BCom 1st Year Diet in Diabetes Notes Study Material
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BCom 1st Year Diet in Diabetes Notes Study Material
Diabetes is not only a major problem in India, but its patients are in many other countries of the world. Presently the number of diabetic patients is increasing day by day.
Diabetes mellitus (also known simply as diabetes) is a metabolic disorder whereby the body cannot utilise blood sugar in the proper way owing to lack of insulin or the body’s inability to use it effectively. This leads to an increase in the blood sugar level causing symptoms such as extreme thirst, passing large amounts of urine, tiredness and weight loss.
In the long term, uncontrolled diabetes can lead to damage of various organs such as the eyes, kidneys and nervous system. It can also increase the risk of developing heart disease and stroke.
Glucose, the form of sugar found in your blood, is one of your main energy sources. A lack of insulin or resistance to insulin causes sugar to build up in your blood. This can lead to many health problems.
Definition of diabetes—“A disease caused by a deficiency or defect in the production of insulin hormone in the body is called diabetes.”
Insulin hormone is secreted by the pancreas of a man. Glucose produced is transported to the liver where it is converted into glycogen.
CAUSES OF DIABETES
- Hereditary-If the parents or any other family members are suffering from this diabetes disease, then the chances of getting this disease in their children also increase and the children become carriers of this disease. So this disease is passed from one generation to another. It is transmitted through generations. If a person gets diabetes before the age of 40, then it is due to hereditary. (BCom 1st Year Diet in Diabetes Notes Study Material)
- Age-Diabetes can occur at any time in a person of any age. Even in infancy, diabetes can occur, but then the disease is temporary, which gets cured after a few days. The chances of getting diabetes increases to a great extent in the age group of 40-50 years.
- Obesity-Diabetes is more common in obese people. In adulthood, especially at the age of 35-40 years, the tendency to store fat in the body increases very much. The physical activity of obese people is also less. As a result, the metabolism of carbs is not done properly, because the proportion in which the food items containing carbs are consumed, insulin is not secreted in that ratio, due to this the disease of diabetes occurs.
- Sex-Although this disease occurs in both women and men, but men are more likely to get this disease than women.
- Mental stress-Due to mental stress, anger, excitement, worry, fear, etc., a person does not take food on time, which gives rise to irregularities. Therefore, carbohydrate metabolism is affected and diabetes occurs.
TYPES OF DIABETES
The three main types of diabetes are:
- Type 1 diabetes
- Type 2 diabetes
- Gestational diabetes
Type 1 diabetes
Type 1 diabetes is believed to be an autoimmune condition. This means your immune system mistakenly attacks and destroys the beta cells in your pancreas that produce insulin. The damage is permanent.
What prompts the attacks isn’t clear. There may be both genetic and environmental reasons. Lifestyle factors aren’t thought to play a role.
Type 2 diabetes
Type 2 diabetes starts as insulin resistance. This means your body can’t use insulin efficiently. That stimulates your pancreas to produce more insulin until it can no longer keep up with demand. Insulin production decreases, which leads to high blood sugar.
The exact cause of type 2 diabetes is unknown. Contributing factors may include:
- Lack of exercise
- Being overweight
There may also be other health factors and environmental reasons.
Gestational diabetes is due to insulin-blocking hormones produced during pregnancy. This type of diabetes only occurs during pregnancy. (BCom 1st Year Diet in Diabetes Notes Study Material)
SYMPTOMS OF DIABETES
The following symptoms are seen in the condition of diabetes:
- Polyurea-Frequent urination has to be done. In this condition excessive amount of urine starts passing. Glucose is also excreted with urine.
- Polyphagia-The patient feels more hungry because carbs are not fully metabolized. Glucose cannot be oxidized in cells and tissues. Therefore, glucose is excreted from the body along with urine without being used. Cells and tissues require energy to perform various activities therefore, the patient feels hungry soon.
- Polydipsia—The patient feels thirst more and more frequently. Frequent urination leads to loss of fluid (water) in the body. Water is needed to maintain the water balance in the body. Hence the patient feels thirsty.
- Dehydration- In the case of acute diabetes, a state of dehydration arises in the body, because a lot of water gets lost in the body due to urine excretion, so the water balance in the body gets disturbed, which creates a condition of dehydration.
- Fatigue-In the condition of diabetes, the patient experiences more fatigue.
- The patient becomes handicapped and weak and his/her weight is reduced.
- Lack of Immunity Power-There is a lack of ability to fight infections diseases in diabetic patients. The patient has fever, tuberculosis, jaundice etc.
