DIABETES WHAT IS DIABETES? Diabetes is a condition in which there is too much glucose in the blood. Glucose is the breakdown product of carbohydrate-containing foods and is the main source of fuel for our bodies. Insulin is a hormone that is needed to control glucose levels in the blood by transporting glucose to the muscles and liver where it can be used for energy. Diabetes develops when the pancreas (the organ responsible for producing insulin) is either unable to make insulin or when the insulin is unable to work effectively. Without insulin doing its job, glucose builds up in the blood leading to high blood glucose levels. The key symptoms of diabetes are thirst, frequent urination, lethargy, hunger, slow healing of cuts, itching, skin infections, blurred vision and unexplained weight loss. Over time, poorly controlled diabetes can seriously damage the eyes, kidneys, nerves and blood vessels, and contribute to cardiovascular disease. THE MAIN TYPES OF DIABETES • Type 1 – In this type, the pancreas produces no insulin because the cells

which make insulin have been destroyed by the immune system. Therefore people with Type 1 Diabetes require insulin injections to control blood glucose levels. It usually occurs in people below age 30.

• Type 2 - This type of diabetes occurs when your body becomes resistant to insulin. This occurs most commonly in people who are over the age of 40 years; have a family history of diabetes; and/or are overweight. Type 2 Diabetes is the type affecting 85%-90% of diabetics.

BLOOD GLUCOSE TESTING Changes in your blood glucose levels can occur from a number of reasons such as the type and time of your last meal, exercise, losing or gaining weight, stress, illness and medication. If you have been asked to monitor your blood glucose levels at home, register with the National Diabetic Services Scheme (NDSS) to be eligible for significant savings. Contact Diabetes Australia (1800 640 862) for a form for your doctor to sign. Most people are required to test their blood glucose levels before breakfast and then 2 hours after each meal. A good range is between 4-8 mmol/L. As your blood sugar levels become more stable you may be able to reduce the frequency of testing.

THE FOUR KEYS TO MANAGING YOUR DIABETES

1. Healthy eating – Healthy eating for diabetics is a well balanced eating pattern that everyone in the family can follow. This will be explained in detail through the rest of this fact sheet.

2. Maintaining a healthy weight – It is ideal to keep your Body Mass Index (BMI) between 20 and 25. However, even preventing further weight gain has significant health benefits.

3. Regular exercise – Exercise helps to maintain and control blood glucose levels, as well as assisting in weight control. Your exercise routine should include at least 30-60 minutes of aerobic exercise each day (e.g. walking, swimming, cycling, dancing, rowing, team sports and aerobics). You also need to do resistance exercises 2-3 times each week. Your Exercise Physiologist will prescribe a strength program to meet your needs.

4. Insulin and medications – These will be prescribed by your doctor if needed.

CHOOSE THE BEST CARBOHYDRATES Carbohydrates are the only foods that directly influence your blood glucose levels. Carbohydrates are broken down to glucose during digestion. Glucose is absorbed from the intestine into the blood vessels and, with the help of insulin, is taken into the body cells where it can be used for energy. To control blood glucose levels it is important to follow a regular eating pattern with an even spread of carbohydrate throughout the day. Carbohydrate foods include breads, cereals, fruits, vegetables, dairy products, bakery items and sweet foods or drinks. Although all carbohydrates are digested into glucose and pass into the blood, this occurs at different rates depending on a number of factors (for example the type of food, processing and the influence of other foods eaten in the meal). Low Glycaemic Index (low GI) carbohydrates are broken down slowly thus help keep your blood glucose levels steadier throughout the day. Therefore, you are best to base your meals on low GI carbohydrates such as:

• Wholegrain bread and fruit loaf • Pasta and basmati / doongara rice • Sweet potato and corn • Low fat dairy products • Pulses and legumes (baked beans, chickpeas, lentils, kidney beans) • High fibre cereal (All Bran, Sultana Bran, Bran Flakes, rolled oats, natural

muesli) • Fresh fruit (apples, pears, peaches, plums, oranges, cherries, firm bananas

and grapes) Sugar and Sweet Foods In the past, it was thought that sweet foods and added sugar must be totally avoided by diabetics. However, recent research has shown that small amounts of sugar (e.g. honey or jam on toast or a teaspoon of Milo in milk) does not significantly affect blood glucose levels. It is best to avoid certain sugars that rapidly elevate blood glucose levels (e.g. glucose, corn syrup solids, maltose dextrose, golden syrup and malt). You should limit sweet foods (e.g. confectionery, cordial and soft drink).

EAT PLENTY OF FIBRE Foods high in fibre are filling and can therefore help with weight management. Fibre also helps to regulate your bowels and is linked to a reduced risk of bowel cancer. A diet high in fibre may also reduce high blood cholesterol levels. Fibre is only found in plant foods. Tips for increasing fibre in your diet:

• Choose brown rice and wholemeal pasta • Include plenty of vegetables and salad each day • Always try to leave the skin on fruits and vegetables • Eat fresh fruit rather than drinking juice • Enjoy regular legumes (e.g. baked beans, lentils, chickpeas, soybeans &

kidney beans) • Use a high fibre breakfast cereal (eg. porridge, All Bran, Weetbix HI-Bran &

natural muesli) • Choose wholegrain/wholemeal bread or high fibre white bread

OTHER FOODS These foods do not affect blood glucose levels and are important for a balanced eating plan. A. Protein Foods (Aim for 1-2 serves/day) Protein foods include meat (beef, lamb, pork, veal), poultry, fish, seafood, soybeans, eggs and cheeses (cottage, ricotta, cheddar). The leanest protein foods are best for cardiovascular health. B. Fats and Oils (Limit to 4-6 teaspoons/day) Fats include butter, margarine, oil, avocado, nuts, peanut butter, cream, mayonnaise, oily dressings and cream cheese. To reduce your risk of high cholesterol and cardiovascular disease, choose unsaturated fats (eg. olive oil, canola oil, nuts, seeds and avocado) rather than saturated fats (eg. butter, lard, fatty meats, cheese). Particularly limit your fat intake if you are overweight.

