This article will help you understand the correct way to treat diabetes by “control your mouth and move your legs”!

Author: Lin Lin, deputy chief nurse, Beijing Chaoyang Hospital, Capital Medical University

Reviewer: Li Guangwei, Chief Physician, Fuwai Hospital, Chinese Academy of Medical Sciences

Vice Chairman of the Chinese Medical Association Endocrinology Society

As we all know, diabetes is a chronic disease that requires comprehensive treatment. Among them, diet and exercise are the basis for the treatment of diabetes. "Control your mouth and move your legs" is also a phrase we often say. How to eat and how to move are one of the issues that many diabetics are very concerned about.

Let’s talk about this topic today.

1. What are the general dietary principles for diabetics?

Controlling diet can lower blood sugar, blood lipids, blood pressure, reduce weight, and keep blood sugar within a reasonable target range. It can prevent and delay the occurrence and development of complications and improve the quality of life of diabetics.

Therefore, controlling diet is the cornerstone of all treatments for diabetics and must be taken seriously. How should it be done specifically?

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There are many specific operations for diabetic diet control, but the general principles are: control total calories, combine coarse and fine foods, eat at regular times and in regular amounts, use less oil, less salt and no sugar, quit smoking and limit alcohol consumption.

Everyone has different height, weight and activity level, so the total calories needed are also different. There are special formulas in medicine to calculate this.

Food types are mainly divided into carbohydrates, proteins, and fats, which can be distributed according to the following proportions: carbohydrates 50%-60%, protein 15%-20%, and fats <30%.

Carbohydrates include cereals, potatoes, fruits and vegetables, such as white rice and white flour are fine grains, potatoes, taro, yam, red (white) potatoes, pumpkin, lotus root, green (red) beans, vermicelli, etc. are considered coarse grains, and coarse and fine grains should be eaten together. You can eat more green leafy vegetables appropriately, because they are low in calories, have little effect on blood sugar, can increase satiety, and are rich in dietary fiber, which is conducive to laxative.

Protein includes various meats, eggs, fish, shrimp, milk, soy products, etc. Try to choose lean meat. Generally speaking, the amount of protein a person can eat every day is the same as the weight of the person. For example, a 50-kilogram diabetic can eat 5-6 servings of protein foods every day, including 1 bag of milk, 1 egg, 2 taels of lean meat, and 2 taels of soy products.

Fats include vegetable oils, animal oils, and nuts. Try to choose vegetable oils, 20-25 grams per person per day.

2. What should diabetics pay attention to in their diet?

First, eat less high-fat foods, such as fat, skin, animal offal, fried foods, cream cakes, ice cream, etc. These foods are high in calories and contain a lot of saturated fatty acids. When saturated fatty acids are taken into the body, they not only increase blood sugar, but also deposit on the inner wall of arteries to form plaques, causing cardiovascular and cerebrovascular diseases.

Second, strictly control all kinds of sweets, and do not eat simple sugar foods, such as candy, snacks, cakes, honey, white sugar, and other sugary drinks or foods. You must learn to distinguish which foods contain sugar, such as biscuits and bread with packaging bags, and learn to read the ingredients behind them to see if white sugar is added.

Third, control salt intake to less than 5 grams per day. Salty taste can stimulate appetite and increase our food intake. Excessive salt intake can also increase the activity of amylase and cause blood sugar to rise. Therefore, not only patients with hypertension should have a low-salt diet, but diabetics should also have a low-salt diet. You can add onions, ginger, garlic, pepper, coriander and other seasonings.

Fourth, quit smoking and limit alcohol consumption. It is not recommended for diabetics to drink alcohol. Drinking liquor on an empty stomach can easily cause hypoglycemia, which can last for more than 6 hours, and hypoglycemia can increase the risk of cardiovascular and cerebrovascular accidents for diabetics. Excessive drinking has caused diabetics to pass out, fall, and die suddenly. If you drink alcohol, you must eat some staple food first, then drink alcohol, and pay attention to monitoring blood sugar. And the daily alcohol intake should not exceed 15g (15g of alcohol is equivalent to 45ml of liquor, or 150ml of red wine, or 350ml of beer). Drink no more than 2 times a week.

