Diabetes Info

If diabetes has been diagnosed in your case then you will probably have a lot of questions. This home page is designed to help you find some of the answers, and to support you in living a healthy life and in taking an active role in the administration of your own treatment.

Diabetes Info

Diabetes

The first thing that you should know is that you are not alone. Throughout the world more than 100 million people have diabetes and live, to a large extent, without any discomfort. The secret lies in learning a new attitude towards nutrition and in using this knowledge your life long.

Eating should be a pleasure, and by choosing nutritionally good foods it should also support our health and general feeling of well-being.

The term “diet” is often interpreted incorrectly and has negative connotations. Most people connect the word with “sacrifice” or “restraint” when they hear it. “Diaita” (Greek) means “a way of life ordered by the doctor” and this is what has to be made clear to people who are affected: Matching the lifestyle and the food consumption style to the needs of the organism. “Diet” does not mean waiving the right to eat, but planning what you eat. A “freestyle” diet does not lead to success.

A healthy, balanced diet of natural foods with little fat , low salt and sugar content is also recommended for people who are healthy and do not suffer from a metabolic illness: it is the base for healthy effective treatment and nutritional therapy for diabetes.

A healthy way of life helps you to feel better than ever before, and to prolong life expectancy.

Interesting facts:
In the diet plan of a diabetic, a sweet tooth can also be catered to. Within the boundaries of balanced nutrition a maximum amount of up to 10% of the daily energy requirements can be consumed by diabetes sufferers in the form of sugar. Sugar has to be used within the confines of the carb count/bread unit treatment (BU therapy) and should not be used in an isolated way in a pure form e.g. for sweetening drinks or desserts ( the same applies to other substances containing sugar such as honey, maple syrup, pear syrup etc).

There is an optimum alternative to sugar and that is KANDISIN . KANDISIN tastes pleasantly sweet, can be easily portioned and can be used without having to calculate the BU value.

Energy requirement

The amount of energy taken in should, on an average, equal the amount of energy burnt. If this is the case, weight stays the same. If there is a change in this balance of energy e.g. if you eat more than can be burnt for days on end, then you gain weight and of course the opposite is also true. It is just as important for diabetics and non-diabetics to maintain normal body weight, respectively to achieve it if they are overweight because incorrect nutriti on can easily lead to metabolic illnesses, high blood pressure and to a deterioration of the diabetes status.

1. Ways of calculating energy requirement:

The measure for energy is recorded in kilocalories or kilo joules: 1 kcal = 4,186 kJ
The term comes from the Latin word "calor" and means "warmth": "A kilocalorie is the amount of energy needed to heat one litre of water by one degree" – that is the physical definition.
The unit "kilocalorie" (1 kilocalorie = 1.000 c alories) was joined by the unit “kilo joule” due to international agreements: 1 kilocalorie (kcal) = 4,186 kilo joule (kJ) Energy requirement is generally dependent on type and amount of physical activity.

1.1 Basal metabolic rate + performance rate

Basal metabolic rate is the min imum calorific requirement needed to sustain life in a resting individual.

Calculation: 1 kcal per kg body weight (normal weight) and hour Example: A person who is 170 cm tall has a normal weight of 70 kg
1 kcal x 70 kg x 24 hours = 1680 kcal

Performance rate is the amount of energy required for physical activity and depending on the degree of physical work is equal to 1/3 (light work), 2/3 (middle to heavy work) respectively 3/3 (heavy work) of the basal metabolic rate.

Example:
Body weight 70 kg, height 1. 70 metres
Occupation: Clerk
Basal requirement 1680 kcal + performance requirement (1/3 BMR) 560 kcal = 2240 kcal

1.2 Energy quotient

With the energy quotient you can calculate the amount of energy required per kilogram of body weight (BW) per day based on normal weight

Energy quotient:

Bed rest 24 kcal per kg BW
Light work 32 kcal per kg BW
Middle work 37 kcal per kg BW
Heavy work 40 kcal per kg BW

Example:
Body weight 70 kg, Height 1.70 Meter,
Occupation: Clerk
70 x 32 = 2240 kcal

Calorific value of nutrients

Water or tea provide 0 kcal
1 g protein4 kcal or 17 kJ
1 g carbohydrates4 kcal or 17 kJ
1 g fat 9 kcal or 37 kJ
1 g alcohol7 kcal or 29 kJ

Nutrition Guidelines for Diabetics

A balanced diet, which is also recommended for people who do not suffer from a metabolic illness , is the basis for every diabetes therapy. Simply avoidi ng sugar and sweets does not constitute a balanced diet.

