SIVASHINEE NAIDOO

BSc Dietetics (UKZN), PG Dip Dietetics (UKZN)

DIETICIAN
Pr No :0332119

Annexure A Cell : 0846797098

Mountedgecombe Hospital Fax : 0867755037
163-174 Redberry drive Email : kzndietician@[Link]
Phoenix
4300

Please be reminded that the following information listed on the diet sheet does
not substitute for a consultation.

It merely provides a summary of diabetic guidelines. Your consultation covers

the meal times, portions and combinations of meals based on the medication
you take, your co-morbidities and physical assessments.

DIABETES GUIDELINES

What is Diabetes?
Diabetes is a chronic disease that occurs when the pancreas does not produce
enough insulin, or when the body cannot effectively use the insulin it produces.
Hyperglycaemia, or raised blood sugar, is due to uncontrolled diabetes and over time
leads to serious damage to many of the body's systems.

Symptoms of Diabetes
Increased urination
Increased thirst
Losing weight without trying
Weakness and fatigue
Tingling or numbness in hands, legs and feet

When to test your sugar

 In the morning before eating, your reading should be between 5-6 mmol/l
 Two hours after eating it should not go above 8mmol/l. If it goes above
10mmol/l it means you’ve eaten too much carbohydrates
 Your blood sugar should not be too low either, below 4 is dangerous.

Low Blood Glucose (Hypoglycemia)

Low blood glucose can make you feel shaky, weak, confused, irritable, hungry, or
tired. You may sweat a lot or get a headache. If you have these symptoms, check
your blood glucose. If it is below 4, have one of the following right away:

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  3 or 4 glucose tablets
 1/2 cup of any fruit juice

 1/2 cup of a regular (not diet) cold drink

 1 cup of milk

 4 or 5 hard sweets

 1 tablespoon of sugar or honey

After 15 minutes, check your blood glucose again. If it's still too low, have another
serving. Repeat these steps until your blood glucose level is 4 or higher.

Which Foods Contain Glucose (sugar)?

Foods that contain carbohydrates are needed by the body for energy and they are
broken down into “sugar”. Some types of carbohydrates have a slow or gradual
affect on the blood sugar levels (eg complex carbohydrates), whilst other types of
carbohydrates have a rapid affect on the blood sugar levels (eg simple sugars).
Examples of carbohydrates;

Bread, pasta, corn, pretzels, potatoes, rice, crackers, cereal, porridge, tortillas,
beans, yams, lentils, fruit, milk, potatoes, sweet potatoes, pumpkin, madumbes,
carrots, peas, beetroot, butternut, samp, roti, mealie meal, mealie rice, cakes,
biscuits and sweets

The goals to treating diabetes are knowing;

 what to eat
 how much to eat
 when to eat

Healthy eating for diabetes;

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 Brown rice or wild rice
 Sweet potatoes and yams
 Whole wheat pasta
 Whole wheat or whole
grain bread, pumpernickel
 High fibre/all bran cereals
 Bran muffin

 Lettuce
 Cucumber
 Onions Use low fat or fat free dairy products
 Broccoli Restrict the use of saturated fats
 Spinach/herbs such as butter, lard, ghee, coconut
 Cauliflower oil, shortening
 Baby marrow Choose healthy fats such as olive oil,
 Green beans canola oil, sunflower oil, flax seeds,
 Mushrooms nuts and avocados
Avoid cream based sauces, rather
opt for tomato based sauces

Eat small frequent meals

Don’t skip breakfast. Eating breakfast every day will help you have energy as well as
steady blood sugar levels.

Eat at regularly set times

Your body is better able to regulate blood sugar levels when you maintain a regular
meal schedule.
Choose high-fiber, slow-release carbs

Limit highly refined carbohydrates like white bread, pasta, and rice, as well as soda,
candy, and snack foods. Focus instead on high-fiber complex carbohydrates—also

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known as slow-release carbs. Slow-release carbs help keep blood sugar levels even
because they are digested more slowly.

Instead of… Try these high-fiber options…

 White rice  Brown/wild rice old mills/Low GI
basmati
 White potatoes (including fries and  Sweet potatoes, yams, winter
mashed potatoes) squash, cauliflower mash
 Regular pasta  Whole-wheat pasta/durum
 White bread  Whole-wheat/grain/low GI
 Sugary breakfast cereal  High-fiber breakfast cereal
 Instant oatmeal  Steel-cut oats or rolled oats
 Croissant or pastry  Bran muffin
However the above should still be consumed in regulated portions to avoid too
much of sugar

Fruit X 2 daily
Fruit has important vitamins and minerals and make healthy snacks
1 serving = 15g CHO

Eat fruits raw or cooked.

