Living with Diabetes

DIABETES Living with

With a little planning and know-how, you can lead an active and fulfilling life

The lowdown on diabetes

DIABETES IS A SERIOUS CONDITION IN WHICH BLOOD GLUCOSE LEVELS ARE TOO HIGH.

When the body breaks down food, glucose (sugar) is absorbed into the blood. Insulin, a hormone made by the pancreas, allows the glucose to enter body cells where it is used for energy production.

THERE ARE TWO MAIN TYPES OF DIABETES:

 Type 1 diabetes, in which the pancreas either releases no or toolittle insulin – it’s an autoimmune disease that often begins in childhood with a sudden onset.

DID YOU KNOW?

In both types of diabetes, because the glucose can’t get into the cells, it builds up in the blood. Over a long period of time, high glucose levels in the blood can cause serious damage to the heart, eyes, feet and kidneys. However, with early diagnosis and the right treatment, people with diabetes can live a healthy life. Losing weight, following a healthy diet and being more physically active are all important for the optimal management of diabetes.

 Type 2 diabetes, in which the pancreas does not release enough insulin or the body becomes resistant to the insulin it makes – it usually develops slowly.

Extra weight around your waist means fat can build up around your organs, and this can lead to insulin resistance and/or Type 2 diabetes. Weight loss can significantly improve insulin resistance and lower the risk of Type 2 diabetes, as the insulin is able to work more efficiently in the body. A loss of just 5-10% of your body weight will have significant health benefits and can lower the need for diabetes medication.

Measure your waist circumference: it should be no more than 88cm for women and 102cm for men.

1

GOOD IDEA

EAT AT LEAST 3 REGULAR MEALS DAILY

USE THIS PLATE GUIDE TO SHAPE YOUR MEAL

Include low-fat dairy products

HAVE PLENTY OF VEGETABLES.

Don’t skip meals and remember that eating breakfast may help you manage your hunger and avoid overeating. Also, reduce your serving portions – small and often is better than large servings of food.

2

EAT FOOD RICH IN PROTEIN.

3

CHOOSE WHOLEGRAINS OVER REFINED ONES.

Meats should be trimmed of excess fat.

ADD GOOD FATS to your meals such as avocado, nuts, peanut butter, seeds, olive oil and canola oil.

CAUTION

Drink fruit juice sparingly because it’s essentially just an excessive amount of fruit and sugar minus the fibre.

Some practical swaps

INSTEAD OF HEALTHIER ALTERNATIVES

Sweetened granola

EAT MORE FRUIT AND VEG

Fresh fruit has sugars (fructose and glucose) that are carbohydrates. Because diabetics need to balance their intake of carbohydrates, they should eat fruit for the nutrients and fibre but in moderation.

Canned fruit in syrup

Desserts

Sweetened yoghurt

Energy and granola bars

Swiss muesli or granola with no added honey or sugar

Canned fruit in juice, drained; fresh fruit

Grilled nectarines with plain yoghurt; baked apple with sugar-free custard

Plain, low-fat yoghurt – add your own fruit or fruit purée

Dried-fruit bars with no added sugar; nut-and-fruit mixes; high-fibre crackers with peanut butter

Rusks

Muffins

Low-GI rusks

Home-made muffins with added banana, raisins or apple purée and less sugar in the recipe

FACT fruit can be fresh, frozen, dried or canned (in juice, not in syrup). Have 1 serving of fruit 3 times a day rather than one large amount in one go.

BE CAREFUL OF HONEY

Honey is often considered a healthier substitute for sugar, but too much honey affects your blood glucose in a similar way as the same amount of sugar.

INCLUDE MORE LEGUMES IN YOUR MEALS

Beans, peas and lentils are very high in fibre and help to stabilise your blood sugar level. They make a great swap for processed and red meat, and help to keep you feeling fuller for longer.

DON’T BOTHER WITH SOCALLED DIABETIC FOOD

Food labelled “suitable for diabetics” usually has no special benefit. It can also often contain just as much fat and kilojoules as similar “non-diabetic” products, and it can still affect your blood-sugar level. These

items can also sometimes have a laxative effect.

EAT FISH AT LEAST TWICE A WEEK

This includes all fish, but particularly fatty fish such as pilchards, sardines, herring, salmon and mackerel, which are high in the heart-protecting Omega-3 fatty

acids. Each serving should be around 100g, or about ¾ cup of flaked fish.

