Diabetes is Australia’s fastest growing chronic health problem, with nearly 1.7 million afflicted by the disease. This will almost double to 3.3 million people by 2031.
People with type 2 diabetes are 2–4 times more likely to develop cardiovascular disease than people who don’t have the disease; and more than twice as likely to have a heart attack or stroke.
But it’s not all doom and gloom – controlling blood glucose levels and maintaining a healthy lifestyle can significantly reduce the complications associated with type 2 diabetes. You don’t have to be a saint to make a difference to your health, either, research shows. These five changes will well and truly have you on your way.
1. Switch to low-GI carbohydrates
Low-GI carbohydrates are slowly digested by the body, meaning they trickle glucose into your bloodstream, instead of quickly bursting into your system. Research shows that a low-GI diet can improve blood glucose control in people with type 2 diabetes. A review of 10 studies published in Diabetes Care found that subjects who followed a low-GI diet for just 10 weeks had significant reductions in HbA1c levels, compared with people following a high-GI diet. Including just one low-GI carbohydrate at each meal and snack can make a noticeable difference. Low-GI foods include: wholegrain bread, pasta, basmati rice, apples, pears and low-fat yoghurt. Find more information on low-GI food on our website, or head to www.glycemicindex.com to find the GI values of specific foods. Look for foods with a glycemic index of 55 or less.
2. Eat at least two serves of wholegrains daily
Upping your intake of wholegrains is a must for type 2 diabetes sufferers. When scientists reviewed the results of 22 studies that incorporated wholegrain foods into the diet of people with type 2 diabetes, they concluded that wholegrains are linked to improvements in glucose metabolism.
Researchers are still not 100 per cent sure as to why wholegrains help in the management of type 2 diabetes, though it’s thought to be linked to the insoluble fibre and magnesium they contain.
A serve of wholegrains is equal to 2 slices wholegrain bread, 1 cup cooked wholemeal pasta, ½ cup natural muesli, 20g popcorn or 1 cup cooked brown rice. Eat at least two serves of wholegrains daily.
3. Lose weight (even 5–9kg can make a big difference)
Sounds easy on paper, but it’s much harder in real life, right? Fortunately, you don’t need to lose a huge amount to improve your health – just 5–9kg will help. Losing weight is probably the best thing you can do to manage your type 2 diabetes. Excess weight increases the body’s resistance to insulin, making it harder to control blood glucose levels. Losing weight can increase the body’s sensitivity to insulin, and reduce your likelihood of developing heart disease and certain types of cancer. It’s also been proven that moderate weight loss can reduce both high blood pressure and glucose levels, as well as improve blood cholesterol levels, which just goes to show how important a small reduction in weight can be. While attaining and maintaining a healthy weight should be your long-term goal, losing a moderate amount of weight is a great way to get started. Once you achieve that, set a new weight loss goal.
4. Get active for at least 2 1/2 hours each week
Increasing physical activity levels improves a number of metabolic risk factors in people with type 2 diabetes. In fact, frequent exercise is one of the best ways to lower blood glucose levels. Exercise also improves your insulin sensitivity by enhancing the way your skeletal muscles absorb glucose.
According to the American Diabetes Association (ADA), anyone with type 2 diabetes should participate in at least 150 minutes of moderate intensity physical activity, or at least 90 minutes of vigorous activity, each week to improve glycaemic control, assist with weight management and reduce the risk of cardiovascular disease. The ADA also recommends that this exercise be distributed over at least three days of the week, with no more than two consecutive days without physical activity. This equates to a minimum of 22 minutes of moderate intensity exercise per day. Weight loss aside, US research shows that more than four hours of exercise each week can result in a significant reduction in the risk of diabetes for people with pre-diabetes. Most importantly, if people with type 2 diabetes make exercise a regular part of their life, their risk of early mortality decreases substantially.
5. Use some weights – 3 times a week
Just like aerobic exercise, resistance training improves both insulin sensitivity in the muscles and blood glucose control. Research shows that resistance training increases lean muscle mass, which is associated with a decrease in HbA1c (a measure of your average glucose levels over the past two to three months) and fasting glucose levels.
People with well-controlled type 2 diabetes should engage in resistance exercise that targets all major muscle groups three times per week. The ADA recommends three sets of 8–10 repetitions for each muscle group, using a weight heavy enough that your muscles are fatigued after 8–10 repetitions.
If you’re new to resistance training, consult an Accredited Exercise Physiologist (AEP) first. An AEP will assess your needs and teach you how to perform the exercises correctly. This will maximise the health benefits and reduce the likelihood of injury.
Step-by-step: Building a healthy diabetes-friendly meal
You can make almost any meal diabetesfriendly, including pizza, pasta and lasagne – just portion your ingredients according to the lists below, and away you go!
1. Give vegetables a leading role
There needs to be at least two serves of vegetables in your meal. A serve of vegetables is equivalent to 1/2 cup cooked vegetables or 1 cup salad (not including starchy vegetables, such as potato or sweet potato).
You can help reach your meal’s vegie quota by adding lots of grated veg to sauces, soups and baked dishes; dishing up your meal with a generous serve steamed green vegies; or making vegetables the ‘star’ of dinner, rather than a side dish.
