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.

                                                     

                                                     
    

Obesity and Type-2 Diabetes

Obesity is a medical condition in which excess fat accumulates in parts of body leading to adverse health effects. Diabetes is more appropriately known as diabetes mellitus (DM). 

DM is a metabolic disorder in which the blood glucose level increases beyond a normal range; the greater are the increased levels and the DM duration, the more serious it can become if it isleft untreated.

DM exists in several forms: type-1 diabetes or insulin dependent diabetes mellitus (IDDM), type-2 diabetes or non-insulin-dependent diabetes (NIDDM), and gestational diabetes which occurs during pregnancy.

                                                                

Type-1 diabetes results mostly in children due to auto-immune destruction of insulin producing beta cells present in the Island of Langerhans of the pancreas gland. 

Type-2 diabetes is a metabolic disorder which occurs in adults as a result of insulin resistance. It is considered as a disease linked to unhealthy lifestyle and obesity in the adults; people genetically predisposed are more vulnerable to be affected by the disease.

Linked to obesity, type-2 diabetes can be prevented and controlled by weight management within the limits of body mass index (BMI) of an individual. If untreated, diabetes can lead to serious consequences such as damage to the nervous system, heart and kidneys. It can even cause increased vulnerability to infections and other diseases, even to some forms of cancers.

How can we prevent diabetes? While there is no known means to prevent from type-1 diabetes, the type-2 diabetes can be prevented because it is closely linked to unhealthy lifestyle caused by faulty diet, sedentary life and lack of regular exercise.

The control of type-2 diabetes at all stages of the disease is best achieved by weight reduction, proper diet intake, healthy lifestyle, treatment and care.

The prevention strategy for type-2 diabetes is primarily healthy and nutritious diet comprising fibrous vegetarian contents (cereals, nuts, whole grain, and brown bread), lean/white meat, unsaturated fats and low salt. 

Saturated trans fats must be fully avoided. In addition active lifestyle and regular physical exercise are necessary.

Increased thirst, hunger, urination, fatigue, blurred vision, numbness or tingling sensation of feet and hands, loss of weight, non-healing sores, are some most prominent symptoms of diabetes. 

Increased body weight is a visible sign and precursor of imminent type-2 diabetes in a span of 5 to 10 years.

Treatment for type-2 diabetes will depend upon the status of the disease. In early cases the disease can be controlled by adopting a healthy lifestyle, directed at weight reduction, involving fibrous and nutritive diet and regular exercise.

In cases where blood sugar level is not controlled by lifestyle changes, physician may be consulted to prescribe blood sugar lowering drugs or treatment with insulin hormone.

In type-2 diabetes it is absolutely necessary to take appropriate treatment for any other accompanying disease like high blood pressure and arthritis; arthritis can limit movement and thus increase body weight and aggravate diabetes. Treatment should also be taken for any complication of diabetes such as foot ulcers.

Patients must comply with a regular schedule for exercise, reduce body weight as per the prescribed limit for the patients’ BMIindex, eat only healthy and nutritious diet as per a diet chart and take all prescribed medication regularly.

Diet is the most important aspect of diabetes control. There is no single diet plan for all patients. The contents of carbohydrates, fat, and proteins need to be individualized for each patient according to the patient’s individual metabolic status such as weight loss needs, blood lipid levels, renal function and blood pressure. 

As carbohydrates fast increase blood sugar, carbohydrate counting is necessary for determining total calories intake and total calories control. 

Everybody above 45 years age must check for type-2 diabetes or pre-diabetes indications. People above the prescribed body weight for their BMI index are especially vulnerable to the disease.

Treatment under medical supervision is recommended for proper control and management of the disease.