Meta Description:Meta Description:
How can nutrition aid diabetes management?
Meta Description: Type 2 Diabetes Can Be Prevented or Delayed with Lifestyle Changes:
According to the Diabetes Prevention Program study: modest weight loss (7% of body weight) + physical activity (30 minutes per day) = 58% reduction in risk for type 2
Keywords: diabetes mellitus, nutrition recommendations, glycemic control, insulin.
Diabetes mellitus is a disease with varying forms and degrees that have the common characteristic of
hyperglycemia. Its underlying metabolic disorder involves all three of the energy-yielding nutrients and
influences energy balance. The most important hormone that controls increased levels of blood glucose is insulin that secrets from the pancreas. people with diabetes have either a lack of insulin or a resistance to its action.
Type 1 and 2 diabetes
Type 1 diabetes affects approximately 5% to 10% of all people with diabetes; It commonly occurs for the first time during childhood, and it is more severe and unstable compared to type 2. The treatment of type 1 diabetes involves regular meals and snacks that are balanced with insulin and exercise. The self-monitoring of blood glucose levels is a critical part of disease management.
Type 2 diabetes occurs mostly among adults, especially those who are overweight. Treatment involves weight reduction and maintenance along with regular exercise. Oral hypoglycemic medications or insulin may be needed.
Type 2 Diabetes Can Be Prevented or Delayed with Lifestyle Changes:
Modest weight loss (7% of body weight) + physical activity (30 minutes per day) = 58% reduction in risk for type 2
A key point to remember is that preventing or delaying type 2 diabetes requires only small changes in lifestyle. Notice that success doesn’t mean starving yourself to reach an “ideal body weight” or running endless laps. A 7% weight loss is equivalent to losing 14 pounds for someone who weighs 200 pounds. Moderate-intensity physical activity equates to taking a brisk walk for about 30 minutes each day, five days a week.
These goals are small steps toward the bigger reward of good health. As you take these small steps and experience small successes, you will develop more confidence in yourself and your ability to make the changes you need to stay healthy.
Body Weight in Type 2 Diabetes
Because excessive body fat can worsen insulin resistance, weight loss is recommended for overweight or obese individuals who have diabetes. Even moderate weight loss (5 to 10 percent of body weight) can help to improve insulin resistance, glycemic control, blood lipid levels, and blood pressure. Weight loss is most beneficial early in the course of diabetes before insulin secretion has diminished. Not all persons with type 2 diabetes are overweight or obese. Older adults and those in long-term care facilities are often underweight and may need to gain weight. Low body weight increases the risks of morbidity and mortality in these individuals.
Physical Activity and Diabetes Management
Regular physical activity can improve glycemic control considerably and is, therefore, a central feature of disease management. Physical activity also benefits other aspects of health, including cardiovascular risk factors and body weight. Children with diabetes or prediabetes should engage in at least 60 minutes of physical activity each day. Adults with diabetes are advised to perform at least 150 minutes of moderate-intensity aerobic activity per week, spread over at least 3 days of the week; they should also perform resistance exercise at least twice weekly unless contraindicated by a medical condition that increases the risk of injury. Both aerobic and resistance exercise can improve insulin sensitivity.
According to the Diabetes Prevention Program study:
Nutrition Recommendations for the Management of Diabetes
Total Carbohydrate Intake The amount of carbohydrate consumed has the greatest influence on blood glucose levels after meals. the more grams of carbohydrate ingested, the greater the glycemic response. The carbohydrate recommendation is based in part on the person’s metabolic needs, the type of insulin or other medications used to manage diabetes, and individual preferences. For optimal health, the carbohydrate sources should be whole grains, legumes, vegetables, fruits, and milk products, whereas foods made with refined grains and added sugars should be limited.
- Monitoring carbohydrate levels—whether by carbohydrate counting, exchanges or experienced-based estimation—is a key strategy for the achievement of glycemic control.
- Sucrose-containing foods can be substituted by other carbohydrates in the meal plan. if they added to the meal plan, they must be considered with regard to the dosage of insulin or other glucose-lowering medications. Be careful to avoid excess energy intake.
- As for the general population, people with diabetes are encouraged to consume a variety of fiber-containing foods to meet dietary recommendations.
- Sugar alcohols and nonnutritive sweeteners are safe when they are consumed according to the daily intake levels established by the U.S. Food and Drug Administration.
- Fructose from natural foods such as fruit may result in better glycemic control compared to the isocaloric intake of sucrose or starch. Avoid sugar-sweetened beverages (including those made with high-fructose corn syrup).
- The amount of dietary saturated fat, cholesterol, and trans fat recommendations are the same as those for the general population.
- Increase the selection of foods containing omega-3 fatty acids (EPA and DHA) and omega-3 linolenic acid (ALA).
- Two or more servings of fish per week (with the exception of commercially fried fish filets) provide omega-3 polyunsaturated fatty acids and are recommended.
- For people with type 2 diabetes, a Mediterranean-style, monounsaturated fatty acid-rich eating pattern may improve glycemic control and prevent cardiovascular disease risk factors.
- Individuals with diabetes and dyslipidemia may be able to modestly reduce total and LDL-cholesterol by consuming 1.6 to 3 g/day of plant stanols or sterols typically found in enriched foods.
- For individuals with diabetes and normal renal function, the evidence is insufficient to suggest any special recommendations. usual protein intake (i.e., 15% to 20% of energy) should be modified.
- For individuals with type 2 diabetes, ingested protein can increase the insulin response without increasing plasma glucose concentrations. Therefore, carbohydrate foods that are also high in protein should not be used to prevent or treat acute hypoglycemia.
- For individuals with both diabetes and hypertension, a reduction in dietary sodium should be less than the general public. (≤2300 mg/day is advisable.)
Alcohol Use in Diabetes
recommendations for alcohol intake is similar to those for the general population, which recommends that women and men limit their average daily intakes of alcohol to one drink and two drinks per day, respectively.
- Be aware that alcohol consumption may put people with diabetes at risk of delayed hypoglycemia, especially if taking insulin or insulin secretagogues.
- recommendations for people with diabetes are the same as for the general population. Vitamin and mineral supplementation is not recommended unless nutrient deficiencies develop; those at risk include the elderly, pregnant or lactating women, strict vegetarians, and individuals on calorie-restricted diets.
Whole Grains and Fiber
Recommendations for whole grain and fiber intakes are similar to those for the general population. People with diabetes are encouraged to include fiber-rich foods such as whole-grain cereals, legumes, fruits, and vegetables in their diet. There are no reasons for these individuals to consume greater amounts of fiber than what is recommended for the general public. Current recommendations are to consume approximately 25 g/day for women and 38 g/day for men.
Physiologic or psychosocial stress may affect glycemic control in patients with diabetes because of the hormonal responses that are antagonistic to insulin. In particular, diabetes-specific emotional stress is associated with poor HbA1c control in individuals with type 1 and type 2 diabetes. People with diabetes, especially those who use insulin, should learn useful stress-reduction exercises and activities as part of their self-care skills and practices. Stress-reducing activities can vary greatly from one person to the next (e.g., meditation, running, yoga, journaling, playing music). Finding the best coping mechanism may require trial and error.
Medical nutrition therapy for people with diabetes should be individualized, with consideration given to the individual’s usual food and eating habits, metabolic profile, treatment goals, and desired outcomes. Monitoring of metabolic parameters, including glucose, HbA1c, lipids, blood pressure, body weight, and renal function, when appropriate, as well as the quality of life, is essential to assess the need for changes in therapy and to ensure successful outcomes.