Professor Changyong Xue, director of the Nutrition Department of PLA General Hospital, pointed out that the methods to control diabetes include drug therapy, exercise therapy and diet therapy. Practice has proved that these therapies are effective. Among them, dietotherapy is the basic therapy, and diabetic patients should understand and master it and use it freely in daily life.

Reporter: Why is dietotherapy the basis of controlling diabetes?

Professor Xue: Many articles in newspapers and magazines have introduced dietotherapy for diabetes, but it is necessary to say it again. In fact, many patients' understanding of this concept is unclear, inaccurate and even wrong. Speaking of diet control, some patients take it for granted that you can't eat this and drink that, so that you lose the pleasure of enjoying food and delicious food. There are also some patients who give up on themselves and think that it is not important to control diabetes well at this age, so they just eat casually. These two wrong understandings will inevitably lead to wrong behaviors and bad results, and diabetes is often not well controlled.

In fact, the diet therapy for diabetes is not simply to limit food intake. Dietotherapy is a dietary measure to control diabetes and prevent and delay its complications. The purpose is to correct the metabolic disorder caused by diabetes through appropriate dietary intervention, make blood sugar and blood lipid reach or approach normal values, eliminate symptoms, prevent or delay the occurrence and development of diabetic complications, maintain normal weight and ensure the normal development of children and adolescents. The overall goal is to let you have a complete and healthy lifestyle and study, work and live like a normal person.

Reporter: What characteristics should the diet of diabetic patients have?

Professor Xue: The diet of diabetic patients is not much different from that of normal people, but there are some special precautions.

1. has a certain regularity, not as casual as normal people eat (normal people often take tasting delicious food as the first principle);

2. Need a balanced diet. Since it is a balanced diet, you need to choose the right food and have the right amount to ensure that all kinds of nutrients in the food you eat can meet your needs;

Dietotherapy is not a once-and-for-all thing. It needs to be implemented every day and lasted for a long time to see the effect.

Many patients have read many books about diabetes diet, but it is meaningless to "toss" in practice. It should be said that it was difficult to implement diet therapy at first, but the main difficulty was that it was not easy to really master the essentials. To master dietotherapy, we must first learn and master the related knowledge of diabetes and dietotherapy for diabetes, just like learning traffic rules and related knowledge before learning to drive. Only by mastering this knowledge and using it flexibly can we control diabetes well. The specific implementation should be like a new driver on the road, which needs constant practice and practice to accelerate or decelerate in time and reach the destination safely and smoothly under complicated and changeable road conditions.

Because each patient's condition and complications are different, it is impossible to have a unified diet treatment plan suitable for all patients. Dietary treatment of diabetes needs individualization. The realization of individualization depends on the patient's own efforts, not a few words from doctors, knowledge introduction in books or the experience of others. Even for the same patient, the diet should be adjusted according to the condition, the existence of complications and the degree of change. Many patients often feel embarrassed about this problem. In fact, consulting an experienced doctor will solve the problem.

Q: We often mention the dietary principles of diabetes. What is the specific principle?

A: Diet therapy for diabetes requires two principles.

The first principle is "one balance, three considerations", that is, a balanced diet, taking into account the control of blood sugar, blood lipid, blood pressure and weight, taking into account the prevention and treatment of complications, and taking into account personal living habits and eating hobbies.

The second principle is "avoid the heavy and be light". According to the condition of diabetes and the existence and degree of complications, priority should be given to controlling or solving major problems. For example, when diabetic nephropathy is complicated, diabetic nephropathy should be considered first in diet, and other problems such as dyslipidemia and hypertension should also be solved if possible.

Can diabetics eat fruit?

Diabetes is a common disease in middle-aged and elderly people. If it is not well controlled, it will cause some complications. Treatment is usually a combination of diet, exercise and medicine, among which diet therapy is the basis of all treatments. For mild diabetes, only diet therapy can control the condition. The basic principle of dietotherapy is to estimate the total calories needed according to the patient's weight and activity, and arrange the daily diet reasonably. Don't eat foods with high sugar content, eat less foods containing fat and starch, mainly vegetables and miscellaneous grains, with a certain amount of high-quality protein foods such as lean meat, milk, eggs and bean products. Fruit contains sugar, can I eat fruit?

