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Diabetes mellitus, often called diabetes, is a condition that affects the body's ability to regulate the level of glucose in the blood. Glucose is the main form of sugar in the body.
There are 4 main types of diabetes mellitus:
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- type 1 diabetes, also known as insulin-dependent diabetes mellitus, or juvenile-onset diabetes mellitus. A person with this type of diabetes makes little or no insulin and needs regular insulin injections to survive.
- type 2 diabetes, also known as non-insulin-dependent diabetes mellitus, or adult-onset diabetes. This is by far the most common type of diabetes. Someone with type 2 diabetes might produce normal or even high levels of insulin, but obesity makes his or her body resistant to its effect.
- gestational diabetes mellitus, or pregnancy-induced diabetes. This type of diabetes develops in a pregnant woman who has never had diabetes before and usually goes away after the birth of the child.
- secondary diabetes, or diabetes mellitus caused by other medical conditions. This category includes diabetes caused by a genetic defect, pancreatic diseases, hormonal abnormalities, or exposure to certain drugs or chemicals.
An appropriate diet for a person with diabetes is based on a nutritional assessment, which is used to determine a nutrition prescription. The prescription:
An appropriate diet for a person with diabetes focuses on 5 overall goals:
- is based on treatment goals
- takes into account what the individual is able and willing to do
- is sensitive to cultural, ethnic, and financial factors
A diet plan for a person with type 1 diabetes is designed to coordinate insulin therapy with the person's usual eating and exercise patterns. Eating times are planned around the effects of the insulin injections. The person measures blood glucose levels on an ongoing basis and adjusts the dose and type of insulin accordingly.
- to maintain blood glucose levels as near to normal as possible
- to keep blood lipids (cholesterol, HDL or "good cholesterol," LDL or "bad cholesterol," triglycerides, and VLDL or "very low density lipoproteins") at optimal levels
- to provide adequate kilojoules for maintaining or reaching a reasonable weight for adults or normal growth and development in children and adolescents. The diet should also provide enough kilojoules for special events such as breast-feeding or recovery from illness .
- to prevent and treat complications of diabetes such as high blood pressure and heart disease
- to improve overall health through good nutrition
A diet plan for a person with type 2 diabetes focuses on keeping the person's blood sugar, blood lipids, and blood pressure as near to normal as possible. Since obesity is the major cause of type 2 diabetes, weight loss is often recommended. Weight loss in a person with type 2 diabetes be achieved through:
A diet plan for a pregnant woman with pre-existing diabetes or gestational diabetes should be based on a nutritional assessment. A dietician will help to develop and adjust a meal plan based on: Specific nutritional considerations for people with diabetes include guidelines for:
- a moderate restriction in kilojoules. Generally, this is a restriction of 1000 to 2000 kilojoules less than the average daily intake that is calculated from the person's food history.
- a meal plan that contains adequate nutrition and has reduced total fat, especially saturated fat
- an increase in physical activity, following exercise guidelines for a person with diabetes
- spacing meals, especially carbohydrates, throughout the day
For fat intake:
- protein. Depending on the person's kidney function, 10% to 20% of the person's daily kilojoules be derived from protein. The protein can be from both animal and vegetable sources.
- fat. Less than 10% of the person's daily kilojoules should be from saturated fats and less than 10% from unsaturated fats.
- monosaturated fats and carbohydrates, which should make up 60% to 70% of the total kilojoules. The breakdown between fats and carbohydrates is individualised. It is based on the person's goals for blood glucose and blood lipid levels, as well as weight.
- cholesterol. The person's intake of cholesterol should be watched carefully.
- fibre. The person should consume 20 to 35 grams of dietary fibre a day from both soluble and insoluble fibres, using a wide variety of food sources.
- sodium. Sodium should be limited to less than 2,400 mg/day for people with mild to moderate high blood pressure. For people with more significant high blood pressure or with diabetic nephropathy, less than 2,000 mg/day of sodium.
- alcohol. Men should consume no more than 4 drinks a day, and women no more than 2 drinks a day. One drink is equal to 285ml of beer, 100ml of table wine, or 30ml of distilled spirits. People with a history of alcohol abuse or women who are pregnant should avoid alcohol. Those individuals who have diabetes along with other medical conditions, such as pancreatitis, high triglycerides, or neuropathy, should restrict or avoid alcohol.
- vitamins and minerals. If a person with diabetes is able to eat a balanced diet with enough nutrients, there is usually no need for vitamin or mineral supplements. For people in special circumstances, some supplements may be recommended by the doctor.
Author: Kimberly Tessmer, RD, LD
- The percentage of kilojoules from fat should be based on identified blood lipid problems and treatment goals for glucose, lipids, and weight.
- People who are at a healthy weight and have normal blood lipid levels should limit fat intake to less than 30% of total kilojoules. Saturated fat should be less than 10% of total kilojoules.
- If the person is obese and wants to lose weight, dietary fat may be reduced.
- For the person who wants to lower blood triglycerides and VLDL cholesterol, a different approach can be tried. This approach involves a moderate increase in monosaturated fat, a more moderate carbohydrate intake, and less than 10% of the daily kilojoules from saturated fats. However, it is important that the increased fat does not increase weight in an obese person.
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 23/11/2004
Potential conflict of interest information for reviewers available on request