Diabetes – 6 Steps to Healthier Eating

How choosing the right food can help you manage your diabetes

If you have diabetes, you have too much glucose (a type of sugar) in your blood. If your blood glucose levels remain high for too long, it can have serious health consequences. However, managing your diabetes carefully can help you live a full, healthy and active life. Whatever type of diabetes you have, enjoying a healthy diet is the cornerstone to managing it well.

Food, glucose and insulin

Glucose is found in carbohydrate foods, such as grains, legumes, milk and yoghurt, fruit, sugary foods and starchy vegetables. During digestion, glucose reaches your small intestine where it passes into your bloodstream. One of the functions of your blood is to carry glucose around your body. When glucose reaches body tissues, such as muscle cells, it moves into the cells, where it’s broken down to provide energy.

The glucose concentration in your blood is automatically regulated by a number of hormones. This includes insulin, which is needed to move glucose from the blood into the cells. Insulin is produced by your pancreas – a gland found behind your stomach – from where it enters your blood.

Both type 1 and type 2 diabetes result in too much glucose building up in your blood. But they have different causes. Let’s look at their differences,

Type 1 diabetes is an autoimmune condition where your pancreas loses the ability to produce insulin, so glucose is unable to move into your cells.

With Type 2 diabetes, your cells gradually become resistant to the action of insulin. Your pancreas then needs to produce more and more insulin to manage your blood glucose levels. Eventually it may not be able to produce enough insulin, so your blood glucose levels continue to rise.

You may experience symptoms of diabetes, such as excessive thirst and passing urine a lot. And over time, increased blood glucose levels can cause irreversible problems to the delicate blood vessels and nerve fibres, which can lead to complications such as loss of eyesight, kidney failure, damage to the blood vessels of the heart, and nerve damage in your hands and feet.

The aim of diabetes management is to lower the risk of long-term complications and reduce the impact of symptoms on your day-to-day life by keeping your blood glucose levels within the range that’s recommended for you.

Your credentialed Diabetes Educator and Accredited Practising Dietitian (APD) can give you advice on lifestyle changes to help you maintain the blood glucose level that’s right for you.

Simple healthy eating habits for people with diabetes

Whichever type of diabetes you have, here are six simple healthy eating changes that can make a substantial positive impact on your short-term and long-term health.

1. Switch to healthier fats

Diabetes increases your risk of cardiovascular disease, so it’s important to do what you can to keep your heart healthy. All fats are rich in kilojoules, but too much of the saturated kind can lead to increased cholesterol levels. This can contribute to a build-up of fatty deposits (plaque) in your arteries and lead to heart attack and stroke.

Excess fats of any type can also lead to weight gain. Being an unhealthy weight can make your cells less sensitive to insulin. Trying to stay within your healthy weight range is important for your diabetes management.

Eating less fat overall and switching to healthier mono-unsaturated and poly-unsaturated fats most of the time can help to manage your weight. This also helps keep your blood glucose levels in your healthy range.

Some simple swaps include:

EAT LESS	REPLACE WITH
Full-fat dairy foods	Low-fat dairy foods
Fatty, processed meats such as sausages and salami	Lean meat and skinless poultry, tofu, legumes (beans and lentils), white and oily fish (see below)
Ready-made meals and takeaways which can be high in fat and salt	Home-cooked meals using fresh low-fat and low- salt ingredients, flavoured with herbs, spices, and citrus juices.
High-fat snacks which may be high in sugar or salt, such as biscuits, cakes, pastries, chocolate and potato chips	Avocados, unsalted nuts (such as walnuts, macadamias, almonds and hazelnuts) and seeds such as sunflower and pumpkin

2. Focus on fish

The essential fatty acids found in fish, the omega-3 fats, are especially important for good health.
Omega-3 fats can help keep your heart and blood vessels healthy, reduce blood pressure and may even be able to boost your mood.

Aim to eat two portions of fish a week. Of these, at least one should be oily fish such as mackerel, rainbow trout, salmon or sardines. The Heart Foundation recommends a daily intake of around 250-500mg of omega-3, which can be obtained by eating two to three 150g portions of oily fish per week.

If you don’t eat seafood, omega-3 fats are also found in walnuts, canola oil, flaxseeds, chia seeds, soy products and omega-3-enriched eggs.

3. Go low GI

Eating carbohydrate-rich foods will result in your blood glucose levels rising, but that doesn’t mean you have to avoid them. The Glycaemic Index (GI) is a system that measures how quickly a particular carbohydrate-containing food will trigger a rise in blood glucose levels. The lower the GI number, the slower the carbohydrates in the food break down during digestion and the slower the release of glucose into your bloodstream. This means you’re more likely to maintain stable blood glucose levels.

