Diet for diabetics, allowed and prohibited foods. Diet for a diabetic, allowed and prohibited foods Cereals and pasta

A diabetic must be smart

Life with a glucometer

Humanity has achieved tremendous success in ensuring its own comfort, and this has played a cruel joke on it. At any time of the day or night, without leaving your place, you can get ready-made food: tasty, filling, fatty, sweet. Overeating has become the easiest thing in life.

When you sit well-fed and a little sleepy from physical inactivity, you somehow don’t think about illnesses. Many people get stuck in this trap of simple pleasures, but not everyone gets out on time, that is, without paying with their health...

Are you afraid of diabetes? Diabetes is a daily life for millions of people, and the future for even more.

” From a WHO fact sheet: “The number of people with diabetes increased from 108 million in 1980 to 422 million in 2014. … The overall risk of death among people with diabetes is at least twice the risk of death among people of the same age who do not have diabetes.”

Why does type 2 diabetes occur?

How insulin works: “key-lock”

Type 2 diabetes mellitus, formerly called adult-onset diabetes ( and now children get it too) is associated with impaired insulin receptor sensitivity.

” Normally, in response to the intake of carbohydrate foods, the pancreas releases insulin, which binds to tissue receptors like a key, opening the door for glucose so that sugars can nourish the body.

With age ( either due to diseases or due to genetics) receptors become less sensitive to insulin - the “locks” break. Glucose remains in the blood, and organs suffer from its deficiency. At the same time, “high sugar” primarily damages small vessels, which means blood vessels, nerves, kidneys and eye tissues.

Strike at the insulin factory

However, failure of the key-lock mechanism is only one cause of type 2 diabetes. The second reason is a decrease in the production of insulin itself in the body.

” Our pancreas “plows” two jobs: it provides enzymes for digestion, and special areas produce hormones, including insulin. The pancreas is involved in any pathological process of the gastrointestinal tract, and every active inflammation ends with sclerosis - the replacement of active tissues (that is, doing something) with simple connective tissue. These coarse fibers are not capable of producing either enzymes or hormones. Therefore, insulin production decreases with age.

By the way, even the healthiest gland cannot provide enough insulin for a modern high-carbohydrate diet. But she tries very hard, so before the last link of defense breaks down, a healthy person’s sugar is regulated within very strict limits, and fluctuations outside the norm never happen, no matter what we do: we even ate cakes with soda. If sugar is beyond these limits, it means the system is irrevocably broken. That's why sometimes a doctor can diagnose diabetes with just one blood test - and not even necessarily taken on an empty stomach.

Life after being diagnosed with type II diabetes

The complexity and simplicity of the situation is that control over this disease lies with the person himself, and he can do something every hour for health or, on the contrary, to increase diabetes, or step back and forth, which, in fact, will lead to the second. All doctors are unanimous in their opinion: in type 2 diabetes, nutrition plays the first fiddle.

” There is a concept of “added sugar” - it is removed. This refers to all products and dishes during the preparation of which any amount of sugar is added at any stage. This is not only sweet pastries, desserts and jam, but also most sauces - tomato, mustard, soy sauce... Honey and all fruit juices are also prohibited.

In addition, the consumption of foods containing too much of their own sugars is strictly regulated - fruits, berries, cooked beets and carrots, vegetables and cereals containing a lot of starch, which also breaks down quite quickly into glucose and can cause an increase in blood sugar in a diabetic. And this includes potatoes, and white rice, and polished wheat and other refined cereals (and flour from them), and corn, and sago. The remaining carbohydrates (complex) are distributed evenly among meals throughout the day, in small quantities.

But in real life this scheme doesn’t work well. Carbohydrates are everywhere! Almost all patients overeat; for some, even medications do not help keep their sugar levels normal. Even when fasting sugar is almost like that of a healthy person, eating carbohydrate foods causes significant fluctuations in blood glucose levels in a diabetic during the day, which will inevitably lead to complications.

Diabetic nutrition: my experience

I thought a lot, read literature and decided that I would stick to a low-carb diet. In reality, of course, there are nuances, especially in the summer. But I eliminated starchy foods and grains completely (simple sugars, naturally, first of all). The most difficult thing was to remove the fruit; it was not possible to do it completely. I left starchy ingredients in small quantities, for example, one potato per pot of soup (not daily). I also occasionally ate small amounts of dishes with carrots and beets after heat treatment (they are not recommended for diabetes, as they can significantly increase sugar levels).

The diet consists of protein at almost every meal, this all types of meat, fish, eggs. Plus non-starchy vegetables: any cabbage, green beans, zucchini, eggplant, bell peppers, tomatoes, cucumbers, raw carrots, avocado, onions and garlic in small quantities. To this are added fat-containing foods: oils, dairy products, lard.

” Oils and lard do not contain carbohydrates, but for dairy products there is a rule: the fattier the product, the less carbohydrates it contains. Therefore, skim milk and cottage cheese, low-fat cheese are a bad choice for a diabetic.

And here hard cheese, produced in a standard way, ripened, contains no carbohydrates at all. Besides this you can eat most nuts and seeds.

Fruits There is no place for low-carb eating, but then my resolve broke. If sugar becomes difficult to control, they will be the next food group I eliminate. In the meantime, I distribute them evenly throughout the day and eat in small quantities (two or three strawberries/cherries at one time, or a small nectarine, or one plum...) If there was starch in the food, the fruit is then excluded.

In terms of volume, I try to eat little, I don’t overeat protein and I don’t try to reach an amount close to the low-carbohydrate diets of bodybuilders - I value my kidneys. By the way, they began to work better on my current diet.

” Another change from last summer - after a couple of weeks of giving up sugar, my headaches, which had been very annoying over the last year, tormented me almost every day, went away. Over the summer I had a headache several times! Increases in blood pressure have become rare. Chronic nasal congestion disappeared (which they like to explain by the presence of dairy products in the diet) and, quite naturally, weight began to decrease.

My appetite also subsided. Contrary to the belief that without complex starchy carbohydrates you become angry and always hungry, this did not happen to me. All moments of increased appetite were clearly connected... with carbohydrates! An extra couple of cherries, an extra piece of bread, an apricot - and hello, old friend - the desire to “chew something” and the feeling “somehow I’m not full.”

There is also a minus - I often feel lethargic and drowsy, especially in the first half of the day. But I’m not sure that the reason for this is the lack of a traditional source of energy - cereals and grains, because I conducted an experiment and tried to eat a piece of bread / a few pasta / half a potato. Alas, my strength and vigor did not increase even an ounce.

” Of course, I couldn’t do without looking for a replacement for bread. After going to the store for alternative flours, the kitchen became more crowded due to Kraft bags of all sizes and colors. After studying them, I learned that flaxseed is one of the lowest carbohydrates.

There is also nut flour, but it is both expensive and very fatty. You can bake “buns” from eggs and vinegar alone, but you already end up with a lot of eggs in your diet. After testing, I decided on flax bread - a tasty and convenient replacement for traditional bread. Diabetics are recommended to add fiber to their food - it slows down the absorption of carbohydrates and increases the feeling of fullness. And, despite the fact that bran, the simplest fiber, is also a carbohydrate, its benefits are greater than the load on the insular apparatus. Therefore, all baked goods contain bran; any bran can be used; the most common are wheat, rye and oat bran. I also add flax seed wherever possible - it provides fiber, healthy fat, and prevents problems with stool.

” The other day a parcel arrived with psyllium - fiber from the shells of flea plantain seeds. They say that it is very useful in baking and with its help you can build something like a real loaf from low-carb flour (low-carb flour lacks gluten, and the texture of the bread is crumbly, it is difficult to cut, psyllium should correct this issue). I will try!

Sweet life without sugar

After the first few weeks of strict nutrition, the fear subsided, and the desire to drink tea with more than just a piece of cheese timidly peeked around the corner. How can you intelligently sweeten the life of a diabetic?

Immediately discard the old chemical sweeteners: aspartame, sodium cyclamate and saccharin. The harm from their use is a proven fact; if you see them in products, then put them back on the store shelf and pass by.

Next come the once famous fructose, xylitol and sorbitol. Fructose is not the best option, although most manufacturers continue to produce confectionery products for diabetics with it. Unfortunately, most of the fructose eaten will be converted into glucose in the intestines, and the rest in the liver. In addition, there are studies showing the negative role of fructose in the formation of abdominal obesity (the most dangerous type for health, when fat envelops the entire abdominal cavity) and fatty hepatosis (popularly “fatty liver”) - a condition that complicates the work of this important organ. Therefore, a diabetic may experience an increase in blood sugar after fructose, and other unpleasant consequences will also affect healthy people. Plus fructose is a pure sweet taste, as close as possible to the taste of sugar.

