Medical Nutrition Therapy for Diabetics

Diabetes is characterized by disturbances in carbohydrate and lipid metabolism leading to elevated blood sugar level over a period of time. While type-1 and type-2 diabetes have different underlying causes, the fundamental approach in the treatment of both forms of the disease is to maintain blood sugar levels within limits.

Diabetics are advised to take a diet that is suitable to them. A ‘diabetic diet’ is worked out by a dietitian keeping in view the requirements of a patient. The diet contains a variety of nutritious foods in moderate quantity. The ‘diabetic diet’ in essence is a personalized ‘medical nutrition therapy’ for a particular patient’s disease status. 

As uncontrolled eating has an adverse effect of the health of a diabetic patient, diet control is very important. For type-1 diabetes insulin dose has to be accurately worked out. The emphasis here is to regulate diet and not increase the insulin dose to maintain blood sugar levels within normal limits.

In case of type-2 diabetes, due to insulin resistance, overall healthy diet has a greater importance in disease control. Further, an increase of insulin dose to lower blood sugar levels is not advisable because of insulin’s anabolic effect in increasing body weight.

Diet has a preventive role before the onset of diabetes. It can effectively prevent onset of disease in most cases except those who have a genetic predisposition. Those genetically predisposed to develop diabetes can however effectively control the disease and its complications to nerves, kidneys and heart.

A healthy diabetic diet can prevent diabetes as well as its worsening into serious complications.

The preliminary symptoms of numbness in hands or feet, increased urination and hunger and gain of body weight around the waist are common warning signs and symptoms of diabetes.

A blood check up may confirm increased blood sugar and this should be an alarm bell calling for immediate changes in lifestyle, in particular the diet and physical activity. 

In most cases, diabetes remains undetected until the late stage of the disease when more visible symptoms help in the detection of the disease when neuropathies, nephropathies and cardiovascular disease have already developed. And, then, diabetes is detected on the sidelines of a major life threatening disease.

In essence a low salt and low calorie diet which is rich in fruits, vegetables and complex carbohydrates (beans, nuts, whole grains) is ideal for diabetics. In case of patients, excluding those having kidney ailments, lean and white meats may be taken in moderation. 

Total calorie intake is to be restricted by total carbohydrate counting and distributing it among different meals. Fruits, vegetable and grains contain fiber and antioxidants which help in restoring health of damaged tissues.

Patients need to follow a healthy lifestyle by adopting measures, such as, change from a sedentary life to an active life by undertaking  regular physical activity or exercise, by changing unhealthy eating habits to a regular healthy ‘diabetic diet’, and by adopting all possible measures for control of body weight  within the prescribed Body Mass Index (BMI) limits applicable to the patient.

Patients having hypertension may give special attention to high fiber diet as fiber reduces hypertension. Patients having cardiovascular disease must take low salt and totally avoid saturated and trans fats. Patients having disturbed renal function must restrict their protein intake.

People falling in the high risk category of diabetes, such as those who have diabetes in the family, or are obese or overweight, or are leading a sedentary lifestyle, must regularly monitor for impending diabetes or cardiovascular disease. Diabetes is a complex disease and therefore any intervention for its control must be carried out only under medical supervision.