Low-GI foods may also help you feel full for longer and increase your body’s sensitivity to insulin.

Each carbohydrate-containing food is given a GI ranking number between zero and 100:

• Low GI = 55 and under
• Medium GI = 56-69
• High GI = 70 and above

Choose mostly foods with low or medium GI, such as oats, muesli, dense, grainy breads, beans and lentils. Yoghurt and milk also count as low-GI foods.

You’ll often find the ‘low GI’ symbol on packaged foods which can help guide your shopping choices.

It’s important for people with diabetes to not eat high-GI foods too often and particularly to not eat a large number of high-GI foods in one go. Low GI foods help to slow down the absorption of an entire meal, including any higher GI foods, reducing the likelihood of fluctuations in blood glucose levels. So if you enjoy an occasional treat, have it in small portions as a part of a healthy meal of mostly low-GI foods.

A simple guide to switching to low/medium-GI foods:

EAT LESS	High-sugar breakfast cereals
White bread and white flour-based foods	High-fibre, low-sugar breakfast cereals such as those made with whole grains, nuts and seeds, and bran-based ones
High sugar breakfast cereals	Baked potato with skin, unpeeled boiled Nicola or Carisma potato, sweet potato.
Mashed potato	Whole fruits such as apples, pears, grapefruits, peaches, plums, oranges, cherries, and firm bananas. Though take note of the sugar content in the fruit if you have diabetes. Vegetables – fill half of your plate with veggies and aim to opt for different colours for a wider range of nutrients
White rice	Basmati rice, Doongara rice, pasta, noodles (not instant), bulgur (cracked wheat), freekeh, quinoa, barley
Fruit juices	Whole fruits such as apples, pears, grapefruits, peaches, plums, oranges, cherries, and firm bananas. Though take note of sugar content in the fruit, if you have diabetes. Vegetables – fill half of your plate with veggies and aim to opt for different colours for a wider range of nutrients

4. Love those legumes

Make legumes (also called pulses) a part of your diet by adding them to soups, salads, casseroles and curries. Legumes such as lentils, kidney beans, haricot beans, black-eye peas, black beans, chickpeas, butter beans, and low-salt baked beans contain soluble fibre, which dissolves in water to form a thick gel in your intestines, helping to lower blood cholesterol levels and slow digestion. They also contain a wide variety of nutrients and are a good source of protein.

Take note that legumes do contain carbohydrates (although they are low GI), and not everyone’s blood glucose levels respond to carbohydrate foods in the same way. It’s important to monitor how your glucose levels respond to different foods. This is especially important if you use insulin or take medicines. Your credentialed Diabetes Specialist or Diabetes Educator can teach you how to check your blood glucose levels.

5. Limit alcohol intake

Alcohol is high in kilojoules (energy), and alcoholic cocktails and pre-mixed drinks can be high in sugar. This means drinking alcohol can raise your blood glucose levels. However, drinking a lot of alcohol can also lead to hypoglycaemia (where your blood glucose levels dip dangerously low) if you are using
insulin or taking certain diabetes medicines.

Avoid drinking alcohol soon after exercising. During exercise, glucose is absorbed by cells in the exercising muscles, so drinking alcohol afterwards could lower your blood glucose levels further.

Alcohol can also make it more difficult to maintain a healthy weight, as it adds kilojoules to your energy intake and can stimulate your appetite.

The Australian guidelines to reduce health risks from drinking alcohol recommend that adults should drink no more than ten standard drinks a week and no more than four on any one day.

Examples of a standard drink include:

♦ 375 ml of mid-strength beer (3.5% alcohol volume); or
♦ 100 ml of red wine (13.5% alcohol); or
♦ 30 ml of spirits (40% alcohol).

If you do choose to drink, keep to the recommended limits, avoid sweet wines and beers, and choose sugar-free mixers.

6. Don’t skip meals without medical

Intermittent fasting and skipping meals are currently popular methods of losing weight, but they may not be suitable if you have diabetes. Some people can experience a drop in blood glucose levels at night, so it’s important to refuel with breakfast in the morning.

Ideally, your breakfast should include a mix of low-GI carbohydrates, lean protein and fibre. Ideas you could try include a boiled egg with wholegrain toast, muesli or porridge made with traditional oats with fresh or dried fruits, natural yoghurt, and a handful of almonds or walnuts, or low-salt baked beans with sourdough toast followed by a piece of fresh fruit.

Always talk to your doctor or credentialed Diabetes Educator before starting an intermittent fasting weight loss program.

For further information visit Diabetes Australia at www.diabetesaustralia.com.au