Diet in diabetes mellitus

See inside…

• Introduction • What is diabetes mellitus? • Types • Causes • Symptoms • Nutritional requirements • Complications • Conclusion

Introduction

Diabetes mellitus is commonly known as diabetes

Serious disease affecting humanity

Undetected/ untreated diabetes causes further complications

Loss of limbs, vision etc

Diabetes is a chronic degenerative disease

Unable to produce insulin

Make too little unable to use

• It can only be kept under control with the help of nutritionist • If not kept under control- a number of complication can occur

Eye disorders

Thickening of arteries

Kidney dysfunction

Proper care is essential to prevent

What is diabetes mellitus??

It is characterized by the passage of sweet urine

Excessive urine production, thirst

Excessive hunger, weight loss

It is defined as a group of disorders with measurable persistent hyperglycemia

Classification:

• Type Ι • Type ΙΙ • Other specific types

Type Ι Also called Insulin dependent diabetes

mellitus (IDDM), Juvenile-onset diabetes

Occurs at any age, although common in younger age group

Pancreas do not produce sufficient insulin

Patient depends on insulin, elevation of blood glucose

Variation in blood glucose levels make

patient prone to two conditions

Ketoacidosis

Hypoglycemia

The onset of this disorder is usually abrupt, and the condition is difficult to control

Causes

Type Ι

Genetic

Environmental factors

Immunological factor

Infectionscutes

Type ΙΙ

• Also called as noninsulin dependent diabetes mellitus (NIDDM), adult onset diabetes

• Patient with this condition can manufacture some insulin but do not make sufficient amount or cannot use insulin efficiently

• Persons with type ΙΙ are not insulin dependent, some of them use insulin because of persistent hyperglycemia

• Most of these persons are obese

Causes

Genetic

Environmental factors

Insulin resistance

Type ΙΙ

Life style Age Abdominal fat Pregnancy

Symptoms

Hyperglycemia High blood

sugar or glucose

Glycosuria Fluid & Electrolyte

Balance

Dehydration Fatigue & loss of weight

Excretion of potassium,

magnesium, phosphorus

Gestational diabetes

• Carbohydrate intolerance during pregnancy

• Pregnancy raises blood insulin levels in all women

• The blood glucose turns to normal after delivery

• Women with this condition are at increased risk for developing type ΙΙ diabetes as they age

Diet Its an essential part of the treatment of diabetic patients

A fixed exchange system is necessary for daily intake

Food exchange list

It is a list of groups measured foods of the same calorific value

& similar protein, fat & CHO

And

Can be substituted one for another in a meal plan

To a good diet

Food exchange list helps the patient To restrict the food intake

according to insulin prescription

To have variety in the diet

Easy learning of the principles of diet

To maintain body weight

Nutritional requirements

• ENERGY: Hospitalized patients are given 25 Kcal/kg body weight

• CARBOHYDRATE: It is maintained to about 45-60% of total

calories.

Should be in the form of polysaccharides

Rapidly absorbed mono & disaccharide should be

avoided

Protein & fat

PROTEIN: It should be 0.8g/kg of ideal body weight

increased intake up to 15 to 20 % of total energy in adolescent

children, pregnant or nursing mothers

FAT: Total fat should be 20 to 30% of the total energy

saturated fat (7-10%), monounsaturated (10-13%) &

polyunsaturated (8-10%) of the total energy.

Cholesterol less than 300 mg /day

Vitamins & minerals

• Similar to those of other individuals. There is no need for

supplement

• Pregnant woman may need a vitamin & mineral supplement

Alcohol: Moderate use of alcohol does not adversely affect

diabetes in a well controlled patient

Dietary fibre

Diet rich in dietary fibre & complex carbohydrates benefit diabetics. It lowers -Insulin requirements -serum cholesterol & triglyceride values Aids in weight control and lowers blood pressure Whole grains, fruits and vegetables and fenugreek seeds are rich in complex carbohydrates

Complications

Hypoglycemia or insulin

shock

Ketoacidosis

Acute complication

s

Chronic complications

Infections

Cataract & retinopathy

Heart disease

Nephropathy

Conclusion

• Diabetes mellitus is caused by an under secretion or

underutilization of insulin &/or receptor or post receptor defects

• It’s a group of disorders with a common sign of hyperglycemia

• Person with diabetes suffer from acute & chronic complication

• Treatment involves medication, nutritional management & exercise

• Nutrition is a fundamental part of treatment