Diet for type 1 diabetes mellitus
diet The first type diabetes diet helps to compensate for the disease
Type 1 diabetes mellitus, unlike type 2 diabetes, is insulin-dependent, soas with this disease the pancreas does not produce insulin.
As a result, the body develops an absolute insulin deficiency - an extremely life-threatening condition.
Insulin-dependent diabetes mellitus( IDDM) of type 1 is often called "youthful", as it develops in children or young people( mostly up to 25 years) against an autoimmune or viral pancreatic lesion.
Under the influence of various viruses( mumps, measles, sore throats, influenza) or some chemicals, the majority of pancreatic cells die( up to 90%), therefore insulin therapy, insulin injections, is vitally important for such patients.
In addition, among the causes of type 1 diabetes, physicians note the important role of the genetic factor( hereditary defect in chromosomes) and severe stresses.
Very often, the first symptoms of the disease appear after acute mental trauma( stress, fear, fright, death of close people), so it is sometimes difficult to determine the root cause of the disease - whether the disease has occurred in a latent form or due to a strong mental overstrain.
Symptoms of type 1 diabetes mellitus ^
Often, IDDM starts abruptly and proceeds in an acute form, up to ketoacidosis and diabetic coma. In addition, the disease is very labile, that is unstable - in patients there are sharp fluctuations in blood sugar levels during the day( from 0.7 g / l to 3.5 g / l).Most often, hypoglycemia occurs at dinner( a sharp drop in blood glucose level), and closer to night and early morning there is hyperglycemia - the opposite of hypoglycemia, characterized by a sharp increase in the level of glucose and a strong thirst, which is satisfied only for a short time after the fluid is drunk.
At the very first signs of developing diabetes, it is very important to ask for medical help in time to make a diagnosis and start treatment.
If the disease is established at the very beginning of development and take appropriate measures( insulin therapy, hypoglycemic drugs and diet), a further prognosis of the first type of diabetes mellitus will be favorable and it will be possible to avoid severe vascular complications and infections. If the disease is allowed to drift, it can very quickly develop into a diabetic coma and lead to a fatal outcome.
Diet for type 1 diabetes †
The diet for type 1 diabetes mellitus, along with insulin therapy and exercise therapy, is an important part of the treatment process and is aimed at restoring normal body weight, normalizing the disturbed metabolism and restoring the patients' performance.
- Dietotherapy for IDDM requires, first of all, strict account of consumed carbohydrates, since they are the main source of energy for the human body and affect the level of sugar in the blood. But, if a healthy person starts developing insulin immediately after the start of the meal, the insulin injected artificially does not react to the ingestion of food.
- Since in the patient's diet carbohydrates should constitute about 50 - 60% of the total daily intake, it is necessary to bring the action of insulin into full compliance with the carbohydrates consumed. The complete exception or serious restrictions of any food, like a diet with type 2 diabetes, is not required.
Diabetes patients need to know that all hydrocarbon-containing foods are divided into 5 groups according to their digestibility:
- digestible carbohydrates( pure sugar and sweets);
- liquid dairy products - milk, kefir, etc.;
- berries and fruits;
- non-starchy vegetables;
- cereals and cereals - cereals, macaroni and bakery products.
If the patient with IDDM does not have excess weight, then it is sufficient to exclude from the menu only hydrocarbon-containing products of the first group, the intake of the remaining carbohydrate groups must be learned to correctly dose during the day so that not more than 4-5 bread units( XE) per meal. With excess body weight and high cholesterol, you also need to limit fat intake.
In addition, patients with IDDM should adhere to the usual rules of rational nutrition:
- Do not exceed the physiologically necessary daily amount of calories, calculated individually for each patient, depending on body weight and energy costs.
- It is very important to create such a rhythm of life that the mode of insulin administration, food intake, carbohydrate dosage, calorie and physical loads were correctly selected and organically combined.
- Since a healthy pancreas produces about 40 units of insulin per day( such is the need of the human body), it is necessary to achieve constant - its stable content in the body in order to be able to control the level of sugar on an empty stomach.
- To do this, provide a fractional intake of insulin during the day and match it to each meal.
