Apart from Medicines,this is an important aspect of treatment of Diabetes

1. Dr Raj Thorat
HAL Hospital

2.  Education –
-What is Type II DM,Causes
-Control/Prevention Stratergies
 Lifestyle Modification
 Exercise
 Diet
 Motivation and Follow Up

3.  Causes of Diabetes
- Obesity (Overnutrition)
and Insulin Resistance
- Beta Cell Failure/Dysfunction

4. Life style factor assessment
1. Age
2. BMI
‐ Over weight (>25 kg/m2)
‐ Obese (>30 kg/m2)
3. Exercise
‐Irregular
‐No exercise
4. Work pattern
‐ Sedentary
‐ Non sedentary

5.  Lifestyle Assesment
 Motivation
 Information and Measures
 Approach
 Goals
 Follow Up

6.  Benefits -
- Weight Loss
- Improved insulin Sensitivity
- Increase HDL, Decrease Tg
- Decrease Blood Pressure
- Sense of well being
(Endogenous Opioids)

7.  Lack Of time
 Lack Of Space
 Lack of Motivation

9.  Food is generally chosen,not based on its
fibre,fat or protein content etc
Food is chosen based on
Taste and Food habit ingrained
 So,its important to find
out the person’s eating habits
And then suggest changes
that suits his dietary habits

10.  Grains : rice, high‐fiber cereals,oatmeal, wheat,millet,
barley,etc.
 Legumes: beans (black, kidney,etc.), peas, split peas,lentils.
 Fruits: all, except pineapple, and watermelon.
 Vegetables: all, except white potatoes. Examples include
tomatoes, cucumbers,carrots, broccoli, cauliflower,
spinach,green beans, sweet Potatoes
 (A note on vitamin B12: Those following a diet free of animal
products should take B12 supplement of 5 micrograms per
day)

11.  Prefer Low GI food like Vegetables,Lentils
 Avoid High GI foods like White
Potatoes,Watermelons,Processed Foods

12.  Begin a Vegan Diet
 Restrict Total Intake and Avoid Added
Vegetable Oils and Other High‐Fat
 Go High Fiber
 For Effective Glycemic Control: Combination
of foods must be encouraged

14.  Sweeter ones – to allow or Not ??
 Avoid WaterMelon,Pineapple
Others can be allowed in moderation
(Use it as a reward to exercise)

15.  Ideal Body Weight (in KGs)
- Men = Height (in cms) - 100
- Women = [ Height (in cms) – 100 ] × 0.9
(Range of 10% is given in between)

16. - If the person is sedentary/mildly active,then
Approx 30 Calories/Kg body weight/day
- If Moderately Active – 35 Calories/Kg body
weight/day
- If Severely Active – 40 Calories/Kg body
weight/day

17.  If the person is in that range,then
- 500 Calories Extra are given for a person
who is underweight
- 500 Calories Less are given for a person
who is overweight

18. Total
Breakfast 1 cup Tea 50
2 Idli 100 200
Chutney 50
Lunch 50 gms Rice 175
Dal 50-100 400
Vegetables 75-100
Curd 50
Dinner 3 chapatti 200
Vegetables 100 400
Dal/Chutney 100

19.  Evening Snacks and Bedtime small snacks ??
Cut down some calories in Lunch/Dinner and
allow other time snacks

20. Breakfast 1 cup Tea 50
2 Idli 100 200
Chutney 50
Lunch 50 gms Rice 175
Dal (1/2) 50 300
Vegetables 75-100
Evening Fruit
(Small Apple)
50 50
Dinner 3 chapatti 200
Vegetables 100 350
Dal 50
Bedtime Milk
(1/2 glass)
100-120 100

21. Pharmaco therapy act as a support to
and Not a substitute to Diet and Exercise, in
treating DM