Dietary Management of Diabetes Mellitus

It is recommended that people with diabetes mellitus work with their diabetes management team (registered dietitian, nurse, physician and other health care professionals, as needed) to develop a nutrition care plan (diet) that fits their own metabolism, nutrition and lifestyle requirements.

Preferred food advice for diabetic patients has been a controversial issue for many years. There is much controversy regarding what diet to recommend to sufferers of diabetes mellitus. The diet most often recommended is high in dietary fiber, especially soluble fiber, but low in fat (especially saturated fat).

Making healthy food choices every day has both immediate and long-term effects. With education, practice, and assistance from a dietitian and/or a diabetes mellitus educator, it is possible to eat well and control diabetes. Those with diabetes need an understanding of diet to maintain reasonable weight and body composition, reduce blood glucose and lipid levels, and delay the chronic complications of diabetes.

Many factors affect how well diabetes is controlled. Many of these factors are controlled by the patient, including how much and what is eaten (about diet), how frequently the blood sugar is monitored, physical activity levels, and accuracy and consistency of medication dosing. Even small changes can affect blood sugar control.

Consistently eating at the same times every day is important for some people, especially those who take long-acting insulin (eg, NPH) and oral medications that decrease blood sugar levels (sulfonylureas or meglitinides). If a meal is skipped or delayed while on these regimens, you are at risk for developing low blood glucose.

Recommendations for diet:

Protein: Protein intake accounts for 15 to 20 percent of total daily calories consumed among the general population as well as those with diabetes.

Carbohydrate: The groups agree that a dietary pattern that includes carbohydrate from fruits, vegetables, whole grains, legumes, and low-fat milk should be encouraged. The groups agree that a dietary pattern that includes carbohydrate from fruits, vegetables, whole grains, legumes, and low-fat milk should be encouraged.

Fiber: Dietary fiber is defined as the complex carbohydrates from plants that humans lack the enzymes to digest. Fiber is divided into two categories: soluble and insoluble. Whereas insoluble fiber passes through the digestive tract relatively unchanged, soluble fiber dissolves to form a soft gel. Some familiar foods that contain soluble fiber are apricots, citrus, oats, lentils, and dried beans and peas.

Non-nutritive Sweeteners. Saccharin, aspartame, acesulfame potassium (K) and sucralose have been approved by the Food and Drug Administration (FDA) and can be used by people with diabetes, including pregnant women, within a balanced diet. Because saccharin can cross the placenta, other sweeteners are better choices during pregnancy.

Sugar: It was previously believed that simple sugars are more rapidly digested and absorbed than starches, and therefore are more likely to cause high blood sugar levels.

Food items likes green leafy vegetables, tomatoes, cucumber, soups, and radish can be eaten freely as they promote the overall health of the person.

Dietary Fat and Cholesterol: The total amount of fat you eat, whether high or low, isn't really linked with disease. What really matters is the type of fat you eat. Total fat should be 30 to 35 percent or total calories. Polyunsaturated fat is limited to 10 percent and monounsaturated fat to 20 percent of total calories. Dietary cholesterol should be less than 300 mg/day. Those individuals with LDL cholesterol greater than or equal to 100 mg/dl may benefit from lowering dietary cholesterol to less than 200 mg/day. Elevated levels of triglycerides (greater than 150 mg/dl) are also a risk factor for CVD.

The Basic Objective of Meal Planning :

• To provide relief from symptoms
• To achieve and maintain a desirable body weight
• To maintain near normal blood sugar level
• To achieve and maintain healthy and productive life
• To prevent, delay or minimise the onset of chronic degenerative complications.
• To maintain optimal nutrition for adequate growth, development and maintenance.