Diabetes Nutrition Therapy - Essay Example

THESIS ON DIABETES AND NUTRITION INDEX S.NO. DETAILS PAGE NO Introduction 2- 4 2. Role of Nutrition in controlling 5 - 22 Diabetes 3. Bibliography 23 INTRODUCTION Diabetes is one of the major degenerative diseases in the United States and is a major risk factor for development of the cardiovascular disease. The disease is characterisized by a reduced ability to use and metabolize dietary carbohydrates, abnormally high blood sugar levels (hyperglycemia), and an abnormal amount of sugar in the urine. Diabetes is classified into two categories: Type I, insulin dependent(IDMM), or juvenile-onset diabetes; and Type II, non-insulin dependent (NIDDM), or adult onset diabetes. IDDM begins suddenly, usually in childhood. It might be precipitated by a viral attack on the pancreas, and probably also is linked at least in part to genetic factors. The control of this type of diabetes requires insulin therapy. There is no cure for IDDM. NIDDM begins after the teen years. The progression of the disease is slow as compared to IDDM, and symptoms are mild in the beginning but progress in severity with time. NIDDM often progresses undetected until later stages. Treatment and control include weight reduction and lifestyle changes. Genetic factors probably contribute to the likelihood of developing NIDDM; however, lifestyle patterns, including overweight, poor diet, and lack of exercise, are as important if not more important in the development of this form of diabetes. Symptoms of NIDDM are similar to those of IDDM; however the pathalogy of the disesae is different. The pancreas contains specialised cells called beta cells that secrete the hormone insulin in response to high blood sugar levels. In normal conditions, dietary carbohydrates are absorbed from the intestenal lining into the blood as glucose and other simple sugars. As blood sugar level rises, insulin is secreted from the pancreas and, in conjunction with Glucose Tolerance Factor, binds to specialized sites on the membranes of body cells and encourages the transportation of sugar from the blood into the cells. This serves two purposes; it lowers blood sugar levels and increases the availaibility of sugar(energy) for norma;l cell functioning. Blood insulin levels return to pre-meal levels as the blood sugar levels also decrease. This process is arrested in the diabetic body. Blood sugar levels rise as a result of a meal, but the pancreas either does not secrete adequate amounts of insulin (IDDM) or normal amounts are secreted but the cells are unresponsive to the hormone (NIDDM). As a consequence, the blood sugar levels remain high; sugar pspills into the urine; and abnormal secondary conditions might develop, such as eye disorders and circulation problems. The cells remain starved for energy, so stored fat is broken down, raising the blood fat levels and increasing the person's risk for developing cardiovascular disease. Incomplete byproducts of fat metabolism build up in the blood, causing ketoacidosis or ketosis. One person in ten with diabetes is insulin - dependent. IDDM diabetics usually have a reduced amount of active beta cells in the pancreas and cannot produce adequate amounts of insulin in response top carbohydrate intake. Insulin injections help to supplement the small amount produced by the pancreas and are timed to coordinate with food intake to maintain normal blood levels of glucose. Overinjection of insulin causes too much glucose to be removed from the blood and the person can enter a diabetic coma. The other nine persons in ten with diabetes are non-insulin dependent. NIDDM diabetics can have reduced number of beta cells, but often their beta cells are normal and their insulin secretion is normal or even higher than normal. It is the body's cells that do not respond to the insulin. The insensitivity is associated with reduced numbers of insulin receptor sites on cell membranes, possibly because of excessive body weight. Oral hypoglycemic agents or injected insulin are sometimes used to override the insensitivity; however, the cells' usual sensitivity returns to normal when the person achieves a desirable weight. Symptoms and outcomes of diabetes include the following: Increased urination Dehydration with increased thirst Fatigue and muscle weakness Nausea and / or vomiting Increased apetite Loss of weight (IDDM) or weight gain(NIDDM) Frequent skin infections or irritations, slowed wound healing, and possible gangrene from reduced blood flow Itching, tingling, and numbness in hands and feet Kidney damage and failure Visual disturbances, such as retinopathy and blindness Cardiovascular disease, including atherosclerosis and hypertension Diabetes is diagnosed by a glucose tolerance test, where the person consumes a dose of sugar on an empty stomach and blood and urine levels of sugar are monitored during a designated period of time. Very high or prolonged high blood sugar levels are indicator of diabetes. Nutrition in the Prevention and Treatment of Diabetes In 1994 the American Diabetes Association revised its position on treating diabetes. The updated goals are : 1. Improve health by maintaining optimal nutritional status and exercise; 2. Maintain near-optimal blood glucose levels; 3. Stabilize serum lipid levels within a normal range; 4. Consume adequate calories to maintain a desirable weight; 5. Prevent secondary disease, such as cardiovascular disease, eye and nerve disorders, kidney disease, and circulation problems; 6. Improve general health by optimal intake of nutrients. This revision advocates individualized diets according to metabolism, nutrition, and lifestyle and recommends nutritional management of NIDDM. The most important dietary guidelines are the control of carbohydrate, protein, fat, and calorie intakes to help regulate blood sugar levels and body weight, and the reduction of fat to prevent cardiovascular disease. In addition, regular aerobic decreases insulin requirement in both Type I and Type II diabetics. General dietary guidelines for the treatment of diabetes include the following: 1. Eat meals and prescribed snacks at regular intervals every day; do not skip meals or snacks. 2. Limit foods high in sugar, such as honey, desserts, candy, pies, and soft drinks. 3. Avoid foods high in fat, especially saturated fats, such as meat, fatty dairy products, and hydrogenated vegetable oils. 4. Include a variety of high-fiber foods in the diet, including fresh fruits and vegetables, whole grain breads and cereals, and cooked dried beans and peas. The American Diabetes Association recommends a diet based on the following percentages of total calories: Protein 10 to 20 percent Saturated Fat < 10 percent Polyunsaturated Fat Garrison Robert(3rd Ed) Nutrition Desk Reference, Keats Publishing Mayo Clinic < www.mayoclinic.com/health > Read More