Nutrition plays a vital role in the treatment of this chronic illness. Diabetes is a condition that affects how the body uses carbohydrates for energy. It is diagnosed when a random venous plasma glucose concentration is greater than 11.1mmol per litre or a fasting plasma glucose concentration is greater than 7.0mmol per litre.
Role of insulin
The body's main source of energy comes from carbohydrates, which are turned into glucose in the body. For glucose in the bloodstream to able to enter into body cells, the hormone insulin, produced by the pancreas, is required. Sometimes, the body cannot make enough insulin or use the insulin it does make effectively, this is known as insulin resistance, which causes blood glucose levels to rise. The reasons why insulin resistance develops are becoming more defined. It is now known that genetics, diet, and level of physical activity are all involved. Insufficient insulin action and the resulting high-blood glucose levels can lead to diabetes. Most of the treatments for diabetes are aimed at restoring and maintaining normal blood glucose levels.
There are three main types of diabetes:
Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.)
Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. (Formerly referred to as non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes.)
Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.
Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.
Type 1 diabetes
Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency. This type of diabetes can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, where beta cell loss is a T-cell mediated autoimmune attack. There is no known preventive measure against type 1 diabetes, which causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults but was traditionally termed "juvenile diabetes" because it represents a majority of thediabetes cases in children.
Type 2 diabetes
Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. However, the specific defects are not known. Diabetes mellitus due to a known defect are classified separately. Type 2 diabetes is the most common type.
In the early stage of type 2 diabetes, the predominant abnormality is reduced insulin sensitivity. At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver.
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery. Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy. About 20%–50% of affected women develop type 2 diabetes later in life.
Even though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations. Increased fetal insulin may inhibit fetal surfactant production and cause respiratory distress syndrome. Hyperbilirubinemia may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A cesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.
A 2008 study completed in the U.S. found that the number of American women entering pregnancy with preexisting diabetes is increasing. In fact the rate of diabetes in expectant mothers has more than doubled in the past 6 years. This is particularly problematic as diabetes raises the risk of complications during pregnancy, as well as increasing the potential that the children of diabetic mothers will also become diabetic in the future.
Pre-diabetes indicates a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. Many people destined to develop type 2 diabetes spend many years in a state of pre-diabetes which has been termed "America's largest health care epidemic."
Latent autoimmune diabetes of adults is a condition in which Type 1 diabetes develops in adults. Adults with LADA are frequently initially misdiagnosed as having Type 2 diabetes, based on age rather than etiology.
Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon. Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). Diseases associated with excessive secretion of insulin-antagonistic hormones can cause diabetes (which is typically resolved once the hormone excess is removed). Many drugs impair insulin secretion and some toxins damage pancreatic beta cells. The ICD-10 (1992) diagnostic entity, malnutrition-related diabetes mellitus, was deprecated by the World Health Organization when the current taxonomy was introduced in 1999.
Signs and symptoms
The classical symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they usually develop much more slowly and may be subtle or absent.
Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape. Blurred vision is a common complaint leading to a diabetes diagnosis; type 1 should always be suspected in cases of rapid vision change, whereas with type 2 change is generally more gradual, but should still be suspected.
People (usually with type 1 diabetes) may also present with diabetic ketoacidosis, a state of metabolic dysregulation characterized by the smell of acetone; a rapid, deep breathing known as Kussmaul breathing; nausea; vomiting and abdominal pain; and an altered states of consciousness.
A rarer but equally severe possibility is hyperosmolar nonketotic state, which is more common in type 2 diabetes and is mainly the result of dehydration. Often, the patient has been drinking extreme amounts of sugar-containing drinks, leading to a vicious circle in regard to the water loss.
A number of skin rashes can occur in diabetes that are collectively known as diabetic dermadromes.
Nutrition for diabetes
Use food to maintain control of your blood sugar levels, and lose weight if necessary. If you've been diagnosed with diabetes, your doctor has probably mentioned that you should pay careful attention to nutrition and diet as part of your treatment program. Nutrition experts say that there is no one diet for diabetes, but people with diabetes should follow the nutrition guidelines in the Food Pyramid, while paying special attention to carbohydrate intake. People with diabetes should also eat about the same amount of food at the same time each day to keep blood sugar levels stable.The primary goal of medical nutrition therapy is to keep your blood sugar levels in the normal range to prevent diabetes related complications. Diet is therefore the cornerstone of treating your illness. You can manage blood sugar levels, lower your blood pressure, and avoid hypoglycemia just by watching what you eat, when you eat, and learning to manage your condition.
Treating your condition
Research shows that treating your diabetes through a combination of dietary changes, weight control, and exercise, implemented and supervised by a state registered dietitian can have a dramatic effect, and in some cases remove the need for medications that lower high blood sugar levels. By managing your diabetes in this way you can effectively lower your levels of hemoglobin A1c. Testing for this type of haemoglobin shows your average blood sugar.
This term means "high glucose in the blood" and is what all people with diabetes are trying to control. Severe hyperglycemia can occur if you eat something very high in sugar, or if you have not produced enough insulin. The symptoms are similar to those you may have had before you were diagnosed with diabetes-fatigue, thirst, and excessive urination.
Reaching and maintaining a healthy weight is important for everyone with diabetes. Weight control is extremely important in treating type 2 diabetes because extra body fat makes it difficult for people with type 2 diabetes to make and use their own insulin. If you are overweight, losing just 10 to 20 pounds may improve your blood sugar control so much that you can stop taking or reduce your medication.
If you smoke and have been diagnosed with diabetes, your doctor will recommend that you quit because smoking makes problems caused by diabetes worse. People with diabetes can experience blood flow problems in the legs and feet, which can sometimes lead to amputation. Smoking can decrease blood flow even more. Smoking can also worsen sexual impotence in men, cause high levels of LDL cholesterol (the bad type of cholesterol), and can raise the risk of heart attack and stroke. If you have diabetes and you smoke, you need to quit.
