Diet in Diabetes

Dietary measures are required in the treatment of all diabetic patients to achieve the overall goal of a normal body metabolism. The purpose of dietary measures is given in the table below:

DIETARY MEASURE	PURPOSE
Maintain daily intake of food constant from day to day in nutritional content and distribution	Allow matching of the insulin / tablet regime to the diet.
Specify total daily energy intake	Maintain desirable body weight.
Allocate proportion of energy derived from carbohydrate, protein and fat.	Avoid fat promoting diet.
Reduce rate of carbohydrate absorption, things which help are: Nibbling rather than gorging Use of soluble fiber rich foods.	Avoid sudden rise in blood glucose.
Frequent, relatively small meals, i.e. 3 main meals and 3 between-meal snacks.	Avoid sudden rise in blood glucose.

Estimating daily energy intake:
The first step in preparing any dietary regimen is to decide the individual patient’s daily energy requirement. An approximate range for the various groups may be:

• An obese middle aged or elderly person 1000 – 1600 Kcal/day.
• An elderly person not overweight 1400 – 1800 Kcal/day.
• A young active person 1800 – 3000 Kcal/day.

Allocating proportion of energy derived from Carbohydrate, Protein and Fat:
The recommended proportions are:
Carbohydrate: 50 – 60%
Protein: 10 – 15%
Fat: 30- -35%

In general it is recommended that the percentage of energy derived from fats be decreased and that derived from carbohydrates be increased. The use of saturated fats should be avoided as much as possible. In fact it is important to realize that the ‘diabetic diet’ is simply, which is now recommended for the population in general.

Carbohydrates:
It is important to realize that intake of simple sugars such as glucose and sucrose can produce sudden increase in the blood glucose levels. Therefore all the carbohydrates should be taken in the form of starches and other complex sugars.

Slowing the rate of absorption of carbohydrates is very useful in the management of diabetes.

The foods which are helpful in this are:
Guar, Pectin, Locust bean gum.

Also use of fiber rich foods like:
Barley, Oats, Legumes, Beans and Peas have been associated with improved glucose control and lower blood fat levels in diabetics.

Proteins:
In patients with Type 2 diabetes i.e. Non Insulin Dependent Diabetes, consumption of protein along with carbohydrate lowers the blood glucose levels. Proteins also promote satiety and helps patients in adhering to the carbohydrate allowance.

Fats:
The total intake of fat should be reduced and portion of unsaturated fats (found in vegetable oils and refined oils) should be increased.

Treatment