must represent between 45-60% of the total caloric intake. A healthy dietary pattern is recommended whose carbohydrates come from fruits, vegetables, grains and skimmed milk.
The estimation of the total carbohydrate content of the diet constitutes the main strategy in glycemic control.
Consumption <130 g / day is not recommended due to the absolute requirement of glucose from the brain and the central nervous system.
Both the total amount and the type of carbohydrate in the food (quality) influence the blood glucose level.
However, the use of the glycemic index (GI) and the glycemic load (GL) is considered to provide a moderate additional benefit over glycemic control than when considering only total carbohydrates. 1 g of Carbohydrates contributes 4 kcal; 10 g of Carbohydrates correspond to a serving of Carbohydrates.
Glycemic index (GI)
is a classification of foods, based on the postprandial response of blood glucose, compared with a reference food. Measures the increase of glucose in the blood, after eating a food or food.
- The higher the glycemic index, the greater the effect of that food on blood glucose concentrations.
- It should not be used in isolation.
- We should not classify a food as harmful because it has a high GI.
- The consumption of low glycemic index foods reduces postprandial hyperglycemia, there is no long-term benefit to recommend low-GI diets.
Fatty acids and cholesterol
- The daily consumption of cholesterol should be limited to 200 mg / day.
- They should represent 20-30% of the total caloric intake.
- The contribution of saturated fats should be less than 7% of total calories. The decrease in the consumption of “trans” fats lowers the LDL-C and increases the HDL-C.
- It is recommended to use two or more times a week fish rich in omega-3 fatty acids (tuna, sardines, mackerel and salmon, among others).
- The monounsaturated fatty acids, found in olive oil, avocado has beneficial effects on blood lipids).
Likewise, the consumption of approximately 2 mg / day of plant sterols blocks the intestinal absorption of cholesterol with the consequent decrease in total cholesterol and circulating LDL-C.
For individuals with diabetes and normal renal function, a protein intake between 15 and 20% of the total caloric value is suggested.
In subjects with type 2 DM, protein intake may increase the insulin response without increasing the circulating glucose concentration.
Therefore, proteins should not be used to treat or prevent nocturnal hypoglycemia. Should be decreased in diabetic nephropathy <(0.8 gr / kg / day) and increased in the elderly, pregnancy and lactation (1-1.2 g / kg / day).
It is recommended to limit the consumption of salt in amounts less than 5 grams daily or 1,000 mg of sodium per 1,000 calories.
14 gr / 1000 kcal is recommended as well as the population without diabetes.
Additional dietary recommendations
Below are common tips for all diets that a patient with diabetes mellitus should follow:
- To reduce fat in the diet, milk can be skimmed. It is a staple food that, if possible, should never be dispensed with. Half a liter is recommended daily in a healthy adult.You can replace 100 cc of skimmed milk (half a glass) with a low-fat yogurt, but not with cured cheeses, which are very rich in saturated fats.
- The most recommended bread is the wholemeal one, because its fiber content produces lower elevation of blood sugar (blood sugar) than white bread.
- The fruit can be of any type, perhaps with the exception of the frequent or excessive consumption of bananas and grapes. Try to take them fresh and raw, not in compote or prepared. It is recommended to take two or three pieces a day.
- It is advisable that the meat be chicken (without skin), turkey, rabbit or beef, always very clean. Only red meats will be taken about four times a month (cow, ox, bull).
- The fish can be white or blue. Always try to take more fish than meat, and at least two or three times a week take blue fish.
- It is recommended not to take more than 4 eggs per week.
- Vegetables should be taken twice a day, the most recommended are those that are consumed fresh.
- The most advisable oil is extra virgin olive oil. You should not use butter instead of oil, because they produce the same calories and carry saturated fats, which are more harmful to health.
- To sweeten, do not use sugar. Use aspartame or saccharin, which do not carry calories and try to avoid sorbitol or fructose (they do carry calories and provide carbohydrates).
- Read carefully the labeling of all food products that are consumed. Substances such as sodium, dextrose, sucrose, fructose or sorbitol are found in many foods. Avoid “light” foods that have sorbitol or fructose.
- The ideal drink throughout the day and at meals should be water. You can also take tea and other infusions freely.