It is not suitable to eat fruit at all, because fruit contains a lot of vitamins, cellulose and minerals, which is beneficial to diabetics. The sugars contained in fruits are glucose, fructose and sucrose, among which fructose does not need insulin to participate in metabolism. Therefore, diabetic patients do not reject fruits after their blood sugar is controlled.

Moreover, the sugar content of fruits is different and cannot be treated equally. The foods below 100g 10g are: dark plum, watermelon, melon, coconut milk, orange, lemon, grape, peach, plum, apricot, loquat, pineapple, strawberry, sugarcane, coconut, cherry, olive and so on. , available for diabetics to choose from. Fruits with sugar content of 1 1-20g include bananas, pomegranates, grapefruit, oranges, apples, pears, lychees and mangoes. So choose carefully. There are dates and red fruits over 20g, especially dried dates, candied dates, dried persimmons, raisins, dried apricots and longan. It is forbidden to eat because of its high sugar content. Many vegetables can be eaten as fruits, such as tomatoes, cucumbers and melons. The sugar content per 100 grams is below 5 grams, and they are rich in vitamins, which can completely replace fruits and are suitable for diabetics.

In addition, the amount of food should be matched, not the same. Watermelon contains less sugar (4%), but if you eat 500g, it is equivalent to banana100g (sugar content is 20%) and pear170g (sugar content 12%), so the above fruits should not be eaten too much. You should also pay attention to the way you eat fruit. Don't eat immediately after meals, but eat between meals or before going to bed. It is best to try to eat, that is, measure urine sugar 2 hours after eating. If urine sugar increases, it needs to be reduced; If urine sugar is still high after fruit reduction, the amount of staple food should be reduced appropriately.

People with diabetes can eat fruit.

With the approach of midsummer, all kinds of seasonal fruits are on the market. However, many diabetics always keep their distance from fruits for taboo reasons. Recently, Ge Sheng, director of the Nutrition Department of Shanghai Sixth People's Hospital, and Donglian Cai, director of the Nutrition Department of Changhai Hospital, all stressed that the key for diabetics to eat fruits is to choose scientifically and reasonably according to their illness.

Can I eat fruit?

Sugar in fruits includes fructose, glucose and sucrose. These sugars are monosaccharides, and the blood sugar rises rapidly after eating them. Among them, fructose does not need insulin to participate in the metabolic process, so diabetic patients can choose some fruits according to their condition under the guidance of nutritionists.

Under what circumstances can I eat fruit?

Not all diabetics can eat sweet fruit, only patients with stable condition and basically controlled blood sugar can eat it. Generally speaking, patients whose fasting blood glucose is below 7.8 mmol/L (140 mg/dl), postprandial blood glucose is below10 mmol/L (180 mg/DL), and glycosylated hemoglobin is below 7.5%, are in stable condition and are not prone to hyperglycemia or hypoglycemia.

What fruits can I choose?

The basis for diabetics to choose fruits is mainly based on the content of sugar and starch in fruits and the glycemic index of different fruits.

Recommended choice: Fruits with sugar content less than 10g per fruit, including cucumber, watermelon, orange, grapefruit, lemon, peach, plum, apricot, loquat, pineapple, strawberry and cherry. This fruit can provide 20-40 kilocalories per100g.

Careful selection: Fruits with sugar content of 1 1-20g per 100g of fruits, including bananas, pomegranates, melons, oranges, apples, pears, lychees and mangoes. This fruit can provide 50-90 kilocalories per100g.

Not suitable for selection: fruits with sugar content higher than 20g per 100g of fruits, including red dates and red fruits, especially dried dates, candied dates, dried persimmons, raisins, dried apricots, longan and candied fruits, should be forbidden to eat. Fresh fruits with a particularly high sugar content, such as red Fuji apples, persimmons, Laiyang pears, Feicheng peaches, cantaloupes, rose grapes, winter dates, yellow peaches, etc., are also not edible. This fruit provides more than 100 kcal per 100 g.

How much is appropriate to eat every day?

Fruit is part of the diabetic diet. The energy produced per 100g of fresh fruit is about 20- 100kcal. Strictly speaking, how much fruit each patient should eat every day should be calculated by nutritionists. But generally speaking, patients with stable blood sugar control can eat about 150g of low-sugar fresh fruit every day. If you eat 200-250 grams of fresh fruit every day, you should subtract 25 grams (half a second) from the staple food of the whole day, so as not to exceed the total energy of the whole day.

