Are you diabetic?

Optimal intake of essential vitamins, minerals and antioxidants plays an important role in maintenance of various aspects of health for diabetics.

Diabetes and Diet


Diet plays a crucial role in the management of diabetes mellitus, in conjunction with the medical treatment consisting of insulin injections for Type 1 Diabetes and diabetic tablets for Type 2 Diabetes.

Carbohydrates and Blood Glucose

Dietary advice is mainly focused on controlling blood glucose levels in diabetics. Carbohydrate foods contain sugars and starches, that affect blood glucose levels as most carbohydrate foods are broken down rapidly in the digestive system to glucose that enters the bloodstream.

Types of carbohydrate foods and the total amount of carbohydrates ingested is usually closely monitored to assist in blood glucose control.

Another factor that is taken into account is the glycaemic index (GI) of foods. High GI foods such as pure glucose, maize meal porridge and even potatoes are digested and broken down to glucose rapidly, with a subsequent rapid increase in blood glucose levels.

The release of glucose from low GI foods such as lentils, sweet potatoes and yoghurt, takes a lot longer, with a slower increase of blood glucose after eating the relevant foods.

Micronutrients and Diabetes

Another very important aspect of the dietary management of diabetes mellitus is optimizing the intake of micronutrients. Micronutrients such as vitamins, minerals, antioxidants and essential fatty acids are vital for maintenance of optimal health for any person. Diabetics need to take special care in optimizing their intakes of these nutrients for the following reasons:

•    Frequent urination caused by uncontrolled diabetes is associated with urinary nutrient losses.
•    The metabolism of diabetic medication may interfere with the metabolism of certain nutrients
•    A very restrictive diabetic diet may exclude nutrient rich foods which may restrict micronutrient intake.

An interrelationship exists between diabetes mellitus and various micronutrients, as they play roles in the body’s control of blood glucose levels.

Diabetics need to ensure intake of a variety of foods rich in vitamins, minerals, antioxidants and essential fatty acids.

Vitamins

•    Vitamin A
Vitamin A plays a very important role in eyesight and deficiencies in this essential vitamin is associated with eyesight deterioration and possibly blindness.

Food Sources: Food sources of Vitamin A include liver, eggs, fish liver oil and Beta Carotene as it’s biological precursor is found in carrots and other orange coloured vegetables.

•    Vitamin B Complex

Vitamin B1, -B2, -B3, -B5, -B6, -B12 and Folic Acid are involved in a variety of metabolic processes. They are important for the body’s energy metabolism, which involves the untilisation of glucose as energy source, the conversion of glucose into bodily stores and the mobilization of stored energy into glucose.

Urinary losses of certain B-Vitamins is associated with uncontrolled diabetes and subsequent frequent urination.
Food Sources: Food sources of B-Vitamins include whole grain cereals,  pulses, dairy products, eggs and dark green leafy vegetables.

•    Vitamin C
Vitamin C, also known as ascorbic acid is a very important antioxidant vitamin. Vitamin C is important for the maintenance of healthy connective tissues and is important for maintenance of the circulatory system.

Food Sources: Food sources of Vitamin C include citrus fruits, sweet peppers, chillies, guavas, lettuce and tomatoes.

•    Vitamin E

Vitamin E is another important antioxidant vitamin. Vitamin E plays a very important role in the maintenance of the circulatory system, in support of healthy blood circulation.

Diabetics may have increased requirements for antioxidant nutrients, especially to assist in the management of the complications of diabetes such as eye problems, poor blood circulation, cardiovascular disease and wound healing.

Food Sources: Dietary sources of Vitamin E include avocado, wheat germ, nuts and seeds.

Minerals

•    Chromium

Chromium is a trace mineral which is found in various tissues in the body and plays an important role in the body’s control of blood glucose levels.

