Nutritional tips for managing diabetes

1. Eat breakfast within 2 hours of waking every day
A balanced breakfast will kick start your metabolism and help stabilise your blood glucose levels.  Ensure that your breakfast is made up of the following:

Slow releasing carbohydrate E.g.: high fibre cereal or seedloaf bread (about a fist full portion)

Lean protein or dairy (about a fist full portion or cup)

2. Keep the momentum by eating regularly
Eating every 3 – 4 hours will prevent dips in blood glucose and thus help to manage appetite and energy levels.  Ideally a balance of slow releasing carbohydrate AND lean protein makes the perfect meal or snack. 

3. Gliding with the GI
The Glycemic Index provides a more user-friendly and revolutionary tool when planning meals suitable for the person with diabetes. The Glycemic Index of foods is simply a rating of foods according to their actual effect on blood glucose levels. In the past it was assumed that complex carbohydrates such as whole-wheat bread, brown rice and potato were digested and absorbed slowly, resulting in a slight rise in the blood glucose level. Simple sugars, on the other hand, were believed to be absorbed quickly producing a rapid rise in the blood glucose level. We now know that these assumptions were incorrect, and people with diabetes no longer need to avoid sugar, provided they use it correctly. 

Foods that are digested and absorbed as glucose quickly are classified as HIGH GLYCAEMIC INDEX foods or fast release foods. They cause a rapid increase in blood glucose levels. 

Constantly elevated blood glucose is detrimental for those with or without diabetes. In fact, research is now pointing to the over consumption of high glycemic index foods as the main culprit in the heart disease pandemic!

Foods that are digested and absorbed slowly are classified as LOW GLYCAEMIC INDEX foods or slow release foods. These foods assist in keeping blood glucose levels constant and produce small increases in blood glucose levels. These are the foods that require less insulin.

How can I use the GI?

To achieve good blood glucose control, every meal should consist mostly of the more slowly absorbed carbohydrates (low GI foods). 

Follow these three easy steps to put together healthy main meals:

a. Choose about a fist full of low GI foods as the bulk of your meal. At least one must be a fruit or a vegetable. Low GI foods include: apples; berries, oats; pears; beans, lentils, sweet potato; citrus fruits; barley; sweet corn; high fibre cereals, seedloaf bread or rye bread. 

b. Add a small portion of lean protein or dairy such as: chicken, tuna in brine, fat free cottage cheese; fat free or low fat plain yoghurt, lean shaved chicken or turkey or an egg. 

c. Choose only one small portion of fat per meal. Give preference to natural fats such as: raw, unsalted nuts, seeds, avocado & cold pressed plant oils such as olive oil. 
1 portion = 1 tablespoon nuts/seeds; 5 olives; ¼ avocado. 1 teaspoon of oil.

4. Fat attack
Reduce the total amount of fat in the diet. Choose low-fat foods; grill, boil, bake or steam foods rather than fry; remove all visible fat from chicken and meat prior to cooking, avoid processed meats such as polony and salami and use low fat or fat free dairy products, such as low fat cheese, milk and yoghurt.  Avoid too much margarine / butter. (Avoid margarine and limit butter intake)  Rather use hummus, fat free cottage cheese, mustard, or even small portion of mashed avocado or baked beans as a spread.

5. Staying fluid 
Alcohol should be taken in moderation - no more than 2 drinks per day is recommended by the South-African Diabetes Association. Always consume alcoholic drinks with a meal or snack, and not on an empty stomach. Watch out for cocktails and mixes of alcohol that contain lots of sugar and alcohol and will dangerously elevate blood glucose levels! Be careful of fruit juices which are highly concentrated and will significantly increase blood glucose levels. If you must have fruit juice limit to 125ml – 250ml per day – always diluted in double the amount of water. Coffee may slightly increase blood glucose levels and should be kept to less than 3 cups daily. Have at least 2 litres (8 glasses) of water each day.  
When it comes to alcohol the best thing you can drink here is one glass of red wine per day.

6. Diabetic foods
There is no need to buy the special, usually more expensive 'diabetic' foods. Many diabetic products such as diabetic chocolate and biscuits, are high in fat and fructose, and should, therefore be used with caution. They are unlikely to help with weight-loss or blood glucose control.   The good news is that “normal�? foods can fit in to a person living with diabetes! 

7. Supplements 
Along with following a low GI diet, introducing other dietary compounds to aid blood glucose control is definitely an option. Products to consider are the essential fatty acids found in salmon and flax seed, alpha lipoic acid, magnesium, vitamin C, vitamin E, carnosine, cinnamon and chromium picolinate to name but a few. 
It is very important though to start these nutritional supplements under the guidance of a health professional that understands their working and mechanism of action.   

Other topical supplements are manna which is thought to improve blood glucose control. 

8. Final notes
Know your physiological tolerance.  This is the difference between your blood glucose levels before a meal and 2 hours after a meal.  Ideally this difference shouldn’t be more than 3mmol/l.  Therefore TESTING and knowing what impact meals and snacks are having on your blood glucose levels will lower your risk for complications significantly. It is highly recommended that you occasionally keep an accurate food record of everything you eat as well as testing before and after certain meals. Use these recordings and measurements with your dietitian to ensure that your risk for any complications is minimised. 

Disclaimer: The information contained in this document is not intended to replace the attention or advice of a physician or other health care professional. Anyone who wishes to embark on any dietary, drug, exercise, or other lifestyle change that is intended to prevent or treat a specific disease should first consult a qualified health care professional.

Click here to read more about what you can do when your child is diagnosed with diabetes.