Diet in diabetes
A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar (i.e.: cardiovascular disease, kidney disease, obesity).
[1][2] For overweight and obese people with diabetes, the most important aspect of any diet is that it results in loss of body fat.
[1][2] Losing body fat has been proven to improve blood glucose control and lower insulin levels.
[9][10] There is no minimum required amount of daily dietary carbohydrates as the body can make glucose through various metabolic processes including gluconeogenesis and glycogenolysis.
[1] However, meta-analyses including the most recent Cochrane Systematic Review have found that a low glycemic index diet results in better blood glucose control as measured by glycated hemoglobin A1c (HbA1c) as well as fewer hypoglycemic episodes.
[1] The ADA does not make a specific recommendation about the total amount of fat that should be consumed by diabetics on a daily basis.
[2] For type 1 diabetics, there is a lack of definitive evidence of the usefulness of low-carbohydrate diets due to limited study of this topic.
[1][11][12] A meta-analysis published in 2018 found only nine papers that had adequately studied the implementation of low carbohydrate diets in type 1 diabetics as of March 2017.
[12] This review as well as the ADA consensus statement suggests that low carbohydrate diets may be beneficial for type 1 diabetics but larger clinical trials are needed for further evidence.
[16] Overall, the ADA recommends people with diabetes develop "healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods".
[1][17] For type 2 diabetics, the focus of a vegetarian or vegan diet should be maintaining a level of caloric intake that results in fat loss, adequate protein consumption, adequate consumption of compounds that are most bio-available in animal products (i.e. vitamin B-12, iron, creatine), and whole food carbohydrate sources that are lower in glycemic index.
If patients check their blood glucose at bedtime and find that it is low, for example below 6 millimoles per liter (108 mg/dL), it is advisable that they take some long-acting carbohydrate before retiring to bed to prevent night-time hypoglycemia.
[citation needed] Night sweats, headaches, restless sleep, and nightmares can be a sign of nocturnal hypoglycemia, and patients should consult their doctor for adjustments to their insulin routine if they find that this is the case.
[27] Another possible sign of nocturnal hypoglycemia is morning hyperglycemia, which actually occurs in response to blood sugar getting too low at night.
[31] In the 18th century, the Scottish surgeon John Rollo argued that calorie restriction could reduce glycosuria in diabetes.
[32] In the 1950s, the American Diabetes Association, in conjunction with the U.S. Public Health Service, introduced the "exchange scheme".
A study at UCLA in 2005 showed that it brought dramatic improvement to a group of people with diabetes or pre-diabetes in three weeks, so that about half no longer met the criteria for the disease.
