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Diet Therapy for People with Diabetes

 

Diet therapy is essential in the control of all diabetics, be they on diet alone, oral medication or insulin. The aims of dietary management are:

  • To help control blood glucose levels and prevent loss of glucose in the urine.
  • To achieve a satisfactory weight. If you are overweight you will need to lose weight to achieve ideal body weight suitable for your age, sex, height and body build. This is important because obesity is a health hazard particularly for diabetics. If you are underweight you will need to increase your body weight.
  • To provide a palatable diet which is acceptable to the individual.
  • To provide sufficient calories for normal activities.

The diet will be individualized for each person. The physician's prescription is based on:

  • Age, sex, weight, height and activity of the individual.
  • Type of diabetes IDDM (Insulin Dependent) or NIDDM (Non-Insulin Dependent).
  • Type of medication, amount and when administered.
  • Nutritional requirements of the individual.

Contrary to popular belief, the purchase and preparation of special diabetic foods is totally unnecessary. The diabetic diet of today follows closely recommendations for the general population.

 

Many diabetic foods are expensive, and they add little in the way of palatability. Their composition is also variable. They emphasize that the patient is "different". The diabetic person can and should eat the same variety of foods as the rest of the family, with the exception of sugar and food prepared with sugar or such food items as advised by the doctor or dietitian.

 

It is important to remember that the diabetic diet is a modification of the normal adequate and well-balanced diet.

 

The planned diet takes into account the individual's economic status, availability and cost of food items, national, religious and social customs, personal idiosyncrasies, occupation, facilities for preparing and obtaining meals and so on. The diet need not be an expensive one, and ideally it should be planned to fit in with the menus of the entire family. However if the family dietary pattern is poor, the entire family will benefit when the basic food groups become the center around which meals are planned.

 

It is neither necessary nor desirable for you to weigh the food. Standard measuring cups and spoons are sufficiently accurate for measuring food at home; in time you will learn to judge the correct size of serving portions.

 

Nothing favors the breaking of the diet as much as serving the same food over and over again. You can learn to select correct quantities of foods from the diabetic exchange lists, so that your menus may be varied.

 

In the Exchange System, foods are grouped according to similar nutrient compositions, and designated "Food Exchange Groups". Within any one group of food items may be freely exchanged, since all foods in that group in the serving portions suggested are of approximately the same food value. This system provides a simple means of dietary regulation which is easily understood and flexible enough to meet a variety of living situations. With a flexible plan that allows a variety of food choices, you are more likely to follow a diet prescribed for you and build consistent food habits that will give better long-term diabetic control.

 

The Glycaemic Index gives a percentage value to foods using as a basis the rise in blood glucose after eating 10gm of carbohydrate found in white bread. For example, the glycaemic index of white bread is 100, that of white rice 83, while honey has a glycaemic index of 126. It means that the same amount of rice will cause a blood sugar rise of 83% compared to that of white bread, while honey will cause a rise of 126%.

 

Varying the amount of fat or protein in a mixed meal affects the absorption of nutrients and causes varying blood sugar excursions following the meal. This means that although exchange lists and the glycaemic index are useful as guidelines, one has to be flexible in applying them.

 

The ultimate success in the treatment of diabetes is dependent on the intelligent cooperation of the patient himself. Most people resist change in a diet. To teach a diabetic the art of living with his impaired metabolic condition, is an important phase in a diabetic's educational program. It requires patience and skill on the part of the doctor, the nurse and the dietitian. Each has a role to play in providing instruction that is adequate, but not overwhelming. The following are guidelines in which the patient should be familiar with:

  • The reasons for a specified diet.
  • The size and portions which may be used.
  • Possible substitutions in the diet.

Diet is the cornerstone in the management of diabetes.

 

 

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