diet in diabetes mellitus...• diabetes mellitus is caused by an under secretion or...
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Diet in diabetes mellitus
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• Introduction • What is diabetes mellitus? • Types • Causes • Symptoms • Nutritional requirements • Complications • Conclusion
Introduction
Diabetes mellitus is commonly known as diabetes
Serious disease affecting humanity
Undetected/ untreated diabetes causes further complications
Loss of limbs, vision etc
Diabetes is a chronic degenerative disease
Unable to produce insulin
Make too little unable to use
• It can only be kept under control with the help of nutritionist • If not kept under control- a number of complication can occur
Eye disorders
Thickening of arteries
Kidney dysfunction
Proper care is essential to prevent
What is diabetes mellitus??
It is characterized by the passage of sweet urine
Excessive urine production, thirst
Excessive hunger, weight loss
It is defined as a group of disorders with measurable persistent hyperglycemia
Classification:
• Type Ι • Type ΙΙ • Other specific types
Type Ι Also called Insulin dependent diabetes
mellitus (IDDM), Juvenile-onset diabetes
Occurs at any age, although common in younger age group
Pancreas do not produce sufficient insulin
Patient depends on insulin, elevation of blood glucose
Variation in blood glucose levels make
patient prone to two conditions
Ketoacidosis
Hypoglycemia
The onset of this disorder is usually abrupt, and the condition is difficult to control
Causes
Type Ι
Genetic
Environmental factors
Immunological factor
Infectionscutes
Type ΙΙ
• Also called as noninsulin dependent diabetes mellitus (NIDDM), adult onset diabetes
• Patient with this condition can manufacture some insulin but do not make sufficient amount or cannot use insulin efficiently
• Persons with type ΙΙ are not insulin dependent, some of them use insulin because of persistent hyperglycemia
• Most of these persons are obese
Causes
Genetic
Environmental factors
Insulin resistance
Type ΙΙ
Life style Age Abdominal fat Pregnancy
Symptoms
Hyperglycemia High blood
sugar or glucose
Glycosuria Fluid & Electrolyte
Balance
Dehydration Fatigue & loss of weight
Excretion of potassium,
magnesium, phosphorus
Gestational diabetes
• Carbohydrate intolerance during pregnancy
• Pregnancy raises blood insulin levels in all women
• The blood glucose turns to normal after delivery
• Women with this condition are at increased risk for developing type ΙΙ diabetes as they age
Diet Its an essential part of the treatment of diabetic patients
A fixed exchange system is necessary for daily intake
Food exchange list
It is a list of groups measured foods of the same calorific value
& similar protein, fat & CHO
And
Can be substituted one for another in a meal plan
To a good diet
Food exchange list helps the patient To restrict the food intake
according to insulin prescription
To have variety in the diet
Easy learning of the principles of diet
To maintain body weight
Nutritional requirements
• ENERGY: Hospitalized patients are given 25 Kcal/kg body weight
• CARBOHYDRATE: It is maintained to about 45-60% of total
calories.
Should be in the form of polysaccharides
Rapidly absorbed mono & disaccharide should be
avoided
Protein & fat
PROTEIN: It should be 0.8g/kg of ideal body weight
increased intake up to 15 to 20 % of total energy in adolescent
children, pregnant or nursing mothers
FAT: Total fat should be 20 to 30% of the total energy
saturated fat (7-10%), monounsaturated (10-13%) &
polyunsaturated (8-10%) of the total energy.
Cholesterol less than 300 mg /day
Vitamins & minerals
• Similar to those of other individuals. There is no need for
supplement
• Pregnant woman may need a vitamin & mineral supplement
Alcohol: Moderate use of alcohol does not adversely affect
diabetes in a well controlled patient
Dietary fibre
Diet rich in dietary fibre & complex carbohydrates benefit diabetics. It lowers -Insulin requirements -serum cholesterol & triglyceride values Aids in weight control and lowers blood pressure Whole grains, fruits and vegetables and fenugreek seeds are rich in complex carbohydrates
Complications
Hypoglycemia or insulin
shock
Ketoacidosis
Acute complication
s
Chronic complications
Infections
Cataract & retinopathy
Heart disease
Nephropathy
Conclusion
• Diabetes mellitus is caused by an under secretion or
underutilization of insulin &/or receptor or post receptor defects
• It’s a group of disorders with a common sign of hyperglycemia
• Person with diabetes suffer from acute & chronic complication
• Treatment involves medication, nutritional management & exercise
• Nutrition is a fundamental part of treatment