Diabetes: eating well with diabetes

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1 Diabetes: eating well with diabetes A healthy lifestyle, including recommended food choices is important to keep you well. A healthy diet for people with diabetes is the same as that recommended for everyone. However it is particularly important that people with diabetes follow the guideline below as they are a vital part of treatment for good health now and in the future: plan your day and be prepared eat regularly do not miss meals have starchy foods at each meal preferably rich in fibre avoid sugar and sugary foods and drinks fat and fatty foods should be used sparingly include oily fish at least twice a week eat a variety of fruit and vegetables, aiming for five portions a day use salt sparingly have alcohol in moderation Your overall weight control indicates whether you are eating the right amount of food. If you are overweight, losing even a small amount of weight and keeping it off will help you control your diabetes. Try to be more active as this will help you control your weight and diabetes as well as reduce your risk of heart disease, high blood pressure and stroke. Plan your day and be prepared eat regularly: breakfast, lunch and evening meal do not miss meals Consider the following: do you need to improve your eating pattern? when are you more active? do you need a bedtime snack? Our bodies need food regularly especially before exercise and perhaps before bed. Starchy foods and high fibre Have starch foods at each meal, preferably rich in fibre. These should be the main part of each meal. They are ideal sources of energy for you: Source: Diabetes Team Reference No: Issue date: 20/11/17 Review date: 20/11/19 Page 1 of 5

2 bread pasta couscous cereals potatoes rice noodles Ideally choose from high fibre choices such as: Breads: find a loaf you like eg multigrain, granary, whole meal, high fibre white bread Potatoes: new with skins, jacket Cereals: wheat biscuits, bran flakes, puffed wheat are all good choices; porridge is especially good Rice and pasta: try wholemeal pasta, easy cook brown rice Beans and pulses: baked beans, kidney beans, pearl barley, lentils etc Beans and pulses are especially useful in your diet, try them in: soups or casseroles, making meat dishes go further, curries or salads. Starchy foods are the most useful fuel. Sugar and sugary foods and drinks Avoid sugar, honey and sugary foods and drinks as they will make your diabetes more difficult to control. You may be surprised at how your tastes can change. If you need to sweeten use artificial sweeteners such as Sweetex, Canderel or Hermesetas in powder or tablet form. Always add artificial sweetener at the end of cooking for the best taste. Do not use Sorbitol. Use diet or low-calorie fizzy drinks and sugar free or no added sugar squashes. Sugary drinks cause blood glucose levels to rise quickly. Try reduced-sugar, low-sugar and sugar-free foods, e.g. sugar-free jelly, reduced-sugar milk puddings and whips, reduced-sugar jam and tinned fruit in juice as they help you reduce the overall sugar content of your diet. Savoury foods e.g. tinned vegetables, baked beans, ketchups, sauces, ready-made meals and tinned soups do not present a problem. Replace hot chocolate type drinks with lower calorie drinks, e.g. cocoa with sweetener, Options, Highlights or supermarkets own blend. Do not use fruit juice to quench your thirst.

3 Fat and fatty foods People with diabetes have a greater risk of heart disease. Having a reduced fat intake is important to minimize that risk. Avoiding fatty foods has the added benefit of successful weight control. Fat and fatty foods should be used sparingly. Cut out fried food. Eat fruit as a snack, instead of high calorie snacks such as biscuits, sweet pastries, crisps and nuts. Suitably cooked chicken and turkey are low in fat especially without the skin. White fish are also low in fat. Have smaller portions of lean meat, removing visible fat. Preferably use spread that is low in saturated fat- use the least amount scrape on scrape off. Dairy products ie milk, yoghurt and cheese are an important part of a well-balanced diet. Use lower fat varieties skimmed milk, low fat no added sugar yoghurt. Remember to use cheese sparingly. Cut down on fatty pastries, processed foods, Yorkshire puds and dumplings. Have casseroles and Tomato based curries more frequently. Beware of creamy sauces. Oily fish Plan to include oily fish in your diet at least twice a week: Fish oils are beneficial in preventing heart disease. Mackerel, salmon, herring, sardines and pilchards are oily fish. These can be bought fresh or tinned (preferably in tomato sauce). For those who cannot tolerate oily fish, supplements containing Omega 3 fatty acids (0.3 1gm) are recommended daily. Fruit and vegetables Eat a variety of fruit and vegetables, aiming for a least 5 portions spread throughout the day. All fruit and vegetables are low in fat and calories and are a good source of vitamins and minerals. A portion of vegetables is two to three tablespoons or a small bowl of salad. Use a fat free salad dressing. A portion of fruit is: a piece of fruit (such as an apple banana or pear) a slice of large fruit (such as melon, mango, pineapple) two small fruits (such as satsumas, apricots) a cupful of berries or grapes

4 three serving spoons of tinned or stewed fruit a dessert soon of dried fruit Have an extra portion of vegetables to replace your Yorkshire puddings and stuffing. Fruit is good as a low calorie snack or pudding. Frozen or tinned fruit in natural juice are useful alternatives to the fresh variety. Dried fruit can be used on cereals. Fruit juice is rich in Vitamin C. However, it can cause blood glucose levels to rise too quickly. A small wineglass taken with a meal is not excessive. Eating plenty of fruit and vegetables helps reduce your risk of heart disease and cancer. Salt Use salt sparingly in cooking and on your plate. Processed foods are often high in salt. Alcohol Alcohol in moderation alcohol can be included in a healthy diet, check with your doctor first. At most 2-3 units of alcohol daily. One unit of alcohol is: ½ pint of beer A glass of wine or sherry A single shot of spirit. Remember to choose diet mixers and go carefully with sweet wines and liqueurs. Never drink on an empty stomach as it makes a hypo (see below) more likely. You may need a starchy snack before bed. Remember alcohol is a source of calories. Diabetic foods Diabetic foods are not recommended. Most are expensive, high in calories and fat. They can cause diarrhoea. Other points Keeping Active: What could you see yourself doing to be more active? Why not try it? Exercise helps lower your blood sugar, keeps your heart in good order, helps you lose weight and keeps you supple. Aim to take some exercise every day and more strenuous exercise 3 times a week. Try energetic gardening, walking or dancing. Do you need to check with your doctor before starting any sort of exercise?

5 Special Treats: An occasional treat is quite acceptable, but should be eaten at mealtimes or before exercise. Illness: Even if you are unwell or feeling run down, you must try to eat and drink regularly. Try to eat little and often or at least have milky drinks. Never stop your insulin or diabetic tablets. Consult your doctor if you are concerned. Fluids: Always remember to drink regularly, through the day water is an easy choice. Hypoglycaemia (hypo): This occurs when your blood glucose level drops too low. It is most likely to happen if you miss or delay a meal, are more active than usual or drink alcohol on an empty stomach. Symptoms of going hypo include dizziness, sweating, trembling and confusion. If you start to feel a hypo coming on you must take something sweet ie dextrose (3 tablets) or a drink containing sugar i.e. sport drink (1/3 of a medium sized glass). This should be followed by wholemeal biscuits, bread or your usual meal. Consult your doctor if you have regular hypos. Overweight: What are you eating? Keep a food diary. Are you eating too much? Your activity levels do they need increasing? For further information go to: Reproduced with permission of Dr Nishan Wijenaike MD, FRCP Consultant Diabetologist West Suffolk Hospital Diabetes Service If you would like any information regarding access to the West Suffolk Hospital and its facilities please visit the disabledgo website link below: West Suffolk NHS Foundation Trust