A chromium deficiency is associated with poor blood glucose control as it enhances the binding of insulin to receptors on our body cells, required for the transport of glucose from the bloodstream into our body cells. Chromium supplementation has only been shown to be effective in cases of existing chromium deficiency.

Food Sources: Dietary sources of chromium include brewer’s yeast, broccoli and organ meats such as kidneys and liver.

•    Magnesium

Magnesium is a mineral which is required in the body for the transport of glucose across cell membranes and therefore plays an important role in diabetic control. With poorly controlled diabetes and subsequent frequent urination, magnesium is lost through the urine, which may result in magnesium deficiency. 

Patients with Type 2 Diabetes have been shown to have lower levels of magnesium. Magnesium deficiency is associated with hypertension and changes in blood lipids, which relate to an increased risk for cardiovascular disease. 

Food Sources: Broccoli, peas, spinach and other dark green leafy vegetables contain magnesium. Other food sources include lean red meat and whole grain cereals.

•    Zinc

Zinc is a mineral with antioxidant properties that plays a role in numerous enzyme functions of the body. Zinc deficiency is associated with impaired blood glucose control as well as impaired wound healing, which already is a problem for most diabetics.

Therefore Zinc as mineral is not only important for blood glucose control in the body, but also for wound healing. Zinc also plays an important role in the healthy functioning of the immune system and is an essential nutrient for eye health. Zinc is another nutrient that may be lost through the urine, in cases of frequent urination caused by uncontrolled diabetes.

Food Sources: Seafood, especially shellfish such as oysters are rich in zinc. Other food sources include pumpkin seeds, sunflower seeds, pulses and eggs.

Antioxidants

•    Beta Carotene, Lutein and Zeaxanthin

Beta Carotene, an antioxidant nutrient is the metabolic precursor of Vitamin A. Both Beta Carotene and Vitamin A have been identified as important nutrients for eye health. Diabetes is one of the leading causes for blindness among adults.

Therefore, optimal intake of nutrients that are known to be important for eye health is recommended. Diabetic patients have been shown to have increased requirements for antioxidant nutrients.

Food Sources: Food sources include carrots, spinach, butternuts and pumpkins.

Essential Fatty Acids

Another aspect of nutrition which is very important for diabetics to consider is the intake of essential fatty acids. The link between heart disease risk and the types of dietary fats has been well established.

Because diabetics are at risk of heart disease, and because intake of essential fatty acids may indirectly assist with the body’s own regulation of blood glucose, it is important that diabetics include sources of essential fatty acids in their diets.

Salmon oil is a rich source of the Omega 3 fatty acids Docosahexaenoic acid (DHA) and Eicosapentanoic acid (EPA), which have been shown to assist in maintaining healthy blood lipids in diabetic patients.

Food Sources: Regular intake of salmon and other fatty fish such as pilchards, sardines and mackerel is encouraged, as sources of Omega 3 fatty acids.

Nutritional Supplements

Nutritional supplements are available to help optimize the intake of micronutrients. However, they should never be used to replace a healthy balanced diet, rich in nutritious foods.

A nutritional supplement cannot substitute the total nutritional value of a diet rich in fruits, vegetables, whole grain cereals, pulses, etc. Nutritional supplements should be used, as the name indicates, to supplement a healthy diet. 

However, the typical Western diet of processed foods is not likely to contain optimal levels of all essential nutrients. Apart from nutritional supplements, fortified foods also play an important role in optimizing nutrient intake.

An article published in the Journal of the American Medical Association in June 2002, reflects a significant shift in the medical perspective to the role of nutritional supplements.

Previously the role of nutritional supplement was mainly viewed to assist in the treatment of nutritional deficiencies. Reviewing the role of nutrient deficiencies in many diseases, including cardiovascular disease and cancer, it was concluded that all adults should take a multivitamin and mineral supplement daily to optimize nutrient intake.

The role of nutritional supplementation is not to control blood glucose, but to ensure optimal intake of essential nutrients.

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