Diabetes, a condition in which too much glucose, or sugar, accumulates in the blood, has two distinct causes. Type 1 diabetes occurs as part of an auto-immune disease that attacks the pancreas, destroying the cells that produce insulin. Type 1 diabetics, previously called juvenile diabetics or insulin-dependent diabetics, always require insulin treatment. Type 2 diabetes develops in people who either don't produce enough insulin or whose cells don't respond properly to insulin. Type 2 diabetics don't always need to take insulin. All diabetics who take insulin need to monitor their diet carefully.
Purpose
Insulin helps cells absorb glucose. Glucose is produced from the breakdown of foods containing carbohydrates. When you eat foods containing carbohydrates, the pancreas releases insulin to assist in the absorption of glucose into the cells. When little or no insulin is released, blood glucose levels--or blood sugar--rises. Foods high in carbohydrates that break down quickly raise blood glucose levels higher than carbohydrates that break down slowly.
Balance
Insulin-dependent diabetics need to be especially careful of how and what they eat. People without diabetes produce insulin in response to the amount of food they eat. The amount they eat determines the amount of insulin that's released, which keeps blood glucose in the normal range. People with diabetes don't have this feedback mechanism, so they often base their insulin dose on their last blood glucose reading. A higher reading means they need to take more insulin to remove more glucose from the blood, while a lower reading requires less insulin. If they eat more or less than planned at the next meal, their insulin dose may not be effective.
Complications
Testing blood glucose levels before eating to determine the exact amount of insulin needed is not an exact science. Diabetics who eat too many carbohydrates for the amount of insulin they injected will have a rise in blood sugar levels known as hyperglycemia. Hyperglycemia can increase damage to the eyes, blood vessels and other organs. If diabetics don't eat enough, on the other hand, the insulin they inject removes too much glucose from the blood, and they develop hypoglycemia, or low blood sugar. Hypoglycemia can cause shakiness, weakness, lightheadedness or passing out. Diabetics can go into a coma from hypoglycemia.
Planning
Both insulin-dependent diabetics and non-insulin-dependent diabetics should get 40 to 60 percent of their daily calorie intake from carbohydrates. Emphasizing complex carbohydrates, which break down more slowly than simple sugars, helps keep blood sugars stable. Increasing the amount of fiber in the diet also helps slow food absorption. Working with a dietitian to develop an eating plan that works with your food preferences and that takes into account whether or not you need to lose weight is essential if you're insulin dependent. Some dietitians use food exchanges, which group similar foods together and allow you to choose a certain amount from each group. There are no forbidden foods if you have diabetes, but because you need to control total carbohydrate intake, you can, for example, eat more fruits and vegetables than candy, which packs more carbohydrates into a smaller serving.
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