Diabetes mellitus ranks sixth among the leading causes of death in the U.S., according to Eleanor Whitney and Sharon Rolfes in "Understanding Nutrition." Persons with diabetes are also twice as likely to develop chronic diseases including heart disease and stroke. High blood glucose and lack of insulin or inefficient use of insulin characterize diabetes. Components of treatment include medication, nutritional therapy and physical activity.
Identification
Diabetes is a disorder of carbohydrate metabolism including altered glucose regulation and utilization. It usually results from insufficient or ineffective insulin. Type 1 diabetes usually occurs in those younger than 30. Type 1 was previously referred to as juvenile-onset or insulin-dependent diabetes. Type 2 diabetes usually occurs in persons older than 30 years old, and was previously known as non-insulin-dependent or adult-onset diabetes.
Medical Management
Medical management of diabetes includes making the diagnosis, then monitoring levels of blood glucose and glycated hemoglobin, a measure of blood glucose over the past 2 or 3 months. Your physician may also prescribe medication such as insulin, a hormone that enables your cells to metabolize and store glucose.
Other medications include sulfonylureas that stimulate cells in the pancreas to release more insulin, biguanides that suppress glucose production in the liver and lower insulin rsistance and alpha-glucosidase inhibitors that work in the small intestine to delay carbohydrate absorption. Your doctor will also determine the level of exercise you can do and will recommend and refer you to a dietitian for nutritional counseling.
Nutritional Management
The role of nutrition in diabetes is to help control your blood sugar by meal planning, carbohydrate counting and the use of exchange lists, according to MayoClinic.com. Nutritional management of Type 1 diabetes includes consistency of timing and amount of food eaten to synchronize the response to food intake with the action of injected insulin.
With Type 2 diabetes, nutritional management includes restriction of calories to promote moderate weight loss, spreading nutrient intake, especially carbohydrates, throughout the day, and nutrition education and self-management training to make healthful food choices.
Significance
Eat healthful meals and you can thrive with diabetes. A goal of treatment is to provide you with the tools to achieve the best possible glycemic control to prevent or delay the onset of complications, while minimizing hypoglycemia or low blood sugar and excessive weight gain. Successful interventions are ongoing throughout the life span.
Nutritional care is an important aspect of diabetes care that delays or prevents complications and saves millions of dollars in hospital costs, according to Kathleen Mahan and Sylvia Escott-Stump in "Krause's Food, Nutrition, & Diet Therapy."
Considerations
Diabetes sufferers, their family members and health care team members need to work together to set treatment goals that are realistic, individualized and achievable. Following meal planning principles can be challenging and requires lifestyle changes. Monitoring blood glucose levels is essential to measuring, evaluating and monitoring the success of the medical and nutritional treatments.
References
- "Understanding Nutrition, Ninth Edition"; Eleanor Noss Whitney and Sharon Rady Rolfes; (2002)
- MayoClinic.com: Diabetes diet: Create your healthy-eating plan
- "Krause's Food, Nutrition, & Diet Therapy, 10th Edition"; Mahan and Escott-Stump; (2000)
- American Diabetes Association: Type 2
- American Diabetes Association: Food & Fitness
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