Type 2 diabetes dietary taboos

The core dietary taboos for patients with type 2 diabetes are never “no sweets at all”. Rather, they should give priority to avoiding three types of foods that can quickly raise blood sugar, increase insulin burden, and disrupt metabolic rhythms – processed foods with more than 10% added sugar, pure white rice and white flour products with a high proportion of refined carbohydrates, and high-fat fried foods containing a large amount of trans fatty acids. Apart from this, there is no absolute “can’t eat”. All taboos must be flexibly adjusted based on their own blood sugar response, medication use, and daily activity level.

A while ago, I accompanied a relative at home to the endocrinology department for a follow-up visit. I happened to see Uncle Zhang downstairs squatting in the corridor and sighing. He said that he had been diagnosed for three months and did not dare to touch even half a sugar. He even gave up his favorite banana. As a result, the glycosylated hemoglobin test last week still soared to 7.2. I took the food record to the doctor and found that he ate two large bowls of white rice at every meal.

When many people are first diagnosed, the first thing they do is search for "10 foods that people with diabetes should not eat" and make a list and post it on the refrigerator. They wish they could throw all the sweet things out of the house. In fact, there is quite a lot of disagreement in the academic circles on this matter. Most clinicians of the older generation will directly ask patients to completely give up fruits and porridge, fearing that the blood sugar will rise quickly and become difficult to control. ； However, the latest "China Type 2 Diabetes Prevention and Treatment Guidelines (2022 Edition)" actually clearly states that low-GI fruits can be consumed in moderation between meals. Whole grain porridge with mixed beans and beans accounting for more than 1/3 of the staple food does not need to be completely taboo as long as the amount is controlled.

Don't tell me, when I was following up people with diabetes in the community, I actually met two very typical examples: a 72-year-old grandmother, diagnosed 12 years ago, eats half an ugly orange every afternoon, and her blood sugar has been stable within 7 after measuring countless times. Her secret is to go downstairs and walk slowly for 20 minutes after eating. This amount of activity is just enough to metabolize the extra sugar.； Another young sugar lover in his 30s greedily ate a quarter of a piece of cake labeled "sucrose-free" and his blood sugar rose directly to 11.7. Later he looked through the ingredient list and discovered that the cake was added with 30% maltodextrin and shortening, which raised blood sugar faster than ordinary white sugar. Trans fatty acids can also aggravate insulin resistance, which is equivalent to adding a big burden to the already tired pancreas.

Many people focus on the sugar on the surface, but ignore the many invisible pitfalls. For example, rock sugar is added to braised pork ribs and sweet and sour fish to enhance the flavor, white sugar is added to marinated meats and pickles to enhance the flavor, and even the "sugar-free cereals" and "sugar-free biscuits" that many elderly people love to buy. Maltose syrup and fructose syrup are among the top three in the ingredient list, and the added sugar has long exceeded the limit. There are also the white steamed buns and white noodles that everyone eats every day. The glycemic index of refined carbohydrates is higher than that of cola. Many people strictly abstain from sugar but eat two large bowls of white noodles every day. How can their blood sugar be stabilized?

Speaking of this, I have to mention the very controversial question "Can people with diabetes eat sweet potatoes and pumpkins?" Some people say that pumpkins are high in sugar and cannot be touched by people with high blood sugar levels. Some people say that eating sweet potatoes instead of staple food can lower blood sugar. In fact, both opinions are too extreme. I have seen people with sensitive constitutions whose blood sugar levels rise by 2 points after eating 100 grams of steamed pumpkin. I have also seen people with diabetes who eat 200 grams of roasted sweet potatoes instead of white rice, and their blood sugar levels are lower than usual. The core issue is never whether you can eat it, but how you eat it - if you finish a bowl of rice and then add an extra piece of sweet potato, no magic can save your blood sugar level.

I was chatting with nurses in the endocrinology department before, and they said that among the patients they manage, the ones with the best blood sugar control are never the ascetics who dare not eat anything, but the smart people who can do their own "blood sugar test": for example, when you want to eat something, just take a small bite, and then measure the blood sugar two hours after the meal. As long as it does not exceed your control goal, you can eat in moderation next time.； If it rises high, you should either eat less next time or exercise for half an hour more after eating. On the contrary, your condition will be much better than those who dare not eat anything. After all, long-term dieting and malnutrition will make blood sugar fluctuate even more.

In fact, after all, the dietary taboos for people with type 2 diabetes are really not as scary as those posted on the Internet, so they don’t need to live a tight life. The core is to control total calories, stabilize the rate of blood sugar rise, and not put too much burden on the pancreas. After all, sugar control is a lifelong matter. You can't go for decades without touching a sip of milk tea or a bite of cake, right? Occasionally, it is better to take a few mouthfuls if you are craving for food, walk two more steps, and discuss with the doctor in advance the plan to adjust the dosage of medicine, rather than holding back and overeating. You know your body best. Testing your blood sugar several times is much more reliable than following the fasting list on the Internet.