Blood sugar is unstable, are you eating right?

This is the 5295th article of Da Yi Xiao Hu

We emergency doctors often encounter patients with diabetes in our clinical work. Some of them are unaware that they have diabetes and come in with severe ketoacidosis; some know that they have diabetes but have irregular diets and medications; and some patients have blood sugar fluctuations under special conditions, such as severe infection, use of glucocorticoids, or other disease conditions.

For diabetic patients, it is important to check blood sugar regularly and take medicine on time as prescribed by the doctor, but it is more important to control blood sugar by controlling diet. But in fact, many patients are not particularly clear about how to eat correctly. The following diabetic diet guide hopes to help you.

Dietary principles: four lows, two highs, and one balance

Four lows

Low in sugar, salt, fat and cholesterol;

Second high

High in fiber and complex carbohydrates;

A balance

That is, moderate protein. No sweets, no tobacco or alcohol. Eat low-sugar fruits between meals.

Also note the following:

① Eat less or no food that can easily cause blood sugar to rise, such as candy, soda, cola, candied fruit, honey, sweetened drinks, and desserts;

② Foods with high starch content should also be limited, such as sweet potatoes, potatoes, taro, corn, sesame cakes, steamed dumplings, moon cakes, rice dumplings, and rice cakes. Use vegetable oil instead of animal oil, and eat less sweet, salty, and oily foods;

③ Eat less foods with high cholesterol content, such as animal offal, egg yolks, seafood, etc. In cooking, try to use light and less oily methods, use less cooking methods such as braising and frying, and use more steaming, boiling, and cold salad.

④ Diabetics should not drink alcohol. Alcohol can cause blood sugar fluctuations. Drinking a lot on an empty stomach can cause severe hypoglycemia. Excessive drinking can often mask the symptoms of hypoglycemia, making it difficult to detect and very dangerous.

What can I eat to reduce blood sugar levels?

Let's first understand a concept: glycemic index (GI). This is a relative indicator to measure the effect of food on blood sugar. Food with low GI stays in the gastrointestinal tract for a long time, has a low absorption rate, releases glucose slowly, and has a low peak value and a slow decline rate after glucose enters the blood. This causes a relatively small fluctuation in blood sugar after a meal, which helps control blood sugar.

Let's take a look at the glycemic index (GI) of some foods.

carbohydrate

Glucose 100.0, soft sugar 83.8, sucrose, sugar cubes 65.0, honey 73.0, chocolate 49.0

Cereals and products

Noodles (wheat flour, wet) 81.6, noodles (whole wheat flour, thin) 37.0, noodles (wheat flour, dry, flat and thick) 46.0, noodles (fortified protein, thin, boiled) 27.0, steamed bread (enriched flour) 88.1, fried dough sticks 74.9, rice porridge (ordinary) 69.4, cooked rice 83.2, brown rice 70.0, black rice 55.0, glutinous rice 87.0, corn (sweet, boiled) 55.0, cornmeal porridge (coarse powder) 50.9, millet (cooked rice) 71.0, millet porridge 61.5, buckwheat noodles 59.3, buckwheat steamed bread 66.7

Potatoes, starch and products

Potatoes 62.0, potatoes (boiled) 66.4, potatoes (baked) 60.0, potatoes (steamed) 65.0, mashed potatoes 73.0, potato chips (fried) 60.3, potato noodles 13.6

Beans and products

Soybeans (soaked, boiled) 18.0, tofu (stewed) 31.9, tofu (frozen) 22.3, dried tofu 23.7, mung beans 27.2

Vegetables

Carrot 71.0, pumpkin 75.0, yam 51.0, taro (steamed) 47.7, asparagus, cauliflower, celery, cucumber, eggplant, fresh green beans, lettuce, green pepper, tomato, spinach all <15.0

Fruits and products

Apple, pear 36.0, peach 28.0, dried apricot 31.0, plum 24.0, cherry 22.0, grape 43.0, raisin 64.0, kiwi 52.0, tangerine 43.0, grapefruit 25.0, pineapple 66.0, mango 55.0, banana 52.0, watermelon 72.0

Milk and dairy products

Milk 27.6, milk (with sugar and chocolate) 34.0, whole milk 27.0, skim milk 32.0, low-fat milk powder 11.9, yogurt (with sugar) 48.0, soy milk 19.0,

Convenience Food

White bread 87.9, bread (whole wheat flour) 69.0, bread (70%-80% barley grains) 34.0, bread (45%-50% oat bran) 47.0, bread (mixed grains) 45.0

From the above introduction, we can see that even if it is the same type of food, different ingredients and preparation methods will have different effects on blood sugar, so you still have to "select carefully" when eating.

We recommend that patients with diabetes eat a fixed amount of staple food and not too much, and choose more whole grains and low-GI foods. However, if you eat too much low-GI food, it will increase the blood sugar burden after meals; high-GI food is not completely restricted, and it should not be consumed in excess. It needs to be properly matched to help maintain blood sugar homeostasis.

What’s the best way to eat it?

Regular and quantitative

This refers to the main meal. It is recommended to eat three meals a day regularly, and keep the amount of food consumed at each meal basically stable. Breaking the whole into small pieces refers to snacks. If blood sugar is well controlled, you can eat some fruits to supplement vitamins. Generally, do not eat immediately after a meal. You can choose to eat fruits 2 hours after a meal. When eating, you can divide the fruit into small pieces. For example, eat an apple in 2-4 times, and do not eat it all at once. The more times you divide the meal, the less impact it has on blood sugar.

Eat dry food instead of liquid food

Diabetic patients should try to eat "dry" foods, such as steamed bread, rice, and biscuits. Do not eat porridge, porridge, or noodles. The thinner the food, the easier it is to digest, and the faster the blood sugar rises.

Hard, not soft

Generally speaking, dry and hard foods raise blood sugar levels more slowly than soft foods. Dry and hard pasta takes longer to chew, digest and absorb. In comparison, soft or cooked foods are digested faster and blood sugar levels rise faster.

Eat green, not red

Generally, vegetables are rich in dietary fiber and chlorophyll, such as spinach, celery, etc. However, the red ones have a relatively high sugar content and are not suitable for consumption. For example, if you eat the same amount of cucumbers and tomatoes, tomatoes will obviously increase blood sugar levels.

How much is appropriate to eat?

Various staple foods

It is recommended to eat a fist-sized amount of starchy food in one meal, and 2-3 fists a day;

Various meats

For beef, mutton, chicken, duck, fish, etc., it is recommended to eat an amount equivalent to the size of two palms and the thickness of the little finger every day;

butter

The amount of butter the size of the tip of your thumb (the first section) is the recommended daily amount of oil, any more than that exceeds the requirement;

vegetable

Such as cabbage, celery, rapeseed, spinach, etc. It is recommended to eat at least one handful of vegetables per day.

fruit

The recommended daily amount is the equivalent of 1 fist size.

I sincerely thank you all for reading to the end. For people with diabetes, controlling diet may be painful, but if we stick to a reasonable diet, combine moderate exercise, and take medication on time, blood sugar can definitely be controlled, and every organ in our body will benefit.

Author: Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

Wen Min, a doctor at the emergency department