Thursday, 30 May 2013

Diabetes Mellitus and the Diet

Diabetes Mellitus is a condition in which the body does not process foods consumed for use as energy. Most foods consumed are changed into sugar or glucose for our bodies to get energy for activities such as breathing, walking, talking etc. The pancreas manufactures the hormone insulin to help get glucose out of the blood and into the cells of our bodies. In the case of diabetes, the pancreas is either not making enough insulin or the insulin that is made is not being used well due to the amount of fat surrounding  the cells. This causes sugar in the form of glucose to build up in the blood. Normal blood glucose is 70-120mmol/L or 3.9-6.6mg/dl. 

Diabetes Classifications:
• Type I
• Type II
• Gestational and other specific types
• Pre- Diabetes 
The risk factors for the development of  diabetes include: pre-diabetes, obesity, lack of, or insufficient amount of physical activity and increasing age. The management goals of Diabetes Mellitus are to:
• Achieve normal Blood Glucose values between 70-120mmol/L(3.9-6.6mg/dl) 
• Achieve and maintain a Desirable Body Weight or Healthy Body Weight with
a Body Mass Index (BMI) less than or equal to 24.9 kg/m2. 
• Achieve and maintain a waist circumference
of 30 inches for females and 35 inches for males. 
• Achieve and maintain normal blood
lipid levels. 
• Slow down or prevent the development of atherosclerosis (Heart Disease),
nephropathy (kidney disease), neuropathy (nerve damage in lower extremities
and retinopathy (eye disease). 

There is no special diet for a person with Diabetes. It is the amount of food that is consumed, how the food is prepared, and when it is consumed. The recommendation is to consume a diet that is rich in fibre -unrefined foods such as yam, potato, whole grain products peas, beans, whole fresh fruits, vegetables raw and lightly cooked; low in total fat, saturated fat and cholesterol from the six Caribbean Food groups. The food groups are Staples (unrefined or complex carbohydrates such as yam, green bananas, plantains, whole grain products etc.), Fruits (whole fresh or  no sugar added juices), Vegetables (raw or lightly cooked), Legumes (peas, beans and nuts), Foods from Animals (milk, cheese, beef, chicken without skin and visible fat) and Fats and Oils (ackee, pear, butter, margarine and cooking oil). 

The general dietary recommendations include eating three meals per day, but when on  insulin, snacks should be included to accommodate the peak in insulin to prevent low blood sugar (hypoglycemia) from occurring. Consideration must be given to individual preference, culture, socio-economics, availability and ability to understand and follow the diet that is prescribed by a registered nutrition professional.  Physical activity or exercise should be done for at least thirty minutes, three to five days per week. This can be broken down into increments of ten minutes, three times per day. 

Uncontrolled diabetes may lead to complications that affect the kidneys, eyes, heart, nerves and feet. Inspect the feet and toes for blisters or unnoticed cuts, check blood glucose level using a glucometer (home blood glucose machine), exercise to prevent excess fat around the abdomen.

BY Marsha N. Woolery, a registered dietitian/nutritionist and adjunct lecturer at Northern Caribbean University