1) Sufficient Carbohydrates (45 – 60 % of energy intake)

  • Use primarily whole grain cereal products as they contain a lot of fibre and help you to feel satisfied, improve digestion and slow down the rise in blood sugar levels
  • Eat vegetables (especially raw) and leafy salads daily
  • Eat fresh fruit for snacks and as a dessert daily
  • Add more pulses , especially as a salad to your menu
  • The “side dishes” should become the main part of the meal
  • Small amount of sugar (10% of the daily energy intake is allowed ; this means you need to be mean with confectionery, cakes, chocolate and biscuits; also avoid drinks and stewed fruit which contain sugar)

2) Little fat (35 % of energy intake, less than 10% saturated fatty acids, daily cholesterol intake should not be more than 300mg, height in cm minus 100 equals fat per day in g)

  • Smaller portions of meat and less meat, luncheon sausage or cheese on your bread
  • Fewer animal fats, saturated fats and hardened fats. Cholesterol intake is reduced
  • Fish several times a week, meat and meat products less often
  • Be mean with cooking fats. Control how much you really use with a teaspoon. Cook more often using a method that doesn’t use fat
  • When preparing meals use vegetable oils, and on bread only a little butter or vegetable margarine
  • Include only fat-reduced dairy products in your menu (low fat quark, cheese, milk, yoghurt)
  • Less salt, use more spices and herbs
  • Drink sufficient low energy, sugar- free fluids. 2 – 3 litres (20 – 45 ml per kg of body weight) in the form of tea, tap water, mineral water, 100% pure fruit or vegetable juices strongly diluted with a lot of water . Strong coffee and black tea are classified as stimulants and are not counted as fluids
  • Fruit and herbal teas have the advantage that they stimulate metabolism and add more variety to the menu in many different flavours
  • Use alcohol sparingly, it has a lot of calories and should only be drunk in accompaniment with a meal (danger of hypoglycaemia)
  • Regular exercise (walking, gymnastics, cycling) not only keeps you fit but improves the effect of insulin

Dividing the daily amount of food into several little meals rich in carbohydrates guarantees optimum energy intake. In addition to this, when the contents of the meals are well-planned, blood sugar highs can be avoided. There should not be more than 3 hours between each meal.

Basic therapy for Type 2 Diabetes
It is necessary to change eating habits, lifestyle and attitude to food step by step. Long-lasting success can only be achieved with a long-term therapy plan, crash diets are not to be recommended .

  • Reach or maintain normal weight
  • Division of meals (5 – 6 small meals)
  • Depending on type of therapy, calculation according to carb count/bread unit ( BU calculation)
  • Taking into account of the effect on blood sugar levels of various foods e. g. carbs from white bread enter the blood faster than those of whole grain bread
  • Increasing the amount of fibre ( complex carbohydrates)
  • Sufficient fluid intake
  • Lowering fat intake and change in types of fat where necessary (high quality vegetable fats)
  • Exercise plan

Basic therapy for Type 1 Diabetes

  • Reach or maintain normal weight
  • Strict compliance with meal times (approx. every 2 – 3 hours)
  • Exact calculation of and compliance with the BU value plan prescribed
  • Taking into account of the effect on blood sugar levels of various foods e. g. carbs from white bread enter the blood faster than those of whole grain bread
  • Increasing the amount of fibre (complex carbohydrates)
  • Sufficient fluid intake
  • Lowering fat intake and change in types of fat where necessary (high quality vegetable fats)
  • Exercise plan

The various types of foods:

Drinks:

Drinks without sugar and calorific value
Tap water, mineral water, tea (with artificial sweetener), coffee ( without milk, with artificial sweetener) and calorie free “light” soft drinks with artificial sweetener. These drinks do not have an effect on raising blood sugar levels. Coffee does not serve as a thirst quencher; it has a diuretic effect, and up to 2 – 3 cups per day can be drunk. Milk raises blood sugar levels and is not a replacement fluid.

Drinks with low sugar content and low calorific value
Diet juice drinks: in the case of these drinks the amount of fructose is reduced to a minimum, nonetheless they have a light effect on raising the blood sugar level.

Reasons for drinking sufficient fluids are that they aid digestion, stimulate metabolism, lower blood sugar and detoxify due to increased urine excretion.

Vegetables:

Vegetables contain a lot of water and few calories. Vegetables are especially val uable due to their high mineral, vitamin and fibre content, and are therefore a valuable mainstay of healthy nutrition. Vegetables, excepting potatoes and corn, no longer need to be calculated for diabetics having insulin treatment.

Fruit:

Eat fresh fruit daily as a snac k between meals and for dessert! You can eat any fruit you like. Diabetics using insulin have to calculate the BU value of fruit as part of their BU therapy plan.

