Diabetes mellitus is not only related to the imbalance of blood sugar regulation, but also closely related to a variety of serious complications such as cardiovascular disease, kidney disease, retinopathy, etc., which brings great challenges to the quality of life and health of patients.

And as we delve deeper into the increasingly prevalent chronic disease of type 2 diabetes, we can't ignore the intricate and crucial links between it and daily diet.

Diet, as our main source of energy and nutrients, directly affects fluctuations in blood sugar levels and insulin sensitivity, which is at the heart of type 2 diabetes management.

1. What is the relationship between type 2 diabetes and diet?

Scientific studies in recent years have shown that dietary factors are the main inducing and influencing factors of diabetes. The most typical diabetes-inducing ingredient in food is high carbohydrates, which are the body's first energy source and the main factor affecting blood sugar levels.

Among the many carbohydrates, syrups and white bread, which are easily digested and absorbed by the body, have a particularly significant effect.

When we consume these simple carbohydrates, they are quickly converted into glucose and enter the bloodstream, causing blood sugar levels to rise dramatically in a short period of time.

Not only can this rapid blood sugar fluctuation trigger an immediate energy spike and subsequent trough, but it can also cause pancreatic islet cells to be damaged due to overwork, insulin secretion is insufficient or weakened, and blood sugar cannot be effectively controlled, thus increasing the risk of diabetes.

It is also important to pay attention to the intake of fat in the daily diet, as adipose tissue is not only an energy storehouse, it also produces a variety of bioactive substances, including adipocytokines and inflammatory factors.

When there is too much adipose tissue, the secretion of these substances increases, and they are able to interfere with the pathway of insulin signaling, affecting the role of insulin in promoting glycolysis in muscle, liver and adipose tissue; The gradual accumulation of visceral fat can also lead to the development of insulin resistance, which in turn leads to the development of type 2 diabetes.

Dietary fiber in food, on the other hand, plays an important role in controlling blood sugar as opposed to carbohydrates and fats.

It slows down the digestion of food by increasing its volume in the digestive system, thus avoiding a rapid rise in blood sugar levels. Dietary fiber also improves gut health, promotes the growth of beneficial bacteria that can improve the absorption of sugar in the gut and produce short-chain fatty acids that have a positive effect on insulin sensitivity.

Some types of dietary fiber, such as soluble fiber, can combine with sugar molecules to form a gelatinous substance that slows down the absorption of sugar, thereby reducing the glycemic response and avoiding the symptoms of diabetes.

The researchers have carried out type 2 diabetes screening and dietary structure surveys, and found that the daily per capita diet of local residents is insufficient in carbohydrate-based cereals and fruits, and excessive intake of fat-based edible oil and protein-based eggs.

It can be seen that the occurrence and development of type 2 diabetes mellitus are closely related to the carbohydrates, fats and fiber components in the diet, and the purpose of controlling patients' blood sugar levels can be achieved by improving the dietary structure.

However, unlike the relatively simple dietary structure in foreign countries, the diverse and complex dietary structure in China means that the prevention and management of diabetes mellitus is difficult, and it is necessary to be more targeted when guiding patients to adjust their dietary structure. There are three food groups that should be avoided or severely limited for people with type 2 diabetes.

2. These three foods are the "enemies" of people with type 2 diabetes

1) High-sugar foods

Processed high-sugar foods such as candies and cakes are not only rich in sucrose and glucose, but also often contain artificial sweeteners such as sucralose, cyclamate, and aspartame.

For patients with hyperglycemia, their main problem is that the blood sugar levels are already high and the cells are less responsive to insulin, i.e., insulin sensitivity is reduced.

In this case, if too much sugary food is consumed, it can quickly lead to a sharp rise in blood sugar concentrations. Moreover, artificial sweeteners may interfere with the body's metabolic process and affect the balance of intestinal microbes, which undoubtedly increases the difficulty of blood sugar control.

People with diabetes are generally highly alert to sugary foods, but often inadvertently ignore certain foods or drinks that appear not to be directly related to high sugar, but may actually significantly affect blood sugar levels.

Cookies and cakes under the "sugar-free" label, although they are marketed as "sugar-free", are often difficult to completely get rid of sweeteners, and these products are rich in carbohydrates, excessive intake will undoubtedly pose a challenge to blood sugar control, so the consumption amount needs to be strictly controlled.

2) High-fat, high-cholesterol foods

High-fat, high-cholesterol foods, such as red meat, full-fat dairy products, and fried foods, are rich in triglycerides, and glycerol residues in their molecular structure can be broken down into glycerol under the action of lipase enzymes.

