diabetes

Diabetes : Carbohydrates

             Carbohydrates are in everything that contains sugar or starch. So for example in bread, potatoes, rice, macaroni, peas and beans, milk, fruit, candy, cookies, and chips.

                  Your intestines change carbohydrates into glucose. That comes in the blood as blood sugar and that is the fuel for your body. But if you have diabetes, there is too much blood sugar in the blood. The blood sugar level is then too high.

Count carbohydrates

                People with diabetes use medication or insulin to keep blood sugar good. Often you have to keep track of how much carbohydrates you eat. There are lists for that. The number of carbohydrates is also on labels of food. It is good to distribute carbohydrates as much as possible throughout the day.

How much carbohydrates can I have?

We are often asked this question. In general, diabetes is recommended to eat fewer carbohydrates than is recommended in the Schijf van Vijf for bread, rice and potatoes. But how much can you do? This depends on your weight, daily activities, medication and blood sugars. Ask advice from a dietitian or your diabetes nurse.

Fast and slow carbohydrates

                  Some carbohydrates are more quickly converted into blood sugar than others. So there are 'fast' and 'slow' carbohydrates. The slower your blood sugar rises, the better. Because if your blood sugar rises quickly and then falls quickly again, you get a lot of peaks in your sugar level and that is not good.

For example: in an egg-cake there are as many carbohydrates as in a wholemeal sandwich. But in an egg-cake are mainly fast sugars. You get a higher and faster peak in your blood sugar and that is not healthy. So preferably opt for food with slow carbohydrates, and not too large portions.

Slow (good) carbohydrates:

Fast (bad) carbohydrates:

everything with white flour: white bread, white pasta and white rice

Advantage of slow carbohydrates: fibers

In slow carbohydrates are often a lot of fiber. Fibers not only reduce blood sugar peaks, but they also provide a feeling of saturation earlier and longer. As a result, you will not snack fast between meals.

Be moderate with potatoes

The carbohydrates in potatoes are broken down into quick sugars. Do not eat potatoes too often, take a small portion and choose wholegrain products and legumes more often.

Glycemic index

Some people like to take into account the so-called glycemic index of nutrition. The number that indicates how quickly a food increases the blood sugar is called the glycemic index (GI). A low GI means that the blood sugar rises slowly, and slowly decreases. That is better than a high GI, which represents a rapid increase, followed by a rapid decline. If you take this into account, you have more control over your blood sugar level. In addition, diet with a low GI reduces the risk of cardiovascular disease in people with diabetes.

depends on different things

There is a problem with the GI: it is very difficult to determine exactly. This is because the GI can be different for the same food, depending on the circumstances. For example, it shows how ripe a fruit is, how small cut or pureed something is, how much water has been added to it, whether there is vinegar and what the temperature is. For example, thick pasta varieties have a lower GI than thin pasta varieties. And boiled potatoes have a lower GI than mashed potatoes.

In addition, other nutrients that occur in the same meal also have an influence. For example, fats and proteins provide a lower GI. That makes it difficult and therefore not everyone finds it useful to work with those numbers. But it does matter if you use as many foods with a low GI as possible. For example, eat wholegrain bread instead of lighter bread.

Also important: glycemic load

Still, after a meal, the blood sugar peak depends even more on how much carbohydrate you eat than what kind. Therefore, a term is used in addition to the GI: the glycemic charge (GL). That is a measure of the total 'load' of carbohydrates from a meal.

Because only the GI of a food does not say much if you do not take into account the portion size. For example: watermelon has a low GI per 100 grams, because melon contains a lot of water. But if you eat a whole melon, the total amount of carbohydrates can increase significantly: the GL is high and that causes a big increase in your blood sugar.

All in all quite complicated. But if you try to avoid the fast carbohydrates as much as possible and do not make the portions too big, you're already a long way.

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Diabetes: Glycemicindex food

Ninety percent of all diabetics suffers from type 2 diabetes, also called age-related diabetes. A different lifestyle and tablets usually suffice to get the disease out of control. Imagine that you have "only" type 2 diabetes, however, is a dangerous attitude. 'There is also a great chance of complications among these people and it is very important to keep the condition under control as well as possible', according to Prof. Luc Van Gaal, head of diabetology at the UZA.

Who and what?

About 3.5 to 5 percent of the Belgian population sooner or later gets type 2 diabetes. The disease usually only develops after 40 years, hence the name of old age diabetes. In these patients there is still insulin production, but it is either inadequate or of poorer quality.

Overweight is important cause

While type 1 diabetes can not be prevented for the time being, the development of type 2 diabetes is closely related to a person's lifestyle. An unhealthy diet, obesity and too little exercise stimulate the disease. Eighty percent of the patients are overweight.

"What does not mean that you get type 2 diabetes by eating too much sugar," Van Gaal emphasizes. 'That is a persistent misunderstanding. Obesity plays a central role, but it does not matter how those kilos have come. "

Therapy

In the treatment, nutrition and exercise, together with medication, are the big pillars. Getting rid of at least a portion of the surplus kilos is a must.

         'As far as medication is concerned, it is sufficient for most type 2 diabetics to take tablets daily. They poke the remaining insulin, so to speak, so that the sugars from our diet still end up in the cells. The disadvantage of conventional drugs is that most cause weight gain, which is extra disadvantage for diabetics. At the moment there are new types of medication in the pipeline that  would not have that side effect. Some would even promote weight loss. '

       If the patient does not get his sugar value under control, he must then proceed to insulin injections.

            Most type 2 diabetes patients go to check-ups twice a year in a specialized center. They can go to the doctor for interim checks.

"Little" diabetes does not exist

Because patients with type 2 diabetes usually do not have to inject insulin during the initial phase of their condition and apparently suffer less from their disease, people sometimes dare to minimize the condition. Especially with a moderate increase in blood sugar it soon becomes clear that 'someone has a little bit of his sugar'. That is also a misunderstanding.

'Even with blood sugar values ​​of less than 140 milligrams per deciliter, there is an important risk of complications and the patient must be treated quickly and with focus. There is no such thing as "having a little diabetes"

Type 2 diabetics risk the same complications as people with type 1 diabetes. But because the disease is not acute, it often takes years before the diagnosis is made. This often only happens when there are serious complications and the patient, for example, has a heart attack. Hence the importance of early and active detection.

Glycemic index

Nutrition with a low or average GI is often recommended to people with diabetes, because the blood sugar level remains more stable. The GI of a food is expressed in a number from 0 to 100. A GI of less than 55 is low, from 55 to 70 is average, and greater than 70 is high.

Because the glycemic index does not take into account the amount of carbohydrates in a product, the glycemic charge (GL) is added to the table. This reflects the effect on the blood sugar level of a portion of a product. Roughly speaking, a GL is greater than 20 high, an average value is between 10 and 20 and a GL smaller than 10 is low.

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