How to control diet for diabetes

Written by Lin Xiang Dong
Endocrinology
Updated on September 24, 2024
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The diet for diabetes mainly involves setting reasonable blood sugar reduction targets. Before achieving these targets, strict dietary control is necessary. All fruits, nuts, fried foods, and barbecued foods must be avoided. Meals should be regular and quantified without any extra meals or snacks. The amount of rice for lunch and dinner should be controlled, approximately a couple of ounces per meal, while intake of sufficient vegetables is encouraged to satiate hunger. However, vegetables like pumpkin should not be eaten. A certain amount of lean meat can be included, but fatty meats are to be avoided. Additionally, dry foods are recommended for diabetics, while liquid diets, like soups and porridges, should be avoided. For breakfast, if blood sugar control is poor, one should temporarily avoid noodles and rice noodles. Instead, consuming some pure milk and an egg, along with buns or dumplings such as steamed dumplings or wontons, is acceptable.

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Gestational diabetes standards

Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.

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Diabetic foot prevention care

First of all, it's important to keep blood sugar under control. It's recommended that people with diabetes check their glycated hemoglobin every three months to see if their blood sugar levels meet the standards. Second, many patients suffer from diabetic foot due to severe diabetic peripheral neuropathy. Injuries such as stepping on a nail or accidental bumps may lead to infections. Therefore, it's suggested that patients with diabetes check their feet daily for any small wounds or ulcers, and if found, they should seek timely treatment from an endocrinology specialist. Third, using warm water for foot baths and treatments like local infrared lamp therapy are advised. It's important to ensure that the temperature is not too high, generally around 40 degrees Celsius, to avoid burning the skin.

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Diabetic foot ulcer precursor

Diabetic foot, as we discuss in medical terms, refers to patients with a history of diabetes who, due to poor blood sugar control, experience various complications such as the narrowing of arteries in the lower limbs, insufficient blood and oxygen supply, and neuropathy, which results in insensitivity to temperature and pain, making them prone to burns or other injuries. Additionally, diabetic patients have compromised immune systems, making them susceptible to infections. When these three factors combine, it easily leads to diabetic foot, which is also the precursor to what is colloquially known as "rotten foot" in diabetes.

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How to reduce sugar in a diabetic diet?

Dietary control is the most important method of treatment for diabetes. If dietary control is improper, all hypoglycemic drugs, including insulin, will not be very effective, and the focus of dietary management in diabetes is to control the intake of carbohydrates. Our Chinese diet is primarily based on carbohydrates like rice. Mainly, we control the amount of rice consumed, with each meal (lunch and dinner) consisting of about 100 to 200 grams of rice. This is complemented by plenty of vegetables and a certain amount of lean meat to enhance satiety. By controlling the intake of carbohydrates in our daily lives, blood sugar levels can drop significantly.

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What should pregnant women with diabetes eat?

If a pregnant woman has been diagnosed with gestational diabetes during pregnancy, it is still necessary to decide what food to eat based on the specific blood sugar levels. If the current blood sugar level is relatively stable, she can follow a diabetic diet, eat smaller meals more frequently, and consume more fresh fruits and vegetables. It's important to avoid foods that cause high blood sugar, and it is essential to walk or engage in appropriate exercise 30 minutes after eating to help metabolize the blood sugar. However, if the blood sugar remains high and does not decrease significantly, insulin might be needed to lower the blood sugar levels.