The main principles of the diet for diabetes mellitus type 1
- fractional meals( 5 - 6 times a day);
- distribution of carbohydrates by meals depending on the number of injections of insulin;
- high content in the diet of dietary fiber and carbohydrates( about 50-60%);
- calculation of the required amount of carbohydrates using a system of bread units and a glycemic index.
The diet for IDDM is directly dependent on the insulin delivery scheme that is individually selected by the doctor for each patient. At present, various types of insulin( long, short or intermediate action) are used to treat patients, and several basic schemes of its use are used: single administration, two-fold and combined.
The most commonly used combination regimen of insulin therapy, in which intermediate insulin is injected twice, and a simple( short) insulin - before each meal. This scheme is the most physiological and flexible, as it easily adapts to the rhythm of the patient's life and reduces the risk of developing hypoglycemia and hyperglycemia after eating. In this case, you do not need to adhere to a strict schedule of nutrition, as in other schemes, because before each meal is introduced a short insulin.
But, due to the fact that the body is constantly acting insulin intermediate effect, too large intervals between meals can not be done. In addition, you should not introduce a short insulin just before bedtime - it should be pricked before dinner, at 19-20 hours. A little later, you need to introduce an intermediate insulin and easy to dine( the second dinner should contain about 2 XE).The second injection of intermediate insulin( morning) is done 12 to 14 hours after the evening.
When compiling a menu, to select and count the required amount of carbohydrates, the international unit of measurement, called the bread unit( XE), is used, which contains 10 to 12 grams of pure carbohydrates.
The XE system greatly facilitates the calculations - to determine the number of XE portions of food, it is sufficient to know the portion of a particular hydrocarbon-containing product equal to 1 XE.Table of the number of basic products containing 1 XE is presented in this article.
Physical activity in the diet ^
If you are under intensive physical work that can provoke a sharp decrease in blood sugar levels, precautions should be taken:
- On the day of the event, associated with a large expenditure of energy reserves, it is recommended that the morning dose of insulin be slightly reduced( by 2 to 4 units) and it is imperative to take sweet tea and sandwiches( 7 - 8 ХЕ) in a thermos.
- If you are taking hypoglycemic drugs, then the morning dose of insulin should not be reduced.
- Before starting physical work, it is necessary to eat well, and after 2 - 3 hours of work again a little refresh yourself, for example, a sandwich( 2 XE) with milk. These measures will help to avoid the rapid development of hypoglycemia.
It is strictly forbidden to consume alcoholic beverages in combination with physical loads, since in this case the likelihood of developing hypoglycemia increases dramatically. In addition, take for yourself the rule of always carrying something sweet( fruit juice, lemonade or lump sugar) - these products will help to quickly suppress dangerous hypoglycemic reactions if necessary.
With properly selected treatment regimens and compensated diabetes, patients can usually lead a normal lifestyle and work alongside healthy people. Special therapeutic gymnastics and an active way of life allow, though not fully, to some extent to compensate for insulin. This is due to the fact that moderate physical activity contributes to increased utilization of glucose by tissues.
- In the absence of complications, you can go hiking, cycling, playing tennis, badminton, attending aerobics, sports dancing - the main thing, the load should be regular to avoid sudden changes.
- That is, if you visit the sports section several times a week, then the rest of the week you need to provide yourself with an equivalent physical load.
- Before starting any sports activities, to maintain good health, do not forget to easily have a bite( 2 - 3 XE).
In order to compensate for diabetes and lead a full-fledged lifestyle, it is necessary to responsibly treat the prescribed treatment and take full responsibility for your own health. Doctors say that the reasons for the development of hard-to-compensate diabetes mellitus are extremely non-assortment, laziness and irresponsibility of the patient.
Each diabetic patient should learn the carbohydrate value of food and maintain a personal diary in which the following important indicators are recorded:
- diet( meal time and amount of XE),
- medication intake( intermediate and short insulin dose),
- sugar level inblood,
- physical activity,
- changes in well-being.
Doing such a diary, according to doctors, will help to fully compensate for diabetes and keep under full control the state of health and performance.