Diabetic diet
From Wikipedia, the free encyclopedia
The diet most often recommended for people who suffer from
diabetes mellitus is high in dietary fiber, especially soluble fiber, but low in
fat (especially saturated fat). Patients may be encouraged to reduce their
intake of carbohydrates that have a high glycemic index. However, in cases of
hypoglycemia, they are advised to have food or drink that can raise blood
glucose quickly, followed by a long-acting carbohydrate (such as rye bread) to
prevent risk of further hypoglycemia.
Diabetes mellitus
Types of Diabetes
Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes
Pre-diabetes:
Impaired fasting glycaemia
Impaired glucose tolerance
Disease Management
Diabetes management:
•Diabetic diet
•Anti-diabetic drugs
•Conventional insulinotherapy
•Intensive insulinotherapy
Other Concerns
Cardiovascular disease
Diabetic comas:
•Diabetic hypoglycemia
•Diabetic ketoacidosis
•Nonketotic hyperosmolar
Diabetic myonecrosis
Diabetic nephropathy
Diabetic neuropathy
Diabetic retinopathy
Diabetes and pregnancy
Blood tests
Blood sugar
Fructosamine
Glucose tolerance test
Glycosylated hemoglobin
Contents
[hide]
* 1 Early history of diabetic diet
* 2 Exchange scheme
* 3 Carbohydrates
* 4 Low-carbohydrate alternatives
* 5 Vegan alternative
* 6 Timing of meals
* 7 Special diabetes products
* 8 Alcohol and drugs
* 9 See also
* 10 Further reading
* 11 References
Early history of diabetic diet
There has been long history of dietary treatment of diabetes mellitus - as
Ramachandran & Viswanathan (1998) note, dietary treatment of diabetes mellitus
was used in Egypt as long ago as 3,500 B.C., and was used in India by Susrate
and Charaka some 2,500 years ago. In the eighteenth century, these authors note,
John Rollo argued that calorie restriction in the diabetic diet could reduce
glycosuria in diabetes. However, more modern history of the diabetic diet may
begin with Frederick Madison Allen, who, in the days before insulin was
discovered, recommended that people with diabetes ate only a low-calorie diet to
prevent ketoacidosis from killing them. This was an approach which did not
actually cure diabetes, it merely extended life by a limited period. The first
use of insulin by Frederick Banting in 1922 changed all that, and at last
allowed patients more flexibility in their eating.
Exchange scheme
In the 1950s, the American Diabetes Association, in conjunction with the U.S.
Public Health Service, brought forth the "exchange scheme". This was a scheme
that allowed people to swap foods of similar nutritional value (e.g.
carbohydrate) for another, so, for example, if wishing to have more than normal
carbohydrates for pudding, one could cut back on potatoes in one's first course.
The exchange scheme was revised in 1976, 1986 and 1995 (Chalmers & Peterson,
1999, p85). However, not all diabetes dietitians today recommend the exchange
scheme. Instead, they are likely to recommend a typical healthy diet: one high
in fiber, with a variety of fruit and vegetables, and low in both sugar and fat,
especially saturated fat. A diet that is high in plant fibre was recommended by
James Anderson (Anderson & Ward, 1979; cited in Murray & Pizzorno, 1990). This
may be understood as continuation of the work of Burkitt and Trowell on dietary
fibre, which in turn, may be understood as a continuation of the work of Price
(Murray & Pizzorno, 1990). Murray and Pizzorno discusses the high-carbohydrate,
high-plant fibre diet (HCF diet) in connection with diabetes (Murray & Pizzorno,
1990, pp277ff.).
Carbohydrates
The American Diabetes Association in 1994 recommended that 60-70% of caloric
intake should be in the form of carbohydrates. This is somewhat controversial,
with some researchers claiming that 40% is better,[1] while others claim
benefits for a high-fiber, 75% carbohydrate diet.[2]
An article summarizing the view of the American Diabetes Association[3] contains
the statement "Sucrose-containing foods can be substituted for other
carbohydrates in the meal plan or, if added to the meal plan, covered with
insulin or other glucose-lowering medications. Care should be taken to avoid
excess energy intake." Sucrose does not increase glycemia more than the same
number of calories taken as starch. Although it is not recommended to use
fructose as a sweetener, fruit should not be avoided because of its fructose
content. Benefits may be obtained by consumption of dietary fibre in conjunction
with carbohydrate; as Francis (1987) points out, evidence suggests that
carbohydrate consumed with dietary fibre will have a less major impact on
glycemic rise than the same amount of carbohydrate consumed alone.
Low-carbohydrate alternatives
Some studies show low carbohydrate diets may be effective in dietary management
of type 2 diabetes. [4][5]
Dr. Richard K. Bernstein has a diet plan that is substantially different from
the plan recommended here and he is harshly critical of the standard ADA diet
plan for diabetics. His plan includes very limited carbohydrate intake (30 grams
per day) along with frequent blood glucose monitoring, and regular strenuous
muscle-building exercise, and for diabetics using insulin, frequent small
insulin injections if needed. His treatment target is "near normal blood sugars"
all the time.[6]
Vegan alternative
Recent studies have shown that a vegan diet may also be effective in managing
type 2 diabetes.[7][8]
Timing of meals
For people with diabetes, healthy eating is not simply a matter of "what one
eats", but also when one eats. The question of how long before a meal one should
inject insulin is asked in Sonsken, Fox and Judd (1998). The answer is that it
depends upon the type of insulin one takes and whether it is long, medium or
quick-acting insulin. If patients check their blood glucose at bedtime and find
that it is low, it is advisable that they take some long-acting carbohydrate
before retiring to bed to prevent night-time hypoglycemia.
