Diabetes is a disease where the body does not properly produce or use insulin, leading to high blood sugar. There are two main types of diabetes - type 1 where the body does not produce insulin and type 2 where cells do not respond to insulin properly. Good management of diabetes involves nutrition therapy such as carbohydrate counting to control blood sugar levels as well as medication, exercise, and monitoring of blood glucose levels.
1) Low glycemic index (GI) diets can help with weight management and reducing risk of heart disease by increasing satiety and reducing subsequent food intake.
2) Studies found that low GI breakfasts led to lower lunch energy intake in children and reduced appetite and increased satiety over 6 days compared to high GI meals.
3) Glycemic index is a key factor in diabetes management as it classifies carbohydrates based on their effects on blood glucose levels, and prescribing low GI diets can help with tight blood glucose control.
Carbohydrates provide an important source of energy. Low-carbohydrate diets restrict carbohydrate intake, often below 130g per day, to induce weight loss. Very low-carbohydrate ketogenic diets reduce carbohydrates to less than 50g per day to produce ketosis, where the body uses fat instead of glucose for fuel. While low-carb diets may aid short-term weight loss, long-term safety and effectiveness require more research due to potential vitamin deficiencies or unfavorable cholesterol changes with strict low-carb intake.
Glycaemic Index A Practical Measure For Maintaining A Healthy DietGeoffreyOsullivan
An overview of methods to determine the effect of increased blood glucose after eating certain foods and linking this to desease risk and improved health
The document discusses the importance of nutrition in diabetes management. It states that diabetes treatment involves controlling factors like diet, drugs, and daily activity. Proper nutrition therapy is an integral part of diabetes management. The document then compares the effects of high-carbohydrate and high-fat diets on various health markers in diabetics. It proceeds to describe Balance-D diabetes medical nutrition therapy, highlighting its balanced macronutrient profile, glycemic control benefits, improved compliance, and other advantages.
This document outlines dietary guidelines for managing diabetes mellitus through medical nutrition therapy. The goals are to provide adequate nutrition for normal growth and development, prevent hypo- and hyperglycemia, and promote lifestyle changes to improve metabolic control. A balanced meal plan calls for 50-60% of calories from carbohydrates, 20-30% from fat, and 10-15% from protein. Meals should be spaced regularly and consistently with flexible timing. Exercise and self-monitoring of blood glucose are also integrated into treatment. Hypoglycemia is managed through consumption of simple sugars to quickly raise blood sugar levels.
The document discusses glycemic index (GI), a method of classifying foods based on their effect on blood glucose levels. Foods that breakdown quickly during digestion have a high GI, while foods that breakdown slowly, releasing glucose gradually, have a low GI. To determine a food's GI rating, its effect on blood glucose levels over 2 hours is measured in healthy individuals and compared to a standard food. Common foods and their GI values are provided, and factors like fiber, fat, and cooking methods that affect a food's GI are explained. Tips to lower the overall GI of daily meals include choosing whole grains, fruits and vegetables, and combining high and low GI foods.
1) Low glycemic index (GI) diets can help with weight management and reducing risk of heart disease by increasing satiety and reducing subsequent food intake.
2) Studies found that low GI breakfasts led to lower lunch energy intake in children and reduced appetite and increased satiety over 6 days compared to high GI meals.
3) Glycemic index is a key factor in diabetes management as it classifies carbohydrates based on their effects on blood glucose levels, and prescribing low GI diets can help with tight blood glucose control.
Carbohydrates provide an important source of energy. Low-carbohydrate diets restrict carbohydrate intake, often below 130g per day, to induce weight loss. Very low-carbohydrate ketogenic diets reduce carbohydrates to less than 50g per day to produce ketosis, where the body uses fat instead of glucose for fuel. While low-carb diets may aid short-term weight loss, long-term safety and effectiveness require more research due to potential vitamin deficiencies or unfavorable cholesterol changes with strict low-carb intake.