Although alcohol in small amounts can be fit into your meal plan if your blood sugar is under good control, drinking alcohol on an empty stomach can cause low blood sugar. Alcohol can contribute to complications of diabetes, so ask your doctor how much alcohol can be included in your meal plan and then stick to it.
If you have diabetes, you are at increased risk of developing cardiovascular disease. Reducing saturated fat is one of the most important changes you can make to reduce your risk. If you have high blood pressure, you should limit your total sodium intake.
What to eat
Knowing what you are eating will make it easier to control and maintain your blood glucose levels. It is especially important for you to control your intake of carbohydrates if you have diabetes. Eating a high fibre diet can help lower your blood glucose levels, reduce your insulin needs, and improve your blood glucose control.
Limit dietary fat
It is important to limit your intake of saturated fats, trans fatty acids, and dietary cholesterol, especially if you have LDL levels greater than3.0mmol per litre. Fats have a limited effect on blood sugar level, but you should cut your total fat intake to reduce calories, especially if you have type 2 diabetes.
Maintain protein levels
There is evidence to suggest that your usually intake of protein (15-20 per cent of your total calories) should be changed if you have diabetes. Protein has a small effect on blood sugar levels, so following a healthy diet should be sufficient for your needs. The long term effects of diets high in protein and low in carbohydrate are unknown. Initially, blood sugar levels may improve and you may lose weight, but it is not known whether long term weight loss is maintained and better with diets than with other low calorie diets. Since they are usually high in saturated fat, the long term effect of such diets on LDL cholesterol is also an important concern.
Eat low fat dairy products
Dairy products are a mix of fat, protein, and carbohydrate, and they do not directly affect your blood sugar levels. If you have diabetes, make sure that you always choose low or reduced fat versions. Also, do remember that your favorite ice cream or milkshake may be high in added sugar, so opt for a low sugar version.
Maintaining carbohydrate levels
A diabetes diet is one that advocates a proportional grouping of foods, that together help to control blood glucose levels. Your glucose level will be higher after you eat a meal, and lower in between. Coordinating what you eat and when, with regular glucose testing throughout the day, and adequate insulin coverage will keep your glucose at normal levels and prevent complications. One of the keys to staying healthy involves eating a healthy diabetic diet.
Carbohydrates: Are made of sugars, starches, and fiber. Carbohydrates provide fuel for our bodies. Eating the right kind of carbohydrates is important for health.
There are good and bad carbohydrates. Knowing the difference between the two can clear up many misconceptions.
Good Carbs - Fresh fruits, green leafy and colorful vegetables; whole grain breads and cereals; and lean meats such as chicken, turkey, and fish. These foods contain cancer fighting agents and are full of vitamins, minerals and other phytonutrients that our bodies need for proper functioning.
Bad Carbs - Sodas and processed foods, such as breads, cereals, and pasta. You can eat these foods in moderation, but when you do, choose the whole grain variety. Whole grains provide fiber, which can help to lower cholesterol levels. An added benefit to fiber is that it helps to keep the GI tract running smoothly. To find out a food's fiber content, read the label. Using the 5/5 rule, chose foods that have less than 5 g of sugar and more than 5 g of fiber. Following this plan ensures you are getting the daily fiber requirements.
Know Your Carbohydrates:
Fiber is derived from plants. If it comes out of the ground then it is a plant food, therefore it is good for you. Plant foods include:
Beans and peas
Whole grains such as wheat, bran, and oat cereals and breads
Fruits and vegetables. The fresher the better
Many people enjoy taking supplements, but it is better to get your fiber from natural foods. Nothing can replace them as a healthy and natural source of dietary fiber.
You can get natural sugar from sources such as milk or fruit. It is the processed sugars you want to avoid, such as canned fruit or cookies. These are bad carbohydrates and serve to raise blood glucose levels.
Food that contain starch are vegetables, dried beans, and grains.
Eating a healthy diet is a part of healthy living. Whether or not you have diabetes, you can reduce your risks for getting it following this simple diet and food list. Eat well for life.
Exercise is important
Physical activity has many benefits for people with dieabetes. Studies continue to show that exercise lowers after meat glucose levels byincreasing the body's uptake of insulin and helping improve insulin sensitivity. In addition, exercise reduced your risk of cardiovascular disease, for example by reducing high blood pressure. It also helps control weight, increases energy levels, and generally brings about a healthier outlook on life. Exercise can lower blood sugar levels, as your muscles use up the glucose in your body for energy.
Delay the onset of diabetes
For people who have an increased risk of diabetes, regular physical activity has been shown to prevent or delay the onset of the disease. If you are overweight, have a family history of diabetes, have metabolic syndrome, or have any other risk factors, it is time to be more active. Prevention is the key.
Energy boosting snacks
You need enough carbohydrate in your system to sustain you during exercise. Good energy boosting snacks include:
- Low-fat, sugar free fruit yogurt
- Banana or apple
- Rice crackers with hummus
- Slice of wholemeat toast or a bagel with peanut butter or low-fat spread.
Make an exercise plan
Your exercise plan will depend on your age, general health, and level of fitness, so check with your doctor before starting. Make sure that you start off gently and do not overexert yourself. Try walking swimming, and cycling, which can all be carried out at a pace that you find comfortable, and increased as your level of fitness improves. Wear a visible diabetes ID, carry some carbohydrate with you, and exercise with a friend who known that you have diabetes in case your blood sugar drops and you become hypoglycaemic.
Disclaimer: This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regime, it is advisible to seek the advice of a licensed healthcare professional.