Grapes, plums, cherries, damsons and bananas are to be consumed sparingly due to their high sugar content.
Dried fruits (e.g. dates , raisins, prunes) lead to rapid, high sugar level peaks. So please only use them with intention and also calculate their value.

Fat and protein:

Fat and protein do not result in a rise of blood sugar.

The daily requirement of protein is between 10 % and 20% of total energy intake. One third of this total daily intake should be consumed in the form of animal proteins (e.g. fish, meat, dairy products) and the other two thirds as vegetable proteins (pulses, grains, potatoes).

Consumption recommendations per week:
2 – 3 times a small portion of meat (100g – 150g per portion)
1 – 2 times salt water fish (cod, sole...)
2 – 3 times sausage (1 portion = 50g)
3 eggs ( including eggs as ingredients in other foodstuffs)

Daily:
¼ ¼ to ½ litre of fat reduced dairy products (buttermilk, yoghurt, milk...)
50g low fat cheese (up to 35 % fat in dry matter)

„Fat makes you fat“. Excessive fat consumption is the cause of unwelcome weight gain in most cases. Fat content should not be more than 25% to 35% of the total energy intake. The quality of the fats depends primarily on their composition. Animal fats contain additional cholesterol (lipids), which damages blood vessels and leads to hardening of the arteries. Sparing use of high-quality vegetable fats such as rape oil, olive oil, sunflower oil and maize germ oil etc. can prevent arteriosclerosis . Coconut oil fat (Ceres) is not an ideal cooking fat!!

Consumption recommendations:
½ = cooking fat and fat spread (visible fat)
½ = hidden fat (in meat, nuts, sausages,)

Daily:
Max. 20g of fat spread (butter or high-quality vegetable margarine)
20g of high-quality vegetable oil = 2 Tbsp oil for cooking or salads
Max. 40g hidden fat contained in sausage, cheese, milk...

Diabetic products:

Fructose and sugar alcohols such as Sorbit, Xylit… are termed sugar substitutes. These sweeteners which also count as sources of energy have no great advantage over refined sugar, except for a reduced carcinogenic effect. Many products which are recommended especially to diabetics often contain a lot of fat and are quite often considerably more expensive than regular products and should therefore be disregarded.

Alcohol:

Alcohol should only be consumed after previous consultation with your doctor! An alcohol intake of 20g per day (= approx. t wo small glasses of wine) is generally acceptable for most people. Alcoholic drinks with a low residue sugar value such as dry wines, dry champagne, or ciders diluted with mineral water ; whisky, vodka, schnapps, rum, etc. a re allowed in small amounts but remember they should be consumed at the same time as a meal (danger of Hypoglycaemia = dangerously low blood sugar level). Sweet dessert wines, diabetic sparkling wines, diabetic beers, malt beer and liqueurs are not suitable . Beer actually raises the blood sugar level and has to be calculated into the BU diet plan. Apart from that, alcohol has a lot of calories and also stimulates appetite.

Sugar:

Within the boundaries of a balanced diet an amount of sugar equal to 10% of the daily energy intake at a maximum, can be consumed by diabetics in the form of sugar. Pure sugar is rapidly absorbed and should therefore be avoided in large amounts . Sugar should not be used in an isolated, pure form e.g. as a sweetener in drinks or stewed fruit. But sweet things do not have to be excluded from the menu as, thanks to KANDISIN, there is an excellent alternative to sugar.

Sugar substitutes:

Fruit sugars (Fructose, Fructan) and sugar alcohols such as Sorbit, Xylit , Mannit, Maltit, and Isomalt are called sugar substitutes. Sugar substitutes are substances which appear in natural form, in fruits, vegetables, mushrooms, seaweeds etc.

In comparison to refined sugar, fruit sugars have a noticeably stronger sweetening power (double as strong) and raise blood sugar levels only slowly. Fruit sugar has to calculated into the BU diet plan and, when using it for baking, the oven temperature should be lower; the baking time proportionately longer (browns quicker).

Sugar alcohols such as Sorbit have the same sweetening power as refined sugar, raise blood sugar levels slowly and have to be calculated into the BU diet plan. Apart from that they sometimes have a laxative and a flatulent effect ( observe consumption recommendation on the packaging).

Sugar substitutes contain the same amount of calories and carbohydrates as sugar; therefore also have to be calculated in bread or carbohydrate units.
(12g fruit sugar = 1 bread/carb unit)
(20g Sorbit, Mannit, Xylit = 1 bread/carb unit)

Artificial sugar substitutes:

For sweetening, artificial sweeteners in tablet form, powder form and fluid form are of fered e.g. KANDISIN
They have strong sweetening power, no calories and no effect on blood sugar levels.

