Watch your diet - Part 2

Diabetes lifestyle care choices are important. They include: nutrition, exercise, diabetes medication, blood sugar monitoring, personal health habits, and frequent medical checkups.

Nutrition

Good nutrition involves following a diabetes meal plan that shows what, when and how much to eat. Using a diabetes meal plan helps blood sugar level stay as close to normal as possible. The plan needs to be personalized to also provide for enjoyment of meals and overall good health. Do not skip meals. Rather, eat several times every day according to your diabetes meal plan and if you are overweight, try to lose 10 to 15 pounds in order to help improve your diabetes control.

There are two types of diets measured and unmeasured. In measured diets the portion of food may be measured either by weighing with scales or more simply by using household measures. Measured diets are required for patients who require insulin or an oral hypoglycaemic agent and also for those who are over weight and require a reducing regimen. Unmeasured diets - If insulin or oral hypoglycaemic agents are not required and obesity is not marked, it may not be necessary for the patient to follow such an accurate diet. Many patients develop the disease when they are already middle aged or elderly and have a mild type of diabetes often associated with moderate obesity for such patients an unmeasured diet may be adequate.

Nutritional needs:

Dietary control is an integral part of management for the diabetic. The diet should always provide the essentials of good nutrition and adjustments must be made from time to time for changing metabolic needs For example during growth, pregnancy, lactation or modified activity.

Proteins:

Since diabetics in general are in negative nitrogen balance they should receive about twice as much protein as normal subjects. The proteins should be of high biological value and provide about 20 - 25 % of the calories in the diet. A diet high in protein is good for diabetics because

.It supplies the essential amino acids needed for tissue repair.
.Protein does not raise the blood sugar during absorption, as do carbohydrates.
.It does not supply as many calories as fats.

Carbohydrates:

The daily intake of carbohydrate should provide about 40 % of the calories to prevent ketosis. Several studies shown that raising the carbohydrates intake does not adversely affect blood glucose levels, glucose tolerance, or insulin requirements provided that total calorie are not increased.

Fats:

After protein and carbohydrates levels have been established the fat allowance makes up the remaining calories for most diets.30 - 35 % of the calories as fat is satisfactory. Foods high in saturated fat and cholesterol should be limited.

Fiber:

Foods those are rich in fiber can reduce the rate of glucose absorption, lower blood sugar rise, decrease urinary glucose excretion, slower stomach emptying and delay intestinal transit time. Fiber also contributes to satiety and consequent decreased food intake helps reduce weight. This fiber containing complex carbohydrates that are slowly digested and absorbed such as pulses, brown rice, bread, roti will produce fewer rises in blood sugar and less excretion of urinary sugar than an equivalent amount of carbohydrates taken as sugar in tea.

The fiber particularly the gums, pectin's when ingested with a diet are reported to reduce post prandial glucose levels (after food) in blood. Studies have shown that gum present in fenugreek seeds (it contains 40 % gum) is most effective in reducing blood glucose and cholesterol levels as compared to other gums. These types of dietary fiber are often recommended for the management of certain types of diabetes.

Calculation of Diabetic Diet

Let us assume that a diet is to be planned for a person who is 25 years old and 165 cm tall. According to her height her desirable weight is 60 kg. Calories required for per kg body weight is 30.

Calories	60 x 30 =1800kcal / day.
Protein	20-25 % of total calories
	1800 x 20% = 360 kcal.
	360kcal /4 = 90gm / day
Carbohydrates	40% of total calories
	1800 x 40% = 720 kcal 720 / 4 = 180 gm / day
Fat	Total calories - calories from protein and carbohydrates
	1800 - (360 + 720) = 720 kcal. 720 / 9 = 80 gm fat / day.

Points to be taken into consideration while planning the diet

.Avoid roots and tubers e.g.: potato, sweet potato, yam, tapioca but carrot and radish can be consumed.
.Avoid sugar, glucose, jams, jaggery, honey, sweets, nuts, etc.
.Avoid fried foods.
.Include salads but no salad dressing like mayonnaise.
.Include plenty of green leafy vegetables.
.Quantity of oil should be restricted.
.Dietary exchanges should be taken into consideration.
.Avoid alcohol.
.Include food rich in fiber.
.Avoid fruits such as mango, banana, custard apple etc

Sample Menu for Diabetics

VEGETARIAN

NON VEGETARIAN

Time	Menu	Quantity	Time	Menu	Quantity
Early morning	Tea/coffee (without sugar)	1cup	Early morning	Tea/coffee (without sugar)	1cup
Breakfast	Skim milk Roti Curry	1 glass 2 nos. 1cup	Breakfast	Skim milk Bread Egg	1 glass 2 slices 2nos.
Mid-Morning	Orange Buttermilk	1 nos. 1 glass	Mid-Morning	Orange Buttermilk	1 nos. 1 glass
Lunch	Rice Roti Chana Dhal Methi Sag Curd Salad (radish, onion, cucumber, tomato)	1 1/2 cup 2 nos. 1 cup 1 cup 1 cup 1 serving	Lunch	Rice Roti Cauliflower Curry Fish curry Curd Salad	1 1/2 cup 2 nos. 1 cup 1 cup 1/2 cup 1 serving
Evening tea	Tea/coffee (without sugar) Biscuit	1 cup 2 nos.	Evening tea	Tea/coffee (without sugar) Biscuit	1 cup 2 nos.
Dinner	Roti Moong whole Karela Curry Salad	2 nos. 1 cup 1 cup 1 serving	Dinner	DinnerRoti Palak Curry Chicken curry Salad	2 nos. 1 cup 1 cup 1 serving
Bedtime	Skim milk without sugar	1 cup	Bedtime	Skim milk without sugar	1 cup