Nutrition & Diabetes

Diabetes mellitus
Diabetes mellitus is a metabolic disorder characterized by elevated blood glucose levels (Hyperglycemia) resulting from defects in insulin secretion and/or uptake. It develops when insulin is absent, not secreted in adequate amounts or there is diminished tissue response, (that is, so that insulin is not used properly by the target tissues).

Hyperglycaemia (elevated blood glucose) is indicated by frequent urination, increased thirst, weight loss, sometimes increased hunger, blurred vision, itching and susceptibility to certain infections. In children, there may be growth impairment.

Type of diabetes
Diabetes mellitus is grouped into two main categories: Type 1, Type 2

• Type 1 diabetes results from an autoimmune destruction of beta cells of the pancreas. The rate of beta-cell destruction varies and is quite rapid in some persons (mainly infants and children) and slower in adults. Type 1 diabetes is more common in younger persons but can occur at any age. There is little or no insulin secretion, therefore individuals with this type of diabetes must rely on external sources of insulin for survival.
• Type 2 diabetes refers to a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency rather than absolute insulin deficiency

Nutritional Management for Diabetes

Nutrition is very fundamental in the management of diabetes. Nutritional management is important to ensure optimal metabolic control through a balance between food intake and physical activity to avoid complications.

Nutrition management depends on individual energy needs, life stage, lifestyle, and any medical conditions of the individual with diabetes.

For type 2 diabetes the aim is to improved sugar and lipid levels and weight loss when required.

For type 1 diabetes the aim of nutritional intervention is improved sugar control through coordination of food, especially carbohydrates, doses of insulin, and physical activity.

Nutrition recommendations for diabetic patients

• Use food labels to check the food composition of processed foods
• Time meals appropriately, keeping mealtimes constant from day to day
• Aim to eat relatively consistent amounts from day to day
• Provide three (3) main meals per day plus snacks as appropriate to balance the peak activity of insulin and exercise
• Ensure regular intake of complex (higher fibre) carbohydrate foods such as corn, brown rice, yam, green bananas, and cassava
• Limit the intake of simple sugars. Approximately 5-10% of total calories may be included as simple sugars
• Control intake of salt. Salt intake should be limited to no more than 6 g (1 tsp) per day. In the presence of hypertension, more severe restriction may be necessary
• Recommend less fried and high fat foods, cholesterol and saturated fats. Total dietary fat intake should be less than 30% of total calories
• Know when your insulins act and consider the time that you eat with respect to the time that you inject your insulin for type 1 diabetic
• Use a calorie counter, or similar book, to assess the carbohydrate, fat and protein content of foods

Weight management
Being overweight or obese also promotes the insulin resistance that is the main mechanism behind type 2 diabetes. Too much body fat makes it harder for the body to use the insulin it makes to process blood glucose. Any activity that gets you moving helps you on the way to a healthier lifestyle. Doing 30 minutes of moderate- to vigorous-intensity activity most days of the week is recommended for prevention of chronic disease. This activitiy is above usual activity at work or home. Try walking briskly, gardening, hiking, or bicycling for moderate activity. Increasing this activity to 60 minutes a day is recommneded for preventing weight gain and 60 to 90 minutes for losing weight. Start slowly and gradually build up to the 30, 60 or 90 minutes of physical activity each day.