DIABETES AND NUTRITION MANAGEMENT

priyanka

Article written by:
Priyanka Dutta
Senior Dietitian
M.Sc in Dietetics and Community Nutrition Management (V.U.)
MBA

The term ‘Diabetes’ or ‘to pass through’ was first used in 230 BCE by the Greek physicians.

Generally diabetes is known as ‘high blood sugar level’. Changes in human behaviour and lifestyle over the last century have resulted in dramatic increases in the incidence of diabetes worldwide. The urban population suffering from diabetes in developing countries is projected to double between 2000 and 2030.

Diabetes is a chronic metabolic disorder that prevents the body to utilise glucose completely or partially. It is characterised by raised glucose concentration in the blood and alternations in carbohydrate, protein and fat metabolism.

If fasting blood glucose level is more than 100mg / dl and post prandial blood glucose level is more than 140 mg / dl it is considered as above normal.

Main causes of diabetes are genetic factor, age, sex, obesity, dietary factors.

Types of Diabetes :

  • Type I Diabetes is insulin dependent diabetes. It is commonly found in the younger generation and is known as ‘Juvenile oneset diabetes’. There is an inability of pancreas to produce adequate amount of insulin. It may be caused by virus or due to autoimmune disorder.
  • Type II Diabetes is non-Insulin dependent diabetes. Insulin is produced by pancreas but its action is impaired. This occurs  mainly in adults.
  • Malnutrition related diabetes mellitus is mainly seen in some tropical countries like India and occurs in young to mid age group between 15-30 years. These types of diabetic patients are usually lean, thin and malnourished as well.
  • Gestational diabetes is diagnosed in the second or third trimester of pregnancy. The condition arises because the action of insulin is blocked, probably by hormones produced by placenta.
  • Pre-diabetes is a serious health condition where the blood glucose level is high, but not enough to be considered as type II diabetic. Generally it is predominant in people aged between 40-45yrs. The insulin production is not sufficient.

The main symptoms are excessive thirst, hunger and urination (Polydipsia, Polyphagia and Polyuria), blurry vision, weight loss, weakness, fatigue.

Severe Diabetes may lead to nephropathy, neuropathy, heart disease, retinopathy, stroke, dental problem, foot ulcer.

Dietary management :

  • The Energy requirement depends on the body weight and nutritional status of the patients. It is advisable to distribute the calories of the day in small frequent meals.
  • Carbohydrate should provide about 55-65% of the day’s calorie intake. Complex carbohydrates also known as ‘slow release carbs’ like whole grain (i.e. brown rice, dalia, oatmeal, quinoa) is much more advisable than simple carbohydrates (such as honey, jaggery, sugar etc.)
  • Protein should be provided in adequate amounts to maintain a normal body composition. 1gm protein/kg/ ideal body weight is recommended. Children, pregnant and lactating woman require about 15% more protein for growth and development and other physiological aspects. Sources are fish, egg, meat, pulses, milk and milk products.
  • Fat, should not provide more than 15-20% of the total energy from daily diet. Unsaturated fat like mustard oil, rice bran oil. soya oil are much more helpful than saturated fat like butter, ghee, lard, margarine .
  • Vitamins and Minerals are important in dietary management of diabetes. Fruits and vegetables are the main source of vitamins and minerals. Vitamin A, C, E and minerals like, magnesium, zinc are considered as antioxidant and help to boost immunity.
  • Fibre helps to control blood glucose level for diabetic patients. Plenty of fiber rich foods like green leafy vegetables, whole fruits should be included in daily diet plan. Whole fruit is preferred to fruit juice. High fiber foods are low in calorie so can be consumed liberally.

Hypoglycemia is also a very serious complication for a diabetic patient. In this situation blood glucose level becomes <70mg/dl and cells do not get adequate glucose. It is also referred to as ‘Insulin shock’. Management is done by giving 15gms glucose; wait for 15 minutes and then check blood glucose level.

MYTHS regarding diabetes :

MYTHS FACTS
Diabetic person cannot consume roots and tubers (like, potato, carrot, beet) All roots and tubers contain fibre and antioxidants, should be consumed moderately.
Rice cannot be consumed. Rice can be consumed along with lots of veggies in the diet.Portion size should be restricted
Mango, Banana, Jackfruits, Grapes are forbidden Fruits contain important vitamins and minerals that combat against oxidative damage. So fruits can be consumed keeping the total calories in account.

“Diabetes is like a roller coaster. It has its ups and downs but it’s your choice to scream or enjoy the ride”

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