Diabetes

The different types of Diabetes Mellitus

Type 1 : Insulin dependant diabetes mellitus
This often happens in young children, but can also develop later in life. Type 1 Diabetes Mellitus (DM) patients require insulin injections to control their blood glucose levels, because their pancreas are unable to manufacture insulin.

Type 2 : Non-Insulin dependant diabetes mellitus

This occurs most frequently in older people, but there have been cases where children developed Type 2 DM. The pancreas do produce insulin, but not always at the right time or not enough, to control blood glucose levels. Type 2 diabetics require medication to help their pancreas to produce enough insulin and also to help the body use the insulin and glucose more effectively.

Diabetics can live a normal life but need to control their blood glucose levels.

What can be considered as 'good blood glucose levels'?

Before a meal (Fasting) 4 to 6 mmol/l
Two to three hours after a meal less than 8.1 mmol/l
HbA1C (Glycosylated haemoglobin) less than 7%

What do diabetics have to do to control their blood glucose levels

  1. Take the right medication. Your physician will prescribe the right medication for you
  2. Eat the right food to ensure optimal control. This is where the dietician plays a vitally important role
  3. Stay active. Do regular exercise and maintain an exercise routine. Consider seeing a biokenetisist to obtain the best exercise plan for you.

More about eating the right food

1. Low Glycemic index food(GI)

 The glycaemic index (GI) of food is a ranking of carbohydrate food based on their immediate effect on blood glucose levels. Carbohydrate foods include fruit, vegetables and starch. The glycaemic index of pure glucose is 100 and every other food is ranked on a scale from 0 - 100 according to its actual effect on the blood sugar levels.

Carbohydrate foods that break down quickly during digestion have the highest GI (> 70). The blood sugar response is fast and high. In other words the glucose (sugar) in the bloodstream increases rapidly. This is also associated with higher insulin levels and can increase insulin resistance, which can have detrimental effects on your health. Carbohydrates that are broken down slowly, releasing sugar gradually into the blood stream, have a low GI value (0 - 55). Low GI foods are associated with lower insulin levels, which makes fat easier to burn and less likely to be stored.

Intermediate GI foods (56-69) are broken down slower than high GI foods but should still be eaten in conjunction with low GI foods to minimize their effect. This ensures better blood glucose control.

2. Eat regular meals

You can eat three regular meals or 6 smaller meals every day. If you skip just one meal your blood glucose levels will not be in control. Because the body expects more glucose that it is not getting from the missing meal, it will use some of the glucose stores from the liver. This upsets your efforts to control the levels. This is an unwanted situation and should be avoided.

3. Eat low fat foods

 

  • Choose low fat or fat free dairy products.
  • Cut off all visible fat before preparing meat
  • Grill or roast rather than fry
  • Use olive or Canola oil
  • Use salad dressings and mayonnaise sparingly
  • Include 'healthy' fats (including mono-unsaturated fats and omega 3 fatty acids) like : olive oil, canola oil, sardines, pilchards, salmon, tuna.

4. Eat high fibre foods

Low GI food generally contains high amounts of fibre. When eating fibre rich foods, your blood glucose levels will be in better control, because fibre is digested slowly.

5. Lose weight if necessary

Your body mass index (BMI) can be calculated as shown by this equation:

  BMI = weight [kg] / Height2[m2]

=> ie. Someone weighing 63kg who is 1.65m tall will have a BMI of 63/(1.65x1.65)=23.7

Ideal BMI 18-24.9
Overweight 25 to 29.9
Obese over 30

Another measure to indicate your risk of developing heart disease is your waist circumference:
Men should have a waist circumference of less than 102cm
Women should have a waist circumference of less than 88cm

If you are larger than these guidelines, you have a significantly greater risk to develop heart disease.

Dining out with diabetes

Remember these are only guidelines, it is up to you to make sure that the portion sizes, and the items you choose from the menu, are appropriate. Healthy food choices are not hard to find. These guidelines will help you when making your selection from the menu's. Most restaurants and hotels offer a wide selection of food to allow the diabetic to choose a meal to comply with the diet planned. Meals do not have to be dull and uninteresting; just a few simple changes to the menu can make a delicious meal to meet your requirements. Keep a "list" of restaurants you have found that offers a wide variety of foods and are also very accommodating with special requests. Restaurants, as with any business, like to offer customers what they want. Know your meal plan, this will form a guide for you to follow when choosing your meal. Try wherever possible to eat within 2 hours of your normal eating time.

Useful tips

  • Avoid fatty and creamy sauces.
  • Fill up on low GI carbohydrate, low energy starters (e.g. Green salad, clear soups, grilled mushrooms).
  • Select generous portions of vegetables.
  • Avoid Italian foods that have cream sauces. If you choose Italian foods then rather choose foods that have a tomato base.
  • If you are dining and dancing, you will use up more energy, this may lower your blood sugar.
  • Some places allow you to order smaller portions.
  • Salads, fish, chicken and vegetables, bakes or boiled foods and whole-wheat breads are items found on almost every menu.
  • Ask for the added butter, sour cream, gravies and sauces to be served on the side - this then allow you to add only the amount that has been planned for you.
  • Avoid crumbed food e.g. chicken schnitzel.
  • Be creative - ask to use cottage cheese over baked potato, instead of butter.

Contact

The practice:

21 Highland avenue
Bryanston, Johannesburg

 

Office  073 179 4907

 

NutritionWeek 2016 link