Defining Diabetic Issues and Putting The 11-Steps Nutritional Plan Together

 

Dorian Venable, M.Ed, RD, LD, CHES, NASM-CPT

 

 

Step 1

Define each condition of Diabetes

 

Insulin-Dependent Diabetes Mellitus (IDDM)

This chronic disease develops at a young age. Patients having IDDM experiences inability to make insulin in their own bodies, due to pancreatic beta cell defect. Insulin injection is required to control the blood glucose serum (BGS).  10% of all Diabetics experiences insulin insufficient. This condition when untreated can cause cells to break down protein and fat. This action causes a development of weight loss and production of partially broken down fats called ketones.

 

Non-insulin Dependent Diabetes Mellitus (NIDDM)

This chronic disease develops at middle age or older. Patients having NIDDM are unable to absorb or use insulin effectively. This is due to elevated fat tissue blocking insulin absorption mechanism. The American Diabetes Association (ADA) diets are recommended to help control BGS and weight status. 90% of all diabetics are experience insulin resistant. This condition causes glucose to slowly enter the cells. This causes BGS to go back to the liver to be converted in to triglycerides in order to be stored in fat cells, which will causes weight gain.  Therefore, it is important to plan all diabetic diets to be lower in fat and cholesterol.

 

Uncontrolled Diabetes

This is a condition of BGS below or above normal optimal level. Patients who are experiencing NIDDM are at risk of Hyperosmolar Hyperglycemic Non-Ketotic (HHNK). This condition occurs when the BGS is above 600 mg/dL. Patients having IDDM are at risk of Diabetic Ketoacidosis (DKA). This condition occurs when the BGS is above 240 mg/dL.

 

Hyperglycemia

It occurs when the BGS is above 180 mg/dL. The diabetic will experience symptoms of extreme thirst (polydipsia), frequent urination (poluuria), ketones in the urine (ketonuria), ketones in the blood (ketonemia), drowsiness, blurred vision, and acetone breath. Beginning symptoms of Diabetes will cause a pronounce effect. Over a period of time some of the symptoms will become less pronounced causing the diabetic to overlook warning signs, which can become hazardous for the patient. 

 

Hypoglycemia

It occurs when the BGS is below 70 mg/dL. The diabetic will experience shaking, dizziness, impaired vision. This is caused by poor function of body cells that are in a state of starvation. Therefore, it is important to plan calorie controlled diet, exercise, and medication regiment.

 

Rebound Effects

There are two types of rebound effects such as Dawn Phenomenon and Somogyi effect, which are common for uncontrolled Diabetes. Patients who have NIDDM may experience Dawn Phenomenon. This condition occurs early in the morning when hyperglycemia conditions develop due to insulin sensitivity decrease between 4:00 AM and 9:00 AM.  This is possibly due to a surge of growth hormones or glucocorticoids. Somogyi effect is caused by an overdose of insulin. This would cause hypoglycemia to develop, which in turn causes a release of hormones that stimulate break down of fats (lipolysis), breakdown of glycogen (glycogenolysis), and developing of glucose from alternative nutrients (gluconeogenisis). This would lead to increase source of whole and partially formed glucose that promotes hyperglycemia and development of ketones (ketosis). Treatment involves gradually lowering the insulin dose to achieve an optimal BGS level.

 

Step 2

Balancing meals

This is important throughout the day are a critical part for diabetics. This allows three meals and two snacks each day. It is recommended never to skip or become excessive with a meal. These guidelines will help a person with diabetes to have a normal and healthy life. Their meals must be well balanced with foods from all of the food groups. Caloric clocks, Glycemic Index, food balancing charts are healthy techniques to help calorie distribution throughout the day. Caloric clock is a pie chart of carbohydrates being converted into four servings, which is ideal for each meal per day.  Glycemic index is a chart of food items ranking from high to low. Items that are ranked high are rapidly absorbed sugar sources, which will cause hyperglycemia. Items that are ranked low are slowly absorbed and generally safe for diabetic. Blending and balancing foods chart is a chart of two columns consisting of carbohydrates and non-carbohydrate food items. This chart gives the diabetic person the freedom of selecting food items to form a balance meal.

 

 

 

 

Step 3:

Eating a variety of foods

It will help insure diabetic to receive proper nutrients. Diabetic will be exposed to all food groups such as fresh fruits and vegetables, lean meat, skim milk, and whole grain wheat.  Fruits contain both simple and complex carbohydrates.  Non-starchy vegetables also contain a small amount of complex carbohydrate.  Milk contains some carbohydrate in the form of lactose. .  Carbohydrate control is a key nutrient to understand with diabetes.  This nutrient is found in many foods and is designed to provide our bodies with fuel.  Carbohydrate can be found in two forms in foods.  Simple carbohydrates are already in the form of absorbable sugar.

 

Food guide pyramid, dietary guidelines, and ADA diets are healthy techniques to help diabetic to a variety of nutritional foods. Patient receive a specific calorie level diet, which require them to eat more controlled amounts of foods at each meal in order to control their BGS and weight.  ADA has developed an accepted system for planning calorie-controlled diets for diabetics.  When diets are planned according to this system it is called ADA diets such as 1200 calorie ADA diet. All food categories and servings are included in these healthy techniques that will help insure good food choices. Proper nutrition through diabetic diets is planned using a variety of nutrients from the food groups to assure that all the important nutrients are provided in the diet. 

