A regular physical activity program is another cornerstone of diabetes care. Much attention must be paid to choosing the most suitable activity. The duration, intensity and frequency should be advised by your doctor or the team of specialists who follow you. The total amount of carbohydrates introduced each day with the diet must be such as to provide between 45 and 60% of the total daily kcal.
Contrary to what many think, people with diabetes do not have to eliminate carbohydrates entirely, but pay more attention to the quantity, quality and type of sugar contained in food. The foods that naturally contain sugars such as fruit, vegetables and milk are not prohibited, while habitually consume sweets and sugary drinks if it already is not advisable for anyone, much less it is for a diabetic person. However, an exception to the rule from time to time will certainly be granted.
Carbohydrates cause the concentration of sugar in the blood to rise more or less rapidly. It is advisable to eat slow-release carbohydrates (bread, pasta, rice, breakfast cereals, fruit) because they are a good source of energy, help to recharge and keep blood glucose at a more stable level. Sugary foods such as candies, sweet and fizzy drinks, sweets and chocolate, cakes and biscuits (especially stuffed), in addition to being more caloric, are digested and absorbed quickly into the blood and cause the blood sugar level to rise more rapidly. Once in a while they don’t hurt, but it’s better to go for low-sugar alternatives.
In addition to the type of carbohydrate, the increase in blood sugar is also influenced by the presence of fiber and the assimilation of food. The higher the fiber content of a food or meal, the lower the increase in blood sugar. Dietary fiber should ideally be more than 40g / day (or 20g / 1000kcal / day), preferably soluble. The daily consumption of 5 portions of vegetables or fruit and 4 portions of legumes per week can be useful in providing the minimum fiber requirement.
The unrefined foods (whole) are more appropriate because they take longer to digest and thus avoid inducing spikes in blood sugar. The recommended carbohydrate quota may vary based on individual metabolic characteristics , as well as personal and local habits. Low-carbohydrate diets (i.e. with a restriction below 130 g / day) are not indicated
Both the quantity and quality of carbohydrates in foods can influence the blood sugar response. Controlling the total amount of carbohydrates, through the use of exchange diets or carbohydrate counting , is a key strategy for achieving glycemic control in the patient treated with insulin on a daily multidose regimen.
Achieving optimal glycemic control can be facilitated by assessing the quantity, quality and distribution of carbohydrates introduced during the day . In diabetic subjects, treated with hypoglycemic drugs, especially if on insulin therapy, it is necessary to evaluate the time of intake as well as the dosage of the drugs , in order to adapt them to the quantity and nature of the carbohydrates introduced. Therefore, a meal with a higher carbohydrate content will require a higher dose of insulin and vice versa.
The intake of sucrose (table sugar) should not exceed 10% of the total daily energy introduced with food . A more restrictive attitude can be helpful for people who need to lose weight. The glycemic index can be a useful indicator for choosing which carbohydrate-rich food to include in the diet of a person with diabetes. The sweeteners acalorici (saccharin, aspartame, acesulfame K, sucralose) are safe when consumed in moderate daily amounts.