Xylitol and sorbitol They haven’t discredited themselves too much over the years of use, but they have a laxative effect, and this has to be taken into account.

The sweetener stands apart isomaltite, synthesized a long time ago, but retaining its reputation.

Relatively new and at the top of popularity among adherents of proper nutrition erythritol, stevioside and sucralose so far they are swimming in a sea of ​​accolades, although some experts are skeptical and are waiting for a sufficient amount of research to accumulate on their real impact on health, which is only possible after a sufficient amount of time has passed. The only downside is the very peculiar taste, which not everyone can get used to.

And I went to the store for sweeteners... Kraft bags in the kitchen have replaced jars, jars and jars. But, alas, my taste buds were clearly expecting something else. Experiments on making different types of ice cream, truffles, brownies, and jelly failed miserably. I absolutely didn't like it. Moreover, in addition to the bitter taste and a nasty long sweet aftertaste, I felt something like poisoning and decided for myself that sweets should be pure pleasure. And if it has not become so, it should not be on the table or in the house.

Attempts to buy harmless sweets in a store will most likely end in failure for many reasons:

Almost 100% of manufacturers use premium white wheat flour, which raises sugar in diabetics almost faster than glucose itself. Replacing flour with rice or corn flour does not change the essence of the matter.

Almost everything is made with fructose, the harm from which I described above.

For some reason, a synonym for healthy is raisins/dried fruits/berries added in large quantities, and they contain an exorbitant amount even fresh, and even more so after removing the water. Yes, unlike sweets, there is fiber, but with such a glucose content it will not help, so you can add bran to sweets - and they will be equal.

Not all types of sweeteners are equally healthy - read the labels.

Manufacturers also do not disdain adding regular sugar, despite the labels “fructose” and “diabetic” - see above - read the labels.

From all the variety, I was able to choose for myself only chocolate with isomalt, I sometimes eat a small piece of it, it is not too disgusting.

A diabetic must be smart

Due to the growing demand for “healthy” products, many tempting offers have appeared on the Internet. But, in my opinion, these sellers have no advantages over regular stores. For example, jams and sauces are offered “only from healthy sources”, without fat and sugar, without GMOs and the dreaded “E”.

” A sauce like ketchup - boiled tomatoes plus additives, but no starch or sugar. The yield is 4 g of carbohydrates per 100 g of product. Meanwhile, fresh tomatoes contain 6 grams of carbohydrates, and tomato paste without any additives contains more than 20. For a diabetic, it matters whether there are 4 grams of carbohydrates in a product or, say, 30, and such carelessness in calculations kills faith in other promises.

Considered a fashionable and harmless sweet, Jerusalem artichoke syrup contains “inulin, which is beneficial for diabetics - that’s why it’s sweet.” Yes, but not so! The earthen pear contains the substance inulin, which many people trust because of its similarity to “insulin” in sound, but it is just a polysaccharide that has nothing to do with insulin or the regulation of diabetes, and it is sweet because it is converted in the body into fructose, and fructose - what? Yes, we’ve already learned everything!

There is only one way out: self-education and control over what you are going to put in your mouth. You definitely need to read the labels, no matter what sweet promises are written in large letters on the packaging. It is important to know that sugar and starch are hidden under many names. Dextrose is glucose, maltodextrin is modified starch. Molasses, molasses - all this is sugar. The words “natural” and “healthy” are not synonymous! Grocery stores and pharmacies are not your advisors or comrades here. You can choose the right product with the help of endocrinologists and good, literate literature.

Life with a glucometer

Thus, treatment begins with diet, continues with physical education (this is a topic for a separate discussion), and only in third place are pharmacological drugs. I would be lying if I said that I manage to follow all the rules of eating on one left, but it would also not be true that it is incredibly difficult and takes up all my time.

For convenience, I have two notebooks: a food diary ( I confess, after the first month I do not use it regularly) and a list of products and proven dishes from which I choose if I suddenly get into a stupor: “Ah-ah! Everything is impossible, there’s nothing to eat!” Here I also put pieces of paper with what I want to try and, if the test was successful, I add the recipe to the list.

” Ideally, it is worth testing all food with a glucometer for an individual reaction, because each person has personal digestive subtleties, and they also affect the sugar level after a particular dish. Then the list of what is permitted may expand or change. I'm going to do this before the New Year holidays.

They say that illness is not a punishment, but type 2 diabetes is exactly that. We, diabetics, have managed to break one of the main life support mechanisms, strong and a hundred times protected, and we pay for this with eternal self-restrictions in everyday life. It's a shame, but, in my opinion, very honest.

Diabetes is like the strictest trainer, you can ask him for an indulgence as much as you like for the holidays or because you feel unwell, but he will raise your sugar in response to the violation even on your birthday. But there is a real opportunity to finally understand that food is just food, there are incomparably more pleasures in life. The time has come to find beauty in all its other manifestations!

Photo by Anna Maslova

To prevent diseases from occurring, all systems of the human body must work correctly. Under certain conditions, failures occur that lead to deterioration of the condition. Type 2 diabetes mellitus is a disease of the endocrine system that causes a constant increase in glucose. This is due to impaired tissue susceptibility.

Type 2 diabetes - what is it?

The pancreas produces insulin and in the case of type 1 disease, its absolute decrease occurs (it is not produced at all). When type 2 diabetes develops, a relative deficiency of the hormone occurs. At first, the amount of insulin may be increased or normal, and then decrease sharply. The sensitivity of cells to sugar decreases, absorption does not occur in full, which is why excess volumes remain in the plasma.

Excess glucose is not excreted from the body and protein structures (nerve tissue, inner linings of blood vessels) crystallize, which reduces their functioning. This process is called glycation, and it becomes the main cause of further complications in type 2 diabetes. Impaired insulin sensitivity is observed more often in tissues due to genetic defects and obesity.

Next, gradual functional depletion of the pancreas occurs. At this stage, an insulin-requiring subtype develops, in which it is possible to reduce the amount of glucose only by administering insulin with a syringe as a medicine. There are risk factors that can cause the development of the disease:

1. Passive lifestyle.
2. Excess weight of the visceral type.
3. High pressure.
4. A large amount of refined carbohydrates in the diet (baked goods, chocolate, candies, waffles), a low content of plant foods (cereals, vegetables, fruits).
5. Ethnicity.
6. Genetic predisposition (presence of type 2 diabetes in relatives).

Nutrition for diabetes

One of the main stages of treatment for a diabetic is optimizing the diet. Food has a significant impact on the amount of glucose in the human body. Nutrition for diabetes is not associated with fasting; you need to stop eating flour, sweets and eat more vegetables and fruits, which contain the necessary vitamins. Every diabetic should adhere to the following rules regarding nutrition and food:

• if you are overweight, it should be normalized;
• there should be 6 proportional meals per day;
• reducing the amount of alcohol;
• reduce your intake of saturated fats;
• per day, the total calorie content should not be more than 1800 kcal;
• reducing the amount of salt;
• eat more foods with microelements and vitamins.

What can you eat

If you have to treat excess amounts of glucose in the blood, then you should remember what you can eat if you have diabetes. You will have to fight the disease all your life, for this reason, nutrition for type 2 diabetes becomes your main menu. It is better to stew, boil, steam or eat all dishes fresh. Below is a list of foods that should be included in your daily table:

• turkey, chicken, rabbit, beef (all low-fat varieties);
• berries, persimmons, kiwi and other fruits (only bananas and grapes are not allowed) in moderation;
• dairy products with fat content 0-1%;
• lean fish;
• all types of cereals, cereals, pasta can be eaten in moderation;
• skim cheese;
• bran, whole grain bread;
• any fresh vegetables, dark leafy greens are especially useful.

What not to eat

When you create a sample menu for a diet during treatment, you need to rely more on the list of what you cannot eat if you have diabetes. If the product you are looking for is not on the list, it means it can be consumed in moderation. According to the rules, the diet should contain a minimum of glucose or elements that load the liver, kidneys, and pancreas. The menu for type 2 diabetes should not include:

• fried, hot, salty, spicy, smoked dishes;
• pasta made from soft flours, rice, semolina;
• fatty, strong broths;
• heavy cream, sour cream, feta cheese, cheeses, sweet cheeses;
• sweet buns and other products that contain a lot of easily digestible carbohydrates;
• butter, margarine, mayonnaise, meat, cooking fats;
• sausages, sausages, smoked fish, sausages, fatty fish, poultry and meat.