 

Step 4:

Avoid simple sugar or sweets

It is important andnecessary to help control BGS. There is a large category of bad choices such as syrup, jelly, honey, cakes, pie, cookies, candy, chips, and soda containing high amounts of sugar.   These items are hard to avoid in a daily routine, and even harder during holidays to avoid.

 

Proper intake of complex carbohydrate (CHO) is a healthy technique consists of making good food choices. This is a complex sugar that takes longer to break down in the body to provide glucose. Complex carbohydrates are what we usually call starches.  Examples of complex carbohydrate foods are bread, rice, potatoes, pasta, corn peas, crackers, etc.  The carbohydrates in these foods must be broken apart and broken down to sugar during digestion.  The body needs 55-60% of CHO from total calories consume per day. Unrefined carbohydrate with fiber is a better source than sucrose and other refined sugars. It allows the diabetic more control of their BGS.

 

 

Step 5:

Choose lean meat and low fat dairy product

It will help decrease excessive fat intake. Preventing bad choices such as fried foods, high fat meat items, whole milk, and regular cheese will help control weight and cholesterol level. Persons with diabetes often also have too much fat and cholesterol in their blood, and they are four times more likely to have heart disease than the non-diabetic person.

Protein facts and dairy guidelines are healthy techniques to help diabetics to choose lean meats and low fat dairy items. Healthy protein choices provide types of protein sources such as different quality of meat, poultry, fish, dry beans, eggs, & nuts. It is recommended to consume two to three servings per day. Meat items are excellent source of protein, iron, Zinc Vitamin B-12. Protein intake of 15-20% of total calories per day is recommended to strengthen blood, muscle, and body structure. It is important to pay attention to portion size and fat content. Dairy intake is recommended three to four servings per day. Healthy choices consist of fat free & low fat items. Dairy is an important source of calcium, protein, and vitamin D.

 

Step 6:

Fruits and Vegetables

If selecting canned fruits it is important to choices fruits packed in water or natural Juice. It is equally important to avoid fruits packed in heavy syrup. This will help avoid simple sugars and insure normal BGS. Fruits and vegetables facts are healthy techniques, which allow the diabetic better food choices. It is recommended three to five vegetables and two to four fruits servings per day. These food items are fat free and a great source of vitamins, minerals, and fiber.

 

Step 7:

Fiber

Daily intake of insoluble fiber is important for bowel function. Soluble fiber helps slow down rapid sugar absorption to allow BGS to become more stable. Fiber also decreases the risk for heart disease and some form of cancer. It lowers your calorie intake by helping you to stay full longer. Fiber facts are healthy techniques for diabetics to maintain about 20-35 grams per day. Good fiber choices such as fruits, vegetables, cereal products, and whole grains are necessary to help maintain these benefits.

 

Step 8:

Fluid Intake

Fluid intake helps with body’s hydration status and proper hydrolysis of nutrients for absorption. This is why it is important to consume eight cups of water daily. Water facts are healthy techniques consists of reaching for a glass of water when you are thirsty instead of a soda.

 

Step 9:

If you got to have sugars try sugar substitutes

Sugar substitutes such as diet sodas, artificial sweeteners, sugarless gum, and diet gelatin, jelly, and syrups are the best way to avoid simple sugar from sneaking into the diabetic plate and causing havoc on the BGS. Sugar substitute list is a healthy technique to become familiar. It consist of Equal, Sweet N’ Low, Sugar Twin, and Sweet One that are important to prevent hyperglycemia. It is also very important for the diabetic person to spread the carbohydrates that he/she eats out over the course of the day as well, rather than eating it all at one meal.  At one time, it was believed that a diabetic person should never eat foods containing high amounts of sugar such as candies, cakes, pies, and cookies.  Now, because we know that many foods break down to sugar anyway, an occasional small piece of high sugar food is considered acceptable, but only if the person’s blood sugar level is well controlled.

 

Step 10:

Losing the weight

Watch your weight closely and if you need to lose unwanted pounds to better control your diabetes call your doctor first. Fat facts are healthy techniques that are helpful in controlling fat intake. It is divided into three categories such as monounsaturated up to 20%, polyunsaturated fats less than 10%, and saturated fats less than 7%. This should provide 30% of total calories coming from fat. Recognizing the different fat sources such as sunflower, corn, soybean, and some fish are from polyunsaturated fats. Meat, dairy coconut, and palm oil are from saturated fats.  Olive, peanut, and canola oil is from monounsaturated fats. These fats provide energy and satiety for the body.

 

 

Step 11

Exercise

Exercise at least 3-5 days per week. Before planning daily exercise event ask your doctor if you have any limitations. Always start out slow and do not exert yourself. Exercise plan is healthy techniques, which provides time for a proper warm up, and cool down for low impact activities such as walking. It is important to stretch and wear good shoes are important to prevent injuries as well.

 

 

Conclusion

Prevention of multiple types of additional long-term chronic diseases through proper control of the BGS through diet, exercise, and medication is the best technique to control diabetes. When diabetes are left uncontrolled it promotes risk factors such as Congestive Heart Disease (CHD), bone atrophy (Osteoporosis), optical atrophy (Retinopathy), Nervous system atrophy (Neuropathy), and kidney atrophy (Nephropathy).