Diabetes is not a condition that imposes inactivity – quite the opposite. There are world-class athletes who have had diabetes since childhood. Exercise will also benefit those who develop diabetes in their later years. Like exercise, diet will be of lifelong importance; the two are closely linked.
A regular regime for diabetics
If you are diagnosed as diabetic, your doctor (or diabetic clinic) will explain these 4 important points immediately.
- Regular meals
- Regular exercise
- Insulin dose or tablets at the same time each day (if needed – some cases can be managed by correct diet only, without medication)
- Regular urine-testing
Probably one of the first things you will be asked to do is to see a hospital dietitian. She will take your individual needs into account, as well as the principles of good eating, in deciding the diet to suggest for you. It stands to reason that the regime planned for a sedentary 60-year-old office worker won’t do for a 25-year-old farmer, even though both are diabetics.
Though your choice of food is going to be specially important for the whole of your life, this does not mean that you will need exactly the same diet in 5 years time that you need now.
Requirements will change, for instance, if you go from a sedentary to a more active job, if you play more sport or start to walk more. You should check your diet every year or so. It matters when you eat as well as what you eat. There are two general rules:
- Try to eat at the same times each day.
- Try to spread your food intake evenly over the day. This applies particularly to the carbohydrates you eat (starchy foods such as bread). This is important if you are on insulin treatment.
Diabetics on insulin are often advised to take part of their food in mid-morning and mid-afternoon snacks. Your doctor will advise you on this.
The dietitian will suggest a wide choice of foods, give you ideas for meals and tell you what portions will be right for you. A regular intake of foods from the basic 5 food groups is important.
If you select the amounts the dietitian suggests for you from these 5 groups, you can be sure that your diet will be adequate – and as there is plenty of choice it should also be appetizing.
Certain foods may be eaten freely by a diabetic at any time:
- Vegetables which are valuable for health but low in calories such as lettuce, cabbage, spinach, tomato, zucchini, mushrooms.
- Condiments and spreads: yeast extracts, fish pastes, artificial sweeteners.
- Drinks which provide hardly any calories, such as water, unsweetened black tea or coffee, and clear broths.
Foods to avoid
- Sugar. As you can see from the sample meal plan, sugar should be left out of your diet. This includes brown as well as white sugar, honey, molasses, glucose, golden syrup, treacle and products containing these, such as sweet cakes. Sugar is for use only if you have symptoms of hypoglycemia (too low blood sugar, which may occur in diabetics on insulin and some diabetics on tablets). Then you may need to take a spoonful of honey, suck a glucose sweet, or take a sweetened drink. (Your doctor will explain this).
- Alcoholic Drinks. It is important to avoid or cut down on alcoholic drinks. Your doctor will advise whether you should take any at all. Remember that although alcohol has a high-calorie content it often causes hypoglycemia. Diabetics who have drunk alcohol may therefore become hypoglycemic and assumed mistakenly to be drunk.
- Sweetened Soft Drinks. Unsweetened drinks should be substituted in the regular regime. Sweetened drinks such as fizzy lemonade may be useful in warding off hypoglycemia.
- Excess Carbohydrates. Particularly if you are on insulin, you should avoid all carbohydrates in excess of the amounts given on your diet sheet. These are foods which contain starches and sugars, such as bread, buns, cakes, pies, scones, etc. They may figure in your diet but in limited quantities, and your doctor will advise on your needs.
- Cardiac Diet Guidelines
- Cardiac Diets for a Stronger Heart
- How to Live a Healthy Life with Diabetes
- Academy of Nutrition and Dietetics
Controlling your weight
A child or teenage diabetic will need enough energy from food for growth as well as activities, and recommended diets will allow for this. Many of the people who become diabetics in their later years will be overweight, however, and correcting this is of great importance in treating their diabetes.
If you are overweight you can reduce successfully by:
- Having regular meals, including a wide variety of the foods recommended in your diet.
- Choosing the minimum number of recommended servings and taking small servings.
- Avoiding sugar and other things listed under “foods to avoid”.
- Avoiding foods cooked in or containing large amounts of fat or oil.
- Resisting second helpings.
- Eating slowly and enjoying the quality of your food.
- Being active and walking for at least half an hour each day.
Extra food before exercise
Exercise is a splendid thing for diabetics and there is no reason why they should not enjoy active sports. Physical activity burns up energy, so when you are more active than usual you will need to provide extra energy from food beforehand.
If you neglect this, there is the possibility that the fall in blood sugar during exercise will bring on a “hypo” (hypoglycemic reaction, when the blood sugar falls too low). This particularly applies to those on insulin treatment, as once a dose of insulin has been injected, its sugar-reducing activity cannot be reduced.
Before exercise, therefore, you should have either a piece of fresh fruit (or glass of fruit juice), or a sandwich (whole or half), or a buttered plain biscuit and a glass of milk.
If symptoms of hypoglycemia occur (dizziness, tremors, weakness, confusion) take some honey, suck a sweet such as barley sugar, or have a sweet drink immediately. Frequent “hypos” usually indicate that either your dieter insulin dosage needs adjusting and you should report them to your doctor.
Any diabetic on tablets who notices symptoms of hypoglycemia during exercise should also report them to the doctor immediately. A reduction in the tablet dose may be advised.
If you are diabetic, discuss exercise with your doctor. The chances are that you are doing too little, not too much. Exercise is an important part of your daily routine, and you should try to take about the same amount each day, not suddenly have a bout of violent activity once a week or at irregular intervals.