Diet for type 2 diabetes

The patient will have to constantly monitor the amount of sugar in the blood; treatment implies that the diet for type 2 diabetes will be followed constantly. The most important restriction falls on everything sweet, baked and fried, because they seriously load the pancreas and liver. With proper treatment and nutrition, a person should not have problems with complications from the disease. A diet for type 2 diabetics might look something like this:

1. Breakfast: whole grain bread, tea, egg, oatmeal.
2. Second breakfast: berries, natural yogurt (low-fat).
3. Lunch: salad, stewed chicken breast, vegetable soup, compote, bread.
4. Afternoon snack: tea, low-fat cottage cheese.
5. Dinner: vegetable salad, baked hake in sour cream, cocoa, bread.
6. Before bed: baked apple, natural yogurt.

Treatment of type 2 diabetes mellitus - drugs

In addition to adjusting the diet and diet, the patient is prescribed specific medications for type 2 diabetes mellitus. Their action is aimed at reducing the amount of sugar in the blood and stimulating the production of insulin by cells in the required quantities. Treatment of type 2 diabetes mellitus is individual for each patient; a regimen must be selected and prescribed by a doctor. As a rule, the course of therapy includes such drugs

1. Glucobay, Miglitol. Medicines are aimed at inhibiting and absorbing oligos and polysaccharides. Due to this, the accumulation of glucose in the plasma slows down.
2. Metformin. Refers to the drug of first choice for hypoglycemic therapy in the treatment of type 2 diabetes, hyperglycemia, and obesity. Helps with the movement and absorption of sugar in muscle tissue by the body, preventing the liver from releasing it.
3. Thiazolidinone derivatives. They enhance the activity of insulin receptors, which helps lower glucose levels and normalizes the lipid profile.
4. Medicines of the 2nd generation sulfonylurea group. They have a stimulating effect on the pancreas to produce insulin and reduce the resistance of peripheral tissues to the hormone.
5. Starlix, Newnorm. The action is aimed at the pancreas, stimulating insulin production.

Folk remedies

When a person is overtaken by an illness, he tries to use any available methods of therapy. Diabetes mellitus type 2 - diet and treatment can be carried out in conjunction with the use of home recipes. It is imperative to consult a doctor before taking it, because in some cases there may be a conflict with diet or drug therapy. Such folk remedies are often used for type 2 diabetes.

1. Recipe 1. To create a decoction of aspen bark you will need 1 tablespoon of wood shavings. Add it to 500 ml of water and boil. Let the medicine sit for 2 hours. Follow a diet for type 2 diabetes, take 3 times a day before meals.
2. Recipe 2. To prepare you need 1 tbsp. l. cinnamon, which needs to be poured with a glass of boiling water. Let the mixture sit for half an hour, then add 2 tablespoons of honey. Place the product in the refrigerator until the morning. Drink half in the morning, the other half before bed.
3. For a diet to be effective for type 2 diabetes, it is necessary to cleanse the body of toxins and improve metabolism. St. John's wort tincture will help, take 3 tbsp. l. herbs, pour ½ liter of boiling water, let it brew for 2 hours. Take a third of a glass before meals 3 times a day.

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Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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Diabetes mellitus type 2 - diet and treatment: nutrition for the disease

Types of sweeteners

It is difficult for a person to imagine his life without sweets. Therefore, sweeteners have been developed for people who suffer from type 1 diabetes. Some of them are similar in nature to sugar, but do not lead to a sharp increase in glycemia. They should be consumed in moderation, in small portions. These products are discussed in the table:

There are certain tricks for those who want to eat real sweets:

• eat them cold;
• after eating;
• eat no more than 50 g of sugar;
• they should contain proteins, slow carbohydrates (berries, ice cream, protein cream).

Diet for type 2 diabetes

Sugar level

With type 2 diabetes, patients should adhere to a more gentle diet. Doctors do not always prescribe medication for them. In order to maintain normal weight, patients must control their calorie intake. So in one day you need no more than 1800 kcal to enter the body. About half of all calories should come from carbohydrate foods. Before you start a diet for type 2 diabetes, you need to calculate the number of calories consumed per meal

It is important to take into account the patient’s initial weight. In order to count calories, it is recommended to use the calorie table

The diet of a patient with type 2 diabetes should be divided into 6 meals. Portions should not be large. If possible, avoid eating fatty foods or limit your intake to 40 g per day. It is strictly forbidden to eat foods that contain complex carbohydrates and fats. These primarily include confectionery, chocolate, and ice cream. The diet for type 2 diabetes cannot be called strict. But at the same time, you must understand that it is better to avoid smoked, fried and spicy foods. Such products can increase your appetite. If you eat bread, choose only those that fall into the diet or whole grain category. Be careful when including soups made with meat broth in your menu. Don't eat them more than 2 times a week. When the daily diet includes only side dishes in the form of cereals or pasta, you cannot eat bread with them. Every day, patients with diabetes should eat at least 150 g of boiled fish or 100 g of meat. Under no circumstances should you give up fresh vegetables and fruits during your diet. In one day, for type 2 diabetes, you are allowed to eat up to 200 g of vegetables and 300 g of unsweetened fruit. It is vegetables and fruits that will help normalize blood glucose levels. It is recommended to make salads from vegetables. Stewed vegetables seasoned with vegetable oil will also be beneficial. If we talk about dairy products, their quantity should be calculated by a doctor. Only he will be able to correctly create an individual diet, taking into account all the features of the course of diabetes. Often, patients with type 2 diabetes are advised to include low-fat cottage cheese, milk and kefir in their diet. Restrictions apply only to heavy cream and sour cream. Alcohol and sweet soda are completely prohibited for type 2 diabetes. It will be better if the patient replaces them with unsweetened coffee or tea. Instead of sugar, you should use sweeteners designed specifically for patients with diabetes.

Diets for diabetes mellitus type 1 and 2 video

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Diet for insulin-dependent diabetes in children

Diabetes mellitus in childhood and adolescence is much more difficult to tolerate than in adults. The child's genetic predisposition, stress and poor nutrition are the main reasons for the development of autoimmune disease.

In 80% of cases, children are diagnosed with an insulin-dependent form of diabetes (type 1). Early diagnosis, immediate treatment and strict adherence to a special diet will help to “stop” the consequences of the disease.

Diet for diabetes in children

Exclude from the menu sugar, sweet carbonated water, confectionery, bakery products made from wheat flour, fried foods, and baked goods.
Enrich your daily menu with unsweetened fruits, vegetables and herbs (without restrictions). Prohibited are grapes, bananas, raisins, dates, persimmons, and figs.
Use natural sugar substitutes - fructose, sorbitol, xylitol.
Distribute the daily food intake into 6 meals

At the same time, it is important to eat food at regular intervals. Permissible deviations in the child’s feeding schedule are 15–20 minutes.
You should eat food after 15 minutes

after insulin administration and 2 hours after injection.
If it is not possible to eat at a set time, you can eat bread, a pear, nuts, a cheese sandwich or an apple as a snack. Under no circumstances should you go hungry.
Immediate consumption of a slice of chocolate will help to “stop” attacks of hypoglycemia. Therefore, an adult who accompanies a child should always have a sweet product available.
Enrich your child’s daily diet with fermented milk products.
Calculate your daily intake of fructose. The amount of sweetener directly depends on the age of the child and the nature of the disease.

How to cope with hunger

Cells receive the necessary nutrition if insulin copes with the breakdown of carbohydrates. When the medicine cannot cope with the amount of food containing carbohydrates, the sugar level rises above normal and poisons the body.

The person begins to feel thirsty and very hungry. It turns out to be a vicious circle: the patient overeats and feels hungry again.

Feeling hungry with diabetes

Therefore, if after dinner you want to have something else to snack on, you need to wait and measure your plasma glucose level. It should not be higher than 7.8 mmol/l 2 hours after eating.

Based on the results of the analysis, you can determine whether it is a lack of carbohydrates or an increase in blood sugar, and adjust your diet.

Diet for table 9

The weekly menu for type 1 diabetes should be varied, with a sufficient amount of vitamins and proteins.

On Mondays and Thursdays:

• Breakfast: rye toast, salad with cucumber, bell pepper and tomatoes, seasoned with herbs and low-fat soft cheese; boiled egg or steam omelette.
• Second breakfast: vegetable juice, 2 rye bread.
• Lunch: lean borscht, vinaigrette, half a portion of buckwheat porridge with a piece of steamed fish and berry juice.
• Afternoon snack: 2 slices of doctor's sausage with baked zucchini, vegetable juice.
• Dinner: boiled potatoes (2 pcs.), steam cutlet, glass of kefir and green apple.