Glycaemic Index A Practical Measure For Maintaining A Healthy DietGeoffreyOsullivan
An overview of methods to determine the effect of increased blood glucose after eating certain foods and linking this to desease risk and improved health
The document discusses the importance of nutrition in diabetes management. It states that diabetes treatment involves controlling factors like diet, drugs, and daily activity. Proper nutrition therapy is an integral part of diabetes management. The document then compares the effects of high-carbohydrate and high-fat diets on various health markers in diabetics. It proceeds to describe Balance-D diabetes medical nutrition therapy, highlighting its balanced macronutrient profile, glycemic control benefits, improved compliance, and other advantages.
This document outlines dietary guidelines for managing diabetes mellitus through medical nutrition therapy. The goals are to provide adequate nutrition for normal growth and development, prevent hypo- and hyperglycemia, and promote lifestyle changes to improve metabolic control. A balanced meal plan calls for 50-60% of calories from carbohydrates, 20-30% from fat, and 10-15% from protein. Meals should be spaced regularly and consistently with flexible timing. Exercise and self-monitoring of blood glucose are also integrated into treatment. Hypoglycemia is managed through consumption of simple sugars to quickly raise blood sugar levels.
The document discusses glycemic index (GI), a method of classifying foods based on their effect on blood glucose levels. Foods that breakdown quickly during digestion have a high GI, while foods that breakdown slowly, releasing glucose gradually, have a low GI. To determine a food's GI rating, its effect on blood glucose levels over 2 hours is measured in healthy individuals and compared to a standard food. Common foods and their GI values are provided, and factors like fiber, fat, and cooking methods that affect a food's GI are explained. Tips to lower the overall GI of daily meals include choosing whole grains, fruits and vegetables, and combining high and low GI foods.
Dr Q's Perfect Meal is a protein supplement powder containing a proprietary blend of New Zealand whey protein concentrate, glutamine, glycine, and taurine. It also contains fiber, medium-chain triglycerides, and other nutrients. The document discusses the various health benefits of the ingredients, such as supporting muscle recovery, immune function, gastrointestinal health, and body composition. It provides details on the product's macronutrient ratio and lack of fructose.
The document provides nutritional recommendations for adults with chronic kidney disease stages 3 to 4. It recommends a daily protein intake of ≤0.8 g/kg, sodium intake <2.3 g/day, potassium intake individualized to serum levels, calcium intake ≤1.5 g/day, phosphorus intake of 0.8-1 g/day, and carbohydrate/fat intake of 30-35 kcal/kg/day with <30% from fat. It also recommends 25-38 g of fiber per day.
The document describes several different diets:
- A soft diet which is easy to chew and digest for those without teeth consisting of minced, ground or soft foods.
- A clear liquid diet allowing only clear liquids like water, gelatin and broths for gastrointestinal issues.
- A full liquid diet providing more calories than clear liquids through liquids or foods that become liquid at room temperature like yogurt and creamed soups.
- Low protein and low cholesterol diets restricting intake of specific foods and nutrients for medical conditions like kidney disease and heart health.
Today, the ketogenic diet is the world's fastest growing diet, and with good reason. When practiced correctly, it has been proven to burn fat, reduce inflammation, fight cancer, balance hormones and gut bacteria, improve neurological diseases, and even increase lifespan. Unfortunately, many people remain unaware of several key factors that are crucial to the diet's success, setting them up for frustration, failure, and relapse.
This document summarizes dietary and lifestyle factors that impact dyslipidemias. It discusses how certain foods like oats, soy, nuts, and plant sterols can lower LDL cholesterol, while foods like trans fats and simple sugars raise it. Physical activity, weight control, and certain nutrients like fiber, omega-3s, probiotics, and vitamin D also favorably impact blood lipid levels. The document provides guidelines from leading health organizations on recommended dietary patterns for managing dyslipidemias.
Low-calorie foods are processed foods developed for individuals needing to restrict calories, such as those with diabetes or obesity. They mimic regular foods in taste and texture but contain substantially fewer calories. Various techniques can be used to lower the calorie content, including substituting or reducing sugars, fats, and other calorie-dense components; adding water, air, or fiber; using enzymes or microparticulation; and replacing foods with lower-calorie alternatives. The goal is to provide tasty, appealing low-calorie options to help with weight control and reduce calorie intake.