Special diabetes products
Recently, Diabetes UK have warned against purchase of products that are
specially made for people with diabetes, on the grounds that:[9]
* They may be expensive,
* They may contain high levels of fat
* They may confer no special benefits to people who suffer from diabetes.
Alcohol and drugs
It is recommended that alcohol and some other drugs are used in moderation.
Alcohol inhibits the glycogenesis in the liver and some drugs inhibit hunger
symptoms. This, together with impaired judgment, memory and concentration caused
by some drugs can lead to hypoglycemia.
See also
* Diabetes management
* Food guide pyramid
* Glycemic index
Further reading
Francis, D. (1987) Diets for Sick Children (Oxford: Blackwell) has chapter on
diet and diabetes (Chapter 5, pp128-144). More in dietary recommendations for
diabetics can also be found in Ireland, J.T., Thomson, W.S.T. & WIlliamson, J.
(1980). Diabetes Today: A Handbook for the Clinical Team. (Chapter 9, pp112-120,
is the chapter on diet).
References
1. ^ Garg, Abhimanyu; et al. (11 May 1994). "Effects of varying carbohydrate
content of diet in patients with non-insulin-dependent diabetes mellitus". JAMA
271 (18): 1421–8. doi:10.1001/jama.271.18.1421. PMID 7848401.
http://www.ncbi.nlm.nih.gov.ezp1.harvard.edu/entrez/query.fcgi?holding=hulib&db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=7848401&query_hl=2&itool=pubmed_docsum.
2. ^ Kiehm, Tae; et al. (August 1976). "Beneficial effects of a high
carbohydrate, high fiber diet on hyperglycemic diabetic men" (abstract page). Am
J Clin Nutr 29: 895–99. PMID 941870. http://www.ajcn.org/cgi/content/abstract/29/8/895.
3. ^ American Diabetes Association (2006). "Nutrition Recommendations and
Interventions for Diabetes–2006". Diabetes Care 29: 2140–57.
doi:10.2337/dc06-9914. PMID 16936169. http://care.diabetesjournals.org/cgi/content/full/29/9/2140?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=29&firstpage=2140&resourcetype=HWCIT.
4. ^ Nielsen JV, Joensson E (2006). "Low-carbohydrate diet in type 2 diabetes.
Stable improvement of bodyweight and glycemic control during 22 months
follow-up". Nutrition & metabolism 3: 22. doi:10.1186/1743-7075-3-22. PMID
16774674. http://www.nutritionandmetabolism.com/content/3/1/22.
5. ^ "Original Human 'Stone Age' Diet Is Good For People With Diabetes, Study
Finds", ScienceDaily.com (2007-06-28). Retrieved on 24 July 2007.
6. ^ Bernstein, Richard K (2007) (in English). Dr Bernstein's Diabetes Solution.
New York, NY: Little, Brown and Company. ISBN 978-0-316-16716-1. http://www.diabetes-book.com/readit.shtml.
7. ^ Nicholson A (02/15/05). "Diabetes: Can a Vegan Diet Reverse Diabetes?".
Physicians Committee for Responsible Medicine. Retrieved on 2007-07-24.
8. ^ Barnard ND, Cohen J, Jenkins DJ, et al (2006). "A low-fat vegan diet
improves glycemic control and cardiovascular risk factors in a randomized
clinical trial in individuals with type 2 diabetes". Diabetes Care 29 (8):
1777–83. doi:10.2337/dc06-0606. PMID 16873779. http://care.diabetesjournals.org/cgi/content/full/29/8/1777.
Related news articles:
* "Low-fat vegan diet treats type 2 diabetes more effectively than a standard
diabetes diet", News-Medical.Net (8-Aug-2006). Retrieved on 24 July 2007.
9. ^ "Diabetic foods -- Joint statement on ‘diabetic foods’ from the Food
Standards Agency and Diabetes UK". Positional statements. Diabetes UK (July
2002). Retrieved on 2006-10-22.
* Bowling, S. (1995). Everyday Diabetic Cookbook. Grub Street. ISBN 1898697256.
- Published in conjunction with the British Diabetic Association.
* Chalmers, K. & Peterson, A. (1999). Sixteen Myths of a Diabetic Diet. American
Diabetes Association. ISBN 1-58040-031-0.
* British Diabetic Association. Festive Foods and Easy Entertaining. British
Diabetic Association. ISBN 1-899288-70-8.
* Govindi, A. & Myers, J. (1995). Recipes for Health: Diabetes. Low fat, low
sugar, carbohydrate counted recipes for the management of diabetes.. London:
Thorsons/Harper Collins. ISBN 0-7225-3139-7.
* Murray, M. & Pizzorno, J. (1990). Encyclopaedia of Natural Medicine. London:
Littlebrown and Company. ISBN 1-85605-498-5
* Ramachandran, A. & Viswanathan, M. (1998). Dietary management of diabetes
mellitus in India and South Asia. In K.G.M.M. Alberti, R.A. DeFronzo & P. Zimmet
(eds.). International textbook of diabetes mellitus. pp773-777. Chichester :
Wiley, 1997.
* Diabetes at Your Fingertips (Fourth Edition ed.). London: Class Publishing.
1998. ISBN 1-872362-79-6.
* This page was last modified on 8 January 2009, at 02:57.
* All text is available under the terms of the GNU Free Documentation License.
(See Copyrights for details.