Buy smaller fruit.
Choose pieces of fruit more often than fruit juice. Whole fruit is more filling and has
more fiber

 1 tennis ball size fruit (small apple/pear)

 1 small banana or ½ big banana
 1 small handful grapes, litchis
 2 golf ball size fruit (2 guavas, naartjies, plums)
 1 cup fruit salad unsweetened
 ½ fruit salad sweetened
 Raisins (2 tbs)
 ½ cup fruit juice (always dilute with water)

Vegetables

Have at least 3 servings of vegetables daily

Don’t add fats to cooked vegetables
Vegetables contain between 1-4g fibre per serving
Tip: These nonstarchy veggies can fill the “vegetables” portion of your plate.
 Artichokes , Asparagus, Beets , Bell peppers , Broccoli, Brussels sprouts, Cauliflower,
Carrots Celery, Cucumber, Green beans , Leafy green, Leeks, onions , Mushrooms,
Tomatoes, Zucchini

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Tip: These starchy vegetables can fill the starch portion of your plate
 Corn , Green peas, Parsnips, Potatoes, Winter squash, butternut, madumbes

Why Lentils Are Great For Blood Sugar

Lentils and all legumes are high in soluble fiber have a low glycemic index; the fiber
in them delays digestion. That in turn triggers a slow, steady release of sugar and
insulin into the bloodstream. However they must be eaten within the recommended
portions.

Dairy Products
1 serving = 12- 15g CHO (approx. the serving of 1 slice bread)
Whole milk 1 cup
Yoghurt ½ cup

Meat Fish and Chicken

1 serving = 30g or size of palm
Restrict the intake of processed foods such as polony, sausages and burgers
 Limit red meat to twice weekly
 Chicken and fish can be eaten more frequently
 Always choose lean cuts
 Remove skin
 Choose dark oily fish-salmon, mackerals,pilchards,trout
 Trim visible fat before cooking
 Grill, bake instead of frying
 Avoiding adding extra fat during cooking

Alcohol
If you consume alcohol there are several precautions you need to consider first;
 Never drink excessive amounts on an empty stomach-can cause low sugar
levels
 Use sugar free mixers
 Use medium dry or dry wines and sherries
 Alcohol is high in calories so maximum for males 2 unit per day and 1 unit for
females
 This equates to 125ml wine, 25mls whiskey or ½ can beer

Fats
Choose heart healthy fats such as pumpkin seeds, linseeds, flaxseed, olives etc.
Vary cooking methods-try grilling, baking, stewing, roasting and steaming. Avoid
frying
1 teaspoon of cooking oil per person…types of oil discussed during your consultation

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Use non stick pans or spray and cook

Fluid
Drink atleast 6-8 glasses of water daily or 2 lt
Avoid fizzy drinks but if you must have, Tab or Sprite Zero-no more than 1 glass per
day as they contain non-nutritive sweeteners…which will be discussed during your
consultation

Food Labels:
 Look for heart healthy ingredients such as whole grains, whole wheats etc
however within the portions discussed during your consultation
 Avoid ingredients such as hydrogenated/partially hydrogenated/trans fatty
acids
 Look at total carbohydrates that include sugar, fiber an and complex carbs
and not just sugar eg if a food has zero sugar it can still have plenty of
carbohydrates which still gets broken down into sugar.
 Sugar free is <5mg sugar per serving
 Look for high fiber foods such as those containing> 5g
 No sugar added means no sugar is added during processing or packaging but
not necessarily no carbohydrates
 No added sugar means that sugar in any form has not been added
 Unsweetened means no sugar and no sweeteners have been added.
 Resistant starches resists digestion in small intestine and is only slowly
fermented in the large intestine such as legumes, seeds etc.
 Sucrose-basically sugar that is added
 Fructose-found in fruit and honey. It is absorbed at a slower rate than sugar,
but it is still broken down into glucose thus affecting sugar levels
 Sugar alcohols such as mannitol,sorbitol and xylitol are nutritive sweeteners.
They do not contain alcohol but too much can cause stomach problems
 Non-nutritive sweeteners contain reduced calories and kilojules.

How can I satisfy my sweet tooth?

Tip: Try having sugar-free popsicles, ice cream or frozen yogurt but in portions
discussed with me, or sugar-free hot cocoa mix or fruit which contains natural sugar

Other tips:
 Share desserts in restaurants.
 Order small or child-size servings of ice cream or frozen yogurt.

 Eat sweets with a meal, rather than as a stand-alone snack. When eaten
on their own, sweets and desserts cause your blood sugar to spike. But if

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 you eat them along with other healthy foods as part of your meal, your
blood sugar won’t rise as rapidly.

 When you eat dessert, truly savour each bite.

Cutting down on sugar

Tip: Reduce how much soft drinks, soda and juice you drink.

 Reduce the amount of creamers and sweeteners you add to tea and coffee
drinks.
 Reduce the amount of sugar in recipes by ¼ to ⅓. You can also boost
sweetness with cinnamon, nutmeg, or vanilla extract.

 Start with half of the dessert you normally eat, and replace the other half with
fruit.

Tip: Cinnamon, cloves, and allspice may have a stabilizing effect on blood sugar.