These glycerols are transported to the liver, the body's metabolic center, along with the blood circulation, and participate in the conversion of non-sugar precursors to glucose.

If the amount of triglycerides is consumed in excess of the body's needs, the concentration of glucose in the blood will rise significantly, affecting the blood sugar balance.

More subtlely, when the fat intake continues to exceed the standard, the metabolic pathway of fatty acids in the body will quietly shift, and they will gradually be converted into ketone bodies, which are a backup energy source.

Long-term ketone energy supply may lead to the accumulation of glucose in the body, forming a vicious circle that is not conducive to diabetes control.

This change in metabolic adaptation is another important factor in the progression of type 2 diabetes.

Effective control of fat intake is not only limited to directly reducing the intake of high-fat foods, but also paying attention to the choice of cooking methods.

Diabetics should abandon high-fat cooking methods such as frying and frying, which often lead to a significant increase in the fat content of food. Instead, healthier cooking methods such as steaming, boiling, stewing and cold dressing are recommended, which can significantly reduce the fat content of the food while maximizing the natural flavor and nutrients of the ingredients.

3) High salt food

There are many types of high-salt foods, including bacon, pickles, and stewed products. Diabetic patients who fail to properly control their salt intake will lead to an abnormal increase in the concentration of sodium ions in the blood.

This high sodium state interacts with pre-existing hyperglycemia and exacerbates the loss of water inside the cells, which in turn disrupts the normal order of cell metabolism and causes other complications.

To complicate matters further, high salt intake leads to an increase in osmotic pressure in the liver, activating the transcription factor TonEBP, which initiates aldose reductase, which promotes the accumulation of intracellular triacylglycerol and insulin resistance, exacerbating diabetes.

Therefore, active salt management in diabetic patients is a new strategy to assist in regulating postprandial blood glucose levels.

However, the salt intake standard should be flexibly adjusted according to the staple food intake: if the daily staple food intake is controlled within 2 grams or 0 grams, the corresponding salt intake is recommended not to exceed 0.0 grams and 0 grams respectively. For patients with cardiovascular diseases such as hypertension, old myocardial infarction, coronary arteriosclerotic heart disease or atherosclerosis, more stringent low-salt dietary measures should be taken, and the daily salt intake should be strictly limited to less than 0 grams.

All in all, foods high in sugar, salt, and fat are undoubtedly three "enemies" that people with type 2 diabetes need to be wary of and strive to avoid. And the reason we take such a serious approach to diabetes is because the consequences are far from a simple imbalance in blood sugar levels. In the long term, patients with poor blood sugar control are at risk of a range of chronic complications.

3. What are the risks of diabetes?

Diabetes mellitus, which is not properly managed for a long time, is prone to a series of chronic complications, among which macrovascular disease and microvascular disease are particularly significant, and each has its own characteristics.

In terms of macrovascular disease, there is a strong association between diabetes mellitus and atherosclerosis.

The high-glucose environment accelerates the deposition of lipids in the arterial intima, and then forms plaques, which not only obstruct blood flow, but also may rupture and lead to thrombosis, blocking the blood vessels of the heart, brain or lower limbs, and inducing serious consequences such as coronary heart disease, cerebrovascular accident and gangrene of the lower limbs. Therefore, the high incidence and mortality rate of cardiovascular diseases in diabetic patients cannot be ignored.

The pathological features of microangiopathy are mainly concentrated in the microvascular system of the kidney, skin and retina, and are more insidious, with thickening of the basal surface membranous structure of fine reticular blood vessels.

In particular, retinal microangiopathy is common in newly diagnosed patients with young diabetes, and its hyperglycemic environment leads to retinal hypoxia, hemorrhage, and exudation, which constitute important risk factors for blindness.

Patients with type 2 diabetes should be alert from the diagnosis of early signs of diabetic nephropathy, such as persistently elevated urine microalbumin-to-creatinine ratio (UACR) and decreased glomerular filtration rate (eGFR).

In addition, diabetes mellitus may worsen dramatically due to specific triggers (e.g., infection, trauma, poor diet, or negligent treatment), leading to acute complications such as ketoacidosis, hyperglycemic hyperosmolar state, and severe hypoglycemia, which are life-threatening emergencies that require urgent treatment.

Diabetes, especially type 2 diabetes, is closely related to daily diet, and the core of its management is to control blood glucose levels and insulin sensitivity. High-sugar, high-fat, and high-salt foods are the "enemies" that diabetics need to be wary of, which not only exacerbate blood sugar fluctuations, but also increase the risk of serious complications such as cardiovascular disease, kidney disease, and retinopathy. Optimizing the dietary structure has become an important means to control diabetes and improve the quality of life of patients.

Proofread by Zhuang Wu