On Tuesdays and Fridays:

• Breakfast: 2 pieces of stewed rabbit, oatmeal, carrot-apple salad, tea.
• Second breakfast: 150 g low-fat cottage cheese with half a banana.
• Lunch: soup with chicken meatballs (300 ml), 150 g of vegetable stew, a glass of compote.
• Afternoon snack: a glass of berries.
• Dinner: buckwheat porridge with sausage, vegetable juice.

On Wednesdays and Saturdays:

• Breakfast: rye toast with soft low-fat cheese, salad with cucumbers, tomatoes and herbs, apple.
• Second breakfast: cottage cheese soufflé, a glass of tea with lemon.
• Lunch: 300 ml of fish soup, 200 g of rice with corn and green beans, baked apple.
• Afternoon snack: a glass of apricot juice.
• Dinner: oatmeal with berries, dried fruit compote.

On Sundays:

• Breakfast: lazy dumplings with cottage cheese, seasoned with low-fat sour cream, a cup of coffee.
• Second breakfast: 2 rye bread and 200 g of fresh or frozen berries.
• Lunch: 300 ml of buckwheat soup, 100 g of baked vegetables and chicken breast, cranberry juice with xylitol.
• Dinner: oatmeal (150 g) with two sausages, apple and celery salad, a glass of tomato juice.

Menu for a week for type 1 diabetes

Day	Menu
Monday	Breakfast: buckwheat porridge with water (150 g), cabbage salad, seasoned with lemon juice and tea without sugar. For second breakfast, you can choose one baked apple and a glass of mineral water. Lunch: borscht cooked in lean broth, a piece of boiled poultry, berry jelly and jelly. Afternoon snack: cheesecakes with pear puree. Dinner: cabbage and meat cutlets, add one rye to them bread and green unsweetened tea. And before going to bed, you can drink a cup of kefir.
Tuesday	Breakfast: pearl barley with grated carrots, a piece of bread and tea. For the second breakfast, a jar of natural yogurt and again tea are offered. Lunch: pumpkin soup, stewed vegetable stew with a small addition of lean meat, cucumber and asparagus salad. Afternoon snack: one orange and rosehip infusion. Dinner: brown rice casserole, one chicken protein eggs and tea. A glass of fermented baked milk at night.
Wednesday	Breakfast: a piece of white boiled fish, 150 g of low-fat crumbly cottage cheese and green tea. A little later, you can eat one grapefruit. Lunch: fish soup, boiled poultry, and as a side dish you can choose boiled broccoli, sprinkled with grated cheese. Afternoon snack: a piece of cottage cheese casserole. Dinner: fish balls and cabbage schnitzel, and before bed a glass of liquid yogurt sugarless.
Thursday	Breakfast: millet porridge baked with pumpkin. You can drink a cup of coffee with milk and eat a slice of hard cheese. An hour later, a compote of dried fruits is offered. Lunch: porcini mushroom soup, baked cauliflower, 150 g of boiled meat. Afternoon snack: one sour apple baked with honey. Dinner: fish soufflé, fresh vegetable salad, beet juice. And before going to bed, you can drink a glass of milk.
Friday	Breakfast: pearl barley porridge with carrots. Beet salad, a piece of bread and tea. After an hour and a half, you can eat fruit jelly. Lunch: bean soup, stewed liver with carrots, 100 g of brown rice. Afternoon snack: salad of two apples and one orange. Dinner: zucchini pancakes, baked in the oven. And two hours later a jar of cottage cheese.
Saturday and Sunday	On weekends, you can choose one of the above diets. The main thing is not to use a lot of vegetable oil when preparing dishes and not to fry foods. The best heat treatment option is boiling and stewing.

Basic principles of nutrition

Doctors advise victims of the disease to adhere to a diet that is essentially not much different from the healthy diet of the average person. However, at the same time, monitor the amount of carbohydrates consumed, the specific gravity of which during each meal should not exceed 8 bread units (hereinafter referred to as XE). Roughly speaking, each meal should consist of:

• 55% carbohydrates,
• 25% proteins;
• 20% fat.

For a long time, doctors prescribed a diet that limited fat intake as much as possible to victims of type 1 diabetes, but over the years it became clear that such steps did not have a positive therapeutic effect. Patients were also forbidden to eat spicy foods and fried foods, however, these taboos were unnecessary. Of course, if people suffer not only from diabetes, but also from other ailments, especially those related to the digestive system, then such restrictions are appropriate.

The only thing that people with type 1 diabetes need to be careful with is foods with a lot of sugar. Before enjoying any dessert, you need to calculate how much XE is in the product. But this, perhaps, is all from the category of strict restrictions.

A sample diet for a type 1 diabetic. You can use the information to create your menu

What other rules should victims of diabetes follow?

• you need to eat in small portions (modest portions, from 5 times during the day);
• try to consume no more than 3000 kcal per day, therefore, each meal should include up to 600 kcal;
• it is advisable to sit down at the table at a certain hour;
• plan the menu for each meal in advance and take into account the dose of insulin administered;
• if necessary, use substitutes instead of sugar;
• control the composition of each piece consumed.

How to correctly distribute calories throughout the day? Focus on the following recommendations (% is indicated of the total daily diet):

• morning – 25%;
• snack – 10%
• lunch meal – 35%;
• afternoon snack – 10%
• evening meal – 20%.

As you can see, the main load (in terms of calories) on the body is permissible in the first half of the day, while after lunch, meals should be modest and low-calorie. You can increase the number of meals, but do it taking into account the given rules.

If you strictly adhere to these nutritional principles, you can live a full life. You will not feel any deviations in your health. The main thing is to make it a rule to follow the recommendations and, if possible, bring the process to automation. By the way, this works very successfully for many patients.

Recommended daily caloric intake for victims of type 1 diabetes. If you want to live a quality life, get used to the new rules

Meals and their ingredients for people with type 1 diabetes

From cottage cheese:

• Cottage cheese with a fat content of no more than 5%;
• Cottage cheese casserole;
• Syrniki.

• Beetroot;
• Okroshka (replace the sausage with chicken breast);
• Borscht (lean meat or vegetarian option);
• Mushroom;
• With meatballs (beef, lean meat).

Cereal porridge:

• Buckwheat;
• Oatmeal (choose the one that cooks for a long time - from 10 minutes);
• Millet;
• Barley;
• Pearl barley;
• Rice (from unprocessed rice);
• Bean.

Meat and fish - any cooking method except frying:

• Lean meat;
• Sea fish, river;
• Canned fish in its own juice;
• Poultry (meat only, no skin).

• Egg white omelette;
• Boiled egg 1-2 pieces (no more than 2 times a week).

Vegetables - in any recipes and cooking methods, except frying:

• All types of cabbage, salads;
• Tomatoes;
• Pumpkin;
• Eggplant;
• Cucumbers, zucchini;
• Greens (parsley, dill).

Sweet dishes:

• Jelly;
• Compotes from unsweetened berries;
• Baked apples, pears;
• Desserts for diabetics.

• Tea, coffee, chicory;
• Freshly squeezed juices - vegetable or fruit;
• Rosehip decoction.

• Mushroom;
• Vegetable;

Diet 9 for insulin-dependent diabetics

When treating any disease, one of the therapeutic methods is changing nutrition. There are special systems aimed at patients suffering from certain pathologies. For diabetics, such a system is also provided - this is diet No9.

This type of diet is not considered strict and can be adjusted based on individual preferences and the patient’s condition.

The basic rules concern small and frequent meals, limiting the amount of salt, as well as methods of cooking (boiling, stewing and steaming are preferred). It is advisable to avoid frying and stewing, although sometimes it is allowed to eat dishes prepared using these methods.

What to exclude from your daily diet

If there are dishes that are good for diabetics, then there are also those that will be harmful to them. These products include:

• legumes and potatoes;
• beets and carrots;
• any types of canned food and pickles;
• sweets based on regular sugar;
• ice cream and sweet carbonated drinks;
• fatty, heavily fried foods;
• baked goods made from premium flour;
• sweet type of fruit.

All types of fruits cannot be excluded from the daily menu, since the vitamins and fiber they contain are vital for the human body. You should just give preference to types that are not too sweet, for example, sour varieties of apples or pears. You can also eat garden strawberries and raspberries, cherries and cherries. But you should avoid bananas, grapes and raisins, as they contain a huge amount of sugar.

Low carb diet menu

The doctor may adjust nutrition depending on the results of treatment.

