Practical strategies for diabetes management

What is diabetes?

Diabetes is a chronic health condition where the body can’t maintain healthy levels of glucose in the blood. When we eat food containing carbohydrate this carbohydrate is broken down into glucose molecules. This glucose then enters the blood stream where insulin (a hormone produced in the pancreas) transports the glucose to our muscles or liver where it is stored for use as energy when required. Individuals with diabetes either do not have adequate insulin to transport glucose or their insulin is resistant to glucose and consequently glucose remains in their blood stream for long periods of time. This can lead to many major long term health consequences including kidney damage, blindness, heart attack and stroke.

Types of diabetes

Type 1 Diabetes

Type 1 diabetes primarily occurs early in life and accounts for around 10% of diabetes cases in Australia. People who have type 1 diabetes do not produce any or only very small quantities of insulin, resulting in accumulation of glucose in the blood as it cannot be transported to the body’s cells for storage.

Type 2 Diabetes

Type 2 diabetes is often referred to as late onset diabetes as it primarily occurs later in life as a result of lifestyle factors, however it is becoming increasingly more common at younger ages. While individuals with type 2 diabetes still produce insulin, this insulin is less effective as the body’s cells do not respond properly to the insulin. This results in high blood glucose levels.

Gestational diabetes

Gestational diabetes refers to high blood sugar levels that occur during pregnancy and may put both the child and mother at risk. Gestational diabetes is most similar to type 2 diabetes as individuals with gestational diabetes still produce insulin however production may have reduced or it may be less efficient. Gestational diabetes can occur in healthy people with no obvious lifestyle factors hence pregnant people are required to do an oral glucose tolerance test during their pregnancy to ensure they do not have gestational diabetes.

Carbohydrate

Carbohydrate is the main source of energy for your body and is found in a range of foods, including whole grains and cereals, milk and yoghurt, fruit, some starchy vegetables, and convenience and processed foods and beverages such as table sugar, honey, biscuits and soft drink.

All carbohydrates are broken down into glucose (sugar) which then enter the bloodstream. It’s then the job of insulin to transport this glucose to your body’s cells. It is important that people with diabetes appreciate that the digestive system doesn’t differentiate where sugar comes from and they manage total carbohydrate intake, not just “sugar”. However, it must also be noted that different carbohydrate-containing foods break down into glucose at different rates, so choosing the right type of carbohydrate foods and eating the correct quantity is important for diabetes management.

Glycaemic Index

The Glycaemic Index (GI) is a ranking between 0 and 100 given to carbohydrate foods according to how they affect blood glucose levels. High GI carbohydrate foods are quickly digested and absorbed in the bloodstream, resulting in a higher and faster rise in blood glucose levels after eating. Low GI carbohydrates break down slowly, releasing glucose gradually into the bloodstream, resulting in a smaller and slower rise in blood glucose levels after eating.

Can you cure diabetes?

Unfortunately, there is currently no cure for diabetes. Insulin is vital to help manage type 1 diabetes and lifestyle intervention such as dietary changes and regular exercise are important for managing type 2 and gestational diabetes. However, it’s important to remember that you can live a healthy and happy life with diabetes; proactive management is the key.

Cooking and diabetes management

Being a confident cook and cooking at home frequently increases your knowledge about food and ingredients. This helps you make informed decisions about what you are putting into your body, and the associated health implications, because many foods often contain more ingredients than meets the eye! Cooking and reading food labels, coupled with sound knowledge regarding the sources of carbohydrate are important skills when it comes to effective diabetes management.

Practical strategies for diabetes management

1. Speak with your dietitian or diabetes educator to determine the recommended amount of carbohydrate you should consume per the day and spread this intake evenly over the day.
2. Use food labels and nutrition apps such as Calorie King to calculate the total amount of carbohydrate you will consume from a product or in a complete meal.
3. Choose mainly high nutrition quality, low GI carbohydrate foods such as whole grains, legumes, fruits and vegetables.
4. Consider the overall nutritional value of low GI foods including the amount of kilojoules, saturated fat, salt and fibre. Not all low GI foods are nutritious!
5. Spread your carbohydrate intake evenly over the day to reduce spikes in blood sugar levels.
6. Include small serves of protein rich foods over the day to assist with managing blood sugar levels. Include foods such as cow’s milk or eggs at breakfast, lean meat, eggs or tuna in wraps, salads and sandwiches, and yoghurt, cheese or nuts as part of snacks.
7. Combine high GI foods with low GI foods to lower the overall GI of a meal.
8. Include small, frequent amounts of unsaturated fats such as extra virgin olive oil, nuts, seeds and avocado to help stabilise blood sugar levels and reduce the risks associated with heart disease, which individuals with diabetes are at a greater risk of.
9. Engage in regular exercise, aiming for at least 30 minutes of exercise per day. This will help improve insulin efficiency, plus it has the added benefit of helping maintain a healthy weight, which is also important for diabetes management.

Themis Chryssidis is an Accredited Practising Dietitian at Sprout Health Studio – a multidisciplinary health care studio in Adelaide. He has a Bachelor of Psychology, a Masters of Nutrition and Dietetics and a Cert IV in Fitness.