Diabetes is a chronic disease in which the body is unable to produce enough insulin or cannot properly use the insulin it does produce. Insulin, a hormone produced by the pancreas, is released into the blood stream when the blood glucose level rises (after a meal). Insulin allows glucose to move into cells where it can be used for energy production. Glucose is a carbohydrate and is the body’s main fuel.
When the body is unable to produce enough insulin or use the insulin it does produce, cells cannot use glucose for the energy they need. When this happens the blood glucose level will become high.
Diabetes is divided into two main categories:
TYPE I DIABETES: little or no insulin is produced. Onset is generally in childhood.
TYPE II DIABETES: insulin is produced, but the body cannot use it properly. Onset is generally in adulthood.
Meal planning involves selecting the right foods to eat, eating the right number of calories, and scheduling meals properly. This is especially important for the patient who needs to lose weight. Since diabetes is directly related to how well the body uses food, meal planning is an important tool for all diabetes patients, both type I and type II.
Good meal planning enables the diabetic patient to do the following:
1. Better control the amount of glucose in the blood.
2. Improve the body’s ability to use insulin (the timing of meals and the amount of food eaten at each meal affect the way the body uses insulin).
3. Control weight by monitoring the number of calories consumed.
4. Feel better and improve overall health through more nutritious meals and eating habits.
The meal plan should help achieve the following three goals of nutritional management:
1. Improve blood glucose and lipid levels (triglyceride level and cholesterol level).
2. Achieve consistency in day to day food intake for those with type I diabetes, and weight management for those with type II diabetes.
3. Provide adequate nutrition for all stages of life and coexisting conditions.
TARGET NUTRITIONAL GOALS
CALORIES: Sufficient to achieve and maintain a reasonable weight.
CARBOHYDRATE: May be up to 55-60% of the total calories (carbohydrates provide 4 calories per gram of carbohydrate). Emphasis should be placed on unrefined carbohydrate sources (whole grains) with fiber. Modest amount of sucrose and other refined sugars may be acceptable contingent on metabolic control (blood sugar levels) and appropriate body weight.
PROTEIN: In most people, the usual intake of protein is double the amount normally necessary. The exact ideal percentage of total calories that should be derived from protein is unknown. The usual intake in protein is 12-20% of the total calories (protein provides 4 calories per gram of protein). The recommended dietary allowance is 0.8 grams of protein per kilogram of body weight. Excess protein intake can put a strain on the kidneys, and the long-standing diabetic kidney may already have some decreased function.
FAT: Ideally, less than 30% of the total calories should come from fat (fat supplies 9 calories per gram of fat). This may need to be individualized since 30% may be unachievable for some individuals.
CHOLESTEROL: Less than 300 mg per day.
SODIUM: Not to exceed 3000 mg per day.
ALCOHOL: Should only be recommended by your physician.
VITAMINS AND MINERALS: No evidence to suggest that diabetes alters the requirement of vitamins or minerals.