Monday

1. For breakfast, prepare 200 g of buckwheat, cabbage salad with lemon juice (100 g). You can eat 60 g of rye bread.
2. Lenten borscht is suitable for lunch (foods are selected from the list of allowed ones), the broth in such a dish should be lean. The second course consists of boiled chicken (80 g), pasta (60 g) and rye bread. The drink is compote.
3. If you want to have a snack, prepare a casserole from low-fat cottage cheese.
4. For dinner, prepare 150 g of meat cutlets, 60 squash caviar. You can eat two slices of bread.

1. Breakfast consists of pearl barley (200 g), cabbage salad (50 g) and rye bread. The drink is tea.
2. For lunch, prepare a light vegetable soup (it is recommended to eat 1 serving - 250 g), boiled meat (80 g), and a salad of vegetables that are included in the list of permitted ones. You are allowed to eat 2 slices of bran bread.
3. For dinner, cottage cheese casserole (170 g), a boiled egg, and a glass of compote are recommended.

Stewed or steamed fish cutlets will not critically increase glucose levels

1. Breakfast will consist of fish cutlets (60 g), bread and low-fat cottage cheese. The drink is tea. After 3 hours you can eat grapefruit.
2. For lunch, prepare vegetable soup, recommended serving - 200 g, chicken fillet (130 g), cabbage salad (130 g). Drink - tea. Bread - 2 slices.
3. Dinner will consist of steamed meatballs in the amount of 100 g, vegetable stew (150 g) and 1 boiled egg. The drink is tea.

1. Oatmeal is prepared for breakfast, serving - 180 g. Brown bread is good - 2 slices. If you wish, you can make a salad of cabbage and apples, the recommended amount is 150 g. The drink may contain a minimum of caffeine; a sugar substitute is used to give a sweet taste.
2. For lunch, borscht is prepared: you need to eat one serving - 250 g. The second dish consists of lean meat (60 g), bread and stewed cabbage (120 g). The drink is compote.
3. For dinner it is suggested to bake fish, portion - 170 g, prepare vegetable stew, portion - 200 g. Drink - tea.

1. For breakfast, oatmeal is prepared, portion - 170 g, boiled beet salad (100 g). Rye bread is allowed. The drink is compote. After a couple of hours you can eat an apple.
2. For lunch, prepare lean soup with vegetables, serving 200 g. You can boil 70 g of liver. Bread is allowed in quantities of 50 g.
3. Dinner consists of pumpkin casserole (120 g), cabbage and tomato salad (100 g), fish cake.

1. For breakfast, a cottage cheese casserole is prepared, serving is 120 g. You can eat an orange.
2. Lunch consists of lean soup (200 g), buckwheat (150 g) and boiled meat in the amount of 100 g.
3. For dinner, beet salad is prepared, serving - 100 g, buckwheat, serving - 150 g. Drink - tea.

Sunday

1. Breakfast will consist of oatmeal (150 g) and 1 egg. The drink is compote.
2. For lunch, vegetable soup is recommended, serving - 250 g, meat stew in the amount of 100 g. Drink - tea.
3. Dinner consists of buckwheat porridge (200 g) and beet salad (120 g). The drink is yogurt.

Some food characteristics

Not all patients with type 1 diabetes are candidates for a high-protein diet. For nephropathy with nephrotic syndrome, it is recommended to reduce the amount of protein foods consumed. To support the body, one of the main rules is a low-protein diet - this is one of the methods of symptomatic therapy in such patients. Therefore, protein intake is limited. Doctors recommend up to 0.8 g per 1 kg of protein per day. In addition to limiting proteins, the patient is prescribed a reduction in salt to 2.5 g in the daily diet. This means that salt is not used at all for preparing dishes, including for baked goods.

Nutritionists recommend using foods with reduced salt content: rice, oatmeal, carrots, all types of cabbage. Among meat products, it is better to give preference to veal, turkey and rabbit, and among fish products - cod, pollock, and hake.

Insulin-dependent patients who administer short- and intermediate-acting insulins should know a few more nutritional rules:

• The number of carbohydrate meals for each day should be approximately the same. You can expand your carbohydrate diet using special tables for diabetics, in which you can find interchangeable products.
• To avoid hypoglycemia, the calorie content of meals should be distributed in strict accordance with the peaks of action of injected insulin.

This will make it possible to avoid hypoglycemia. For plain insulin:

• First morning injection + protein breakfast.
• You can include carbohydrates for your second breakfast.
• For lunch, exclude bread.
• After the second injection: carbohydrates after an hour or an hour and a half.

For long-acting insulin, carbohydrates are distributed across all meals in approximately equal amounts.

For patients with the threat of a diabetic coma, fats are limited to 30 g per day, proteins - up to 50 g. It is possible to increase the amount of easily digestible carbohydrates to 300 g. To enhance the anti-ketogenic effect (against the synthesis of ketone bodies), during this period patients are allowed sugar and cereals in small doses , honey In a precomatose state, fats and proteins are completely excluded from the diet, and the diabetic eats carbohydrate foods.

Each patient with diabetes has its own characteristics: age, daily dosages of insulin injections, level of physical activity, and concomitant diseases. Therefore, adjustments in frequency, volume and total calorie content of foods and dishes must be determined by the attending endocrinologist.

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Table 9 for diabetics

For patients with mild to moderate diabetes mellitus who are overweight, the so-called diet 9 or table No. 9 was developed, which subsequently became extremely popular. Table No. 9 for diabetes mellitus is a balanced diet, within which the patient consumes daily from 300 to 350 grams of carbohydrates, 100 grams of protein, and no more than 80 grams of fats, at least 30% of which should be vegetable.

The essence of this dietary regimen is to limit the caloric intake of such patients. In this case, sugar and any sweets are absolutely excluded, which can easily be replaced with sweeteners. Experts highlight low-fat fish, cottage cheese, vegetables and fruits, as well as whole grain cereals as recommended foods for diet No. 9. This kind of diet maintains a chronic feeling of hunger in patients and is very harmful for diabetics, as it increases sugar levels in the body.

In addition to diet No. 9, experts have developed a very detailed weekly menu for diabetics with type 1 of the disease. This diet will help you effectively fight weight and significantly improve your overall health. Thus, the diet of diabetics plays a huge role. After all, it is this aspect of the lives of such patients that significantly affects their health and condition.

ENTIRE COURSE in Diabetes School

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Type 1 diabetes mellitus: proper diet and treatment to improve quality of life! ✓ Doctor's lecture.

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Nutrition for type 1 diabetes

How to eat properly with type 1 and type 2 diabetes: regimens, menus

Diet for type 1 diabetics for a week

Nutrition for type 1 diabetes: the right menu

Low-carb diet for diabetes: menu for the week

The dangers of not following a diet

Impaired glucose metabolism causes two dangerous conditions, the symptoms of which must be distinguished in order to cope with them in a timely manner.

Hyperglycemia

This condition occurs when insulin cannot cope with excess carbohydrates. The breakdown of proteins and fats begins with the formation of ketone bodies. The liver does not have time to process them, and they end up in the kidneys and urine. A urine test shows high levels of acetone.

Symptoms of hyperglycemia:

• strong, unquenchable thirst;
• dry skin and pain in the eyes;
• frequent urination
• long wound healing;
• weakness;
• high blood pressure;
• arrhythmia;
• blurred vision.

The condition is caused by a surge in blood sugar to high levels. The person feels dizzy, nauseated, drowsy, and weak. The patient's condition requires urgent hospitalization.

Hypoglycemia

Lack of glucose also causes the appearance of acetone in the body. The condition occurs due to an overdose of insulin, fasting, diarrhea and vomiting, dehydration, overheating, and after intense physical exertion.

Symptoms:

• pale skin;
• chills;
• weakness;
• dizziness.

The condition requires immediate hospitalization because starvation of brain cells can lead to coma.

If the sugar level is below 4 mmol/l, the patient should immediately take a glucose tablet, a piece of refined sugar, or eat a lollipop.

About fast foods and snacks

This is a very serious pathology: with gastroparesis, metabolism is disrupted and the gastrointestinal tract suffers. In people with this pathology, food from the stomach enters the intestines in different ways, as a result, sugar after eating either increases or decreases. With diabetic gastroparesis, it is difficult to control glucose levels. Symptoms of the disease appear in the evening. An increase in sugar levels can occur during sleep, then a person will not be able to normalize it.

Diabetic gastroparesis develops when you abuse fast food

If a person is following a low-carb diet, he should not snack (with other diets, snacking is acceptable)

If the patient nevertheless snacks, the food should not be heavy, and it is important to select a dose of short-acting insulin before meals, so that the glucose level will remain at normal levels. When following a low-carb diet, you should avoid snacks.