How to cure diabetes naturally without medicationRahul Singh
This document discusses type 1 and type 2 diabetes, their causes, and strategies for reversing diabetes naturally. It states that type 2 diabetes is reversible according to medical experts, yet many are told it is genetic. It then outlines foods and supplements that can support diabetes reversal, including removing sugar, grains, and GMOs from the diet, and emphasizing fiber, healthy fats and low glycemic foods. Regular exercise including walking, interval training and strength training is also recommended to balance blood sugar levels.
The document summarizes a nutritional analysis report that analyzes a person's diet and provides:
1) An assessment of the strengths and weaknesses of their diet and whether it provides an adequate balance of nutrients for their age, sex, height, weight and activity level.
2) Suggestions on how to improve their diet to positively impact their health.
3) A breakdown of their calorie, protein, fat, carbohydrate and micronutrient intake compared to government guidelines.
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan LifestyleJen King
This document outlines a study comparing the effects of a low-fat vegan diet to a conventional diabetes diet in individuals with type 2 diabetes. 99 participants were randomly assigned to either a vegan diet avoiding animal products and high-fat foods or a diet following American Diabetes Association guidelines. Both groups showed improvements in glycemic and lipid control, though the vegan diet produced greater reductions in A1c and body weight. The vegan group also significantly improved their diet quality scores compared to the conventional diet group.
The document discusses the Glycemic Index, which ranks foods based on how quickly they raise blood sugar levels after consumption. A high GI means blood sugar rises quickly, while a low GI means it rises slowly and stays steady. High GI foods break down rapidly, causing blood sugar fluctuations, while low GI foods break down slowly for stable blood sugar levels. However, a low GI food is not necessarily nutritious if it contains unhealthy ingredients like saturated fat or lacks nutrients. An overall balanced diet and exercise are most important for health.
Medical Nutrition Therapy for Cardiovascular Diseases, Krause Book 14th editionBatoul Ghosn
Prepared from the chapter of MNT of CVD from Krause's book 14 the edition 2017 as well as some part from " Modern Nutrition in health and disease" 11th edition.
What Should I Eat includes information and answers to patient questions regarding diet, nutrition and scleroderma. It is presented by Bethany Doerfler, MS, RD, LDN
Dozens of diet plans on the market. everybody search for diets offering a way to reduce without accompanying cravings, hunger pangs, or need for heavy exertion.
Bethany Doerfler MS, RD, LDN discusses top nutrition concerns of scleroderma patients, as well as the results of a recent medical nutrition therapy study. She also discusses strategies for healthy eating, combating GI issues, maintaining muscle, a Mediterranean diet, supplements and more.
The document discusses nutrition recommendations for heart health, focusing on good and bad fats, providing evidence-based diet and lifestyle guidelines including limiting saturated and trans fats, increasing omega-3 fatty acids, fiber, and plant sterols/stanols to lower risk of heart disease, and addresses specific dietary goals and options for an individual with metabolic syndrome.
The ketogenic diet was initially developed in the 1920s to mimic the metabolic effects of fasting for treating epilepsy. It has since shown benefits for a variety of metabolic, oncologic, neurodegenerative, and psychiatric disorders through mechanisms like improving mitochondrial function and ATP production. Common indications for the ketogenic diet include epilepsy, Parkinson's disease, Alzheimer's disease, cancer, traumatic brain injury, autism, and depression. Side effects can include low-level acidosis, constipation, and nutrient deficiencies.
Medical Nutrition Therapy (MNT) involves a four-step approach of assessing an individual's metabolic and lifestyle parameters, identifying nutrition goals, designing interventions to achieve those goals, and evaluating therapeutic outcomes. The assessment identifies eating habits and goals for things like weight loss, blood glucose and lipid control. Individualized treatment goals and meal plans are created, focusing on education, appropriate macronutrient distribution, fiber intake, and exercise. Progress is monitored and the nutrition care plan is reviewed and revised as needed.
Brian MacAulay, Director of the Innovation Index at NESTA, gave this presentation at a workshop on 'innovating out of recession' held at the West Midlands Regional Observatory's Annual Conference, 20th October 2009.