Exceptions are sweeteners based on Aspartam the effects of which are negligible. Aspartam consists of amino acids, which in opposition to other sweeteners are not excreted unchanged but are digested normally. Due to the concentrated sweetening effect it is only used in tiny amounts, therefore the calorific value is so small that it does not have to be considered in the calculations of diabetics.

What is Diabetes?

The term diabetes denotes a collection of chronic symptoms which are brought on by a high level of sugar (Glucose) in the blood which is excessively high above the normal value.

The sugar (Glucose) comes from food. Normally this sugar serves, together with the fats, as a source of energy for the human body. To be able to break down the sugar , the body needs insulin, a hormone produced by the pancreas, which is situated behind the stomach in the abdominal cavity .

When insulin is not produced, or only in insufficient amounts, diabetes is the result and therefore the body has problems in using and controlling the level of sugar (Glucose).

If the blood sugar (Glucose in the blood) is not able to enter t he cells, the level in the blood rises and this leads to the symptoms of diabetes. High blood sugar levels are transported over the kidneys (kidney threshold) and excreted with the urine.

If high blood sugar levels remain untreated, they can lead to further diabetes-related complications in the eyes, kidneys, heart, nervous system and feet.

There are three main types of diabetes:

Type 1 Diabetes Mellitus:

  • Insulin-Dependent Diabetes Mellitus, arises when the cells of the pancreas no longer produce any insulin, and is usually found in children and youths, generally in people under the age of 30.
  • It arises suddenly and is accompanied by noticeable symptoms (strong thirst, increased urination, weakness etc.)
  • The nutritional status of the patient is usually normal; sometimes there can be cases of leanness. When the symptoms have become noticeable a conspicuous weight loss sets in.

Type 2 Diabetes Mellitus:

  • Noninsulin-Dependent Diabetes Mellitus generally appears in persons over 40 years of age and is the most common form of the illness. Heredity is a deciding factor as well as the risk factors of obesity, lack of exercise, (illness of the affluent society).
  • The pancreas produces insulin, but too little of it or body cells are resistant to it.
  • The illness begins inconspicuously and progresses gradually. Symptoms are hardly noticeable, which is why they often remain undetected. The illness and obesity go hand in hand. Usually there is no weight loss to be seen when the illness arises.
  • Treatment can take the form of a diet (weight reduction) alone or as a combination of diet and medication.

Gestational Diabetes Mellitus

  • Often arises in the second half of the pregnancy, normally disappears after birth, is quite often he reditary and can develop into type 2 at a later age.

What are bread units?

Our main nutrients are carbohydrates, protein and fats. The greatest amount of our food (45 – 60 % of total energy intake) should be consumed in the form of carbohydrates. When carbohydrates are consumed they directly influence the blood sugar level . Fats and protein hardly affect the blood sugar level.

In a word:

A bread unit is the amount of a foodstuff containing carbohydrates, in which there are 10 g – 12 g of available carbohydrates
1 Bread Unit (BU) = 12 g carbohydrates

An exact calculation of carbohydrates (B U calculation) is only necessary for people undergoing insulin therapy.

The amount of carbohydrates the body needs depends on the weight and the personal eating habits of each individual. Diabetics must balance the effect of the insulin and the intake of carbs very carefully. That is why the amount of insulin and the dividing up of the carbohydrate intake is to be discussed with your doctor and a diabetes consultant.

BU calculation in practice:

Use of the BU calculation table (Novo nordisk, Aventis)
The following carbohydrate foodstuffs are listed in the BU table:

  • Grain products
  • Fluid dairy products (yoghurt, sour milk products, skimmed and full fat milk, whey, kefir)
  • Nuts (cashew nuts, chestnuts)
  • Potatoes, corn
  • Fruit, fruit products
  • Beer
  • Sugar
  • Sugar substitutes (fruit sugar, Sorbit...)

Foods and foodstuffs with a negligible amount of available carbohydrates are not included (almost no effect on blood sugar levels - “negligible“) respectively foodstuffs containing no carbohydrates at all:

  • Most vegetables (except those mentioned above)
  • Pulses
  • Meat and meat products
  • Poultry, fish
  • Egg
  • Oil, butter, margarine, mayonnaise
  • Cheese, quark

Diabetics should definitely mind their intake of fats. In most cases of undesired weight gain an excessive intake of fat Diabetics should definitely mind their intake of fats. In most cases of undesired weight gain an excessive intake of fat i s the cause. “Fat makes you fat“. It is largely the Type 2 diabetic who is affected. In addition the quality of the fats used also plays a role in general well-being and in care of blood vessels and organs of the body.

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