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Saturday, May 23, 2009

Diabetes Types and Diet Plan

To manage diabetes, one should have proper information about diabetes and should follow a diet plan to control blood glucose level.

Diabetes Types

Type 1 Diabetes

In type 1 diabetes (Insulin dependent diabetes), also known as juvenile onset diabetes, patients depends on insulin. Some important points regarding type 1 diabetes are -

1. There is usually sudden onset.
2. This form occurs mainly in the younger age group.
3. There is an inability of the pancreas to produce adequate amount of insulin. This may be caused by virus or due to autoimmunity.
4. The child is usually underweight.
5. Acidosis is fairly common.

Type 2 Diabetes

In type 2 diabetes (Non-insulin dependent diabetes), also known as adult onset diabetes, patients do not depend on insulin. Some important points regarding type 2 diabetes are -

1. It develops slowly and usually milder and more stable.
2. This form occurs mainly in adults. Women who have had large babies are also prone to develop this type of diabetes later in life.
3. Insulin may be produced by pancreas but action is impaired.
4. The person is usually overweight.
5. Acidosis is infrequent.
6. The majority of patients improves with weight loss and is maintained on diet therapy.

Diabetes Diet Plan

1. Dietary calorie should be 60-70% from carbohydrates, 15-20% from protein and 15-25% from fat. The minimum amount of carbohydrates should be 100g to prevent ketosis.
2. Fat with high poly unsaturated fatty acids like vegetable oil is preferred (sunflower oil, gingelly oil, corn oil) than animal fat and hydro-generated fat which contain more saturated fatty acids. Fish and chicken are preferred than meat and egg.
3. Simple sugars should be restricted since they are easily absorbed and have a high glycaemic index.
4. Whole wheat is preferred to rice because it contains ‘Ascarbose’ which allow carbohydrate to be absorbed slowly.
5. Food exchange lists should be followed to prevent hypo and hyperglycaemia. The exchange systems should be followed to avoid monotony, dietary constancy and flexibility.
6. Sodium intake is to be no more than 6g daily. Sodium is restricted to 3g in hypertensive diabetic patients.

Diabetes Foods

Foods that can be eaten as much as one wants – Green leafy vegetables, fruits except banana, lemon; clear soups, onion, salads, mint, spices, plain coffee or tea, skimmed and butter milk

Foods that can be eaten in moderation – Fats, meat, egg, cereals and pulses

Foods to be avoided – Simple sugars (glucose, syrup, sweets and honey), dried fruits, cake, fried foods, candy, alcohol and nuts

Nutritional Requirements for Diabetics

Carbohydrates – High carbohydrate and high fiber diet improve insulin binding and increase in monocyte insulin receptor binding. High carbohydrate diet is likely to elevate serum triglyceride levels (endogenous cholesterol). Hence carbohydrate is maintained to about 50% of total calories. Most carbohydrates should be in form of polysaccharides such as bread, cereals, beans, etc. Rapidly absorbed mono and disaccharides such as sweets, chocolates and sweetened drink should be avoided.

Proteins – A diet high in protein is good for the health of diabetics because it supplies the essential amino acids needed for tissue repair. Protein does not raise blood sugar during absorption as do carbohydrates and it does not supply as much calories as fat.

In patients with NIDDM, consumption of protein along with carbohydrate will lower the blood glucose concentration due to amino acid stimulation of insulin secretion; this help to compensate for the defect in glucose mediated insulin secretion seen in so many of these patients. Protein also promotes satiety and helps both types of diabetic patients to adhere to the carbohydrate allowance.

Fats – Low fat diet increases insulin binding and also reduces LDL and VLDL levels and lowers the incidence of atherosclerosis which is more common in diabetics. Fat content in the diet should be 15-25% of total calories and higher in polyunsaturated fatty acids.

Dietary Fiber – Diets high in carbohydrate and fiber improve glucose metabolism without increasing insulin secretion. They lower fasting serum and peripheral insulin concentrations in response to oral glucose administration in both diabetic and non-diabetic individuals. Fenugreek seeds which contain high fiber are useful to diabetics.

Artificial Sweeteners - High content of sugar consumption is undesirable for diabetics and for obese individuals. Non-caloric and high intense sweeteners are available as sugar substitute. These sweeteners are as sweet as sucrose, have a pleasant taste, are colorless, odorless, readily soluble, stable, functional and economically feasible.

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