 Fresh herbs (rosemary, basil, mint, cilantro, chives, dill, etc.) Low-sodium
spices Vinegars

Instead of having sweetened store bought beverages try:

2 rooibos teabags with 2lt water
Add slice orange or sliced lemon with peel
Add rolled stick of cinnamon
Optional is handful of pomegranate seeds
Leave to soak overnight
Strain out the tea and add ½ to 1 teaspoon honey for taste

Tips To Reduce Salt and Sodium

● Choose low- or reduced-sodium, or no-salt-added versions of foods and
condiments when available.
● Choose fresh, frozen, or canned (low-sodium or no-salt-added) vegetables.
● Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed
types.
● Limit cured foods (such as bacon and ham); foods packed in brine (such as
pickles, pickled vegetables, olives, and sauerkraut); and condiments (such as
mustard, horseradish, ketchup, and barbecue sauce). Limit even lower sodium
versions of soy sauce and teriyaki sauce. Treat these condiments sparingly as you
do table salt.
● Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavoured
rice, pasta, and cereal mixes, which usually have added salt.
● Choose “convenience” foods that are lower in sodium. Cut back on frozen dinners,
mixed dishes such as pizza, packaged mixes, canned soups or broths, and salad
dressings—these often have a lot of sodium.
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● Rinse canned foods, such as tuna and canned beans, to remove some of the
sodium.
● Use spices instead of salt in cooking and at the table. Flavour foods with herbs,
spices, lemon, lime, vinegar, or salt-free seasoning blends. Start by cutting salt in
half.
B

FOODS HIGH IN SODIUM TO BE RESTRICTED

All yellow cheeses & all hard white cheese. Feta
Cheese spread / wedges

Canned meatballs / bully beef

Processed meat – viennas / polony / frankfurters / Russians / ham
Bacon / biltong / dried wors
Boerewors / sausage

Gherkins / pickled onions / olives

Canned vegetables & canned baked beans

All cereals e.g. Rice Crispies / Cornflakes / All Bran / Pro-Nutro

Pizza / Ouma buttermilk rusks
Chips + crisps / Salted peanuts
Savoury biscuits – Salticrax / Tuc

Bisto / Beef + chicken stock / packets soups / Seasoning salt /

Aromat / soya sauce
Bottled sauces – Chutney / Worcester sauce / Atchar / Chakalaka
Bovril / Marmite / Oxo / Fish paste
All chocolates
Toffees / fudge / liquorice

Reducing Salt and Sodium When Eating Out

● Ask how foods are prepared. Ask that they be prepared without added salt, MSG,
or salt-containing
ingredients. Most restaurants are willing to accommodate requests.
● Know the terms that indicate high sodium content: pickled, cured, smoked, soy
sauce, broth.
● Move the salt shaker away.

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● Limit condiments, such as mustard, ketchup, pickles, and sauces with salt-
containing ingredients.
● Choose fruit or vegetables, instead of salty snack foods.

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 Sample Menu

Meal Plan Day 1 Day 2 Day 3 Day 4 Day 5

Breakfast:
Milk/Protein Milk Greek yoghurt Poached/boiled Milk Greek yoghurt
eggs with baked
beans
Starch Cooked oats with Muesli Low GI bread Cooked oats with Muesli
cinnamon cinnamon

Mid-AM Snack Fruit 3-4 Provita/ Fruit Supplemental sip Fruit

(see list for Wheatsworth (see list for feeds (see list for portions)
portions) biscuit + cottage portions)
cheese

Lunch:
Protein Salmon and pasta Bean and Fish cakes with Chicken and Roast beef sandwich
salad vegetable soup pilchards and sweet vegetable soup
potatoes
Starch Durum wheat pasta Slice rye/low GI Sweet potatoes Rye/low GI bread Rye/low GI bread
bread
Vegetables/Salads Mix salad Vegetables from Mix salad Vegetables from Mix salad
soup soup
(see unrestricted (see unrestricted
veg list) veg list)
Fats Herb and mustard Oil used in soup - Oil used in soup Tub margarine in the
(dressing/cooking) dressing sandwich

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Mid-PM Snack Sugar free jelly Supplemental sip Slice of low GI Sugar free jelly Supplemental sip
feeds bread with feeds
unsweetened
peanut butter

Dinner:
Protein Beef vegetable Roasted chicken Lentil bake bobotie Baked fish and Roast beef (from
stew with grilled mashed cauliflower lunch) with brown rice
vegetables with baked potatoes and grilled vegetables
Starch Brown/Basmati rice Low GI bread Baby marrow, patty Baked potatoes Brown/Basmati rice
Vegetables/Salads Vegetables from Grilled peppers, pans, ratatouille, Mashed cauliflower Mix salad
stew carrots, carrot and green
(see unrestricted mushrooms, salad
veg list) cabbages
Fats Olive oil, lemon Oil for grilling - - -
(oil for cooking) juice, herbs

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