People with type 2 diabetes are frequently overweight, so advice about nutrition is directed not only at controlling carbohydrate intake, but also at limiting calories. If you have type 2 diabetes, there are several reasons why you still need to estimate the carbohydrate content of your food:
• Limiting the carbohydrate intake and substituting some of the calories with monounsaturated fats can help reduce your triglyceride levels and increase HDL cholesterol levels.
• Abnormalities in insulin secretion mean that eating a high-carbohydrate meal results in high glucose levels immediately after the meal. You want to avoid these high postmeal glucose levels because they can contribute to increases in HbA1c levels.
• If you are using insulin injections, you need to count carbohydrates in order to adjust your insulin doses (just like people with type 1 diabetes).
• Estimating carbohydrate content is also important if you are taking sulfonylureas, nateglinide, or repaglinide. This is because with these medicines, too few carbohydrates can cause low glucose levels.
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High blood pressure occurs frequently in people with type 2 diabetes and with diabetic kidney disease. Reducing your salt intake can help lower the blood pressure.
Summary
• According to the ADA, a normal, healthy diet for people with diabetes should consist of
• 45 to 65 percent of total daily kilocalories from carbohydrates
• 25 to 35 percent of total daily kilocalories from fat
• 10 to 35 percent of total daily kilocalories from protein
• The glucose rise after eating is due to the carbohydrates in the meal, and therefore all people with diabetes should learn carbohydrate counting.
• If you are on insulin, your dose should be based on the amount of carbohydrates in your meal.
• When taken on an empty stomach, alcohol can lower glucose levels.
• Dietary recommendations include:
• Restrict calories if overweight or obese.
• Reduce cholesterol and trans fats to reduce risk of heart disease.
• Limit carbohydrates to avoid very high glucose levels after meals. Eat foods that have a high fi ber content and a low glycemic index and have not been highly processed.
• Replace carbohydrates with monounsaturated and polyunsaturated fats to lower triglycerides and raise HDL cholesterol levels.
• Take omega-3 fatty acids with medical supervision to lower triglyceride levels.
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