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C

Calorie

See kilojoule

Canned Foods

There are no practical differences between most canned foods and their fresh counterparts, both vitamins and minerals being retained by canned food. Canned foods can thus make a significant and convenient contribution to the Recommended Dietary Intake (RDI) of nutrients for adults and children. When used in combination with fresh foods they provide optimum convenience and nutrition. However, it is worth checking labels as some canned foods have substantial amounts of sugar added, which is not suitable for diabetics.

Carbohydrate

One of the major sources of kilojoules in the diet. Carbohydrate comes primarily from sugar (also known as simple carbohydrate; found in refined foods, fruits and some vegetables) and starch (also known as complex carbohydrate; found in grains and vegetables including legumes). During digestion carbohydrate is broken down into glucose, is absorbed into the bloodstream and thus raises blood glucose levels. The amount of carbohydrate you require daily varies considerably between individuals and depends on activity level, age, blood sugar control and the levels of cholesterol and triglyceride (part of the fatty acids group) in the bloodstream. In the past it was believed that all sugars (simple carbohydrates) should be avoided by diabetics. However, this did not take into account the information now available on the glycaemic index (GI) of foods, which classifies foods according to how fast they are broken down to glucose. You may find some foods with apparently high sugar content have a relatively low GI value, and thus are suitable to be eaten by diabetics.

Cataracts

A cataract is a condition where the lens of the eye, which is normally clear, becomes cloudy. It looks like a grey-white film, and it obscures vision. Cataracts tend to occur in people over 50 years of age, but can appear at a younger age and will advance more rapidly in the presence of diabetes. If left untreated, cataracts can cause blindness. The usual treatment for advanced cataract is replacement of the lens with an artificial one.

Celebrations

People – adults and children – with Type I diabetes must follow an organised food schedule. However, it is possible to indulge a little on occasions, such as Christmas or birthdays. If a diabetic's blood sugar is okay, a small slice of birthday or Christmas cake (approximately 75 g) may be eaten after taking insulin and waiting for half an hour.

Type II diabetics may eat a small slice of cake as a treat. However, it must be small, as excess weight needs to be avoided by all diabetics.

A birthday cake can be adapted to make it more suitable for diabetics. Hire a cake mould from a party store to make an interesting shape. Decorate the cake with low-fat but delicious ricotta cream (see recipe p. 00) rather than icing, sugar or fresh cream, and serve with seasonal fresh berries.

Children's party

If organising a diabetic child's birthday party, check first with a dietitian about relaxing the rules, so the occasional high-sugar food – such as a slice of birthday cake – will not cause harm.

Blood glucose control at children's parties

Running around at parties can result in blood glucose dropping too low. Ensure your child has plenty of carbohydrate during the party. Keep a 'hypo kit' handy. Check blood glucose level after the party and before dinner. If the blood glucose level is low before sleep give a carbohydrate snack such as a glass of milk.

Chickpeas

An excellent carbohydrate source, chickpeas are a flavoursome and versatile legume with a low GI factor. Prepare dried chickpeas by soaking well, then boiling for 1–1½ hours. More conveniently, use canned chickpeas. Chickpeas are a staple pulse in the Middle East, where they are made into patties called felafel and are also the basis of hummus dip. They are delicious when served spiced, for instance added to a curry sauce.

Children with Diabetes

See juveniles and diabetes

Chocolate

Most people with diabetes crave for a chocolate fix at some time. The good news is that the world's favourite food has a relatively low GI factor, but you must bear in mind that 50 per cent of the energy in chocolate bars comes from fat. There are a number of ways to get your chocolate fix without being out of control with the kilojoules and fat: some diabetic chocolate bars are available, while if you want to make a chocolate dessert or cake suitable for diabetics, you can do so using unsweetened chocolate and an artificial sweetener.

Tips for cheating with chocolate

• Drizzle melted chocolate onto cakes, biscuits and fruit for decoration. This uses a minimum of chocolate.
• Dust cakes with a light mix of cocoa powder and icing sugar.
• Combine low-fat chocolate ice cream with fresh fruit for a simple dessert.

Cholesterol

Cholesterol is a type of fat which is both made naturally in our bodies and is eaten by us as it occurs in animal fats (meat, seafood, poultry, dairy products, eggs). Cholesterol is needed to make cell membranes and some hormones, but if too much is eaten it can be deposited on the walls of arteries, causing fatty blockages: arteriosclerosis. The cholesterol is transported round the body by a carrier, lipoprotein, and there are two kinds: LDL (low-density lipoprotein) and HDL (high-density lipoprotein). It is now believed that only the LDL-carried cholesterol is dangerous to health. If you have your cholesterol level tested you will usually have your LDL and HDL levels checked at the same time, to see if your LDL is also raised.

Chronic

A disease or disorder that is present over long periods of time, often the remainder of one's lifetime. Diabetes is a chronic disorder.

Coeliac Disease

A condition where someone is sensitive to a protein called gluten in the diet, and cannot absorb it. This may be present from birth (congenital), or develop later in life. In coeliac disease the lining of the small intestine is damaged, and this can be used to diagnose the condition. Gluten is found in wheat, rye, triticale (a wheat–rye cross), barley and oats. The symptoms of this disease are extremely varied, which can lead to a delayed diagnosis, but commonly include a number of the following: diarrhoea, constipation, flatulence, pain, nausea, bloating and weight loss. Children with coeliac disease may fail to put on weight even though they are eating a lot, which is also a symptom of diabetes.

Coeliac disease: link to diabetes

If you have Type I diabetes you are more at risk of developing coeliac disease than a non-diabetic. If blood tests indicate coeliac disease then a small bowel biopsy is usually necessary to confirm it. Statistics suggest that 2.5 per cent of children with Type I diabetes develop coeliac disease. If you have both coeliac disease and Type I diabetes a strict gluten-free diet must be maintained in tandem with the high carbohydrate diabetic diet.

Coma

A state of unconsciousness. In diabetes, it may result from a variety of causes including hypoglycemia (glucose level being too low), hyperglycemia (glucose level being too high) or ketoacidosis.

Convenience

Supermarket shelves are filled with 'convenience' foods. Many of these are high in fats, salt and sugar, and should be avoided by diabetics. However, not all convenience foods need to be avoided: for instance, canned lentils are a healthy choice. Many convenience foods will fit into a healthy eating plan. Read the labels and try different foods; by choosing wisely you can easily slip into a healthy eating pattern.

Creatinine

A compound present in the muscles and blood that is passed out of the body in the urine. A 'creatinine clearance test' is a diagnostic test for kidney function. Diabetics are at risk of kidney damage, so their urine may be tested for creatinine to check.

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