Nutrition For Patients With Diabetes Mellitus

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a source of ready fuel for body cells

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glucose

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cells of the brain and rest of nervous system rely solely on

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glucose for energy

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fasting blood glucose equal or above 126 indicate

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diabetes

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is a group of metabolic diseases characterized by hyperglycemia related inadequate insulin secretions, diminished insulin effectiveness or both

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diabetes mellitus

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this type of diabetes individual - cannot prevent, make no insulin need an outside source and most often detect at a young age

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type 1 diabetes

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it occurs from autoimmune response that damages or destroys pancreatic beta cells, leaving them unable to produce insulin

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type 1 diabetes

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classic symptoms of this type of diabetes polyuria (excessive urine), polydipsia (excessive thirst) and polyphagia (excessive appetite)

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type 1 diabetes

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what is the first sign of type 1 diabetes

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ketoacidosis (DKA)
burning a lot fat, hyperventilate (get rid of extra co2 in system)

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this type of diabetes occur at any age, account of 90-95% of dx cases of diabetes, non-insulin diabetes or adult-onset (this is preventable)

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type 2 diabetes

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decreased cellular response to insulin

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insulin resistance

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2 hour values in the oral glucose tolerance test of 140 to 199 mg/dl

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impaired glucose tolerance

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fasting plasma glucose level 100 to 125 mg/dl

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impaired fasting glucose

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fasting plasma glucose of 100 to 126 mg/dl or oral glucose tolerance test of 140 to 199 mg/dl

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prediabetes

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elevated blood levels of insulin

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hyperinsulinemia

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over 45, race, family hx, physical activity, giving birth to over 9lbs baby, previously id, HDL under 35 or trig over 250, nigricans

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risk factor for type 2 diabetes

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risk factor factors can be all put together as

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metabolic syndrome

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people with metabolic syndrome are ? as likely to develop diabetes

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5X and risk of heart disease doubled

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most effective tool in preventing or delaying type 2 diabetes

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modest weight loss, moderate physical activity and healthy diet

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is hyperglycemia that develops during pregnancy usually around 24th week of gestation

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Gestational diabetes mellitus (GDM)

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women at average risk of GDM should be tested at

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24 to 28 weeks of gestation

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long term complications of diabetes to small vessel (micorvascular) can lead to

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retinopathy, nephropathy and neuropathy (dialysis)

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long term complications of diabetes to large blood vessel (macrovascular) can increase the risk of

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cardiovascular disease and stroke

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alcohol counterpart of glucose - exerts osmotic pressure

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sorbitol

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compounds containing glucose or glucose fragments and proteins - high glucose levels can promote their formation

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glycoproteins

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state in which the production of oxidants - free radicals exceeds the body's ability to neutralize damaging effects

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oxidative stress

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type 1 and 2 diabetes - nutrition therapy, physical activity and blood glucose monitoring are all components of

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diabetes management - goal to monitor glucose

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preventing type 2 diabetes best resulted in - b/c type 2 link between excess weight and insulin resistance

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weight loss, combination of healthy eating and exercise

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whole grains correlate to improved

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insulin sensitivity regardless of body weight

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has been associated with improved insulin sensitivity and improved ability to secrete insulin to overcome insulin resistance

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fiber

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normal BMI

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18.5 to 24.9

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BMI 25.0 to 29.9 consider

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overweight

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BMI 30.0 begin

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obese

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over 40.0 BMI considered

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extreme obesity

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bariatric surgery reserved for people with

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BMI equal or over 35

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fruit, veggie, whole grain, legumes and low fat milk

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good carbs

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the incremental rise in blood glucose (above baseline) compared to that induced by a standard usually 50 g of glucose or a white bread challenge

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glycemic index

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of the same calorie level

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isocalorically

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sucrose and sucrose containing foods are not restricted but should be counted as carbs and not as

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extra

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people with diabetes are advised to limit their intake of sat fat to less than

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7% of total calories

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diabetes should consume less than how much cholesterol daily

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200 mg

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naturally occurring substances in plants that help block the absorption of cholesterol from the GI tract

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plant sterols/stanols

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people who take alcohol should be consume with food to avoid

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hypoglycemia

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this essential mineral has been studied for its possible role in the prevention and treatment of diabetes

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chromium

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whole grains, nuts, mushrooms, broccoli, egg yolks, yeast, organ meats, pork, dried peas and beans are sources of

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chromium

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nutrition recommendations for controlling diabetes - reduce protein intake to

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0.8 to 1.0 early CKD to 0.8 for later stages of diabetic kidney dieases

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treatment of management of CVD risk

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control HB1AC and lower sodium intake, fruit, veggie and low fat dairy products

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counting is appropriate for people who understand the importance of consuming consistent intake to match insulin or medication peaks

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basic carbs

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alpha lipoic acid, bitter melon (bitter cucumber), cassia cinnamon, fenugreek, gymnema

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common supplements used in diabetes management

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pharmacologic management of diabetes in type 1 diabetes in order for them to survive they rely on

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exogenous insulin deliver by injection or pump

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nutrition therapy and exercise are capable of controlling glucose in type 2 - however if not control type 2 will eventually require

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oral agents, insulin or combination of both to manage blood glucose level

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rapid or short acting insulin used before each meal so total number of daily injections is 3 to 4 hours

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on set 15 min (rapid) to 30 (short) mins

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intermediate and long- acting insulin used to meet basal need

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onset 1 to 4 hours

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Intensive insulin therapy for - this type of diabetic can vary their mealtime insulin dose based on carbs and timing of food - also change their insulin need dose for stress or exercise

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type 1 diabetes
use long acting (one or 2 a day) (short acting between meals and snacks

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type 1 diabetes - characterized by hyperglycemia over 250 and ketonemia

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DKA

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hyperventilation occurs in an attempt to correct acidosis by increasing expiration of

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Carbon dioxide

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if DKA occurs in type 2 diabetes - what is normally to blame

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infection or illness

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glucose levels over 600 mg this occur w/o significant ketonemia

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HHNS
Hyperosmolar Hyperglycemic Nonketotic Syndrome

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HHNS most commonly in

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type 2 diabetes

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symptoms of HHNS include

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dehydration, hypotension, decrease mental acuity, confusion, seizures and coma

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treatment and best protection

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protection = monitor glucose regularly and treatment insulin, fluid and electrolyte replacement (tx the same as DKA)

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blood glucose below 70 mg is often referred to as insulin reaction

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hypoglycemia

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weakness, shakiness, dizziness, cold sweat, clammy feeling, headache, confusion, irritability and seizures are all symptoms of

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hypoglycemia

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15g to 20 g and any carbs containing glucose may be use to treat

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hypoglycemia

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exercise is beneficial to all however people with this type of diabetes ? can improve cardiac risk factors and sense of well being

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type 1 diabetes

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exercise can help improve glucose control and blood lipid levels, and blood pressure and help maintain weight loss in

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type 2 diabetes

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for all with diabetes and exercise should

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exercise induced hypoglycemia