If a diabetic snacks, he should eat foods without carbohydrates.

If you need to have a snack, you need to be sure that the food is digested after the main meal. This way you can avoid an increase in glucose from eating. Before a snack, you should inject insulin; you should not allow the effects of the injections to overlap. Otherwise, hypoglycemia will occur. It should take 5 hours from the main meal to the snack. For more information about the dangers of fast food, watch this video:

Don't snack at night: your blood sugar may rise in the morning! It is important to follow all nutritional rules. The food offered on the menu is light and easily digestible

We have already mentioned more than once that diabetes is a chronic disease.

At the moment, there is no cure for it, and all “side” drugs and methods are aimed exclusively at stopping or delaying a number of complications of this disease, which will manifest themselves sooner or later anyway.

“Sugar disease” in its destructive effect is so multifaceted that it is possible to increase the patient’s lifespan only if both the endocrinologist and the patient himself fight together against this disease.

For the most part, the leading role in the treatment process, naturally, should be played by the diabetic himself, because no one but him will be able to respond in time to the slightest signals sent by the body, and the first thing any patient should do is self-control.

We dare to give a little advice to our readers. Keep a personal diary in which you will note your readings daily. Thus, you will be able to timely track all quantitative fluctuations during the day and prevent them in time. Either your doctor or our subsequent advice will tell you how to react to certain changes.

To put it simply, the algorithm for modern treatment of type 2 diabetes is as follows:

1. Diet
2. Medicines
3. Standardized physical activity
4. Conducting self-control
5. Prevention of late complications in diabetes mellitus

Let us say right away that we personally do not entirely agree with traditional methods. In this therapy, we are very confused by drug intervention in the treatment process.

We would recommend refraining from taking any medications for as long as possible and, if possible, limiting yourself to diet, self-control, leading an active lifestyle and thereby delaying the further development of diabetes and its complications.

In addition, instilling eating habits is a fairly long-term process, which many diabetics do not cope with immediately.

The main goal of introducing diet and physical activity into therapy is the desire to normalize disturbed metabolic processes in the body (carbohydrate, fat, protein and water-salt) in order to bring the patient’s condition closer to normal. Thus, it is possible not only to normalize all processes, but also to adjust the patient’s weight. When losing weight, special emphasis is placed on low-carbohydrate or balanced diets.

At the same time, it is completely wrong to completely refuse food and such a technique as fasting for diabetes is unacceptable.

We do not exclude the fact that with high-quality fasting (in the process of following all recommendations, total control and supervision of the patient by a real practicing specialist in this field!) you can achieve amazing results.

BUT! At the moment, we cannot say for sure that there are many such specialists in Russia. Moreover, those who simply extract money from unfortunate people also consider themselves to be professional specialists. They manipulate a person’s fear, driving him into a dead end, frightening him with scary stories about unfortunate people who were treated with traditional methods and could not live a “decent” and long life. At the same time, they talk about the incredible healing of people after a 40-day fast, so much so that the unfortunate person begins to completely believe this “doctor,” because the patients are surrounded by supposedly miraculously cured sufferers who tell him about their false destinies.

Let us remind you! The most difficult thing about fasting is starting and finishing the process correctly. With the wrong fasting technique, you can greatly harm the entire body! The consequences of such methods, developed by crooked-handed and sweet-voiced “specialists”, are actually terrible. Therefore, before you entrust your life, health and a fabulous amount of money to someone, check all regulatory documents and their authenticity, because you can print ready-made review forms on any color printer.

And remember that none of them is responsible for your life and health, because you yourself agree to such experiments.

Nobody forced or forced you. At the same time, all checks usually bear the inscription: “Voluntary donation in the amount of ....”

But let's return to our topic.

So, in order to lose excess weight, which significantly interferes with normalizing all metabolic processes, improving your health and almost completely forgetting about diabetes, you need to clearly understand that:

• Without desire, aspiration and willpower, nothing will come of it
• It is important to follow all the recommendations of your doctor (but do not swallow pills that are “useful” in the most extreme case, when it is simply impossible to live without their intervention)
• It is necessary to diversify your life with a love of training (love working out in the gym, because without them it will be more difficult for you to join the ranks of healthy people living a full life)
• Eat right (watch what and how much you consume)
• Never be discouraged (despondency is the enemy of any person, which drives him into an even more serious state - depression)
• Remember that all the diseases that have grabbed hold of us progress against the background of a complex stressful state (do not let negative emotions cloud your consciousness)
• Any diet should be adjusted depending on the current state (if you have already lost a certain amount of kilograms, usually 10 or more, then you need to reduce the total number of daily calories, etc.)

Diabetics should completely avoid:

• sugar and sugar syrups (jam, condensed milk)
• confectionery products (sweets, cookies, pastries, cakes, etc.)
• white baked goods
• fruits and dried fruits (you can drink compotes, but without sugar)
• beer, spirits and sweet wines
• sweet drinks (including packaged store-bought juices with sugar)

The cooking process is also important! Eating highly fatty, deep-fried foods is dangerous not only for diabetics, but also for healthy people. Try to cook dishes by simmering the ingredients in a small amount of oil and fat. It is better to eat fresh vegetables and herbs; when cooking, try not to cook them a little. It is best to steam or bake foods in their own juices in the oven. Give preference to lean varieties of meat, fish and other seafood. It is also not recommended to rely on salt.

Drink more water! The body must not be dehydrated. In diabetics, all excess sugar and oxidation components after metabolic processes are excreted in an abundance of urine. This is why the process of urination may be difficult and they often urinate more often than others. At the same time, be careful with any tea drinks. Remember that any tea is a diuretic.

When following a diet, you should also remember the vitamin balance. In diabetics, many nutrients that do not have time to be absorbed in time are also washed out of the body in the urine, and if the patient adheres to a diet, the amount of vitamins is sharply reduced, especially in the off-season or winter. To ensure the normal course of redox processes, it is important to consume a sufficient amount of fresh vegetables and herbs, which contain fiber. Sometimes an endocrinologist may prescribe some additional vitamin complex.

Smoking, which increases the already high level of lipid peroxidation in diabetes, is strictly prohibited. You should also not drink alcohol, even in small doses. All this has an extremely detrimental effect on the functions of all organs, the central and peripheral nervous systems.

How to correctly calculate your daily calorie intake

We understand perfectly how doctors work in city and regional hospitals. Such a salary does not at all encourage them to conduct a more thorough analysis and work with each patient who comes to the hospital with this or that question. Therefore, most likely, when working with a patient, the doctor will limit himself to some general recommendations and advice. To get more specific and high-quality advice, you have to contact either a paid clinic or look for answers to your questions yourself.

In both the first and second cases, no one will give you any guarantees, because in a paid clinic you will have to pay literally every breath you take (as long as your finances allow), and if you search for information on your own, you can come across groundless, empty, stupid and even dangerous advice that is far from based on factual information.

Therefore, in this article we will post one method that, thanks to some calculations, will allow you to calculate your individual daily calorie intake. To do this, you only need to have a few knowledge (know: weight, height, age, gender and activity level).

Of course, you can limit yourself to studying the simpler information contained in the table below, but it is much more important to conduct detailed analysis and calculations in order to identify your own criteria.

Daily norm

For men	age	norm	excess	norm	excess	Women
	19-24	2600	2080	2200	1780
	25-50	2400	1920	2000	1600
	51-64	2200	1780	1800	1440
	over 64	1900	1520	1600	1280

Why does the total number of calories consumed decrease with age?

The thing is that the older a person is, the slower his metabolism. All metabolic processes slow down and, accordingly, to normalize and supply the body with energy, a smaller amount of “fuel” - food - is required. Therefore, people over the age of 40 who are overweight are at a particular increased risk of developing or.

Calculation of individual criteria

• activity level

From the table below, select the definition that suits you and write down its coefficient separately.

coefficient	definition	description
1.2	inactive	inactive lifestyle without physical activity (sedentary work - home - work)
1.375	inactive	occasional workouts in the gym (about 2 days a week)
1.55	active	more frequent workouts (about 3 - 5 days a week)
1.725	very active	frequent training (every day)
1.9	hyperactive	a large amount of physical activity (professional sports, daily long hours of training or physical labor)

When determining your activity level, you need to be as honest as possible. The accuracy of subsequent calculations depends on this.

• Total metabolism per day

He calculates according to a formula taking into account gender differences.

