Diabetes is a condition in which the amount of glucose (sugar) in the blood becomes too high because the body is unable to either convert it into energy or to store it.
We obtain glucose from the foods that we eat, and a hormone called insulin usually helps glucose to enter the cells, where it can be used as fuel by the body. After a meal, the blood-glucose level rises and insulin is released into the blood. Without insulin, the level of blood-glucose in the body rises and can cause symptoms ranging from increased thirst and going to the toilet all the time - especially at night - to extreme tiredness, weight loss, blurred vision and even unconsciousness.
Although Type 1 diabetes can occur at any age, it is generally diagnosed in younger people. Therefore Type 1 diabetes is also known as juvenile or early onset diabetes.
People with Type 1 diabetes cannot produce insulin because the insulin-producing cells in the pancreas have been destroyed. Nobody knows what causes this, but the most likely reason is an abnormal reaction of the body to the cells, which may be triggered by a viral or other infection.
Daily insulin injections, as well as a carefully balanced diet, are essential for people with Type 1 diabetes.
This type is often known as adult, late or maturity onset diabetes. It develops most commonly in people over the age of 40, although it does occasionally appear in younger people.
People who are overweight are particularly likely to develop Type 2 diabetes. It also tends to run in families, and is more common in Asian and Afro-Caribbean communities. Type 2 diabetes occurs when the body no longer responds normally to its own insulin, and/or does not produce enough insulin.
This type of diabetes develops slowly and the symptoms are usually less severe. Some people do not notice any symptoms at all and their diabetes may only be picked up in a routine medical check-up.
Generally, eating a healthy balanced diet is sufficient to control Type 2 diabetes. However, in some cases medication is also required.
People with diabetes of either type have a higher chance of developing a range of serious health problems, including heart disease, stroke, high blood pressure, circulation problems, nerve damage and damage to the kidneys and eyes.
The risk of problems will be greatly reduced by controlling blood-glucose and blood pressure, eating healthily and taking regular physical exercise.
There are no foods that diabetics cannot eat; however, it is essential to reduce the amount of certain foods and to increase others. The dietary guidelines for people with diabetes are very similar to those recommended for everyone else - eating less sugar and fat, more fibre-rich, starchy foods, and more fruit and vegetables, with moderate amounts of meat and fish, as well as milk and dairy foods.
There is no need to buy special diabetic foods - ordinary everyday foods in the right balance are the key to diabetic control. Choosing the right foods, however, can make a big difference.
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Eating regularly helps to ensure your blood sugar does not swing from one extreme to the other. People with diabetes need to base each meal on a starchy carbohydrate food for energy and to help maintain control over their blood-glucose level. It is a good idea to try to eat about the same amount of starchy foods each day, with plenty of vegetables, salad or fruit, and a smaller portion of meat or dairy foods. Starchy foods to try include: cereal, toast, rolls, bread, noodles, rice, pasta and potatoes.
It is important to try to eat wholemeal versions of these foods whenever possible, and to choose foods that are high in fibre, as these help the digestive system and prevent constipation. Fibre can slow down the rate at which starch and sugar in foods enter the bloodstream. It can also help reduce blood-cholesterol levels as part of a balanced diet. This kind of soluble fibre is found in oats, pulses, fruit and vegetables.
Try to choose fibre-rich starchy foods. Look for wholemeal or whole-grain breads, high-fibre breakfast cereals, wholemeal pasta or flours, brown rice, all types of vegetables and salads,especially pulses, and make sure you have fruit every day.
You don't have to avoid sugar completely. As long as your everyday diet is healthy and generally low in sugar, some sweet food (in small portions) will do no harm, particularly if eaten as part of a meal.
Sugar can be eaten as part of a healthy diet without having a bad effect on blood-glucose control.
Savoury and plain foods, such as tinned tomatoes, baked beans, or plain (not sugar-coated) breakfast cereals, do not contain enough sugar to have a harmful effect on your blood-sugar levels. These foods are often eaten as part of a meal, so there is no need to worry about them.
Sugary drinks can cause blood glucose levels to rise quickly, so choose sugar-free, diet or low-sugar squashes and fizzy drinks.
Aim for at least five portions of fruit or vegetables a day. If you are unsure how much constitutes a portion, the following guidelines will help. Any one of these options counts as a portion: half a grapefruit; two kiwi fruits or two satsumas or other small fruit; two heaped tablespoons of vegetables; a dessert bowl of salad.
Fat does not directly affect your blood-glucose levels, but it is important for reducing overall weight and the risk of coronary heart disease, both of which are risks associated with diabetes. It is best to try to reduce the total fat in your diet - especially saturated fats. These are the ones found in butter, lard, fatty meat and meat products, full-fat dairy products, and savoury foods such as pies, pastries and crisps.
Try the following tips for cutting down on fat:
- Use semi-skimmed or skimmed milk
- Choose a monounsaturated or polyunsaturated margarine or low fat spread instead of butter.
- Watch your cheese consumption - look out for lower-fat varieties (Edam and Brie are medium-fat cheeses, for example).
- Cut down on pastries and pies
- Avoid frying, if possible, and avoid oily salad dressings - choose fat-free dressings.
- Yogurt or fromage frais make good alternatives to cream for toppings. Greek yogurt is a slightly creamier option, but still has less fat than cream.
- Choose lean meat, or trim fatty cuts, and remove the skin from chicken.
- Cut down on fatty meat products, such as some sausages and burgers.
- Use more vegetables in stews and casseroles
Avoid having salt on the dining table, and use less salt in cooking - add fresh or dried herbs and spices instead to enhance the flavour of food.
It is best to keep to safe drinking limits, which means no more than the 2-3 units of alcohol a day for women, and 3-4 units a day for men.
- One small glass of wine = one unit
- Half a pint of ordinary strength beer, lager or cider = one unit
- One pub measure of spirits = one unit
People with diabetes should have some alcohol-free days each week and should not drink alcohol on an empty stomach, as this can make low blood-glucose levels more likely to occur.
Eating regular meals that are low in fat and sugar, high in fibre and based on starchy carbohydrates is a great start.
Check with a registered dietitian that you are not only eating a healthy diet, but also eating the right quantity to maintain your weight at an ideal level. During exercise or physical activity your blood glucose level falls so you may need to adjust your insulin and have a sugary snack available.
The Waitrose Nutrition Advice Service offers guidance on diet and healthy eating. We can supply a list of our own-label foods that are fat and sugar controlled as part of a healthy balanced diet.
You can also download a list of our top 10 basic shopping basket items for diabetes, recommended by our nutritionist, around which you can build your choice of meals.
Nutrition Advice Service
Tel: 0800 188884
Other useful contacts
Tel: 020 7424 1000
www.diabetes.org.uk (This link opens a new window)
- What is diabetes?
- Type 1 diabetes
- Type 2 diabetes
- Food choices for diabetics
- Planning your meals
- Reduce your sugar intake
- Eat plenty of fruit and vegetables
- Cut down on fatty foods
- Reduce your salt intake
- Moderate alcohol intake
- Healthy weight
- How can Waitrose help?
- For more information
- Useful links
Ask our nutritionist
If you have any nutrition or diet questions or need some advice on eating a healthier diet you can email our nutritionist and receive a personal reply to your question.