When is a good time to eat fruit?

It is best to eat fruit between meals, when hungry or after physical activity as a supplement to energy and nutrition. Usually around 9: 30 am, around 3: 30 pm, or after dinner 1 hour or before going to bed 1 hour. It is not recommended to eat fruit immediately before or after meals, so as to avoid excessive carbohydrate intake at one time, which will lead to increased blood sugar after meals and increase the burden on the pancreas.

Everyone's specific situation is different, and each fruit has different effects on blood sugar. For patients with a blood glucose meter at home, it is very helpful to test blood glucose or urine sugar before eating fruit and 2 hours after eating fruit to know whether they can eat this fruit.

Pay attention to the diet of diabetic patients at 8 o'clock.

Diabetes is a lifelong disease, and the treatment of diabetes should adhere to the comprehensive treatment methods of dietotherapy, physiotherapy and drug treatment. Among them, diet therapy is the most basic treatment. If you control it well, you can live a normal life. Luo, director of the Department of Endocrinology of the Second People's Hospital of the city, suggested that diabetic patients should pay attention to the following points in their daily diet:

1. Properly control the amount of staple food: Under normal circumstances, rest patients eat 250-300g of staple food (rice, flour, corn, millet, buckwheat, etc. ) every day; 350-400g per day for light manual workers; Heavy manual workers 450-550g per day. After the blood sugar and urine sugar drop, the staple food can be appropriately increased by 25-50g. The staple food should be eaten in rotation or mixed to improve the nutritional value. Patients should pay attention to summing up the changing rules between meals and blood sugar and urine sugar, so as to achieve stable condition and fixed staple food; If the condition fluctuates, adjust it in time. Be flexible and keep your weight within the standard range.

2, control diet: It does not mean that the less you eat, the better, because long-term hunger and insufficient calories will lead to the body's own consumption, not only thin, weakened resistance, but also aggravate diabetes. Therefore, diabetic patients should follow the doctor's advice, reasonably arrange the appropriate proportion of daily total calories, protein, fat and carbohydrates, and make their own ideal recipes.

3. The time and quantity of meals should be kept stable: try not to eat snacks, quit smoking and avoid alcohol.

4. Restrict the intake of cholesterol: Middle-aged and elderly diabetics and patients with coronary heart disease and hyperlipidemia should strictly limit the intake of cholesterol in the diet. Animal fat and viscera contain high cholesterol, so you should eat less or not, and no more than two eggs a day.

5. Eat coarse but not refined food: within the quantitative range of staple food, eat coarse grains, beans and vegetables as much as possible, with green leafy vegetables as the best, such as rapeseed, Chinese cabbage, leeks, spinach and celery. These foods are not only rich in vitamins and inorganic salts, but also contain more crude fiber, which can effectively prevent blood sugar from being absorbed too fast, and also have the functions of lowering cholesterol, preventing arteriosclerosis and preventing constipation.

6. Strictly restrict sucrose and sweets: diabetics should not eat sugar, candy, honey and sweets and sugary drinks. These high-sugar foods are easily absorbed by the human body, which promotes the increase of blood sugar and aggravates the burden on the pancreas, thus aggravating the condition.

7. Learn some knowledge of nutritional therapy: basically master the main nutrients contained in commonly used foods, especially the sugar content. At the same time, we should know which foods can be eaten more, which foods should be eaten less and which foods should be fasted, and we should be aware of the exchange methods of foods with equivalent nutritional value.

8, eat fruit in moderation: according to the patient's blood sugar, urine sugar flexible control. If fasting blood sugar does not exceed11mmolh \ (2000 mg/dl \), urine sugar does not exceed 3 plus signs, and there is no ketoacidosis, you can eat a small amount of fruit, but you should master it well, don't eat a lot, and eat at most 150-200 grams a day. According to the determination, the sugar content of bananas, oranges, apples and pears is moderate: melons, watermelons and cherries have less sugar content, so you can eat them first; Tomatoes and cucumbers are low in sugar, so you can eat more instead of fruit.

If diabetic patients can seriously follow the above dietary requirements and persevere, it will effectively control their illness and prevent complications.