Diabetes Diet

Diabetes mellitus (DM) commonly known as Diabetes is a group of metabolic diseases characterized by high blood glucose concentration resulting from either defective insulin or impaired action of insulin.

Insulin is a hormone produced by beta cells of pancreas. After a carbohydrate rich meal, there is a rise in blood sugar level, this in turn stimulates the pancreatic cells to secrete insulin, which acts on glucose and bring blood sugar under control.

When there is a destruction of beta cells leading to lack of insulin, it is known as Insulin Dependent Diabetes Mellitus or Type 1 Diabetes Mellitus. It is also known as Juvenile Diabetes. Inability of pancreas to produce adequate insulin can be caused by virus or due to autoimmunity.

When there is defect in tissue sensitivity, more of insulin is needed for normal effect, this is known as Non Insulin Dependent Diabetes Mellitus or Type 2 Diabetes Mellitus. Insulin is produced by the pancreas but their action is impaired. The patient becomes obese.

Few women have insufficient secretion of insulin during pregnancy, it is known as Gestational diabetes.

SYMPTOMS

• Deficient supply of insulin affects the metabolism of carbohydrates, which in turn increase the glucose level in the blood, resulting in Hyperglycemia.

• When blood glucose level exceeds the renal threshold, Glycosuria occurs.

• Fluid & electrolyte imbalance, acidosis, polyuria(increased urine output) and nocturia, polydipsia (increased thirst) and polyphagia(increased hunger).

• Loss of water and electrolytes and continuous depletion of extra cellular fluids lead to severe dehydration.

• Impaired utilization of carbohydrate results in sense of fatigue and also weight loss.

• Increased excretion of potassium, magnesium and phosphorus.

TREATMENT

Diabetes can be treated by diet alone or diet & hypo glycemic drugs or diet & insulin depending on the type and severity of disease.

There are various medications to control the blood sugar level. But just taking those medications is not enough for long run. Diet plays an important role in controlling any type of diabetes, as it exerts direct influence on the blood glucose levels.

The main goal of diet is to maintain and prolong a healthy, productive and happy life. Clinical parameters should be monitored regularly and changes should be made in the diet prescription.

Diabetic diet should be individualized diet, based on, patient’s nutritional status. It should be practical, suited to needs and can be followed to meet the dietary goals.

Dietary goals are,

• Supply optimum nutrition to maintain good health,

• Provide calories for ideal weight and in case of children, for normal growth and development,

• Maintain blood glucose level,

• Achieve optimum blood lipids level and

• Minimize acute and chronic complications of diabetes mellitus

NUTRITIONAL REQUIREMENT

Calories: Sufficient calories should be taken to maintain ideal body weight. The calorie required per kg body weight differs according the person’s body weight and lifestyle.

Calorie requirements according to weight and activity

Proteins: Proteins should be provided in adequate amounts to maintain a normal body composition and to prevent tissue depletion. For adults without complications, 1.0g protein per kg ideal body weight per day. For children, adolescent, pregnant and lactating women, the requirements are higher than the RDI and can also be given 10 to 15% increased protein.

Fat: Total fat recommended should be not more than 10-15% of total energy. This is because, in case of obese patients, they may have complications like hypertension or cardiac disorders.

Carbohydrates: Around 55-65% of total calories should comprise of carbohydrates. Simple sugars must be avoided and only complex carbohydrates like pulses, cereals and vegetables should be included.

Vitamins and minerals: Requirement is same as normal person, except for magnesium and chromium. Low levels of magnesium increases with risk of diabetes, as magnesium depletion has been associated with insulin insensitivity, and chromium supplements show beneficial effects in diabetic patients.

DIETARY FIBER:

Dietary fiber plays an important role in diabetes diet. The part of food not digested by intestine is called dietary fiber, and food high in fiber has good glycemic control in diabetes. It also lowers cholesterol benefiting cardiac patients, relieves constipation and good for some cancers. Fiber is found in wide range of foods like whole cereals, pulses, green leafy vegetables and fruits.

FOOD EXCHANGE LIST:

The diabetic diet is prescribed in terms of exchange lists. Food exchange lists are group of measured foods giving same calories and similar protein, fat and carbohydrates and can be substituted for one another in a meal plan. All foods make a specific contribution to the diet and none of the exchange groups can itself supply all nutrients for balanced diet.

Food exchange list helps,

• To restrict food intake according to the insulin prescription, to prevent hyperglycemia and hypoglycemia,

• To have variety in diet

• Easy learning of principles of diet

BENIFICIAL EFFECTS OF CERTAIN FOODS:


Fenugreek seeds are rich in fiber which is mucilaginous and also contain an alkaloid substance called Trigonelline, known to reduce blood glucose levels.


About 20-25g of fenugreek seeds can be soaked in water or they can be powdered and mixed in buttermilk and taken as drink. Powdered form can also be used in cooking.


Wheat bran, Bengal gram, guar gum also have hypoglycemic effects in diabetic patients