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t.Essentuki

THE DIABETIC DIET.

Abstract on English by Kuranov Alina Olegovna – a student of Essentuki
medical college group № 261.

2002г.

DIABETES.

Diabetes Mellitus (when the term diabetes is used alone, it always
refers to diabetes mellitus) is a condition in which the body is unable
to use sugar properly. Sugar (carbohydrate) is the substance our body
uses as its major source of energy. Once this sugar is absorbed in the
blood, it is referred to as blood sugar or blood glucose.   Insulin (a
hormone made in the pancreas that regulates the blood sugar) is either
missing or deficient. As a result, the body cannot use energy nutrients
(carbohydrates, fat, protein) effectively and the cells of the body
"starve". The sugar in the blood may rise to high levels instead of
being used for energy.  Blood sugar is excreted through urine, which
makes extra work for the kidneys causing frequent urination and
excessive thirst.

Treatment

Diet, exercise and medication are important factors that must be
coordinated for diabetes to be kept in control. Medication is not used
to treat all cases of diabetes. Medication when used can either be in
the form of a pill (oral hypoglycemic agents) or insulin, which must be
injected. Diet, exercise and medication all affect treatment but unless
the diet plan is followed carefully no method of treatment will be
effective. By eating the right foods in the right amounts diet can
actually help control the basic problem of diabetes.

According to Control Your Diabetes Education Program for Life, a program
sponsored by the National Diabetes Education Program, people who take
control of diabetes will, in the short run, feel better, have more
energy, and prevent the following signs and symptoms of high blood
sugar: thirst, fatigue, frequent urination, weight loss, blurred vision,
and slow healing of cuts and bruises.  In the long run, they decrease
their chances of developing eye disease, kidney disease, and nerve
damage, and add years to their lives.

THE DIABETIC DIET.

Purpose: The diabetic diet is designed to achieve and maintain desirable
body weight and near normal blood glucose levels, reduce hyperglycemia,
glycosuria, and associated symptoms of diabetes in order to minimize the
complications frequently associated with this disease.

Use: It is used for the person with either insulin-dependent diabetes
mellitus or non-insulin-dependent diabetes mellitus. The
calorie-controlled diet may be adapted for weight reduction and weight
maintenance.

The calorie level prescribed for the diabetic is based on whether the
person needs to lose or gain weight or simply maintain the present
weight. The calorie level specified is determined from the height, body
build, ideal weight and physical activity level.

General Guidelines for the Diabetic Diet.

Avoid HYPERLINK
"http://www.dietsite.com/dt/Diets/Diabetes/DiabeticDiets/No%20Concentrat
ed%20Sweet%20Food%20List.htm" concentrated sources of carbohydrates
(sugars) such as table sugar, honey, jelly, jam, molasses, syrup, corn

as table sugar, honey, jelly, jam, molasses, syrup, corn
syrup, candy, regular soft drinks, pies, doughnuts, cookies, pastries,
regular chewing gum, and sweet pickles.

Avoid sweetened fruits, juices and fruit drinks. Choose fruit, which is
fresh, frozen or packed in water or its own juice. Avoid fruits canned
in heavy syrup.

Avoid sweetened carbonated sodas, juices and water.

Learn foods both high and low in sugar that are presented in the
HYPERLINK
"http://www.dietsite.com/dt/Diets/Diabetes/DiabeticDiets/No%20Concentrat
ed%20Sweet%20Food%20List.htm" No Concentrated Sweet Food List

Three meals at regular times should be consumed daily. Do not skip
meals.

A nutritionally adequate meal plan that limits the amount of HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/Low%20Fat%20&%20Salt%20Di
et.htm" saturated fat, cholesterol and salt in the diet. Fat intake
should be 30% or less of caloric intake and less than 10% of daily
caloric intake from saturated fat. Dietary cholesterol should be limited
to 300 mg or less daily. 2,400 mg or less per day of sodium is
recommended.

Daily consumption of 20-35 g of HYPERLINK
"http://www.dietsite.com/dt/Diets/EatingWell/Fiber/High%20Fiber%20Diet.h
tm" dietary fiber from a wide variety of foods is recommended.

Mild to HYPERLINK
"http://www.dietsite.com/dt/Diets/WeightManagement/Weight%20Loss%20Manag
ement.htm" moderate weight loss (10-20 pounds. has been shown to
improve diabetes control, even if desirable body weight is not
achieved.)

