NUTRITION MANAGEMENT on DIABETES MELLITUS

Multitude of mechanisms
Insulin Regulation Secretion Uptake or breakdown Beta cells damage

Carbohydrate Facilitates the transport of glucose into muscle and adipose cells Facilitates the conversion of glucose to glycogen for storage in the liver and muscle. Decreases the breakdown and release of glucose from glycogen by the liver

Protein Stimulates protein synthesis Inhibits protein breakdown; diminishes gluconeogenesis

Fat Stimulates lipogenesis- the transport of triglycerides to adipose tissue Inhibits lipolysis prevents excessive production of ketones or ketoacidosis

Low or absent endogenous insulin Dependent on exogenous insulin for life Onset generally < 30 years 5-10% of cases of diabetes Onset sudden
Symptoms: 3 Ps: polyuria, polydypsia,

polyphagia

Genetic component to disease

Insulin levels may be normal, elevated or depressed

Characterized by insulin resistance, diminished tissue sensitivity to insulin, and impaired beta cell function (delayed or

inadequate insulin release)

Often occurs >40 years

Risk factors: family history, sedentary lifestyle, obesity and aging Controlled by weight loss, oral hypoglycemic agents and or insulin

 Nutrition Blood glucose Medications Physical activity/exercise Behavior modification

 Primary Goal improve

metabolic control

Blood glucose Lipid (cholesterol) levels

Maintain short and long term body weight Reach and maintain normal growth and development Prevent or treat complications Improve and maintain nutritional status Provide optimal nutrition for pregnancy

 Consistency and timing of meals Timing of insulin Monitor blood glucose regularly

Weight loss Smaller meals and snacks Physical activity Monitor blood glucose and medications

Carbohydrate
60-70% calories from carbohydrates and

monounsaturated fats

Protein
10-20% total calories

Fat
<10% calories from saturated fat 10% calories from PUFA <300 mg cholesterol

Fiber
20-35 grams/day

Alcohol
Type I limit to 2 drinks/day, with meals Type II substitute for fat calories

Weight control Blood glucose control Prevention and management of short-term and long-term complications of diabetes

Eat starchy foods regularly Eat more fruit and vegetables Reduce animal or saturated fat Cut down on sugar Reduce salt

Balancing food choices

Bread Potatoes Rice Pasta Cereals Plantain

Eat more fruit and vegetables

Fresh Frozen Tinned Dried Juice

To help maintain blood glucose levels and cholesterol levels

Helps to maintain a healthy gut

Fruit Vegetables Pulses Oats

Wholegrain cereals Wholemeal bread Wholewheat pasta Brown rice

Use low fat milk Use low fat spread instead of butter Use oil high in unsaturated fat, eg olive oil, rapeseed oil

Grill Dry-roast Microwave Steam

SATURATED Full fat dairy produce (eg cheese, butter, full cream milk) Pies Biscuits Savoury snacks Lard

MONOUNSATURATED Olive oil Rapeseed oil

POLY- UNSATURATED Sunflower oil (products) Oily fish

Groundnut oil

Hard vegetable fat

Not a sugar free diet

Cut out sweets

Cut out sugary

drinks

Use diet or low calorie, sugar free drinks

 Tablet Liquid Granulated

Cut down on added salt Use alternative seasonings Look out for reduced/low sodium foods, eg bread Avoid salt substitutes

Breakfast