DIABETES MILLETUS

• Is a condition in which a person has a high blood sugar (glucose) level as a

result of the body either not producing enough insulin

• A healthy individual maintains blood glucose levels between 3.5 – 8 mmol/L

(63-144 mg/dL)

• Diabetes mellitus is a chronic disease that causes serious health

complications including renal (kidney) failure, heart disease, stroke, and
blindness.

Types of Diabetes

• Type 1 diabetes aka Juvenille Diabetes : results from the body's failure to
produce insulin, and presently requires the person to inject insulin. It is also
known as insulin-dependent diabetes mellitus (IDDM)

• Type 2 diabetes aka Adult type Diabetes : results from insulin resistance, a
condition in which cells fail to use insulin properly, sometimes combined with
an absolute insulin deficiency. It is also known as non insulin-dependent
diabetes mellitus (NIDDM).

• Gestational diabetes: is when pregnant women, who have never had

diabetes before, have a high blood glucose level during pregnancy.

Signs and Symptoms

• polyuria (frequent urination)

• polydipsia (increased thirst)

• polyphagia(increased hunger)

• Hyperglycemia (Blood sugar level rises)

Causes

• Lifestyle

• Genetics

- Both type 1 and type 2 diabetes are partly inherited.

• Obesity

- Excessive body weight is one of the predisposing factor of DM. Commonly

seen on 40 y.o suffering from Type 2 Non-Insulin dependent diabetes mellitus. Due
to extra amount of the fat in the body, the insulin does not function properly in the
body. Normally, the main function of insulin is to allow the sugar present in blood
enter to the muscle and tissue cells.

• Smoking
- If the diabetic patient does not stop smoking, there are chances of
premature mortality due to DM.

• Age
- Particularly about 45 of age, in them the chances to develop diabetes
are increased.

Diabetic Diet Plan And Food

• Eat lots of vegetables and fruits.

• Choose whole grain foods over processed grain products.

• Include dried beans (like kidney or pinto beans) and lentils into your diabetic
diet meal.

• Include fish in your meals 2-3 times a week.

• Choose lean meats like cuts of beef and pork that end in "loin" such as pork
loin and sirloin.

• Choose non-fat dairy such as skim milk, non-fat yogurt and non-fat cheese.

• Choose water and calorie-free "diet" drinks instead of regular sugar-

sweetened drinks.

• Choose liquid oils for cooking instead of solid fats that can be high in
saturated and trans fats.

• Eating too much of even healthful foods can lead to weight gain. Watch your
portion sizes.

• Cut back on high calorie foods like chips, cookies, cakes, and full-fat ice
cream in your diabetic meal.

• Choose Colors - Eat multicolored, not monochromatic, foods. Fruits,

vegetables, grains, low-fat dairy products and low-fat meats all offer different
nutrients. A diet that revolves around just a handful of foods won't provide
balanced nutrition.

• Focus on Fiber - Shoot for 30 grams of fiber daily in whole-grain products

and in high-fiber fruits and vegetables.

• Avoid Portion Distortion - It's not just what you eat but how much you eat
that counts. As a general rule, people who are sedentary may require about
10 calories per pound per day (so a 160-pound person would need to eat
roughly 1,600 calories). More active people may need a lot more calories.
 Your doctor and a nutritionist can help you determine the correct portion size
for every meal.

• Be A Horse, Not A Camel - Horses need food and water throughout the
day, but camels can go a long time without either. Our grandparents' habits
were more like a horse's, eating meals at regularly scheduled times. But
many of us now eat like camels: We skip breakfast, sometimes lunch, and
then hit it hard at dinner. Diabetics should eat regularly scheduled meals
throughout the day so they're not going without food for more than four to
five hours. By doing so, they improve their blood sugar control.

• Target Blood Glucose Levels For Diabetes Patients

• Before Meal

• 90 to 130 mg/dL

• 1-2 Hours After Meal

• less than 180 mg/dL

Why Change Eating Habits?

