DIABETIC DIET

DIABETIC DIET

Diabetes mellitus is a metabolic disorder which is characterized by decreased ability or complete inability of the tissues to utilize carbohydrates, accompanied by changes in the metabolism of fat, protein, water and electrolytes. The disorder is due to a deficiency or diminished effectiveness of the hormone insulin.

Predisposing factors

1) Acquired and environmental factors

  1. Infection

  2. Cell cytotoxicity

  3. Damaged beta cell function through other mechanisms like toxic substances, inadequate protein intake and other factors.

2) Changes in lifestyle

  1. Over nutrition and obesity

  2. Sedentary lifestyle

  3. Malnutrition

  4. Severe or prolonged stress

  5. Drugs and hormones

  6. Pancreatic disorders

  7. Increased catabolism

Diabetes is of following types:

  1. Insulin Dependent Diabetes Mellitus (IDDM) or Type I

  2. Non-Insulin Dependent DM (NDDM) or Type II

  3. Malnutrition Related Diabetes Mellitus (MRDM)

  4. Impaired Glucose Tolerance (IGT)

  5. Gestational Diabetes Mellitus

Blood glucose levels – The normal fasting glucose concentration in blood is 70 – 110 mg/100 ml. When the fasting level of glucose in blood rises above 170 mg/ 100 ml sugar begins to appear in the urine. In severe diabetes fasting blood glucose may reach upto 400 mg/dl.

Plasma glucose levels

 

Fasting

2 hours post load

Normal

< 110

<140

Impaired fasting glucose

110-125

<140

Impaired glucose tolerance

< 126

140-200

Diabetes

126

>200

Metabolic changes:

  1. Hyperglycemia

  2. Glycosuria

  3. Loss of water and electrolytes

  4. Dehydration

  5. Haemo-concentration

  6. Peripheral circulatory failure

  7. Hypotension

  8. Decreased renal blood flow

  9. Anuria

  10. Coma and death

Symptoms:

  1. Polyuria

  2. Polydipsia

  3. Polyphagia

  4. General weakness

  5. Decreased resistance to infection

  6. Decreased ability of wound healing

  7. Dehydration

  8. Vulvitis

  9. Ketoacidosis

  10. Degenerative changes in advanced cases

Acute complications of diabetes

  1. Hypoglycemia - It refers to insulin shock. It occurs when there is imbalance between diet and insulin dosage, delay in eating, omission of food or loss of food by vomiting or diarrhea. In some persons excessive exercise may also cause hypoglycemia.

In such cases, the person becomes pale, nervous, weak and hungry. The person may have excessive perspiration and a moist skin. He may have uncoordinated movements, nausea, vomiting or convulsions. If not treated by giving sugar or fruit juice, the person may go into coma and even die.

2. Hyperglycemia – This condition occurs when there is not enough insulin to meet the body’s needs. With high sugar levels, the sugar in the urine is excreted at high levels. In addition, the body breaks down fat for energy and ketones are made. Increased production of ketones is known as ketosis or Diabetic keto-acidosis. There may be feeling of weakness, headache, anorexia, pain in the abdominal region. The skin is hot and flushed while the breathing is painful and rapid. Keto-acidosis is extremely serious condition which can cause diabetic coma or even death.

Chronic complications

  1. Diabetic eye disease

  2. Kidney diseases

  3. Diabetic neuropathy

  4. Cardio-vascular diseases

  5. The diabetic foot

MANAGEMENT OF DIABETES

We all know that diabetes cannot be cured but it can be treated and managed so that an individual leads a normal life. A good synchronization between dietary modification, lifestyle changes and drugs can help in preventing / delaying the onset of complication of diabetes.

Dietary modifications

DM can be managed by therapeutic diet which can be used alone or in combination with insulin or oral hypoglycemic drugs. The diet plan of an individual is based on height, weight, age sex, physical activity and nature of diabetes. The following are the objectives of dietary modifications:-

  1. Determining energy requirements

  2. Distribution of energy in terms of carbohydrates, fat and protein

  3. Determining the type of carbohydrate, fiber and type of preparations

  4. Distribution of carbohydrate

  5. Stage of diabetes with reference to absence or presence of any complication

The fundamental principle of dietary control is to give the individual only the necessary calories according to the body’s daily requirement. The obese patient who is required to reduce his weight must have lower calorie diet but on the other hand, an underweight person requires a high calorie diet.

EXERCISE

Regular physical activity for the diabetic should be encouraged and incorporated into his daily routine. Regular controlled exercise helps to increase glucose utilization. It helps attain ideal body weight by burning calories. It also builds stamina and provides a sense of well being. A moderate exercise schedule should be a part of the daily routine of people suffering from diabetes. Aerobic exercise for atleast 20 – 30 minutes daily for four or more times a week is recommended. E.g. walking, jogging, cycling, playing tennis, swimming, gardening, golfing, taking long walks may be practiced.

Pranayama and certain yoga asanas can be helpful in lowering and maintaining the blood sugar levels. Long hours of sweaty exercise are not required to keep blood sugar under control. Many studies suggest that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30 percent. Physical activity helps to correct the associated lipid abnormalities, increases cardiovascular fitness as well.

Benefits of exercise

  1. Decrease insulin resistance

  2. Lowers or eliminates the need for insulin or hypoglycemic drugs.

  3. Helps in weight loss and maintenance of ideal body weight.

  4. Lowers triglyceride and increases the HDL levels.

  5. Improves circulation throughout the body.

  6. Reduces stress.

  7. Reduces high blood pressure.

GLYCEMIC INDEX

It is the numerical index given to a carbohydrate rich food that is based on average increase in blood glucose level occurring in blood after the food is eaten. The higher the number, the greater the blood sugar response.

Glycemic index or the blood response of certain foods is important in deciding whether to include them or not in the meals of persons with diabetes. Foods with high glycemic index must be avoided in the diets of diabetic individuals. There are glycemic index of individual food items. For e.g. Cereals like wheat, rice, vegetables like potato and carrots have GI of 65-75%, which is high. Fruits have 45-55%, lentils (peas, beans, green gram, Bengal gram) have a GI of 30-40%. Glucose has GI 100%.

So, diets with lower GI are more beneficial for diabetics. Several factors such as nature of cooking, physical form of preparation, fat and fibre content also influence glycemic index of different foods.

Now-a-days, we come across a term called glycemic load. Glycemic load of a food is the glycemic index divided by 100 and multiplied by its available carbohydrate content (i.e. carbohydrate minus fiber) in grams. It’s calculated on the portion size of the food which is to be eaten. As a result, when calculated, it may come out to be smaller value than glycemic index which may be high.

Here at NUTRIDIETS, we will help you to plan a customized diet that is suitable for the respective disease and your requirements taking into consideration your eating habits and lifestyle. Following our diet plans, you will be eating not only healthy but also it will help you lose weight, which is one of the important part of a healthy life. With our diet you will also reduce the risk of further complications that are associated with the disease.

Join us, avail our nutrition packages and together we will make your life happier and healthier.