Nutritional treatment in type 2 diabetes

Nutritional treatment plays an important role in the management of type 2 diabetes. Although there are many factors that affect the development of this disease, a good diet is essential to control it and avoid related complications . What do you need to know about it?

What is type 2 diabetes?

Diabetes mellitus is a chronic metabolic disorder that manifests with glucose levels higher than those recommended in the blood. In the specific case of type 2 diabetes, the body stops using insulin correctly. The latter is a hormone produced by the pancreas whose function is to help glucose enter the cells and be used as energy.

Among the risk factors for developing this pathology are: having a family history of diabetes mellitus, age, obesity and physical inactivity. In fact, it is common for people with type 2 diabetes to also be obese or overweight.

In these patients, reducing energy in the diet , while maintaining an adequate and healthy supply of nutrients in meals, is beneficial in promoting weight loss. Losing weight could translate into benefits in both glycemic control and blood pressure.

Nutritional treatment in type 2 diabetes

Since there is no ideal pattern for all patients, nor a percentage of macronutrients that can be used generally, according to current evidence,  the most recommended treatment would be a joint diet and physical activity plan established by a professional.

According to the latest consensus of the American Diabetes Association (ADA), the goals of nutritional treatment should be:

• Improve the parameters of glycated hemoglobin, reduce hypertension and cholesterol levels.
• Achieve and maintain a healthy weight (at this point the patient’s adherence and change of habits is of special interest).
• Prevent complications.

Therefore, one of the points that must be taken into account, once the disease is diagnosed, is the dietary factor.

Carbohydrates

Whole grain fruits, vegetables, greens, legumes, and cereals. These foods should be the main source of carbohydrates in any healthy diet, but especially for these patients. Being partly made of fiber, its entry into the bloodstream is slower and no blood glucose spikes occur.

In addition, they increase the feeling of satiety, which helps weight control. According to different studies , fiber consumption seems to have a beneficial effect on serum cholesterol levels and other causes of cardiovascular risk such as hypertension.

Therefore, a consumption of approximately 26 grams a day in women and 28 grams a day in men is also recommended in people with type 2 diabetes.

It is not what happens with foods rich in simple carbohydrates, where we would find pastries, sweets, fruit juices, etc. These foods are devoid of fiber and, therefore, their impact on blood glucose is greater.

The consumption of whole grain cereals (cereals that preserve their three parts, germ, bran and endosperm, also called whole grains) has been studied and, although there is insufficient evidence to justify better glycemic control with its consumption, it has been related to a decrease in systemic inflammation and mortality.

Non caloric sweeteners

Although studies claim that non-caloric sweeteners such as saccharin or stevia do not alter glycemic function, many of the foods that contain them could alter it due to the ingredients used in making the product.

Used as sugar substitutes it may be beneficial in reducing sucrose or “table sugar” consumption, although more studies are needed to confirm this.

Other foods

Regarding other foods, the recommendations would be the same as for the general population. In the case of proteins, they must also be individualized, but the recommendations are the same as for other people. In fact, the intake of proteins of high biological value could be related to an improvement in the insulin response, without increasing plasma glucose.

In the case of fat, the same as in the case of proteins; the evidence suggests that the quantity is not so important but the quality of these. The consumption of good quality fats (seeds, avocados, fatty fish, etc.) should be increased and those of poorer quality, existing in processed meats and precooked foods, among others, should be reduced.

Other recommendations for the nutritional treatment of type 2 diabetes include:

• Choose healthy dishes in which carbohydrates are low glycemic.
• Control foods rich in trans and saturated fats due to their relationship with increased dyslipidemia.
• In the case of fish, especially blue fish, its recommendation is the same as that of people who do not have diabetes. Due to its content in omega 3 fatty acids, it is recommended to take fatty fish at least twice a week.
• To reduce the risk of dyslipidemia, it is also advisable to take foods rich in sterols (usually fortified), always within a healthy diet.
• The moderate consumption of dairy products, especially fermented ones (such as yogurts and cheeses), seems to be beneficial in the control and prevention of type 2 diabetes.

Tips for Nutritional Treatment of Type 2 Diabetes

Since many patients with type 2 diabetes are overweight or obese, a tailored nutritional plan, along with physical exercise, is vital to reduce weight and reduce the risk of complications. In general, some tips to be followed are:

• Make a distribution of meals using fresh and healthy food, always taking into account the preferences and characteristics of the patient.
• Reduce the consumption of specific foods for people with diabetes . Normally low in fiber and rich in poor quality fats, therefore they could not be considered healthy foods. Just consume them on time.
• Reduce free sugars such as “table sugar” (sucrose) and foods rich in them (cakes, pastries, sweets, ice creams, sugary breakfast cereals and juices), but also pre-cooked dishes, prepared sauces, etc., since In addition to containing a high amount of sugar, they are rich in trans , saturated fats and salt. Instead, it is advisable to learn to make our own recipes, eliminating or substituting other foods for sugar. For example, sweetening with fruit.

• In people taking insulin, insist on nutritional education to balance the insulin dose with carbohydrate intake.
• It is important to avoid alcohol, since in these patients the risk of hypoglycemia may increase, especially if they are treated with insulin.
• In the case of salt, the recommendation for the general population is also valid for patients with diabetes, paying special attention to those who, in turn, suffer from hypertension. In the latter case, you should reduce your consumption to the maximum and instead use other flavorings such as spices.

Finally, the nutritional treatment for patients with type 2 diabetes must be individualized, since it depends on the characteristics of each one. However, in general, some guidelines should be applied, such as choosing a good source of carbohydrates, excluding sources of sugars and trans fats, moderate total calorie intake, etc.