Diabetes
Diabetes is extremely common in older people and is the most common metabolic long term condition. Half of people living with diabetes in the UK are aged 65 or over and a quarter are over 75. Year on year, the number of people with type 2 diabetes is increasing.
Type 1 vs type 2 diabetes
Diabetes is a serious condition where your blood glucose (sugar) level is too high. This happens when there is a complication with insulin. Insulin is the hormone, made by the pancreas that allows the glucose in blood to enter our cells and fuel our bodies.
It is extremely important to learn the difference between both type 1 and type 2 diabetes. Type 1 diabetes is where the body’s immune system destroys and attacks cells that produce insulin and you can’t make any insulin. Type 2 differs as this is where the body does not produce enough insulin. Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with diabetes have type 2. Type 1 diabetes is not linked with diet or lifestyle but are linked with type 2 diabetes.
In both types, glucose can’t get into your cells properly, so it begins to build up in your blood, which causes a lot of problems.
If a person is diagnosed with diabetes they will need to eat healthily, take regular exercise (if possible) and carry out regular blood tests to ensure their blood glucose levels stay balanced. People diagnosed with type 1 diabetes also require regular insulin injections for the rest of their life. Type 2 diabetes is a progressive condition and medicine may eventually be required but a healthy diet, regular exercise and achieving a healthy body weight can help manage type 2 diabetes.
Key aims for diabetes care
To optimise quality of life and well being of residents
To provide support, education and opportunity for residents to manage their own diabetes where possible
Minimise hypoglycaemia and maintain healthy blood sugar levels
Provide tailored and individual nutrition support
Maintain an optimal level of physical and cognitive function
Be aware of the services and medical teams available to you and your resident to help manage and support effectively
There is no one size fits all approach to making food choices, it is important that food choices help to achieve blood sugar management goals and improve nutritional status and quality of life for the individual.
Any dietary changes should be done gradually whilst monitoring glucose levels and ensuring the changes can be applied long term. The resident living with diabetes is at the centre of consideration so it is important to be caring and flexible. Overly restrictive diets may result in undernutrition and unintentional weight loss. It is important that all menus include nutritional information and carbohydrate content.
Catering for residents with diabetes
Residents with diabetes should have a health review as soon as moving to a new institution with qualified health care team and dietician.
Managing weight
Underweight and malnutrition
Oral health
Dehydration
Eating difficulties
Managing weight
Not all residents with type 2 diabetes are obese or overweight. When weight loss is recommended, there are some solutions to apply. It is important to ensure nutrition sufficiency focusing on regular nutrient dense meals. Reducing overall calories by around 5% while increasing energy expenditure if possible may be beneficial for improving blood sugar markers. this may just involve reducing portion sizes.
Underweight and malnutrition
It is important to note that for this specific resident a therapeutic high energy, high protein diet may be appropriate. In some cases nutritional support, for example supplement drinks or nasogastric feeds may be needed. Where high blood glucose levels are noted in a person receiving nutritional support it may be necessary to adjust their medication to achieve blood glucose levels as near as possible. A registered dietitian can advise more fully on specific individual dietary requirements. Discuss with the residents healthcare team for more guidance.
Oral health
It is estimated that people with diabetes can be up to approximately three times more likely to develop gum disease than people without diabetes. Residents with diabetes and gum disease should be identified and dietary adjustment made according to specific needs.
Dehydration
A resident with diabetes and uncontrolled diabetes may be at additional greater risk of becoming dehydrated due to increase urination.
Tips to help:
- Offer water regularly through the day
- Nourishing smoothies, milk based (or alternative) drinks
- A variety of drinks offered such as herbal or regular tea
- Have an offering of soup
Eating difficulties
Poor or irregular eating can often be a cause of low blood sugar episodes or hypoglycaemia and therefore attention should be given on ensuring regular meals and snacks are offered to residents. Many residents may have difficulty with self-care, medication and associated health conditions. Eating difficulties such as poor oral health, swallowing, digestive health or vision impairments can all cause complications when it comes to mealtimes and eating.
Foods to avoid when serving diabetics
Foods to avoid if you are serving type 1 diabetics
Foods to avoid if you are serving type 2 diabetics
Foods to avoid if you are serving type 1 diabetics
Foods to avoid if you are serving type 2 diabetics
- Reduce red meat and processed meat
- Limit the amount of processed foods which are high in salt. Salt intake should be less than 6g/day
- Reduce sugary and highly processed starchy foods
- Alcohol has no nutritional value and is high in calories. Alcohol can make hypoglycemia (low blood glucose levels) more likely to occur when taking certain diabetes medication. For this reason people with diabetes are advised to avoid.
What foods are best for people with diabetes?
Best foods for type 1 diabetes
Best foods for type 2 diabetes
Best foods for type 2 diabetes
- Quality of diet is important, and the focus should be on whole foods, seasonal produce and unprocessed foods
- Serve a variety of certain foods such as vegetables, fruits, wholegrains, fish, nuts and pulses
- Aim for 5 servings of different fruit and vegetables per day
- focus on healthy fats, these include monounsaturated fats and polyunsaturated such as cold pressed rapeseed oil, olive oil, olives and avocado, unsalted seeds and nuts.
Explore our delicious recipes for diabetes
Our Culinary Development chef Wayne Wright has put together some delicious recipes to cater for diabetics.
“I really enjoyed the challenge of creating these recipes. I wanted to create dishes you wouldn’t usually associate with a diabetic offering.” – Wayne Wright – Culinary Development Chef
Our support tools
Diabetes e-learning
This new e-learning module takes you through everything from what is diabetes, how to cater for it and how to plan your menu effectively. offering you an excellent module to bring your team up to speed on all things diabetes within the care sector. Simply log in, or if you have not yet signed up, please get in touch with your account manager or become a customer.
