Diabetes - Diet In Insulin Therapy

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Diabetes - Diet In Insulin Therapy
Diabetes - Diet In Insulin Therapy
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Diabetes: nutrition in insulin therapy

Keeping blood sugar levels within a certain range (so-called normoglycemic setting) is the goal of every diabetes therapy. In order to achieve a good blood sugar control and to avoid hypoglycaemia, the adjustment of the short-acting insulin dose to the carbohydrates in the meal is a prerequisite. The bread unit, BE for short, is used to calculate carbohydrates.

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  • What is a bread unit (BE)?
  • What are the effects on blood sugar?
  • Bread units table
  • What is the procedure for hypoglycaemia?

Depending on the type of therapy, it is necessary to regulate the timing and quantity of meals in diabetes. With so-called intensified insulin therapy, which works according to the basic bolus principle , the time, amount and composition of the meals can be individually designed very flexibly. A short-acting insulin is administered with each meal in order to absorb the high blood sugar levels after the meal. More on the topic: drug therapy for diabetes.

In order to be able to assess how much a meal raises the blood sugar level, it is helpful to be able to estimate the value of the bread units (BU).

What is a bread unit (BE)?

The bread unit (BE) is the estimated carbohydrate content of food.

Note One bread unit corresponds to twelve grams of carbohydrates.

The bread units to be calculated are:

  • Grain and grain products, side dishes such as rice, pasta, potatoes, dumplings, dumplings, tender wheat, couscous, bulgur, barley, etc.,
  • Sweet corn,
  • Fruit,
  • Fruit products (jams, compotes, juices, syrups),
  • all sugary drinks: fruit and vegetable juices, lemonades, syrups, sweetened wellness drinks. Warning: Sugar in liquid form causes a very rapid increase in blood sugar!
  • liquid dairy products such as milk, yogurt, cocoa, etc.,
  • Sugar and sugar substitutes,
  • Sweets, snacks, pastries (according to the label).

Note All liquid milk products are calculated with 250 milliliters for one BE.

The following foods do not have to be calculated in bread units:

  • Vegetables and salads (exception: sweet corn),
  • Legumes,
  • Mushrooms,
  • Nuts,
  • Fish, meat, sausage,
  • Cheese, curd cheese, butter
  • Eggs,
  • Margarine, oils as well
  • Sweeteners (acesulfame K, aspartame, cyclamate, neohesperidin DC, saccharin, thaumatin).

The so-called bread unit (exchange) table has proven itself as an aid for assessing the carbohydrate content (see below).

What are the effects on blood sugar?

The bread unit only indicates the carbohydrate content of a food. However, it says nothing about the glycemic effect, ie how quickly the carbohydrates are digested and thus increase blood sugar. Other components of the respective food are not taken into account (such as dietary fiber), these can also have an influence on the rise in blood sugar. More on the topic: diabetes and nutrition.

Mixed meals (with fat and protein) cause blood sugar to rise much more slowly than carbohydrate-heavy food compositions. In addition, the consistency of the food is largely responsible for the rise in blood sugar. For example, applesauce increases blood sugar faster than eating an apple in one piece. The degree of ripeness also plays an important role in fruit: the more ripe the fruit, the higher the glycemic response.

Other factors that play an essential role in the rise in blood sugar:

  • Frequency of food intake,
  • Fiber content,
  • beverages supplied,
  • physical activity before eating,
  • possibly existing diabetic gastroparesis (stomach paralysis),
  • individual fluctuations (time of day, eating speed, etc.) and
  • Drugs that delay gastric emptying.

Bread units table

Here you will find a small sample selection of foods containing carbohydrates and their bread units. If insulin therapy is in place, extensive bread unit (exchange) tables are recommended by the doctor or dietician.

Food 1 BE corresponds to (in g) Estimation aid
oatmeal 20th 2 heaped tbsp
Muesli without sugar 20th weigh
Mixed bread 25th ½ slice
Pasta, cooked 50 weigh
White rice +

brown rice, cooked

50 weigh
Potato 70 1 medium size
Natural yoghurt) 250 ¼ liter
Apple 100 1 smaller
Peeled banana 60 ½ normal
vegetables does not have to be calculated Exception: sweet corn
Sweet corn, raw 70 3 tbsp
chocolate 20th weigh

Source: Bread unit exchange table (2015 edition), Association of Diaetologists Austria

Special products with fructose or other energy-containing sugar substitutes such as sorbitol, isomalt or maltitol are not recommended as they are of no use. These are often marketed with terms such as “wellness”, “sugar-free” or “sugar-reduced”. A look at the list of ingredients provides information about the ingredients. Energy-free sweeteners (e.g. acesulfame K, aspartame, cyclamate, neohesperidin DC, saccharine and thaumatin) do not cause a rise in blood sugar.

Note Many “diet” products have no advantages. Often the energy and fat content are very high. The price of such products is also sometimes higher than average.

What is the procedure for hypoglycaemia?

The occurrence of acute hypoglycaemia (hypoglycaemia, blood sugar below 60 mg / dl) primarily affects diabetics who

  • are under insulin therapy or
  • Take medication that directly increases insulin release (e.g. sulfonylureas, glinides).

Alcohol consumption as well as physical activity and sport can also cause blood sugar levels to drop sharply.

To successfully combat hypoglycaemia, effective carbohydrates should be consumed immediately. The rule of thumb is: blood sugar below 60 mg / dl -> 1 BE, below 40 mg / dl -> 2 BE.

Note As soon as symptoms of hypoglycaemia occur (eg cold sweat, tremors, weakness, concentration problems, cravings): Eat first, then measure your blood sugar!

The following are suitable against hypoglycaemia:

  • Grape sugar (2 square leaves = 1 bread unit),
  • Fruit juices and lemonades (100 ml = 1 BE),
  • Household sugar (3 sugar cubes = 1 BE) or
  • a glass of water with 1–2 tablespoons of syrup (15 ml = 1 BE).

After combating the first severe symptoms of hypoglycaemia, a piece of bread or fruit should be eaten or the next meal should be brought forward. After that, blood sugar should be checked regularly.

Note Chocolate, diet products or light lemonades are not suitable for treating hypoglycaemia.

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