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Diabetes is a condition in which the amount of glucose (sugar) in the bloodstream is too high because the body cannot control it properly. The blood glucose level is normally kept in range by a hormone called insulin, which is produced from the pancreas. Insulin controls blood glucose levels by allowing glucose to enter the cells so it can be used as fuel by the body. In people with diabetes there is either not enough insulin being produced, or it does not work properly.

There are two main types of diabetes, and the approach to food may vary depending on the type of diabetes and the treatment being followed.

Type 1 diabetes occurs when the body is unable to produce any insulin and this has to be replaced, usually through insulin injections.

Type 2 diabetes is when the body is able to make some insulin but not enough, or when the insulin produced does not work properly (called 'insulin

resistance').

The aim for both types of diabetes is to achieve and maintain the best possible control of blood glucose, blood pressure and cholesterol; which will reduce your risk of diabetes complications in the future. What you eat or don't eat and your physical activity level are vital in controlling all these factors, but that does not mean that you should not still enjoy your food and the occasional 'treat'!

This fact sheet will give you simple information about healthy food choices suitable for everybody, including adults with diabetes. The national diabetes charity, Diabetes UK, produces more

comprehensive information available both online and in print (see www.diabetes.org.uk

Type 1 diabetes

If you have Type 1 diabetes, you should see a dieitian who will help you to understand the balance between the carbohydrate you eat and your insulin doses. This will help you to manage your diabetes more effectively. You will also reduce your risk of long term health problems if you follow some of the key points highlighted for people with type 2 diabetes.

Type 2 diabetes

Being aware of carbohydrate foods and food portion sizes is important if you have Type 2 diabetes. The following general guidelines will help to manage your diabetes and benefit your general health:

1. Eat regularly - aim for three meals a day, including breakfast
   

2. Include some carbohydrate foods with a lower glycaemic index at each meal
   

3. Aim for at least 5-a-day: that's portions of fruits and vegetables
   

4. Eat oily fish such as mackerel, sardines or salmon twice a week
   

5. Eat fewer sugary foods and drinks
   

6. Eat fewer fatty foods, particularly saturated fats
   

7. Eat less salt and salty foods.
   

Eat regularly

Aim for healthy balanced meals based around the Balance of Good Health.  Include some 'starchy' carbohydrate foods at each meal, such as bread, potatoes, rice, pasta, or chapatti. The larger the portion, the more effect these foods will have on raising blood glucose. Wholegrain

starchy foods may help to control your blood glucose. These have a lower 'Glycaemic Index' (G.I.), which helps you to feel full longer, reduce rapid rises & falls in blood glucose and so should be chosen more often. Examples of lower G.I. carbohydrate foods include

wholegrain bread, porridge oats, pulses, most fruit and low fat yogurt.

Weight

Excess weight, in particular around your waist, can make your diabetes harder to control. Losing weight can be difficult but evidence shows that even a small weight loss of just 5-10% of your body weight can bring significant health benefits. Losing weight gradually, about 1/2 to 1kg (1-2lb) per week is the most effective. You may also need advice about adjustments to your medication if

you are making significant changes to your diet andphysical activity level.

Fruits & Vegetables

Eating more fruits and vegetables will lower your risk of heart disease, strokes and some cancers.

Contrary to popular belief, people with diabetes can eat all types of fruit, but eating large quantities, for example several portions at once, will raise blood glucose. That's why it's useful to

know what counts as one portion:

1. One piece of ordinary sized fruit, e.g. apple, orange,banana
   

2. Two small fruits, e.g. plums or satsumas
   

3. A handful of grapes or a slice of a large fruit, e.g. melon
   

4. 1/2 - 1 tablespoon of dried fruit, e.g. sultanas
   

5. A small glass of pure fruit juice (150ml)
   

6. 2-3 tablespoon of cooked vegetables or a small bowl of mixed salad.
   

Oily Fish

The Omega-3 fats found in oily fish may have several health benefits but in particular eating more oily fish can protect your heart, so it's recommended people with diabetes eat one or two portions each week. Examples of oily fish include mackerel, sardines, salmon, trout and herring. Fish oil supplements are not generally recommended but speak to your doctor for personalised advice.

Sugar

It's not necessary to follow a sugar-free diet, nor would it be possible to. Choose lower sugar or reduced-sugar foods where possible. The amount of sugar in savoury foods is not usually significant. Artificial sweeteners can be useful for people with diabetes, especially if trying to

lose weight

Fats

Fat is extremely high in calories so eating less fat and fatty foods will help you lose weight. Saturated fats, such as those found in pastry, butter, fatty meat and high-fat dairy foods like cheese, are linked to heart disease so reduce this type of fat as much as possible. Replace it

with leaner and reduced fat versions, and with monounsaturated fats such as rapeseed oil, pure vegetable oil, olive oil and spreads made from these.

Salt

It's recommended that we have less than 6g of salt per day. Prepackaged and convenience foods

contain a lot of salt, so a simple way to reduce your salt intake is to include more fresh food and 'home cooking' in your diet. Lowering your salt intake will help to improve your blood pressure and reduce your risk of heart disease, strokes and some cancers.

Alcohol

There's generally no reason why people with diabetes should not drink alcohol, unless you have

been advised not to, but it is important to stick to the safe limits.

That's up to two units per day for women and up to three units per day for men. A small glass of wine (125ml) is usually about 11/2 units, while a pint of ordinary strength (3.5%) beer is roughly two units. Single pub measures (25ml) of spirits are also one unit. Alcohol is high in calories, so if you're trying to lose weight it can be helpful to reduce your intake of alcoholic drinks.

'Diabetic' Foods

Foods labelled as 'diabetic', such as sweets, cakes and chocolates, offer no special benefits and are not recommended. They may be high in fat and calories, are expensive and some may cause diarrhoea

.

Physical Activity

Aim for at least 30 minutes of moderate physical activity on five days of the week. 'Moderate' means breathing more deeply and feeling warmer, e.g. walking, gardening, housework etc