Read the HYPERLINK
"http://www.dietsite.com/dt/NutritionFacts/FoodLabels/Terms/SugarLabelin
g.html" label to determine the sugar content of packaged foods. In
addition to sugar, brown sugar and corn syrup, other names that are used
on ingredient labels include: sucrose, glucose, dextrose, fructose,
maltose, lactose, sorbitol, mannitol, honey, corn syrup, corn syrup
solids, high fructose corn syrup, molasses, maple syrup.

Monitoring of lipids, blood pressure and body weight is crucial.

Glycated hemoglobin (HbA1C) and daily monitoring of blood glucose are
standard tools to measure glucose control.

For individuals with Type 1 diabetes, self-monitoring 4 times daily or
more is recommended to maintain near-normal blood glucose levels and
gain control.  Testing 4 times a day, before each meal, and at bedtime,
facilitates adjustments to insulin, meals, and exercise program. 

For individuals with Type 2 diabetes, self-monitoring 1-2 times daily or
more is recommended to avoid hypoglycemia and hyperglycemia symptoms.   


Newly diagnosed individuals should test blood glucose 4 times a day,
before each meal, and at bedtime, or more is recommended to maintain
near-normal blood glucose levels and gain control.  Testing  
facilitates adjustments to insulin, meals, and exercise program. 

After a stable pattern has been established in blood glucose levels,
individuals should test before breakfast, 3-7 times each week.  Once or
twice each month you should return to testing 4 times a day (before each

u should return to testing 4 times a day (before each
meal, and at bedtime) to assure maintenance of a stable pattern.

NO CONCENTRATED SWEETS, LOW FAT DIET.

(LOW SUGAR-LOW FAT)

Purpose: The no concentrated sweets, low fat diet is designed to limit
the total amount of fat and sugar in the diet to reduce serum lipid
levels and to achieve and maintain near normal blood glucose levels.
This diet is for people who find the exchange system too confusing or
restricting to follow.

Use: It is used for the person with either non-insulin-dependent
diabetes mellitus or for people who need or want to cut down on their
sugar and fat intake. The HYPERLINK
"http://www.dietsite.com/dt/Diets/WeightManagement/Calorie%20Controlled%
20Diet.htm" \t "_self" calorie-controlled diet may be adapted for
weight reduction and weight maintenance for individuals that do not have
diabetes. It is also used for persons with elevated serum cholesterol
levels or those who are high-risk candidates for heart disease.

General Guidelines.

Limit total fat intake to less than 30% of total daily calories.

Reduce HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/Tips%20To%20Lower%20Fat%2
0Intake.htm" saturated fat intake (red meat, cheese, whole milk,
butter, ice cream, etc.)

Eat less HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/FatDictionary/Trans%20Fat
s.htm" trans fat (stick margarine, shortening, cakes, pies, French
fries, snack chips.)

Eat less HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/FatDictionary/Dietary%20C
holesterol.htm" cholesterol (limit egg yolks to more than 4 per week
and meat, fish, poultry to no more than 6 ounces a day)

Reduce sugar intake.

Eat more fruits, vegetables, beans, whole grain breads, and cereals.

Maintain a healthy weight.

Exercise at least 30 minutes on most days (brisk walking, aerobics,
biking, etc.)

Experiment with recipes by gradually reducing the amount of sugar by
1/4th then l/3rd then 1/2.

Use the "sweet" spices—cinnamon cloves ginger or nutmeg—to bring out
sweetness in baked goods.

Be careful when using special diet or dietetic foods such as dietetic
cake, cookies, candy and ice cream. These foods contain some form of
sweetener and, therefore, calories.

NO CONCENTRATED SWEET FOOD LIST.

Purpose: The no concentrated sweets diet is designed to achieve and
maintain near normal blood glucose levels, and reduce associated
symptoms of diabetes in order to minimize the complications frequently
associated with this disease. This diet is for people who find the
exchange system too confusing or restricting to follow.

Use: It is used for the person with either non-insulin-dependent
diabetes mellitus or for people who need or want to cut down on their
sugar intake. It is not intended for the person with diabetes taking
insulin. The HYPERLINK
"http://www.dietsite.com/dt/Diets/WeightManagement/Calorie%20Controlled%
20Diet.htm" \t "_self" calorie-controlled diet may be adapted for


weight reduction and weight maintenance.

Eat three meals at regular times. Do not skip meals.

HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/Tips%20To%20Lower%20Fat%2
0Intake.htm" \t "_self" Limit total fat intake to less than 30% of
total daily calories.