- Late Healing of Wound—In diabetic patients, the wound heals late because the ability of white blood cells (W.B.C.) to fight decreases. The main reason for this is the high amount of glucose in the blood.
- Swelling (Edema)—Sometimes swelling also occurs in the condition of diabetes.
- Retinitis-Diabetes also affects the health and vision of the eyes Bleeding occurs from the blood cells present in the eyes.
It increases the chances of blindness and sometimes the vision becomes blurred.
Treatment—There is no permanent cure for diabetes, but it can be kept in control to some extent. If a person has diabetes due to obesity, then it is very important to control the weight. Diabetes can be controlled by making changes in diet and making other necessary changes. Diabetes can be treated as follows:
- Insulin injection
- Food and Exercise.
TREATMENT BY DIET
- Diet-Diabetes can be controlled by diet. While treating diabetes with diet, care should be taken that the energy obtained from diet should be 5% less than the total physical energy demand of the patient. Also, the prescribed quantity of food items should be used only after weighing it. (BCom 1st Year Diet in Diabetes Notes Study Material)
- Calorie—According to the patient’s height, age and body weight, the calories should be given 5% less than the proposed energy demand, that is, 5% of the energy is given less than the ideal weight.
If the diabetic patient has a normal weight and ketone bodies are not present in the urine test, then the amount of carbs in their diet should be reduced, i.e. 5% less energy is given as per ideal weight. The proportion of carbs, fat and protein in the diet depends on the type of diabetes. (BCom 1st Year Diet in Diabetes Notes Study Material)
Diet planning of obese diabetic patients should be as follows:
- Low Calorie-Even after giving a low calorie diet, there is no need to change the diet even if the disease is not improving and glucose comes in the urine. Therefore, one should not lose patience in such a situation. After a few days, the weight starts decreasing and the glucose also stops coming from the urine.
- Protein—The amount of protein should be increased because in the case of diabetes, there is a negative nitrogen balance so diabetic patients need twice the amount of protein than normal people.
- Carbohydrate-Control of calories is necessary to prevent ketosis and ketonuria in the blood. In a normal weight person, 40% of the calories should be obtained from carbs. For obese people, up to 60% of calories should be obtained from the amount of carbs and by reducing the amount of fat. Body fat is also oxidized in obese individuals. If the amount of carbs is increased by more than 40% in a normal weight person, then the patient’s condition can become serious.
- Vitamins and Minerals—A multi-vitamin tablet should be given to replenish the vitamins. Green leafy vegetables and low-sugar fruits should be used for the replenishment of mineral salts.
DIET PLANNING IN DIABETES
(1) Roti of mixed flour benefits in diabetes.
(2) Sweets should be considered completely forbidden.
(3) All these fruits which are high in carbs are prohibited; such as banana, grapes, amla, lemon, orange, melon, berries, papaya, pear, guava etc. All those fruits can be used in which up to 15% carbs are present.
(4) Sugar, jaggery, honey, biscuits should not be given.
(5) Tea should be given without sugar.
(6) There should be variety in food.
(7) The amount of calories should be given according to the activity of the patient.
(8) Onion, garlic and other foods should be included in the diet, because they reduce the amount of glucose and cholesterol in the blood.
(9) There should be an abundance of milk, eggs, meat, fish and milk products in the food.
Dr. H. B. Chandolia of Jaslok Hospital, Mumbai emphasizes that it is also necessary to focus on exercise for the treatment of diabetes. Diet and exercise should be given more attention than medicines. Carbohydrates accumulated in the body are used up while exercising. Patients should be brisk walking in the morning and evening. Playing badminton, swimming etc. is the best exercise.
Diabetic patient should be given this daily:
(1) 70 grams of protein,
(2) 256 grams of carbs and 62 grams of fat.
On this basis, the diet table of a day for a diabetic patient has been prepared as follows.
Diabetes Education: Cornerstone of Diabetes Management
Unlike other disease conditions (such as high blood pressure or high cholesterol levels) where medication alone can often time successfully treat it; here there are lots of other components to diabetes. Diabetes require day-to-day knowledge of nutrition, exercise, medication, glucose monitoring, psychosocial adjustment etc. Diabetes education therefore becomes important.
Diabetes education means empowering people with diabetes with knowledge and providing tools crucial for making them active partners in the diabetes management team. (BCom 1st Year Diet in Diabetes Notes Study Material)
People with diabetes need to be educated regarding:
- The nature of disease, the possibility of development of short term and long term complications, if the condition is not managed appropriately.
- Self-monitoring skills
- Appropriate self-care skills
- Appropriate resources
- Positive attitude
In addition to the list provided in Table some do’s and don’ts and basic tips are presented in Table. Make a note of these.