The Diabetic Diet: What to Eat if you Have Type II Diabetes
In a normal, healthy person, the hormone insulin is produced in response to rising levels of glucose in the bloodstream, for example after you eat something containing sugar. Insulin regulates how the body stores and uses this glucose, and stops the bloodstream levels of glucose falling too low, or rising too high.
Type II diabetes is caused when not enough insulin is produced by the pancreas, or when the insulin produced is not effective. The disease can run in families, but being overweight and a lack of physical activity are also significant risk factors. It is thought that inflammation, stress and autoimmunity can also lead to Type II diabetes. Symptoms include excessive thirst, extreme tiredness and unexplained weight loss.
There is no drug treatment or cure available for Type II diabetes, however making healthy lifestyle changes can have remarkable effects for people suffering with this condition. Uncontrolled diet and weight can lead to serious complications including heart disease, stroke, nerve damage, diabetic retinopathy and kidney disease.
The diabetic diet
The healthy eating recommendations for an optimal diabetic diet are centred on maintaining a healthy weight and eating food that helps your body to control its internal glucose levels.
Controversy over NHS guidelines
The NHS states that if you have diabetes, you should a healthy balanced diet that is low in fat, sugar and salt and contains a high level of fresh fruit and vegetables1,2.
Most Diabetic groups and Associations agree with these recommendations. However there is considerable disagreement around the NHS’s current advice to include starchy, low glycaemic index (GI) carbohydrates like potatoes, cereals, pasta, rice and bread with every meal. Anecdotal evidence shows that many diabetics cannot tolerate any starchy carbohydrates in their diet.
When carbohydrates are consumed, the body breaks them down into simple sugars so that it can use them for energy. Carbohydrates are ranked on the GI scale, which is based on how quickly the body can break these carbohydrates down.
Carbohydrates with a high GI score, such as white bread and white potatoes, are broken down quickly in the body and cause a rapid spike in blood sugar levels. Because a Type II diabetic’s insulin doesn’t work properly, they will have problems in regulating this sugar spike. For this reason, high GI scoring foods should be avoided by Type II diabetics.
Carbohydrates with a low GI score such as whole oats, beans, lentils or brown rice take longer to break down in the body and cause a slower release of sugar into the body. Type II diabetics should choose carbohydrates with a low GI score.
Factors affecting the GI of food
Food processing – refining grains to remove the bran and germ gives foods a higher GI than minimally processed whole grain products such a whole wheat flour and brown rice.
Fibre – foods containing high levels of fibre have lower amounts of digestible carbohydrates. This slows down the rate of digestion and causes a slower rise in blood sugar levels.
Size of grain particles – finely ground grains such as finely milled whole wheat flour or brown rice flour can also increase the GI of a food. Whole grains such as oats and brown rice have a lower GI because their physical form is still intact.
Fat content – foods containing higher levels or fat are broken down more slowly by the body3.
So what should you eat?
The most suitable diabetic diet is a healthy balanced diet that contains plenty of fresh fruit and vegetables, is high in fibre and low in saturated fat, sugar and salt. Because extensive food processing can increase the GI of foods, it is important for all diabetics to avoid refined carbohydrates such as white bread, pasta, rice and baked goods.
Although current NHS guidelines suggest basing every meal around a starchy carbohydrate with a low GI, this may not be suitable advice for all Type II diabetics. A report issued by Diabetes UK in 2011 suggests that ‘a modest reduction in carbohydrate intake is associated with improvements in glycaemic control and low carbohydrate diets can be particularly effective if associated with weight loss.’4. In other words, a low carb diet can be effective in some patients.
Some general rules to follow:
– Eat plenty of fresh fruit and vegetables
– Eat plenty of lean protein such as fish, chicken and eggs
– Weight management is important for diabetics so minimise foods high in saturated fat and refined sugar, and watch your portion control
–Eat a diet low in processed foods which often contain high levels of sugar and salt, and may have a higher GI score because of the processing procedures used to produce them
– Never skip meals (this is very important for stabilising blood glucose levels) and have regular, small healthy snacks during the day
– Eat plenty of high fibre foods such as pulses and legumes, as well as non-starchy fruit and vegetables
– Every person is different, you will need to monitor your own body’s tolerance to eating low GI, minimally processed foods such as coarsely milled whole wheat bread, whole grain pasta and brown rice. Once you know how these products affect you, you can decide how often to include them in your diet
– A low carb diet may be a suitable choice for you if you find that your blood sugar levels increase significantly even after eating low GI foods
A low carbohydrate, diabetic diet with plenty of fresh fruit and vegetables is optimal, based on current scientific evidence, under the full guidance of your GP or dietitian.
Medical disclaimer: Sonia Nicholas is a Biomedical Scientist, not a medical doctor. The information provided in this article is for general information and is not intended as medical advice. If you have diabetes you must always consult a doctor about your condition and treatment. If you are planning to make significant changes to your diet, you should also discuss this with your doctor.