Diabetes & Gestational Diabetes
What is diabetes?
Diabetes is a chronic medical condition that affects how your body processes glucose, the primary source of energy for your cells.
When you eat, your digestive system breaks down food into glucose, which enters your bloodstream. To enter your cells and be used for energy, glucose requires a hormone called insulin.
In diabetes, there is a problem with insulin production, utilisation, or both. There are two primary types of diabetes: Type 1 and Type 2.
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In Type 1 diabetes, the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas.
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Type 2 diabetes occurs when the body becomes resistant to the effects of insulin or doesn't produce enough insulin to maintain normal blood glucose levels.
Both types can lead to high blood sugar levels, which, if not managed, can have serious health consequences.
What are the symptoms of diabetes?
The symptoms of diabetes can vary but often include frequent urination, excessive thirst, unexplained weight loss, fatigue, and blurred vision.
In type 2 diabetes, the onset of symptoms is gradual and, if caught early, patients might not yet have developed overt symptoms.
If you or someone you know is experiencing any symptoms suggestive of diabates, it's crucial to consult a healthcare professional for evaluation.
How is diabetes diagnosed?
A diagnosis typically involves blood tests to measure fasting blood glucose levels and, in some cases, an oral glucose tolerance test. The results help determine whether you have diabetes and which type.
It's essential to diagnose diabetes early, as untreated or poorly managed diabetes can lead to complications such as heart disease, kidney problems, vision impairment, nerve damage, and more.
How is diabetes managed?
While diabetes is a chronic condition, it can be effectively managed, and many individuals with diabetes live full, healthy lives.
Treatment approaches vary based on the type and severity of diabetes.
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In Type 1 diabetes, treatment usually involves insulin therapy, either through injections or an insulin pump. Different regimes are available depending on lifestyle.
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Type 2 diabetes management often begins with lifestyle changes such as a balanced diet, regular physical activity, and weight management. Some individuals may also require oral medications or insulin.
Monitoring blood glucose at home is only important for people on certain medications (gliclazide and insulin). A blood test done by your GP is sufficient for most people with type 2 diabetes. This should be done twice a year or more frequently when making changes to lifestyle and medication. Some people will be asked to monitor in the early days of management to learn about the effects of different foods on blood glucose levels
Successful diabetes management not only involves controlling blood glucose levels but also addressing associated risk factors like blood pressure and cholesterol levels to reduce the risk of complications.
What is gestational diabetes?
Gestational diabetes develops during pregnancy and typically appears around the 24th to 28th week of gestation. It affects a small percentage of pregnant women, usually around 2-10% of pregnancies.
It occurs when the body cannot produce enough insulin to meet the increased demands during pregnancy. Hormonal changes and weight gain during pregnancy contribute to insulin resistance in some women.
Gestational diabetes is typically temporary and usually resolves after childbirth. However, women who have had gestational diabetes are at a higher risk of developing Type 2 diabetes later in life.
It is usually managed through dietary modifications, exercise, and sometimes insulin or metformin therapy. Monitoring blood glucose levels is crucial when fasting or after meals for both the mother and the baby's health, with tighter targets during pregnancy to protect your baby.
How can nutrition support diabetes?
Nutrition plays a crucial role in managing diabetes by helping control blood glucose levels, preventing complications, and promoting overall health. Here are several ways in which nutrition helps individuals with diabetes:
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Blood Glucose Control: The type and quantity of carbohydrates consumed have a direct impact on blood glucose levels. Proper nutrition involves managing carbohydrate intake, choosing complex carbohydrates that are slowly digested (like whole grains, vegetables, and legumes), and monitoring portion sizes. This helps prevent rapid spikes and drops in blood glucose, promoting stable glucose levels.
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Weight Management: Achieving and maintaining a healthy weight is often a key component of diabetes management, especially for those with type 2 diabetes. A balanced diet that supports weight loss or maintenance can improve insulin sensitivity and reduce the need for medication.
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Balanced Macronutrients: A well-rounded diet includes a balance of carbohydrates, proteins, and fats. Protein and healthy fats help with satiety, prevent overeating, and provide a steady release of energy. For people with diabetes, maintaining this balance is important for blood glucose control.
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Fibre Intake: Fibre-rich foods, such as whole grains, fruits, vegetables, and legumes can help slow the absorption of carbohydrates and improve blood glucose levels. Fibre also supports digestive health and helps manage weight.
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Portion Control: Controlling portion sizes is critical in managing calorie intake and blood sugar. Measuring and understanding portion sizes helps prevent overeating and maintain a consistent carbohydrate intake.
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Glycemic Index: The glycemic index (GI) is a measure of how quickly a food raises blood glucose levels. Low-GI foods, which are absorbed more slowly, can be helpful in managing blood glucose, while high-GI foods should be consumed in moderation.
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Meal Timing: Consistency in meal timing can help regulate blood glucose levels. Eating at regular intervals, including healthy snacks, prevents extreme fluctuations in glucose levels and supports energy balance.
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Individualised Meal Plans: A registered dietitian can create personalised meal plans tailored to an individual's specific needs and preferences, taking into account factors like age, activity level, medications, and health goals.
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Monitoring and Adaptation: People with diabetes should regularly monitor their blood glucose levels to evaluate the impact of their dietary choices. This information can guide adjustments to their diet plan.
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Long-Term Health: Proper nutrition not only helps manage diabetes but also reduces the risk of complications such as heart disease, high blood pressure, and kidney problems, which are more common in individuals with diabetes.
It's important to note that diabetes management is not a one-size-fits-all approach. What works for one person may not work for another. Consulting with a registered dietitian or healthcare provider is essential to create a tailored nutrition plan that meets individual needs, promotes better blood glucose control, and supports overall health and well-being.
Who would I see?
Clare Morris is a registered dietitian with an interest in all types of diabetes. She specialises in helping those diagnosed with prediabetes to avoid the progression to diabetes as well as assisting those diagnosed as type 2 to achieve remission.
Clare is available for Virtual Dietetic Appointments.
