Diabetotherapy for diabetes mellitus
The treatment of diabetes mellitus is mainly carried out with the help of proper selection of food products. Therefore, let us dwell on the basic principles of proper nutrition.
1. With the help of the attending physician, the patient should adjust the diet by the amount and nature of the carbohydrates taking into account the daily caloric content of the products.
2. Patients, especially those with high weight, need to reduce the intake of fatty foods that increase cholesterol levels and lead to the progression of atherosclerosis and diabetic complications.
3. Increase the number of vegetables and fruits and foods containing dietary fiber( herbs, bran) in the diet that slow the absorption of carbohydrates from the intestine and normalize its activity.
4. Older patients and people suffering from hypertension should try to reduce the amount of salt consumed.
Food taken during the day, as a percentage of total calorie content, should be distributed as follows: breakfast - 30, lunch - 40, lunch - 10, dinner - 20. This avoids large fluctuations in blood glucose and improves overallexchange in the body. Each patient should conduct an individual calculation of the daily energy value of the diet, taking into account the sex, age, height, body weight, profession and associated energy costs.
Special attention should be paid to the amount of carbohydrates contained in food. At their selection it is necessary to adhere to following principles.
From the diet of patients who do not receive drug therapy, products containing easily digestible carbohydrates should be excluded, including: sugar and products containing it - sweets, chocolate, cakes, muffins, cookies, wafers, ice cream, condensed milk, jam, sweet drinks andwine, etc.
Patients who do not receive insulin and do not suffer from obesity are allowed to consume sugar to 20-30 g per day.
When choosing products containing carbohydrates, preference is given to rich vitamins and minerals: wholemeal bread, whole grain cereals, legumes, vegetables, fruits and berries. When you consume fruits and berries, you must remember that they also contain carbohydrates, and they should be taken into account in the daily diet. For the convenience of calculating the amount of carbohydrates, a carbohydrate unit( 1 unit = 10 g carbohydrates) was taken.
A patient suffering from diabetes should always remember two things:
1. Uncontrolled consumption of carbohydrates leads to hyperglycemia and a coma.
2. A sharp restriction of carbohydrates is also undesirable, as this leads to the consumption of a spare carbohydrate - glycogen of the liver, as well as the formation of glucose from proteins and fats of the human body, to a decrease in body weight and the accumulation of ketone bodies in the blood that poison the body and can lead to a coma(loss of consciousness).
The amount of fat in the diet should also be reduced, as their excessive intake worsens the course of diabetes, contributes to the development of complications and severe cardiovascular pathology. The amount of fat in the food of patients should not exceed 0.75-1 g per 1 kg of body weight. Usually for adults it is 60-80 g.
From the diet it is necessary to exclude foods with a high fat content: fat pork and lamb, duck, goose, smoked sausages, fatty fish, fatty cottage cheese and cheeses.
At the same time in the diet should additionally include foods rich in substances that reduce the fat content in body tissues: low-fat cottage cheese, oatmeal, buckwheat and other cereals.
For protein: the food ration should contain the optimal amount of protein - 1 - 1.2 g per 1 kg of body weight of a person, therefore, the daily requirement for protein is 70-80 g. As the physical load increases, the need for protein increases.
In food there must be proteins of both animal and vegetable origin. Proteins of animal origin we get from meat, fish, eggs, cottage cheese, cheese;vegetable - from legumes, bread, cereals. The most optimal for the human body is the ratio of proteins of the first and second groups 55: 45%.
The use of alcohol in diabetes mellitus about t and in is provided. EC does the patient not refuse alcohol, then he must comply with a number of conditions to reduce his adverse effects on the body.
1. It should be remembered that alcohol is a rich source of calories( 7 kcal per 1 g of alcohol), and this must be taken into account when calculating the daily calorie intake.
2. Drinking alcohol is possible only in the process of eating or after eating. Do not skip meals provided by the diet.
3. You can not use liqueurs or sweet wines.
4. The amount of alcohol consumed must be strictly limited - no more than 100 g of strong drinks( vodka or cognac) or 200 g of dry wine at one time, not more often 1-2 times a week.
The diet should be as close as possible to the family, so that at the table the patient does not feel apart. A set of products, their culinary processing should not be very different from the usual ones. Contraindicated products need to find an adequate substitute for taste.
It is very important for the patient to clearly observe the time of food intake in accordance with the introduction of insulin: the number, time and dose of injections. The time of food intake after the introduction of insulin is determined by the onset, the period of maximum insulin action and its duration. Thus, it is necessary that the period of the highest rise in glucose in the blood coincides with the onset of insulin action or its maximum. If insulin is administered 2 times a day( in the morning - before breakfast and in the afternoon - before lunch), then 65-70% of all carbohydrates of the diet are included in these meals. With a three-time appointment of insulin, the amount of carbohydrates for breakfast, lunch and dinner should be approximately the same. After the introduction of insulin, you should take the food twice: during the onset of action and the period of maximum insulin action.