Diabetes

Diabetes mellitus (DM) is a chronic metabolic disease with multiple causes, resulting from various pathophysiological changes that lead to a persistent increase in blood glucose levels.

This increase is mainly due to failures in the normal action of insulin and/or a lack of this hormone. The prevalence of diabetes is growing, affecting around 13% of the adult population in Portugal. It is estimated that there are approximately 400 million people with diabetes worldwide, with numbers constantly rising.

Glucose is essential for cellular metabolism. In order for it to be transported to the cells, the pancreas produces insulin, a hormone that captures glucose from the bloodstream and transports it to cells throughout the body, where it is used as a source of energy. Anyone can develop this disease, but exposure to risk factors can increase the likelihood of its onset.

Around 90% of diabetes cases are classified as type 2 diabetes. This type mainly affects adults and the elderly, especially those who are overweight or obese, sedentary and with unhealthy lifestyles, and there is often a family history.

Type 1 diabetes is much less common and essentially results from the sudden and irreversible destruction of pancreatic cells, usually due to autoimmune inflammation.

This form of the disease mainly affects teenagers and young adults.

In pregnant women, the new hormonal environment, combined with excess weight, a sedentary lifestyle and an unbalanced diet, can trigger a specific type of diabetes during pregnancy, called gestational diabetes. This is usually controlled by diet and physical activity alone, but may require treatment with insulin. The main problems with this type of diabetes, when uncontrolled, are fetal complications and complications during childbirth.

The symptoms of diabetes result from the amount of sugar present in the blood, either associated with an increase in its level (hyperglycemia) or a decrease in its level (hypoglycemia).

Symptoms of hyperglycemia

Hyperglycemia can occur in poorly controlled diabetics or when a large amount of sugar is ingested. It can result in

• Blurred vision
• Feeling of dry mouth
• Excessive sweating
• Tiredness

Symptoms of hypoglycemia

Hypoglycemia usually occurs in diabetics who use drugs to control the disease (insulin or oral antidiabetics). It can result from taking too much or the wrong medication, prolonged fasting or inadequate physical exercise. Blood sugar levels should not be lower than 70mg/dl. When taking medication to control the disease, attention must be paid to diet so that sugar levels don’t drop too low. The main symptoms of this condition are:

• Unexplained tiredness
• Dizziness
• Blurred vision
• Difficulty in reasoning

The pancreas releases insulin, the hormone that controls the storage and use of sugar in the blood. Diabetes occurs when:

• The pancreas produces insufficient or no insulin at all;
• When the body does not respond adequately to insulin – the condition of “insulin resistance”.

It’s a public health problem that often results from the way people live and the habits they have. Its incidence has been increasing.

This disease is responsible for various complications that affect quality of life and can lead to early death. It is a disease that has no cure. Even so, advances in treatment and understanding of the disease allow diabetics to lead a practically normal life. Often, careful eating and regular exercise are enough to prevent the disease or keep it under control.

For those with diabetes, it is essential to maintain a balanced diet that helps control blood glucose levels. Maintaining a balanced diet and making healthy food choices is fundamental to diabetes control and general well-being.

What to eat:

1. Legumes and vegetables: They are low in calories and rich in fiber, vitamins and minerals. Examples: spinach, broccoli, cabbage, carrots and tomatoes.
2. Fresh fruit: Although they contain natural sugars, fruit is rich in fiber and nutrients. Opt for apples, oranges, strawberries and berries.
3. Whole grains: Wholegrain bread, brown rice, oats and quinoa are healthy options because they have more fiber and cause a slower rise in glucose levels.
4. Lean proteins: Skinless chicken, fish, eggs, tofu, lentils and beans. These protein sources help maintain satiety without increasing blood glucose levels.
5. Low-fat dairy products: Skimmed milk, natural yogurt and low-fat cheeses are good options.
6. Healthy fats: Avocado, nuts, olive oil and seeds (such as chia and linseed) are sources of unsaturated fats that are beneficial for the heart.
7. Water: Adequate hydration is crucial. Prefer water and unsweetened infusions.

What to avoid:

1. Refined sugars and sugary products: Cakes, sweets, soft drinks, chocolates and other products with a high sugar content rapidly increase blood glucose levels.
2. Refined carbohydrates: White bread, white rice, non-wholemeal pasta and sugary cereals should be avoided as they have little nutritional value and cause glucose spikes.
3. Saturated and trans fats: Fried foods, fast food, processed meats (such as sausages and bacon) and industrial pastries are harmful to cardiovascular health.
4. Sugary drinks: Industrialized fruit juices, energy drinks and soft drinks should be avoided due to their high sugar content.
5. Foods high in sodium: Consume less salt and avoid processed foods that tend to be high in sodium, such as salty snacks and instant soups.

Additional tips:

• Meal planning: Distribute meals throughout the day to avoid large variations in glucose levels.
• Constant monitoring: Check blood glucose levels regularly to understand how different foods affect the body.
• Consultation with health professionals: Nutritionists and endocrinologists can offer personalized diet plans tailored to individual needs.

Type 1 diabetics are treated with insulin (insulin therapy), administered subcutaneously several times a day from the beginning of the disease. This should be done at the same time as proper blood glucose monitoring, a healthy diet and regular exercise.

Type 2 diabetics monitor their blood glucose with oral antidiabetics. Sometimes no medication is necessary, as this type of diabetes can be controlled by adopting a healthy lifestyle, restricting high-calorie foods, portioning food, exercising, taking medications that facilitate the action of insulin and, in certain cases or in more advanced stages of the disease, by administering insulin (if treatment with oral antidiabetics fails to achieve the expected goals). Weight loss is essential for these patients.

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are prepared and reviewed by medical experts in Portugal.