Tips for reducing your fat intake • Choose lean meats (eg. diet mince, leg steaks & skinless chicken breast)

and trim all visible fat from meats before cooking • Use low fat cooking methods (eg. grilling, dry frying, baking, steaming,

roasting on a rack, stewing, microwaving & skimming off excess fat) • Limit oil in cooking – use non-stick pans and spray oil to brown food

if necessary. Use wine, lemon juice, ginger wine, stock, tomato paste, water and/or herbs to add flavour and prevent sticking

• Use low fat milk (eg. Trim, Physical No Fat, Smarter & So Good Lite) and yoghurts

• Choose low fat (cottage, ricotta, continental) or reduced fat cheeses (eg. Bega Super Slims, Devondale Seven & Kraft Extra Light)

• Use a thin spread of margarine, or try avocado, cottage cheese or hummus instead

• Choose low fat snacks (eg. fruit, vegetables, yoghurt, rice crackers & popcorn)

C. Carbohydrate Free Foods Free Vegetables

Asparagus Bamboo shoots Bean sprouts Beans, green Beetroot Brussel sprouts Cabbage Capsicum Carrot Cauliflower

Choko Celery Cucumber Eggplant Garlic Ginger Lettuce Mushrooms Onion Parsely

Peas Pumpkin Radish Shallots Silverbeet Spinach Tomato Turnip Zucchini

Fruits Cooking Ingredients ½ grapefruit Gelatine, essences, 2 passionfruit garlic, pepper, salt*, kiwi fruit fresh or dried herbs, 15 strawberries ginger, cinnamon, lemon juice, 1 lemon spices, vinegar, mustard, rhubarb chilli sauce*, curry, soy sauce* Other Foods Tea, coffee, coffee substitutes, cocoa Bonox*, Bovril* Water, soda water*, mineral/spring water Clear soup, stock, vegetable soup

Low joule soft drink / cordial Fish paste*, meat paste* Mint sauce, apple sauce Vegemite*, promite*, marmite* No oil salad dressing

* indicates foods high in salt and should be limited if you have high blood pressure

D. Artificial Sweeteners and Products Containing These Artificial sweetners provide no calories or kilojoules but are best to be used sparingly as they also promote a preference for sweet foods. Consuming these will not affect your blood glucose levels. Splenda is the only artificial sweetener suitable for use in cooking. All others are unstable at high temperatures and can make cooked food taste bitter instead of sweet (but can be added to a food after cooking). “Diet” products are artificially sweetened and suitable in moderation. They include “diet” cordial, soft drink, topping, jelly and yoghurt. E. Water Water is important for assisting the removal of waste products from the body; controlling body temperature; and enhancing general well-being. Those with diabetes have a heightened risk of kidney damage, and thus need to be having at least 6-8 glasses of water every day.

MEAL IDEAS FOR DIABETICS Choose one of the following options for each of your meals and snacks BREAKFAST Option A: A low GI cereal (e.g. porridge, All Bran or Special K) topped with fruit and

low fat milk Option B: 2 slices of wholegrain toast, with avocado, low fat cheese, egg, tomato or

vegemite 1 piece of fruit A 200g tub of natural or diet yoghurt Option C: 2 slices wholegrain toast with ½ cup baked beans, tomato and some

reduced fat cheese Option D: Raisin toast Option E: A fruit smoothie LUNCH Option A: 2 slices of wholegrain bread A spread of avocado or hummus, if desired 80-100g of lean meat/chicken/egg/low fat cheese/tinned fish Plenty of salad vegetables Option B: A large bowl of salad 80-100g of lean meat/chicken/egg/low fat cheese/tinned fish A 200g tub of yoghurt, piece of fruit or smoothie or glass of Sustagen Option C: A toasted ham, cheese, tomato and onion sandwich (on wholegrain

bread) A piece of fruit or cup of fruit salad Option D: Leftovers from dinner, served with salad Option E: Homemade pizza – pita bread base with tandoori marinated chicken,

capsicum, onion, cherry tomatoes, baby spinach and reduced fat cheese (topped with natural yoghurt)

DINNER Option A: 90-120g lean meat or chicken/180g fish

Steamed vegetables (eg. sweet potato, squash, mushroom, capsicum, zucchini) or salad

Option B: ¾ -1cup pasta, with a tomato based or low fat creamy sauce 1 cup legumes or 100-200g lean meat Mixed colourful vegetables or salad Option C: Chicken or lean beef strips, stir fried in soy sauce, oyster sauce, fresh

herbs and water Plenty of vegetables (e.g. snow peas, capsicum, mushrooms, bok choy, cherry tomatoes)

¾ cup cooked basmati rice, if desired

SNACKS Carbohydrate free vegetables & salads – as much as you like Only have other snacks if you are hungry. Here are other some healthy snack suggestions:

Fresh fruit salad or ½ cup unsweetened tinned fruit with yoghurt or custard

A piece of fresh fruit Fruit toast or an English muffin with a thin spread of jam or honey A glass of low fat milk, with a teaspoon of Sustagen or Milo if desired A 200g tub of low fat yoghurt A handful of popcorn or pretzels A small bowl of low GI cereal with low fat milk 2 plain biscuits (e.g. Spicy fruit pillows or shredded wheatmeal)

Disclaimer This fact sheet is provided for your information only and does not replace qualified medical advice. The information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication. © Complete Performance Solutions All rights reserved