June 12th 2017
Diet and Diabetes
Sarah Ballis, our Clinical Dietitian at The Harley Street Clinic, discusses Diabetes and ways of improving your health through healthy dieting.
There are 4.5 million people diagnosed with diabetes in the UK and an estimated 1.1 million people who have the condition, but don’t know it . Diabetes is a group of metabolic disorders in which sugar levels in the blood become elevated causing serious immediate and long term effects.
The main types of diabetes:
Pre- Diabetes: Metabolic Syndrome: a collection of factors including obesity, insulin resistance, high cholesterol, high blood pressure, pro-inflammatory state (high CRP) that occurs together and can cause blood sugar levels to elevate. This ‘pre-diabetes’ state may be reversible or may later become type 2 diabetes.
Gestational diabetes: when elevated blood sugar levels occur during pregnancy and often disappear when the baby is born, or become type 2 diabetes later on in life.
Type 1 Diabetes: accounting for 10% of cases and where the bodies own immune system permanently destroys insulin producing cells in the pancreas. Insulin injections are required life-long giving this type the previous name ‘insulin dependent diabetes’.
Type 2 Diabetes: is when the insulin produced by the pancreas is too little, or does not work properly because the body is resistant to it. Over 90% of people have this type which is widely prevalent in south Asian people. It is caused by a genetic predisposition interplaying with lifestyle factors.
What can a good diet do?
The role of nutrition in managing diabetes is to:
- Aid blood sugar levels to remain stable between 4-8 mmol/L for as long as possible during the day. Blood sugar levels elevate for 2 hours after eating, but what determines the height of the elevation is the type and amount of carbohydrate eaten
- Keep cholesterol controlled. High blood sugar levels typically result in an altered cholesterol profile, which is a risk factor for cardiovascular disease, heart attack and stroke. This is a high blood triglyceride level, a high LDL (bad) cholesterol level and low HDL (good) cholesterol level
- Regulate body weight to keep body fat stores as low as possible. High levels of body fat lead to insulin resistance
Where does the sugar in blood come from?
Sugar (or glucose) is carbohydrate, and gets into the bloodstream when carbohydrate foods are eaten, digested and absorbed. All carbohydrates increase blood sugar levels, so the more carbohydrate you eat or drink, the more sugar gets into your blood.
Some carbohydrates require longer digestion because of their ‘complex’ structure or fibre content like wholegrains, oats, pulses, and legumes. These enter the bloodstream slowly. Other carbohydrate foods have a more ‘simple’ structure and breakdown very quickly like white bread, honey, sugar, rice, jam, and sugary drinks.
Unfortunately our bodies need sugar to make energy. We cant just stop eating carbohydrate to reduce sugar in the bloodstream but we can adjust the type and reduce the amount. It is the amount of carbohydrate we eat that has the greatest impact on blood sugar levels.
Diet and Lifestyle Tips
If you are one of the 4 million people in the UK with type 2 diabetes there are a number of dietary and lifestyle targets important to you:
- Reduce your body weight as low as possible towards a body mass index (BMI) of 20-25kg/m2 . The more body fat you have distributed around the abdomen the greater the body’s resistance to insulin. Men and women should have a waist measurement of less than 94cm, and less than 80cm respectively
- Eat a diet low in calories, low in sugar and low in fat
- Do more exercise like walking, cycling and swimming and aim to exercise straight after meals to bring carbohydrate levels down faster after meals
- Eat smaller meals such as 4-5 smaller meals/snacks per day about every 2-3 hours rather than large sittings of food intake
- Try to eat the same amount of carbohydrate at each meal (no more than fist size) and roughly the same amount each day
- Choose slowly released carbohydrate foods to ‘trickle’ sugar into the blood stream as the carbohydrate is digested over the day such as wholegrains, legumes, beans and oats
- Replace saturated fats (animal fats and fried foods) with healthier monounsaturated fats like olive oil, peanut oil, nuts, canola and avocado
- Eat two portions of oily fish each week like mackerel, sardines or salmon (canned, frozen or fresh)
Sarah Ballis, our Clinical Dietitian at The Harley Street Clinic who looks after people undergoing cancer treatments that affect their ability to eat and drink. For more information on dieting and improving your lifestyle, visit our ‘Five dietary improvements’ article
 Diabetes UK. Facts and stats. October 2016
 Diabetes UK. Evidence-Based Nutrition Guidelines for the prevention and management of diabetes. May 2011
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