For men: 66.47+(13.7×weight/kg)+(5×height/cm)-(6.76×age)

For women: 655.1+(9.6×weight/kg)+(1.8×height/cm)-(4.7×age)

For example, the weight of a fifty-six-year-old woman of average height is 115 kg, her daily norm will be: 655.1+(9.6×115)+(1.8×168)-(4.7×65)=1756 kcal/day

However, we should not forget that rapid weight loss is fraught with negative consequences, especially for a diabetic, who, even with his diagnosis, has already experienced a serious disruption in lipid, carbohydrate, purine, and water-salt metabolism.

Normal, healthy weight loss for overweight and diagnosed obesity is only possible by 4 or 5 kg per month!

The indicator obtained at this stage is only a rough, dirty criterion that requires further polishing and cutting, because such a daily norm is very arbitrary!

• Calorie norm

Calculated according to the formula: total metabolism per day×activity level

It turns out, 1756 × 1.2 (a person is inactive, does not engage in heavy physical labor and leads a predominantly “sedentary” lifestyle) = 2107.2 kcal/day

In other words, a person should consume approximately 2108 calories, but to lose weight he needs to subtract 500 kcal from this amount. We get 1608. The optimal option will be presented to us by calculating the calorie corridor, which will allow us to determine the low and high limits.

Low limit: 1608-250=1358

High limit: 1608+100=1708

This way we will get approximate guidelines in order to vary the calorie content of the daily diet within acceptable limits. In this case, the level and speed that are characteristic of healthy, smooth weight loss are achieved.

Norm of proteins, fats and carbohydrates

But when drawing up a diet, planning appropriate treatment for type 2 diabetes, it is necessary to maintain a balance of various substances and microelements. The daily diet should contain: carbohydrates - 45-60%, fats - 20-35%, proteins - 10-16% of the daily requirement.

How to determine their exact number for a specific person?

In this matter, we will be helped by the previously obtained calorie corridor indicators (low and high limits) in order to calculate the nutrient corridor.

Low level:

• proteins 1358×0.10÷4=33.95
• fats 1358×0.20÷9=30.17
• carbohydrates 1358×0.45÷4=152.77

High level:

• proteins 1708×0.16÷4=68.32
• fats 1708×0.35÷9=66.42
• carbohydrates 1708×0.60÷4=256.2

In addition, when creating your menu, it would be a good idea to classify foods according to their usefulness for a diabetic. Will help with this.

Self-control

The next thing that is used in the treatment of type 2 diabetes mellitus after dietetics and standardized physical activity is self-control!

To do this, you can either print this page with tabular data, or sketch them out yourself in your personal diary.

Self-control (standard from 1993)

Indicators	Control
	good	satisfactory	bad
Glucose
on an empty stomach	4.4 - 6.1	6.2 - 7.8	>7.8
after meal	5.5 - 8.0	11.1 - 14.0	>14.0
HbA1C(N<6%)	<6.5	6.5 - 7.5	>7.5
HbA1C(N<7.5%)	<8.0	8.0 - 9.5	>9.5
Total cholesterol
mmol/liter	<5.2	5.2 - 6.5	>6.5
Fasting triglycerides
mmol/liter	<1.7	1.7 - 2.2	>2.2
Body mass index (kg/m²)
men	<25.0	25.0 - 27.0	>27.0
women	<24.0	24.0 - 26.0	>26.0

The European standard, developed in 1993 by the insulin-dependent diabetes group, suggests monitoring the following biochemical parameters:

• Glucose level

Blood sugar levels vary throughout the day and are directly related to the quality and quantity of foods consumed.

If you consume food rich in fast carbohydrates, then, of course, your blood sugar level will increase greatly. If you eat foods with slow carbohydrates, then the “sugar” level will also rise, but not critically. Gradual normalization will occur within 5 hours after eating food.

More details about carbohydrate-containing products and the process of their interaction with our “inner world” can be found in the article:

Therefore, control must be carried out, as you may have guessed, throughout the day. Usually the first blood draw occurs in the morning on an empty stomach before breakfast. Then after every meal. At home, glucometers can help you measure your glucose levels.

For inpatient or sanatorium treatment, an additional control method is. You can also take a similar test during outpatient treatment if you receive a direct referral from your attending endocrinologist.

Compensation of carbohydrate metabolism

Research time	Glucose content (mmol/liter)
	perfect compensation	satisfactory compensation
before breakfast	3.89 - 5.0	3.87 - 6.11
before any meal	3.89 - 5.83	3.89 - 7.22
After meal
After 1 hour	6.11 - 8.88	6.11 - 9.99
In 2 hours	4.44 - 6.66	4.44 - 8.33
at 2 and 4 pm	3.89 - 5.0	3.89 - 6.66

Looking ahead, we note that more intense self-control in order to stop hypoglycemia is necessary before, during and after training or any physical activity. Very often, patients consult a doctor at a critical moment who do not take this fact into account when working in their garden.

Remember: digging beds for planting, landscaping the area, caring for and harvesting crops - all this refers to increased physical activity. During this time and after work, you need to monitor your health especially often.

If you forget about this, then set an alarm clock that beeps every 30 - 40 minutes!

A portable express blood cholesterol analyzer, which has several test strips, will help you measure your total cholesterol level at home. Similar devices allow you to find out not only the level of “bad cholesterol” (LDL cholesterol, low-density lipoprotein cholesterol) and “good cholesterol” (HDL cholesterol, high-density lipoprotein cholesterol), i.e. show the amount of triglycerides as well as the level of glucose in the blood.

Typically, such a set consists of several items: a lancet (a pen with a needle at the end), the device itself, which measures readings, and a set of test strips, which act like a litmus test when a drop of blood is taken on a strip soaked in a special chemical solution incoming react upon contact with human blood.

It is necessary to draw blood for analysis strictly on an empty stomach! (with a twelve-hour fast)

The strip is inserted into the niche of the device and all that remains is to wait for the information to be made public, which will be reflected on the monitor in the form of symbols, which the attached instructions will allow you to decipher.

It is not necessary to buy an expensive express analyzer. You can take a referral from an endocrinologist and donate blood as part of a laboratory analysis.

• Body mass index

To calculate BMI (body mass index), you need to know your height and weight.

Formula: BMI=weight/kg÷height/m2

Thus, if a person’s weight is 95 kg with a height of 175 cm, then: 95 ÷ (1.75 × 1.75) = 31

And then we check the diagnostic table, which also reflects the level of risk of developing endocrine diseases in combination with cardiovascular and other types of complications in the presence of overweight and obesity.

BMI (kg/m2)	Diagnostics	Risk level
<18.5	underweight	low (average risk of developing other diseases)
18.5 - 24.9	normal body weight	normal condition without complications
25 - 29.9	overweight	elevated can diagnose prediabetes
30.0 - 34.9	obesity I degree	high (metabolic syndrome)
35.0 - 39.9	obesity II degree	very tall
≥40	III degree obesity	extremely high

If the methods described above do not help normalize the patient’s condition, then insulin therapy, which is indicated in the following cases:

• ketoacidosis, diabetic coma;
• fast and strong weight loss;
• the occurrence of intercurrent diseases;
• surgical intervention in critical condition of the patient;
• pregnancy and lactation;
• lack of effect from other treatment methods.

Only a doctor can prescribe this type of treatment for type 2 diabetes!

Drug treatment of type 2 diabetes mellitus

All treatment comes down to normalizing glycemic levels and normalizing carbohydrate metabolism, stimulating insulin secretion and increasing cell sensitivity to insulin, speeding up metabolism.

Sugar-burning drugs are also used in the treatment of type 2 diabetes. There are only two types: sulfonylurea derivatives and biguanides.

Sulfonylureas, depending on their effect (central or peripheral), can act directly on the pancreas when the pancreatic islets are stimulated and insulin is produced, and the sensitivity of β-cells to glycemia is improved. Such drugs can participate in the process of glucose utilization in the liver and muscle tissue, when the process of glycogen formation in them is enhanced. Other relatively positive results are also achieved, allowing the time of development to be delayed.

But! Long-term treatment leads to a strong decrease in sensitivity to them. Further attempts to increase the dosage do not lead to positive results!

Contraindications for sulfonylureas

In addition, if a person experiences the following complications, then the use of these drugs is strictly prohibited:

• ketoacidosis,
• precomatose state
• diabetic coma
• pregnancy and lactation,
• the presence of any infectious disease,
• the need for surgical intervention,
• development of trophic skin lesions,
• the appearance of symptoms of developing renal or liver failure,
• progressive weight loss of the patient.

Side effects

In some cases, taking medications can provoke the development of the following complications and negative consequences:

• dyspeptic disorders,
• allergic reactions,
• leukopenia,
• thrombocytopenia,
• agranulocytosis,
• toxic hepatitis.