2 cups* cooked non-starchy vegetables, such as broccoli, cauliflower, carrot, etc
2 cups* salad, such as lettuce, spinach, tomato, capsicum, etc
* These quantities are the minimum you should aim for –feel free to load up your plate!
2. Add a portion of lean protein
Protein is an important part of a diabetes-friendly meal because it helps to lower the total GI of the overall meal (protein foods are generally low- GI because they contain minimal carbohydrates). It will also help you feel full for longer. Always choose reduced-fat dairy products and lean meat, and remove all visible fat prior to cooking.
2 small (45g) eggs
100g cooked skinless chicken (150g raw)
100g cooked lean beef, lamb, pork or kangaroo (150g raw)
120g cooked fish (170g raw)
including canned tuna, salmon and mackerel
40g (about 2 slices) reduced-fat cheese
1/2 cup cooked lentils, chickpeas, or 3 bean mix
3. Choose low to moderate GI carbohydrates
Adding low to moderate GI carbohydrate foods will help keep the overall GI of the meal low. Choose pasta, noodles, basmati rice, pearl barley, quinoa, grainy or sourdough breads and legumes. Starchy vegetables contribute carbohydrates to a meal, so choose low-GI varieties where you can.
Finally, don’t forget that legumes contain low-GI carbohydrates as well as protein (see no. 2 above), so be mindful of that when you’re creating your meal.
1 cup cooked pasta or noodles, preferably wholemeal
1 small wholegrain bread roll
2 slices wholegrain bread
1 cup cooked couscous
3/4 cup cooked brown or
3/4 cup cooked quinoa
1 small cooked potato
1 medium cooked sweet
1 medium corn cob (80g)
4. Add a little healthy fat
Like protein, healthy fats help lower the GI of the overall meal. Good fats are also important for keeping cholesterol levels in check. Aim for only small quantities of healthy fats, like olive oil, avocado and nuts or seeds. Note that adding fat is not always necessary as many sources of protein – such as meat and tofu – can provide ample fat.
2 teaspoons pesto
1 teaspoon plant-based oil(eg – olive)
2 teaspoons crushed or sliced nuts
2 teaspoons seeds
1 tablespoon hommous dip
2 teaspoons salad dressing
What your plate should look like
Before serving up your meal, mentally divide your plate into four quarters. One quarter should contain protein foods, another quarter should contain low to medium GI carbohydrate foods and the rest of your plate (the final two quarters) should be filled with vegetables and/or salad. This will help you get the right balance to your meal and help with portions sizes. Remember, smaller plates help decrease portion sizes!
Not just sugar...
Most people think of sugar when they are cooking for someone with diabetes. While this is something you need to consider, there are a few other things to keep in mind, too.
1. Boost the fibre
Add fibre by including vegetables, beans and legumes where possible (but especially in sauces, soups and salads), and choose wholegrain or wholemeal varieties of breads, cereals and pastas.
2. Reduce the saturated fat
Trim any visible fat from meat, remove skin from chicken, choose low-fat versions of all dairy foods and minimise total fat whenever possible, to help keep the overall kilojoules down.
3. ‘Pass’ on the salt
Cook with low-salt,salt-reduced or no-added-salt ingredients, especially when it comes to canned veg and legumes, and stock. Choose foods canned in spring water, rather than brine, and don’t add salt to your food.
Eating out (and takeaway) checklist
Choose a low-GI carbohydrate source, such as wholegrain bread, pasta or basmati rice.
Control the amount of food you eat by choosing the smallest size, and eating extra vegetables and salad if you’re still hungry.
Quench your thirst with plain, soda or mineral water instead of soft drink and fruit juice.
If you drink alcohol, limit your intake to one standard drink for females and two standard drinks for males.
Choose lean protein sources, such as lean red meat, skinless chicken, fish, tofu and legumes. Choose foods with lower levels of saturated fat and salt (by limiting processed meats and cheese, sauces, butter and cured meats). And avoid adding extra salt – your taste buds will eventually adjust!
Easy grab-and-go snacks
1 small handfull raw unsalted almonds
1 pear or 1 apple
1 Uncle Toby's Crunchy muesli bar
1 tub low-fat yoghurt
1 Be Natural Honey Nut trail bar
Type 1 diabetes is an autoimmune disease where the body has destroyed the insulin-producing cells in the pancreas. Therefore, the body is unable to produce insulin and regular insulin injections must be given.
Type 2 diabetes is generally caused by lifestyle and occurs when the insulin produced does not work properly, or the body cannot produce enough insulin to maintain normal blood glucose levels. Approximately 85 per cent of all people with diabetes have type 2.
Can you reverse type 2 diabetes?
Type 2 diabetes cannot be reversed, but the right diet, exercise and weight loss can make blood glucose control easier. In fact, in over 50% of sufferers, blood glucose levels can be normalised by:
following a kilojoule-controlled diet
increasing your physical activity
losing some weight
What about pre-diabetes?
Pre-diabetes is a condition when cells in the body are becoming insulin resistant and blood glucose levels are higher than they should be, but are not high enough to be classified as diabetes. For those diagnosed with pre-diabetes, taking steps to improve insulin resistance (such as eating a healthy and balanced diet, losing weight and participating in regular physical activity), may be enough to avoid ever being diagnosed with type 2 diabetes.