, rosehip broth, coffee with milk (without sugar), mineral water;
Dark chocolate in very small quantities, rarely;
Natural honey with care, rarely and in small quantities;
Sugar should be replaced with xylitol, sorbitol, fructose or saccharin.

What foods can not be eaten with diabetes?

Avoid or at least severely limit:

Confectionery with a high sugar content, muffins, puff pastry, fresh white bread;
Sweet curd products (cheese, mass, etc.);
semolina porridge;
Fatty meat broths;
Smoked products;
Canned food in oil;
Spicy, salty, spicy sauces and condiments;
Cooking oil, margarine, fatty sour cream;
Fatty varieties of fish, caviar;
Sweet fruits and dried fruits: grapes, bananas, dates, raisins, figs, etc.
Banned drinks: sugary juices, sodas with sweet fillings, soft drinks.

Specialists have developed numerous nutrition systems used for various diseases. They exist under numbers: for example, table number 1, table number 2, etc.

Treatment of diabetes is impossible without diet number 9. Here is an approximate daily menu based on this diet.

Breakfast

Buckwheat porridge, milk, fat-free cottage cheese, green tea or coffee.

2nd breakfast

Decoction of wheat bran.

Dinner

Fresh cabbage soup, boiled meat, stewed carrots, rosehip broth.

afternoon tea

Green apples.