What is Type 2 diabetes?
Diabetes is a condition where the amount of glucose (sugar) in your blood is too high because your body cannot use it properly. In Type 2 diabetes this happens because your pancreas doesn’t produce enough of the hormome insulin (that helps glucose enter body cells) and/or the insulin that is produced does not work correctly (insulin resistance).
The importance of good blood glucose control
People with Type 2 diabetes need to control their blood glucose. It is also important to look after your heart health. Making changes to your lifestyle, diet and activity level can be key to reducing the risk of diabetes causing you problems now and in the future.
What can you eat?
People with diabetes should eat a healthy diet, the same as somebody without diabetes. It should be low in saturated fat, high in fibre and include a variety of fruit and vegetables.
The eatwell guide
The eatwell guide represents the main food groups and shows how much of these foods (as a proportion of your diet) you should eat to have a wellbalanced diet.
Ten top tips to help you achieve a balanced diet:
1. Eat regular meals – eating breakfast may help you to manage your hunger and avoid overeating
2. Reduce your portion sizes to help you reduce and maintain a healthy weight.
A portion is:
- a fist size of potatoes, bread, pasta or other starchy carbohydrates
- a palm size of meat/fish or poultry
- two handfuls of vegetables or salad
- a cupped-handful of fruit
- top of your thumb size of oil or fat spread.
Try using a smaller plate, filling half of your plate with vegetables and avoiding second helpings.
3. Carbohydrates are used for energy so include some in your diet each day. Opt for wholegrain options, fruits and vegetables, beans, pulses, low fat milk and yoghurt. Controlling or limiting portions can help reduce weight and improve diabetes control.
4. Some saturated fats are linked with increasing cholesterol. Reducing your intake of all fats can also help reduce energy intake and help weight loss. Focus should be on reducing intakes of foods such as butter, cheese, processed meat and pastries
5. 5-a-day – you can have any fruit, vegetables or salad you enjoy (however, it pays to be careful with dried fruit and juices). Aim for at least 5-a-day and try to have a variety.
6. Swap meat for beans, pulses and lentils. This reduces fat and increases the fibre of your meals. Fibre helps to reduce cholesterol and prevent certain cancers. Try adding to soups, casseroles and stews.
7. Fish is a good source of low fat protein (white fish) and heart-protecting omega-3 (oily fish). Aim to eat two portions a week of fresh, canned or frozen oily fish, like mackerel, sardines or salmon.
8. Sugar can be eaten if you have diabetes but don’t overdo it. Keep foods containing sugar to small servings as an occasional treat and whenever possible choose sugar free drinks. Artificial sweeteners are safe to use.
9. Drink 8–10 glasses of fluid per day. Water is best, but tea and coffee, herbal teas, no added sugar squash and diet fizzy drinks can all contribute. You don’t have to cut out alcohol – just keep an eye on how much you are drinking.
10. Try to be more active.
Foods labelled ‘suitable for diabetics’ have no special benefit. They are often high in calories, may still increase your blood glucose level and may have a laxative effect! Ordinary packaged food, eaten as part of a healthy diet is suitable; just remember to consider portion sizes and how often you have them.
Which foods affect your blood glucose level?
All carbohydrates are broken down to provide glucose. Glucose is used by our body’s cells for energy. Starchy carbohydrates include bread, rice, pasta, breakfast cereals and potatoes. Sugary carbohydrates include biscuits, sweets, chocolate, jams, and sugary drinks. Fruit and milk also contain natural sugars, dried fruit and juices contain these in higher concentrations.
All types of carbohydrate will increase your blood glucose level. Many people find it useful to spread carbohydrate throughout the day to keep their blood glucose levels stable. Whereas, other people find it helpful to reduce the quantity of carbohydrate in their diet to help control blood glucose levels. A lower carbohydrate diet could be an option for you but talk to a healthcare professional first, preferably a dietitian, as it may not be suitable or your medication may need adjusting. How much your blood glucose goes up will depend on:
- the amount of carbohydrate in your food and drink
- how active you are
- how much insulin your body still produces and how your body uses it
- your medication.
Blood Glucose Targets
Some people with Type 2 diabetes have a blood glucose monitor to check blood glucose levels. Most people visit their GP or practice nurse who checks your HbA1c at least once a year. HbA1c is your average blood glucose levels over the past three months. It is recommended people should aim for a HbA1c of 48 mmol/l but this should agreed between you and your healthcare team. If you struggle with hypoglycaemia or have other health conditions it may be higher.
If you are overweight, weight loss is the most important thing you can do to help control your blood glucose levels by allowing the insulin to work more effectively and reducing insulin resistance. Weight loss can also help reduce your cholesterol and blood pressure. Losing weight can be difficult but evidence shows that a weight loss of just 5-10% of your current body weight can bring significant health benefits. There is also evidence emerging that weight loss of 15% (using meal replacements) can even bring diabetes into remission. If you are trying to lose weight you may need support adjusting your medication if you are making significant changes to your diet and physical activity levels, so speak to your healthcare team.
Being active is an important part of a healthy lifestyle and helps:
- control blood glucose by helping your insulin to work more effectively
- reduce heart and circulation related risk e.g. heart attacks and strokes
- manage weight.
Aim for at least 30 minutes of moderate physical activity five days a week. ‘Moderate’ means breathing more deeply and feeling warmer. Focus on spending less time sitting still!
Know your condition
When you find out you have diabetes, you should be able to see a dietitian. There are many education groups specific to learning about Type 2 diabetes to help you manage your condition or you could see a dietitian on your own. Ask your GP surgery what is available in your area.
Type 2 diabetes is a condition where your blood glucose is too high due to lack of insulin and/or insulin resistance. It is important to have good blood glucose control to reduce the risk of complications. If overweight, losing weight is the most important thing you can do. Working with a dietitian will help you identify the changes in lifestyle, diet and physical activity you can not only achieve but also enjoy and stick to in the long term.