In any case, remember that before conducting any experiments on your health, be sure to consult a doctor for timely advice!

The above should not push you towards thoughtless self-medication!

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Type 2 diabetes mellitus is an endocrine disease in which there is a constant increase in glucose in the blood.

The disease is characterized by impaired sensitivity of cells and tissues to insulin, which is produced by pancreatic cells. This is the most common type of diabetes.

Reasons for appearance

Why does type 2 diabetes occur and what is it? The disease manifests itself in insulin resistance (lack of the body's response to insulin). Sick people continue to produce insulin, but it does not interact with body cells and does not accelerate the absorption of glucose from the blood.

Doctors have not identified the detailed causes of the disease, but according to current research, type 2 diabetes can manifest itself when the volume or receptor sensitivity of cells to insulin varies.

Risk factors for type 2 diabetes mellitus are:

1. Poor nutrition: the presence of refined carbohydrates in food (sweets, chocolate, candies, waffles, pastries, etc.) and a very low content of fresh plant foods (vegetables, fruits, cereals).
2. Excess body weight, especially of the visceral type.
3. The presence of diabetes mellitus in one or two close relatives.
4. Sedentary lifestyle.
5. High pressure.
6. Ethnicity.

The main factors influencing tissue resistance to insulin include exposure to growth hormones at puberty, race, gender (a greater tendency to develop the disease is observed in women), and obesity.

What happens with diabetes?

After a meal, the blood sugar level rises, and the pancreas cannot produce insulin, which occurs against the background of elevated glucose levels.

As a result, the sensitivity of the cell membrane responsible for recognizing the hormone decreases. At the same time, even if the hormone penetrates inside the cell, the natural effect does not occur. This condition is called insulin resistance, when the cell is resistant to the effects of insulin.

Symptoms of type 2 diabetes

In most cases, type 2 diabetes does not have pronounced symptoms and the diagnosis can only be established through routine fasting laboratory testing.

As a rule, the development of type 2 diabetes begins in people after 40 years of age, in those who suffer from obesity, high blood pressure and other manifestations of metabolic syndromes in the body.

Specific symptoms are expressed as follows:

• thirst and dry mouth;
• polyuria - excessive urination;
• itchy skin;
• general and muscle weakness;
• obesity;
• poor wound healing;

The patient may not be aware of his illness for a long time. He feels a slight dry mouth, thirst, itchy skin, sometimes the disease can manifest itself as pustular inflammation of the skin and mucous membranes, thrush, gum disease, tooth loss, and decreased vision. This is explained by the fact that sugar that does not enter the cells goes into the walls of blood vessels or through the pores of the skin. Bacteria and fungi thrive on sugar.

What is the danger?

The main danger of type 2 diabetes is lipid metabolism disorders, which are inevitably caused by impaired glucose metabolism. In 80% of cases, against the background of type 2 diabetes mellitus, coronary heart disease and other diseases associated with blockage of the lumen of blood vessels with atherosclerotic plaques develop.

In addition, type 2 diabetes mellitus in severe forms contributes to the development of kidney disease, decreased visual acuity, and deterioration of the reparative ability of the skin, which significantly reduces the quality of life.

Stages

Type 2 diabetes mellitus can occur with different severity levels:

1. The first is that the patient’s condition can be improved by changes in dietary principles, or by using a maximum of one capsule of a sugar-lowering agent per day;
2. Second, improvement occurs with the use of two or three capsules of a sugar-lowering agent per day;
3. Third, in addition to sugar-lowering drugs, you have to resort to insulin administration.

If the patient’s blood sugar level is slightly higher than normal, but there is no tendency to complications, then this condition is considered compensated, that is, the body can still independently cope with the disorder of carbohydrate metabolism.

Diagnostics

In a healthy person, normal sugar levels are around 3.5-5.5 mmol/l. 2 hours after eating, it can rise to 7-7.8 mmol/l.

To diagnose diabetes mellitus, the following tests are performed:

1. Blood test for glucose: on an empty stomach, the glucose content in capillary blood (finger prick) is determined.
2. Determination of glycosylated hemoglobin: its amount increases significantly in patients with diabetes mellitus.
3. Glucose tolerance test: on an empty stomach, take about 75 g of glucose dissolved in 1-1.5 glasses of water, then determine the concentration of glucose in the blood after 0.5, 2 hours.
4. Urinalysis for glucose and ketone bodies: Detection of ketone bodies and glucose confirms the diagnosis of diabetes.

Treatment of type 2 diabetes mellitus

When type 2 diabetes has been diagnosed, treatment begins with diet and moderate exercise. In the initial stages of diabetes, even slight weight loss helps normalize the body's carbohydrate metabolism and reduce glucose synthesis in the liver. Various medications are used to treat later stages.

Since most patients with type 2 diabetes are obese, proper nutrition should be aimed at reducing body weight and preventing late complications, primarily atherosclerosis.

A low-calorie diet is necessary for all patients with excess body weight (BMI 25-29 kg/m2) or obesity (BMI > 30 kg/m2).

Drugs

Drugs that lower sugar are used to stimulate cells to produce additional insulin, as well as to achieve the required concentration in the blood plasma. The selection of drugs is carried out strictly by a doctor.

The most common antidiabetic drugs are:

1. Metformin is the first choice drug for glucose-lowering therapy in patients with type 2 diabetes mellitus, obesity and fasting hyperglycemia. This remedy promotes the movement and absorption of sugar in muscle tissue and prevents the release of sugar from the liver.
2. Miglitol, Glucobay. These drugs inhibit the absorption of polysaccharides and oligos. As a result, the rise in blood glucose levels slows down.
3. Sulfonylurea drugs(SM) 2nd generation (chlorpropamide, tolbutamide, glimepiride, glibenclamide, etc.) stimulate insulin secretion in the pancreas and reduce the resistance of peripheral tissues (liver, muscle tissue, adipose tissue) to the hormone.
4. Thiazolidinone derivatives(rosiglitazone, troglitazone) increase the activity of insulin receptors and thereby reduce glucose levels, normalizing the lipid profile.
5. Novonorm, Starlix. They act on the pancreas to stimulate insulin production.

Drug treatment begins with monotherapy (taking 1 drug), and then becomes combined, that is, including the simultaneous use of 2 or more glucose-lowering drugs. If the medications listed above lose their effectiveness, then you have to switch to the use of insulin drugs.

Diet for type 2 diabetes

Treatment of type 2 diabetes begins with a diet that is based on the following principles:

• proportional meals 6 times a day. You should always take food at the usual time;
• calorie content should not exceed 1800 kcal;
• excess weight requires normalization;
• limiting the consumption of saturated fats;
• reducing salt intake;
• reducing the amount of alcohol;
• food with plenty of vitamins and microelements.

Products that should be excluded or limited if possible:

• containing a large amount of easily digestible carbohydrates: sweets, buns, etc.
• spicy, salty, fried, smoked and spicy dishes.
• butter, margarine, mayonnaise, cooking and meat fats.
• full-fat sour cream, cream, cheeses, feta cheese, sweet curd cheeses.
• semolina, rice cereals, pasta.
• fatty and strong broths.
• sausages, sausages, sausages, salted or smoked fish, fatty poultry, fish, meat.

The dose of fiber for diabetic patients is 35-40 g per day, and it is desirable that 51% of dietary fiber consist of vegetables, 40% of grains and 9% of berries, fruits, and mushrooms.

Sample diabetic menu for the day:

1. Breakfast – oatmeal, egg. Bread. Coffee.
2. Snack – natural yogurt with berries.
3. Lunch – vegetable soup, chicken breast with salad (beets, onions and olive oil) and stewed cabbage. Bread. Compote.
4. Afternoon snack – low-fat cottage cheese. Tea.
5. Dinner – hake baked in sour cream, vegetable salad (cucumbers, tomatoes, herbs or any other seasonal vegetables) with vegetable oil. Bread. Cocoa.
6. Second dinner (a few hours before bedtime) – natural yogurt, baked apple.

Follow simple rules

Basic rules that a diabetic patient should take into account:

• stick to a healthy diet
• exercise regularly
• take medications
• check blood sugar levels

In addition, getting rid of extra pounds normalizes the health of people with type 2 diabetes:

• blood sugar levels reach normal
• blood pressure normalizes
• cholesterol levels improve
• a person feels lightness in the body.

You should regularly measure your blood sugar levels yourself. Once your sugar levels are known, your diabetes treatment approach can be adjusted if your blood sugar is abnormal.