Determining Your Nutritional Needs
Editor’s Note: This piece was verified by Peggy Kraus CDE, RCEP.
According to the American Diabetes Association (ADA), many nutritional recommendations are still given to those with type 2 diabetes that have no real bearing or evidentiary support. It’s incredibly important when managing diabetes to not only create a nutritional plan for yourself but to be absolutely certain that your plan is based on a correct understanding of what your body’s nutritional needs to properly maintain diabetes so that you ultimately can thrive with it.
The following are parameters every person with diabetes should seek to operate within to achieve good management:
Metabolic Outcomes
Keeping blood glucose levels in the normal range, or close to it, in order to prevent complications is absolutely crucial. Maintaining healthy lipids and blood pressure levels are also important, as these reduce risks of vascular disease.
According to ADA, recommended goals for these are as follows:
- Blood glucose levels between 4.4 mmol/L80 mg/dL and 7.2 mmol/L130 mg/dL*
- A1C <7 percent
- Blood Pressure: <140/80mmHg
- LDL Cholesterol: <100 mg/dL
- Triglycerides: <150 mg/dL
- HDL Cholesterol >40 mg/dL for men
- HDL Cholesterol >50 mg/dL for women
*These parameters were updated as of 2017.
Nutritional Intake
Carbs and Fat
There has been a great deal of back and forth in terms of the proper carbohydrate and fat intake for people with diabetes and nothing is entirely conclusive. That said, the ADA outlines that specific sources of carbs should ideally be vegetables, whole grains, fruits, legumes and dairy products, rather than sources that contain added fats, sodium, or sugar. The latest ADA nutrition guidelines detail the need for specific nutrition plans designed for the individual by their healthcare professional. These guidelines also indicate that as far as fat is considered, quality over quantity is always preferable and good fats reign supreme over saturated ones, though still in moderation.
Sugar and Sodium
Those with type 2 diabetes (T2D) might want to limit or completely avoid sugar-sweetened beverages and other added sugars or substantially caloric sweeteners to reduce the risk of weight gain or obesity. According to the AHA, sugar in take should be limited per day to 45 grams for men and 30 grams for women. Daily sodium intake is recommended to be less than 2300 mg, with additional reductions individualized for those who have high blood pressure.
Supplements
It’s been proven that people with type 2 diabetes do not benefit from omega-3 supplements specifically for the prevention or treatment of heart disease. That said, the recommendation to eat fatty fish at least twice per week is as appropriate for people with diabetes as it is for the general public. In general, vitamins, mineral supplements and herbs have not been shown to benefit those with T2D in any way in particular.
There are a wealth of nutritional needs tools online that can help you calculate remotely what your intake should be based on gender, weight, activity level, etc. As always, people with diabetes should consult a physician or certified diabetes educator to be sure they are taking the right steps and planning according to their particular needs.
Complications
It is crucial to attempt to prevent other complications that might arise as a result of diabetes, including heart disease, stroke, hypertension, nephropathy, narrowing of blood vessels, retinopathy, obesity and neuropathy, among others. Aside from good glycemic control, healthy food choices and exercise play a significant role in reducing the risk of diabetic complications. Once complications arise, it is crucial to do whatever is recommended by your healthcare team, including changing and adapting lifestyle choices, among those food intakes and patterns of physical activity.