Fifth, after your blood sugar level reaches the target, you can eat fruits or nuts between meals. Eat about 200 grams of fruit a day, divided into two portions. It is recommended to eat low-sugar fruits such as apples, kiwis, pears, strawberries, watermelons, loquats, etc. Eat less bananas, hawthorns, lychees, mangoes, fresh dates, etc. Try not to eat dried dates, candied dates, dried persimmons, raisins, etc. After eating nuts, reduce the amount of cooking oil and eat a small handful each time, such as 15-20 pistachios.

Sixth, when cooking, try to use stewing, boiling, steaming, braising, and cold dressing methods. Avoid frying, deep-frying, braising, etc.

Seventh, sugar-free foods cannot be eaten casually. Sugar-free foods use sweeteners to replace sucrose, such as sugar-free moon cakes, sugar-free cakes, etc., but they still contain a lot of carbohydrates and added fats, so the calories are relatively high and should not be eaten too much.

Eighth, when eating, it is best to change the order. Drink vegetable soup first, then eat vegetables and meat, and finally eat staple food. This can slow down the rate of increase in blood sugar after meals and is beneficial for blood sugar control.

I would like to emphasize that diet control must be adhered to for a long time to see good results. Diabetes is a lifelong disease, and controlling blood sugar is also a lifelong long-distance race. There is no quick fix, and only long-term adherence can benefit you.

3. What should diabetics pay special attention to when exercising?

Exercise therapy should be continued throughout the course of diabetes. In other words, you should start exercising after you get diabetes. However, not all diabetics are suitable for exercise.

Those who can exercise are: people with type 1 and type 2 diabetes whose condition is stable and without serious complications; people with overweight diabetes; and pregnant people with stable diabetes.

Those who are not recommended to exercise are: diabetics who suffer from repeated hypoglycemia or large fluctuations in blood sugar; diabetics with concurrent diabetic ketoacidosis, acute infection, proliferative retinopathy, severe kidney disease, and severe cardiovascular and cerebrovascular diseases.

Before exercising, measure your blood sugar. If it is lower than 5.6mmol/L or higher than 16.7mmol/L, it is not recommended to exercise. It is best to exercise 1 hour after a meal, when blood sugar is relatively high and hypoglycemia is less likely to occur. Do not exercise immediately after a meal, as it can easily cause digestive problems.

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In addition, you should drink enough water before exercise, and it is also recommended that diabetics drink more water after exercise. Keep some food and candies with you, and wear a diabetics information card. Do 5-10 minutes of warm-up exercises before starting formal exercise.

Types of exercise include aerobic exercise: Tai Chi, square dancing, brisk walking, cycling, jogging, swimming, etc., 5-7 days a week, 30-60 minutes each time. Adult diabetics in good physical condition are also recommended to add resistance exercise, such as sit-ups, push-ups, dumbbells, machine exercises, elastic bands, etc., 2-3 days a week.

During exercise, if you experience chest tightness, shortness of breath, discomfort in the precordial area, etc., stop exercising and take a rest. If the symptoms do not improve, seek medical attention immediately.

After exercise, do 5-10 minutes of warm-up activities. Do not sit or lie down immediately, or take a shower or use air conditioning immediately to prevent colds. Check your feet for redness, swelling, and ulcers.

4. Can diabetics lower their blood sugar levels through diet and exercise alone?

There are five "horses" in the treatment of diabetes. The first "horse" is diet, and the second "horse" is exercise. These two "horses" are the basis of all treatments, but simply using these two "horses" generally cannot lower blood sugar to normal.

The third "horse" is medicine, including oral medications, insulin, and GLP-1 receptor agonists. Different medicines can be selected for treatment according to the different conditions of diabetic patients.

The fourth "horse" is self-monitoring of blood sugar, because diabetics cannot be in the hospital every day, nor can they rush to the hospital to test their blood sugar after eating, so they must learn to self-test. You can use a portable blood sugar meter, which is very convenient.

The fifth "horse" is education. Only when the knowledge of diabetes prevention and treatment is deeply engraved in the minds of diabetics can they manage their blood sugar well.

Therefore, these five pillars of diabetes treatment are indispensable.