Reduce HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/FatDictionary/Saturated%2
0Fats.htm" \t "_self" saturated fat intake (red meat, cheese, whole
milk, butter, ice cream, etc.)

Eat less HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/FatDictionary/Trans%20Fat
s.htm" \t "_self" trans fat (stick margarine, shortening, cakes, pies,
french fries, snack chips.)

Eat less HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/FatDictionary/Dietary%20C
holesterol.htm" \t "_self" cholesterol (limit egg yolks to more than 4
per week and meat, fish, poultry to no more than 6 ounces a day.)

HYPERLINK
"http://www.dietsite.com/dt/Diets/HeartHealthy/Low%20Salt%20Diet.htm" \t
"_self" Reduce salt intake (canned and dried soups, fast food, frozen
dinners, pizza, processed meats and cheese.)

Eat more fruits, vegetables, beans, whole grain breads, and cereals.

Maintain a healthy weight. Mild to moderate weight loss (10-20 lbs. has
been shown to improve diabetes control, even if desirable body weight is
not achieved.)

Recommend 20-35 grams/day of HYPERLINK
"http://www.dietsite.com/dt/Diets/EatingWell/Fiber/Dietary%20Fiber.htm"
\t "_self" dietary fiber from a wide variety of foods.

Be careful when using special diet or dietetic foods such as dietetic
cake, cookies, candy and ice cream. These foods contain some form of
sweetener and, therefore, calories.

Monitor blood glucose, glycated hemoglobin, lipids, blood pressure and
body weight.

Exercise at least 30 minutes on most days (brisk walking, aerobics,
biking, etc). Regular exercise improves control of blood sugar and is an
important part of any healthy lifestyle.

Experiment with recipes by gradually reducing the amount of sugar by
1/4th then l/3rd then 1/2.

Use the "sweet" spices—cinnamon cloves ginger or nutmeg—to bring out
sweetness in baked goods.

HYPERLINK
"http://www.dietsite.com/dt/NutritionFacts/FoodLabels/Terms/SugarLabelin
g.html" \t "_self" Read the label to determine the sugar content of
packaged foods. In addition to sugar, brown sugar and corn syrup, other
names that are used on ingredient labels include: sucrose, glucose,
dextrose, fructose, maltose, modified food starch, natural sweeteners,
lactose, sorbitol, mannitol, honey, corn syrup, corn syrup solids, high
fructose corn syrup, molasses, maple syrup.

ABOUT THE MAJOR NUTRIENTS IN THE DIABETIC DIET.

CARBOHYDRATES are made up of simple sugars, complex carbohydrates, and
fiber. Simple carbohydrates are commonly known as sugars, sources of
simple carbohydrates include table sugar, candies and other sweets,
sodas and bakery goods. The sugar in these foods is in a form that is
absorbed easily by the body, as opposed to the slower-digesting complex

posed to the slower-digesting complex
carbohydrates.

Complex carbohydrates include all the complex starches and fiber, such
as those found in grains, cereals, breads and starchy vegetables like
potatoes, corn, peas and beans. Milk, fruit and vegetables also
contribute significant amounts of carbohydrate in the diet.

100% of the carbohydrates eaten are broken down into glucose. Therefore
carbohydrates elevate the blood sugar at a faster rate than either
protein or fat so only measured amounts should be consumed. Complex
carbohydrates contain many essential nutrients and are the body's most
effective source of energy.

PROTEIN provides amino acids for your body to build, maintain, and
repair cells and muscle tissue, heal wounds, and support the immune
system. It is very easy to get protein in our diet, in fact, most
Americans consume 2-3 times more protein than necessary. Excess protein
does not create muscle, as many hope, but is stored as fat. Excess
protein can put strain on the liver and kidneys. The best protein
sources are milk, yogurt, cheese, lean meat, poultry, fish, beans, eggs,
and nuts. Breads, cereals and vegetables contribute small amounts of
protein in the diet. About 60% of the protein eaten are broken down into
glucose.

Nutritionists recommend about 45 to 50 grams of protein a day for most
women and 50 to 60 grams a day for most men or 10 percent to 20 percent
of daily calories. Children and infants, who are growing rapidly, need
more protein, as do pregnant women.

FAT, like carbohydrates, are used by the body for fuel and are essential
for the absorption of certain vitamins. Although some fat in the diet is
necessary, too much fat can lead to heart disease, obesity and other
health problems. Fats should comprise no more than 30 % of daily
calories, or even lower.

The remainder is stored as fat for future use


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