• To prevent complications of diabetes

– by keeping control of:

• Blood glucose

• Cholesterol

• Blood pressure

• To improve your health

– by making healthy food choices

– and being physically active

Carbohydrate and Diabetes

• Include foods containing carbohydrate from whole grains, fruits, vegetables

and low-fat milk in your diet

• The amount of carbohydrate at a meal affects your blood glucose more

than the type

– Sugar and starch have similar effects on blood glucose

• Consistency in carbohydrate intake is important from day to day

– For people not taking diabetes medication

 – For people taking a fixed dose of insulin

– Insulin should be adjusted based on amount of carbohydrate at meals

– For people on varying doses at meal times

• Several things affect how much your blood glucose increases after you eat:

– amount of carbohydrate

– type of sugar or starch

– cooking and food processing

– food form

– other foods in the meal that slow digestion

• Limited amounts of sugar or foods containing sugar can be used without

affecting blood glucose

– when substituted for other carbohydrates at the meal

– Large amounts of sugar-containing foods are not recommended

Substituting Sweets

Usual diet: 45 grams carbohydrate (or 3 Carbohydrates Choices)

1 slice bread

1/3 cup rice

1/2 cup fruit

3 ounces chicken

Vegetable salad

Substitute ice-cream for 15 grams of carbohydrate (or 1 Carbohydrate

Choice)

1/2 cup ice-cream

1/3 cup rice

1/2 cup fruit

3 ounces chicken

Vegetable salad
 To observe effect of new food on blood glucose:

• check blood glucose 2 hours after meal for several days

• substitute food containing sugar for other carbohydrate in meal

• check blood glucose 2 hours after meal and compare

Sweeteners and Diabetes

Sugar alcohols (polyols):

sorbitol, mannitol, xylitol

• Used as sweeteners and bulking agents

• Safe to use

• May cause diarrhea, especially in children

Fructose:

• Not recommended as a sweetener

Fiber:

• Fiber is encouraged for everyone:

20-35 grams/day

• Good sources of fiber:

– Whole grain cereals

– Fruits

– Vegetables

– Beans and peas

Fiber:

• Only large amounts (50 grams/day) have shown improvement in blood

glucose and cholesterol

– Primarily soluble fiber (barley, oatmeal, beans, apples, broccoli)

– Side effects make this difficult for many people

Protein and Diabetes

• Protein has very little effect on blood glucose

• Avoid large amounts of protein

– may promote kidney disease

• Restrict protein only if you have

early kidney disease

• Protein does not slow the absorption of carbohydrate

– Adding protein to snacks does not help prevent hypoglycemia

– Fruit or crackers are good snack foods

• Safety of high protein, low carbohydrate weight loss diets are unknown

– do not promote long-term weight loss

– may increase LDL cholesterol

Dietary Fat and Diabetes

• Primary goal - Lower LDL cholesterol by:

– Eating less saturated fat and cholesterol

– Eating less trans fats

Foods That Contain Saturated Fats:

• Meat and meat fats (bacon, lard)

• Dairy products (whole milk,

butter, cheese, cream, ice-cream)

• Palm and coconut oil

• Baked goods made from these fats

Foods That Contain Trans Fats:

• Formed when a liquid oil is made more solid

• Found in many types of stick margarine, fast foods, and baked goods like
cookies, crackers, snack foods, pastries and croissants

Foods That Contain Cholesterol:

• All animal foods

• Organ meats like liver

• Egg yolks Choose monounsaturated fat in place of saturated:

– olive oil, canola oil, peanut oil, olives, avocados, nuts

– Eat less total fat

– Low-fat diets can help:

• with weight loss

• improve cholesterol and other fats

– Eat 2-3 servings fish per week

• contain a type of fat protective against heart disease

• fatty fish especially beneficial

Weight Loss and Diabetes

A small amount of weight loss can:

• improve insulin resistance

• lower blood glucose

• improve blood cholesterol

• reduce blood pressure

Vitamins and Minerals and Diabetes

• Vitamins and minerals from foods important

• High doses of vitamin and mineral supplements can be toxic

People who may benefit from a multivitamin supplement:

• persons deficient in a vitamin or mineral

• elderly

• pregnant or nursing mothers

• strict vegetarians

• persons on calorie-restricted diet

• No clear benefit from vitamin and mineral supplements except

 • calcium for prevention of bone disease

• folate for prevention of birth defects

• Use of antioxidants is not advised

• vitamin C, E, selenium, beta carotene

• long-term safety and effectiveness unknown

Alcohol and Diabetes

• If you choose to drink, limit to:

– 1 drink/day for women

– 2 drinks/day for men

• To reduce risk of hypoglycemia, consume alcohol with food

High Blood Pressure and Diabetes

You can lower blood pressure by:

• Eating less salt

• Losing a modest amount of weight

Preventing Diabetes

Family members of people with Type 2 diabetes can prevent diabetes by:

• Weight loss if overweight

– using a structured weight loss

program

• Regular physical

activity
 Angeles City

Submitted by:
Shekinah Rosha F. Cantor
Jhean Klaudine V. Isip
Jake Dizon

Submitted to:
Mrs. Diana S. Dionicio R.N. MSN