Diabetes is characterised by an increased amount of sugar in the blood, caused by insufficient levels of insulin, the sugar-processing hormone, in the body. When the pancreas is performing properly after you've eaten food containing sugar, your blood-sugar level rises, whereupon the pancreas releases insulin to help the body's cells absorb and use the sugar, causing your blood-sugar level to return to normal. If you have diabetes, however, the pancreas cannot produce enough insulin to assist the cells to absorb sugar, with the result that the sugar remains in the blood. In Type II diabetes, this occurs either because the pancreas has become tired (more common in older people) or because the cells, particularly fat cells, are unable to take up the sugar (this usually occurs in people who are overweight).
Most overweight Type II diabetics can control their blood-sugar levels better when they lose weight - because the strain is taken off the pancreas, thereby improving the body's ability to use the small amounts of insulin it produces. By improving the blood's fat profile and blood pressure, losing excess fat also reduces heart disease - a significant boon, as diabetics are roughly twice as likely to develop cardiovascular disease as other people. But don't crash diet, as this will cause you to gain weight rapidly once you start eating normally and your metabolic rate has recovered, and can also destabilise your blood-sugar levels.
Whether you lose weight or not, the key to living well as a diabetic is sticking to a healthy eating pattern, which can include eating foods that contain sugar. Avoiding such foods is not only unnecessary, as your body can learn to tolerate sweet foods when eaten correctly, but almost impossible in practical terms. In addition, if you avoided foods whose labels say that they contain sugar, your diet would be too restricted. You can discount the presence of sugar in savoury foods, as the quantities are so small that they shouldn't affect your blood-sugar levels adversely. Just have small meals within a balanced diet consisting of plenty of vegetables, fruit, lean proteins, wholegrains and water, and you should feel and stay well. As long as you don't binge on fruit, your blood-sugar levels should remain within the ideal limits; grapes and bananas, for example, don't contain too much fructose (fruit sugar) for diabetics. If you start experiencing an unquenchable thirst, check your blood-sugar level: it could be that it is too high, in which case your diet and/or medication may need adjusting.
Although almost every person who has diabetes can eat sweet foods, you must accept that they raise your blood-sugar level. If you eat too many biscuits, chocolates or sugar-coated cereals, for example, your blood-sugar level will shoot up, causing you to feel ill and ultimately to gain weight. I recommend that you occasionally enjoy small amounts of sweet foods at meal times, making sure your meal also contains fibre (found in vegetables, wholegrains and pulses), to cushion the effect of the sugar. For instance, instead of having a doughnut in the middle of the afternoon, save it until after your evening meal.
In fact, the ideal sweet foods for everyone, diabetic or not, are those that also contain some fibre, as these are gently absorbed by the body, discouraging wild blood-sugar swings and giving your body additional benefits including reducing the risk of developing heart disease and certain forms of cancer. So opt for cakes and desserts made with wholemeal flour, such as carrot cake or an apple and blackberry crumble topped with wholemeal flour. Note that artificial sweeteners like saccharine, aspartame and sorbitol can also give you wind and diarrhoea when eaten in excess.
The type of fat consumed also has a major impact on a diabetic's health. Monounsaturated fats, found in nuts such almonds and cashews, avocados and olive oil, are the gold-medallists in the health stakes, while polyunsaturated fats, in corn and sunflower oil, receive the silver. The fats to watch are saturated animal fats such as diary and fatty meat products including sausages and pies, which have a greater tendency to fur up diabetic blood vessels.
Because fat of any sort is a concentrated form of calories, if you are watching your weight, control the amount you eat and limit salt levels, as too much can irritate your blood vessels and lead to hypertension and heart disease. Instead, use herbs, garlic, spices and black pepper to spice up your life.
Jane Clarke is a state-registered dietician and author of the Bodyfoods series of books.
