Changes in the nutritional treatment of diabetes

It is not a novelty that in recent decades, the incidence of type 2 diabetes mellitus (DM2) is increasing considerably: so much so, which currently affects more than 246 million people worldwide.As for Spain, 12% of the population suffers from this disease.

This is an article whose author has been Mª Paula Avellaneda Dietitian-Nutritionist goalkeeper in Obésitas Clinic.

But do we know what is the consequence of suffering DM2?

DM2 is a chronic or autoimmune disease, in which our body is not able to effectively use insulin produced by the pancreas.Insulin is the hormone responsible for facilitating glucose into our cells, so that they can use it as a source of energy.

So, as insulin is not used correctly, the cells of patients with DM2 do not give way to glucose, therefore creating an excess of it in the bloodstream.That is where the problem lies, since a high concentration of long -term blood glucose (hyperglycemia), can damage different parts of the organism: kidneys, retina, heart, nervous system, blood vessels, etc.

Sedentary lifestyle, overweight and/or obesity, and to a greater extent, abdominal obesity and/or visceral fat, are the main factors that contribute to generating this insulin resistance.

On the other hand, the lack of physical exercise causes the muscles not to require "fuel", so that this situation decreases the ability to use glucose from the bloodstream.

So how can we prevent and/or treat the DM2?

It is evident that, one of the first measures that we must take is to achieve weight loss, as well as increase the intensity of physical exercise, even reverting the DM2, since we would increase the sensitivity to insulin by our cells, andTherefore improve diabetes control.

On the other hand, dietary recommendations aimed at patients with DM2 have evolved over the years: various investigations have observed that these patients can greatly benefit with low carbohydrates diets, and not with those casualties in fat, ashas recommended so far.

This is because a lower contribution of carbohydrates reduces blood glucose and therefore a lower insulin production by the pancreas is needed.

For this same reason, those who are in medical treatment with insulin must be careful to drastically reduce carbohydrates from their diet, since if it is not controlled correctly, hypoglycemia can be caused.In these cases, the ideal would be to reduce the doses of insulin administered.

And the fruit?Should it be restricted?

The fruit has simple or sugars (fructose) carbohydrates in its composition, and that is why many people with DM2 think they should reduce their intake.

However, the American Diabetes Association (ADA) insists that there are no reasons for people with DM2 to avoid fruits.

In fact, the recommendation that should be given is precisely the opposite, since the risk of cardiovascular diseases is higher in these patients, and precisely the fruit can have beneficial effects on the main cardiovascular risk factors.

On the other hand, the fruit is not only composed of fructose, it also contains various vitamins, minerals, fiber and, to a greater extent, water.Which makes it an ideal food to achieve weight loss in a healthy and nutritious way.

Nutritional treatment of type 2 diabetes mellitus:

Despite what was mentioned above, according to the Spanish Diabetes Society (SED), recommendations aimed at patients with DM2 at a nutritional levelThey should be the same as the general non -diabetic population.

That is, despite the benefits found in low carbohydrates diets, recommendations at the nutritionThey are more recommended.

In this sense, the nutritional recommendations for patients with DM2 would be the following:

- Increase the consumption of fiber -rich foods, since thanks to it it is possible to absorb carbohydrates more slowly.But it is recommended that they have a low glycemic load: vegetables, vegetables, legumes, tubers, fruits, whole grains.

- Minimize or eliminate the consumption of food with added sugars: pastries, chucheías, cookies, sugary soft drinks, commercial juices, jams, breakfast cereals, ice cream, ultra -processed products, etc.These products immediately increase blood glucose, and therefore cause high insulin production, increasing their resistance risk.In addition, they are poor nutrient foods, provide empty calories and can contribute to weight gain, mainly visceral fat.

- Decrease or eliminate the consumption of alcoholic beverages.Alcohol considerably increases the risk of late hypoglycemia in patients with DM2, especially if it is in insulin treatment.

- Consuming cardiosaludable fats: extra virgin olive oil, nuts, blue fish ... The quality of the greasy fat is more important than the quantity.

In conclusion, the food or nutritional pattern of a person with DM2 should not be greatly differentiated with the guideline as healthy eating for the general population.Of course, you must be more care when consuming processed products, mainly those rich in added sugars.

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