Importance of Weight loss in Diabetes Mellitus - Research Paper Example

? Low-Carb versus Low Glycemic Index First and of Low-Carb versus Low Glycemic Index Introduction Type 2 diabetes mellitus is the most common type of diabetes afflicting 90% to 95% of all diabetics. Type 2 diabetes mellitus is otherwise known as non-insulin dependent diabetes mellitus. It is usually caused by insulin resistance. The resistance of insulin makes it difficult for the body to absorb sugar, thus, leads to an increase of blood sugar which can then clog up the blood vessels, leading to various other complications such as stroke. The primary treatment for this type of diabetes is dietary modification and exercise. Oral antidiabetic agents can be given if diet and exercise are not enough. Insulin may be used on either a long or short-term basis to prevent hyperglycemia. As one of the primary interventions for diabetes mellitus type 2, dietary changes are easily done and are as simple as following a menu. The focus for dietary changes is on the glucose consumption of the individuals. There have been arguments whether the amount of glucose or the quality of glucose is the key to reducing weight and managing diabetes mellitus type 2. The quality of glucose is all about its glycemic index (GI), which indicates how fast certain food increases your blood sugar. This study aims to identify the most effective diet for weight loss in diabetic patients with a BMI of more than 29 between low-carb and low glycemic index (Smeltzer & Bare, 2003). Importance of Weight loss in Diabetes Mellitus According to Smeltzer and Bare (2003), “nutrition, diet, and weight control are the foundations of diabetes management” (p. 1156). Maintaining the proper caloric intake is a way to make sure that the blood sugar does not rise to harmful levels. Maintaining proper nutrition and having proper food intake by limiting the carbohydrate intake to as much as the person needs prevents hypo and hyperglycemia. The patient’s caloric needs must be calculated, so that the amount of calories he or she can consume is also calculated. The monitoring and calculation of the caloric needs of the patient are so complex that a registered dietitian has the major responsibility of making most of the therapeutic plan. The nutritional management of diabetes has the following goals: 1. Providing a well-balanced diet with the right amount of nutrients; 2. Providing sufficient calories for the patient’s energy needs; 3. Maintaining a reasonable weight; 4. Preventing high or low blood glucose levels, with them being as close to normal as possible to prevent complications from hyperglycemia and hypoglycemia; 5. Decreasing serum lipid levels to lessen the chances of the patient developing a macrovascular disease. Maintaining proper weight is also important for patients who need to take insulin to control their blood glucose. Consistent caloric intake prevents the patient from experiencing hypoglycemia as a side effect of insulin replacement therapy. For obese patients, weight loss is necessary. People with a BMI of more than 29 are considered obese. These people are at a larger risk for diabetes mellitus type 2 since obesity leads to a greater resistance to insulin. If they can reduce their weight, they might even lessen or completely eliminate the need for pharmacological intervention. Losing as little as 10% can really help reduce blood glucose levels in obese diabetic patients. If the obese patient does not take insulin, the most important part of their dietary management is the reduction of their caloric intake. Abete et al (2010) wrote that the challenge in diabetes mellitus concerned not just the weight loss, but also the body weight maintenance, which is difficult for them to do. There is no question that they should limit the caloric intake of diabetics, but the question is how best to go about it. This is what this research is for. Low-carbohydrate diets and weight loss In the interest of reducing their caloric intake, one of the ways to do that is to reduce the amount of carbohydrates in the food that the patients eat. Reducing the overall carbohydrate intake is a direct way to reduce the caloric intake. Since most foods contain carbohydrates in various forms, it means reducing the amount of food he eats. According to Anderson and Woodend (2003), high glycemic carbohydrates produce satiety, but can only maintain it for a short time, meaning the person can get hungry faster. Pairing this with the lesser amount of food means the person will seek more food often, making it difficult for them to keep up with the therapeutic regimen. High glycemic foods are useful when the body needs glucose right away, but when it does not need it, it is stored as lipids, leading to weight gain. Foods with a high glycemic index also provide glucose, but it is not so quickly absorbed. It takes around 2 to 3 hours for it to be fully absorbed into the bloodstream, providing a less potent, but longer-lasting source of glucose, which staves off hunger. Shifting to a low-carbohydrate diet would promote weight loss, but it comes at the price of cell hunger. The person would most likely experience hypoglycemia, which is a condition that could result in death if not handled properly. Low-glycemic index diets and weight loss Starches are considered complex carbohydrates. It takes a while before they become glucose; because of this, starches such as beans and grains have been considered food with low glycemic index. A diet with low carbohydrates seeks to limit simple carbohydrates such as sugar or other sweets. Limiting the glycemic index is about keeping the person full and making the person less likely to eat more by increasing the satiety and quality of the food he eats. Low glycemic index foods increase satiety for 2 to 3 hours, which is longer than the high glycemic foods. This would make people less likely to eat more, since they feel full most of the time, making it easier for them to keep up with the nutrition plan (Anderson & Woodend, 2003). This was supported by the study of Navas-Carretero, Abete, Zulet, and Martinez (2011), who found out that low glycemic, moderately high-protein foods in meals may promote body weight and fat-mass loss. Low glycemic foods prevented the person from eating often, while the increased protein helped in the creation of muscle tissue which consumed more energy and glucose, leading to less excess glucose and lipid formation, therefore, resulting in weight loss. Conclusions What these studies show is one aspect of the effectiveness of dietary modifications in obese diabetics. This shows only the weight loss of these individuals which, though a very important part of the treatment, is merely a state of physical health. Managing a lifestyle illness involves more than adjusting the physical aspect of the person’s lifestyle. It has to also adjust the person’s perspective and mindset. Losing 10% of your body weight in six months is pointless if you can gain it back on the seventh. Instead of just looking at which diet lost the most weight, nutritionists, dietitians, and diabetics also have to consider which diet is an easier change to that person’s lifestyle. Finding a diet that a person could stick has a better long-term effect than finding out how to lose a lot of weight in a short amount of time. To summarize, a low-calorie diet can reduce the person’s weight. It is a straightforward method, and can reduce weight quickly, but it also carries a higher risk of hypoglycemia, aside from being more difficult to maintain. Calculating the glycemic index of the food that the patient eats adds another complication to the patient’s therapy. The diet has to be planned to account for how long the foods glycemic index can keep up the patient’s hunger, and it must account for the patient’s activity level. Knowing all these, the meal times must be spaced according to when the person would need the glucose, and should amount to just enough. With diet and a properly scheduled diet, the patient should be able to reduce and maintain their weight. References Abete, I., Astrup, A., Martinez, J. A., Thorsdottir, I., & Zulet, M. A. (2010). Obesity and the metabolic syndrome: Role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance. Nutrition Reviews, 68(4), 214-231. doi:10.1111/j.1753-4887.2010.00280.x Anderson, G. H., & Woodend, D. (2003). Effect of glycemic carbohydrates on short-term satiety and food intake. Nutrition Review, 61(5, pt. 2), S17-S26. Navas-Carretero, S., Abete, I., Zulet, M. A., & Martinez, J. A. (2011). Chronologically scheduled snacking with high-protein products within the habitual diet in type-2 diabetes patients leads to a fat mass loss: a longitudinal study. Nutrition Journal, 10, 74. doi: 10.1186/1475-2891-10-74 Smeltzer, S., & Bare, B. (2003). Brunner and Suddarth’s textbook of medical-surgical nursing (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Read More