Healthy Eating and Type 2 Diabetes

What is diabetes?

Type 2 diabetes is the most common form of diabetes. It is also called late onset or non-insulin dependent diabetes. Type 2 Diabetes is the 6th leading cause of death in Australia.

Diabetes is a chronic disease characterised by high blood glucose levels resulting from the body not producing insulin or not using it properly. Genetic predisposition and lifestyle factors contribute to the development of Type 2 diabetes. If blood sugar is not controlled, complications develop over time. Complications of poor blood sugar control include blindness, kidney disease, nerve disease in lower limbs, heart disease and stroke.

Why are Carbohydrates so Important?

Carbohydrates are starches and sugars which are broken down to glucose in the body. The glucose then enters the bloodstream and the blood glucose level gradually rises. The body then sends insulin (a hormone required to transport glucose) to the blood. This allows the glucose to leave the bloodstream and enter the cells in muscle tissue and the brain. It is then used for energy, much like a car uses petrol.

Having diabetes means that your body is not able to uptake glucose from the blood and into the cells. Your body either does not produce enough insulin, or the receptors on your cells are not working and cannot take the glucose in.  Either way, you need to monitor the amount of carbohydrate that you take into your body in food, so that your blood sugar levels do not rise too high or fall too low. 

By having regular meals and ensuring that they contain some carbohydrate, your blood sugar levels should remain relatively stable. By testing your own blood glucose levels you can see how effective this is, and alter your intake accordingly.

Where is Carbohydrate Found?

· Breads and cereals

· Fruit

· Starchy vegetables (potatoes, sweet potato and corn)

· Legumes (dried peas and beans)

· Milk and yoghurt

· Confectionery and other sweets

· Sweet beverages

· There are no carbohydrates found in meat and fats.

Healthy lifestyle

Type 2 Diabetes can be prevented or delayed by following a healthy lifestyle. This includes regular physical activity, making healthy food choices, and not putting on weight. The eating habits recommended for a person with diabetes are the same as those recommended for the general population.  To help manage your diabetes, your meals need to be:

· Spaced regularly and evenly throughout the day.

· Low in fat, especially saturated fat.

· Based on high fibre carbohydrate foods such as whole grain breads and cereals, beans, lentils, vegetables and fruits.

If you are overweight it is important that you try to lose some weight.  This will help to control your diabetes and it will also decrease your risk of developing heart disease and high blood pressure.

Glycemic index (GI)

Glycemic index refers to the effect carbohydrates have on blood sugar levels after being consumed. Historically, carbohydrates were referred to as ‘simple’ and ‘complex’ and it was believed that simple sugars affect the blood sugar levels more quickly than the complex. New research has found that all carbohydrates enter the blood stream at differing rates and that it is the type of carbohydrate that determines how quickly the blood levels change. Other factors affect the GI of a food, including the physical form of the food, how processed/cooked the food is, and the fat and fibre content.

The rate at which carbohydrate is broken down to glucose affects the blood sugar response.  Carbohydrate foods which are broken down more quickly will enter the bloodstream more quickly and therefore increase the blood sugar levels more dramatically. Conversely, carbohydrate foods which are broken down slowly enter the blood stream more slowly. Therefore the blood sugar level rises gradually, and this rise is sustained for longer.  A more gradual release of sugar into the bloodstream means that sugar does not build up in the blood. Your body is able to remove the sugar from the blood as quickly as it enters it, hence preventing high blood sugar levels.

To highlight which foods raise the blood glucose levels quickly and which raise them slowly, foods have been given a number or a Glycemic Index (GI).  This takes into consideration the rate at which carbohydrate is broken down into glucose. 

· Low GI foods enter the blood stream slowly

· High GI foods enter the blood stream more quickly

To control blood glucose levels it is beneficial to choose from the group of foods which have a low GI (ie. slowly digested).

Which carbohydrates have a low GI?

Generally the more highly processed a carbohydrate food is, the higher the GI value. Therefore, foods which have not been processed to a great extent will typically have a low GI.

The following list shows those carbohydrate foods which have a low GI. It is important to note that other carbohydrate foods are still acceptable, but these are your best choices.  You should aim to include one of these at every meal.

· Particular breads such as Burgen breads, Performax, Ploughman’s Wholegrain, Multigrain/wholegrain/mixed grain, heavy fruit loaf, pumpernickel, oat bran and honey.

· Particular crispbreads, crackers, biscuits such as Ryvita, Rye Cruskitts, Salada, Snack Right Fruit Slice.

· Particular breakfast cereals such as rolled oats, All Bran, Kelloggs Guardian, untoasted muesli, mini-wheats (plain), Special K.

· Temperate fruits such as apples, oranges, firm bananas, apricots, peaches, plums, pears, grapes, dried fruits. Whole fruit is better than juice.

· Starchy vegetables such as sweet potato and sweet corn,

· Pasta and other grains such as Basmati or Mahatma Premium Classic white rice, barley, bulgar and cous cous.

· Legumes (dried peas and beans)

· Milk products and alternatives - low fat varieties of milk, soy drink (calcium fortified), custard, yoghurt.

· Other non starchy vegetables (such as salad vegetables, green vegetables and orange vegetables) and are generally low in carbohydrate and therefore have little effect on your blood glucose levels. Include five or more serves of vegetables per day.

How much carbohydrate should I have?

You should have at least 2-3 serves at meals.  If you are on insulin you may need to have some carbohydrate at mid-meal snacks.  You may also need extra carbohydrate if your activity level is higher.

1 serve = 1 slice bread

   = 1/2 cup breakfast cereal

   = 1/2 cup cooked rice or pasta

   = 1 piece fruit

   = 1 medium potato / 1/2 cup starchy vegetables

   = 1 cup milk (250 ml)

   = 200 g tub of yoghurt

   = 1 cup cooked legumes

At least one serve at each meal should be a low GI food.

 

Most importantly, remember to:

· Have regular meals

· Have carbohydrate at each meal

· Participate in regular activity

· Lose weight if overweight

For More Information

Wesley Corporate Health

Level 2 / 46 Edward Street

Brisbane  Qld  4000

Phone:  07 3234 2600

Email: info@weshealth.com.au

Contact Diabetes Australia 1300 136 588
Website: www.diabetesaustralia.com.au

Disclaimer

This Fact Sheet is provided for your information only and does not replace qualified medical advice. The information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.