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Experts on diet and health and the American Diabetes
Association state that there is no single dietary regimen for diabetes. Dietary
recommendations may be developed based on the individuals requirements and treatment
goals. |
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Successful
nutritional management of diabetes entails: |
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Regular monitoring of
metabolic parameters (including blood glucose, glycated hemoglobin, lipids, and blood
pressure) |
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Maintaining healthy body
weight |
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Lifestyle management |
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It
is important that diabetics space meals adequately over the day to avoid glucose overload
and low blood sugar. |
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The
daily, dietary, caloric breakdown recommended states that 12-20% of the total calories
should be supplied by protein, less than 10% of the total calories should be from
saturated fats and up to 10% of the calories from polyunsaturated fats and 60-70% of the
total calories to be distributed between monounsaturated fats and carbohydrates, based on
individual requirements. Complex carbohydrates, such as those from whole grains and
vegetables are advocated because they have a lower glycemic index. |
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The
glycemic index represents the sugar value of the food as compared to glucose given a value
of 100. All carbohydrates are ultimately converted to glucose in the body. Some
nutritionists use white bread as the standard, in which case white bread would have a
glycemic index of 100 and glucose would have an index of 142. The lower the glycemic
index, the slower the carbohydrate would convert to glucose, thereby avoiding glucose
overload. |
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In
view of the increased risk of cardiovascular disease, diabetics should avoid saturated
fats (limit to <10% of dietary fat) and limit daily cholesterol intake to < 300 mg. |
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A
diet containing adequate fiber is recommended and is beneficial in maintaining healthy
cholesterol levels and gastrointestinal health. Current guidelines advocate a daily intake
of 20-35 g per day. |
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For
people with mild to moderate hypertension, 2,400 mg or less per day of sodium is
recommended. For people with hypertension and nephropathy, 2,000 mg or less per day of
sodium is recommended. |
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Mild
to moderate weight loss (5-10 kg [10-20 pounds]) has been shown to improve diabetes
control, even if desirable body weight is not achieved. According to the ADA, weight loss
is best attempted by a moderate decrease in calories (250-500 calories less than average
daily intake) and an increase in caloric expenditure. |
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According
to ADA sources, exercise programs have not been exclusively shown to improve glycemic
control in people with IDDM. However, IDDM individuals would benefit from exercise in
terms of cardiovascular health and positive social interaction. |
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NIDDM
patients are recommended to exercise in order to support cardiovascular health, inhibit
obesity and augment nutritional measures. The recommendations are that:
- Aerobic exercise at 50-70% of an
individual's maximum oxygen uptake be included.
- The regimen should last 20-45 min and
be repeated at least 3 days/wk,
- The regimen should include
low-intensity warm-up and cool-down exercises
- The exercise should be appropriate to
the person's general physical condition and lifestyle.
- All people with diabetes should be
advised to comply with the following guidelines:
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use proper footwear and,
if appropriate, other protective equipment; |
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avoid exercise in
extreme heat or cold; |
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inspect feet daily and
after exercise; |
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avoid exercise during
periods of poor metabolic control. |