DRINK MORE WATER

Plan on drinking eight to 10 glasses of fluid per day. Water is best but tea and coffee, herbal infusions, sugar-free squash and diet cooldrinks can all contribute.

CHOOSE HEALTHIER FATS

Healthier fats are found in food such as unsalted nuts, seeds, avocados, oily fish, olive oil, canola oil and sunflower oil. Unhealthy saturated fats can increase the amount of cholesterol in your blood, which can lead to heart problems. These fats are mainly found in animal products and more processed food, such as: fatty red meat; processed meat like boerewors, sausages, salami and polony; ghee and butter; brick margarines; many biscuits, cakes, pies and pastries.

Some practical swaps

AVOID THESE DRINKS HEALTHIER ALTERNATIVES

Sweetened cooldrinks

Cordials

Fruit juice

Sports drinks and energy drinks

Flavoured water

Coffee and tea with sugar

Hot chocolate

DRINK ALCOHOL SENSIBLY

Alcohol is high in energy (kilojoules), so if you do drink and you’re trying to lose weight, cut back. Limit your intake to no more than one drink a day for women and two drinks a day for men. Avoid binge drinking and go several days a week without any alcohol.

Still or sparkling water; artificially sweetened cooldrinks

Still or sparkling water with sliced lemon; artificially sweetened cordial

Still or sparkling water; 125ml fruit juice diluted with water

Still or sparkling water; 125ml fruit juice diluted with water

Flavoured water with no added fructose or sugar (check the ingredients list)

Coffee and tea with artificial sweetener or no sugar

Artificially sweetened hot chocolate powder or cocoa mixed with low-fat milk and sweetenerOs volupti issit, ipsam aut re pre niam est, sumque quuntinusa pro

LIMIT DRINKS WITH ADDED SUGAR

Avoid drinks that have large amounts of added sugar.

TRY THIS

EAT LESS SALT

Eating lots of salt can increase your risk of high blood pressure, which in turn increases the risk of heart disease and stroke.

When you have diabetes, you’re already more at risk for all of these conditions.

ASK AN EXPERT

If you have diabetes, make an appointment with a registered dietitian who can review your individual needs and circumstances and help you tailor a nutrition plan that’s right for you. You can go to www.adsa.org.za to find a dietitian in your area who is registered with the Association for Dietetics in South Africa (ADSA).

FACT

If you take insulin or other diabetes medications it’s not a good idea to drink on an empty stomach. This is because alcohol can make hypos more likely to happen.

DON ’ T FORGET TO KEEP MOVING

Being more active goes hand in hand with healthier eating. It can help you manage your diabetes and reduce your risk of heart problems.

Aim for at least 150 minutes of moderateintensity activity a week. This is any activity that raises your heart rate, and makes you breathe faster and feel warmer. You don’t have to do all 150 minutes in one go. Break it down into bite-sized chunks of 10 minutes throughout the week or 30 minutes five times a week

CHOOSE HEALTHIER CARBOHYDRATES

All carbohydrates in food will affect your blood-sugar level. Some of the healthier sources of carbohydrates are:

 legumes, such as chickpeas, kidney beans, baked beans in tomato sauce, lentils and soya

 whole fruit and vegetables – just avoid fruit juice

 unsweetened dairy products, such as low-fat milk and plain yoghurt

 wholegrains, such as bran-rich cereals, oats, brown rice, wholewheat pasta, rye bread and seed loaf

BEAN SALAD WITH TUNA TONNATO SAUCE

Bring some Italian flair into your kitchen with this crunchy bean salad, served with a tangy tuna mayo dressing

SERVES 4

Tonnato sauce:

2 egg yolks

3 Tbsp (45ml) lemon juice

1 punnet (20g) parsley, leaves picked

1 can (120g) shredded tuna in water, drained

1 clove garlic

2 anchovy fillets

(optional)

5 capers (optional)

⅓ cup (80ml) canola oil

⅓ cup (80ml) olive oil

2 packets (200g each)

fine green beans, blanched

1 can (400g) white kidney beans or butter beans

Salt and milled pepper

1 packet (3s) baby

gem lettuce

LIVE

WELL BUTTER BEANS IN BRINE (410g)

½ red onion, sliced (or pickled)

1 packet (200g) calamata olives

capers (if using). Combine oils and add in a slow, steady stream while blending until a thick sauce forms.

Toss green beans and canned beans with 2 dollops of tonnato

sauce and season. Arrange lettuce on a platter, top with saucy beans and scatter with onion and olives. Drizzle salad with remaining sauce just before serving.

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