This document outlines key aspects of innovation and strategic thinking for a company. It discusses 1) visualizing industry growth and the role of innovation in strategic thinking, 2) portfolio management metrics to track performance, 3) using research to build conceptual models, and 4) ideation through a "sandbox" approach. It then provides details on the innovation process, including insight, targeting, prototyping, and market development. Lastly, it discusses innovation types and notes several factors for innovation success, such as customer focus, technology leverage, process discipline, and an risk-embracing culture.
Dr Q's Perfect Meal is a protein supplement powder containing a proprietary blend of New Zealand whey protein concentrate, glutamine, glycine, and taurine. It also contains fiber, medium-chain triglycerides, and other nutrients. The document discusses the various health benefits of the ingredients, such as supporting muscle recovery, immune function, gastrointestinal health, and body composition. It provides details on the product's macronutrient ratio and lack of fructose.
The document provides nutritional recommendations for adults with chronic kidney disease stages 3 to 4. It recommends a daily protein intake of ≤0.8 g/kg, sodium intake <2.3 g/day, potassium intake individualized to serum levels, calcium intake ≤1.5 g/day, phosphorus intake of 0.8-1 g/day, and carbohydrate/fat intake of 30-35 kcal/kg/day with <30% from fat. It also recommends 25-38 g of fiber per day.
The document describes several different diets:
- A soft diet which is easy to chew and digest for those without teeth consisting of minced, ground or soft foods.
- A clear liquid diet allowing only clear liquids like water, gelatin and broths for gastrointestinal issues.
- A full liquid diet providing more calories than clear liquids through liquids or foods that become liquid at room temperature like yogurt and creamed soups.
- Low protein and low cholesterol diets restricting intake of specific foods and nutrients for medical conditions like kidney disease and heart health.
Today, the ketogenic diet is the world's fastest growing diet, and with good reason. When practiced correctly, it has been proven to burn fat, reduce inflammation, fight cancer, balance hormones and gut bacteria, improve neurological diseases, and even increase lifespan. Unfortunately, many people remain unaware of several key factors that are crucial to the diet's success, setting them up for frustration, failure, and relapse.
This document summarizes dietary and lifestyle factors that impact dyslipidemias. It discusses how certain foods like oats, soy, nuts, and plant sterols can lower LDL cholesterol, while foods like trans fats and simple sugars raise it. Physical activity, weight control, and certain nutrients like fiber, omega-3s, probiotics, and vitamin D also favorably impact blood lipid levels. The document provides guidelines from leading health organizations on recommended dietary patterns for managing dyslipidemias.
Low-calorie foods are processed foods developed for individuals needing to restrict calories, such as those with diabetes or obesity. They mimic regular foods in taste and texture but contain substantially fewer calories. Various techniques can be used to lower the calorie content, including substituting or reducing sugars, fats, and other calorie-dense components; adding water, air, or fiber; using enzymes or microparticulation; and replacing foods with lower-calorie alternatives. The goal is to provide tasty, appealing low-calorie options to help with weight control and reduce calorie intake.
How to cure diabetes naturally without medicationRahul Singh
This document discusses type 1 and type 2 diabetes, their causes, and strategies for reversing diabetes naturally. It states that type 2 diabetes is reversible according to medical experts, yet many are told it is genetic. It then outlines foods and supplements that can support diabetes reversal, including removing sugar, grains, and GMOs from the diet, and emphasizing fiber, healthy fats and low glycemic foods. Regular exercise including walking, interval training and strength training is also recommended to balance blood sugar levels.
The document summarizes a nutritional analysis report that analyzes a person's diet and provides:
1) An assessment of the strengths and weaknesses of their diet and whether it provides an adequate balance of nutrients for their age, sex, height, weight and activity level.
2) Suggestions on how to improve their diet to positively impact their health.
3) A breakdown of their calorie, protein, fat, carbohydrate and micronutrient intake compared to government guidelines.
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan LifestyleJen King
This document outlines a study comparing the effects of a low-fat vegan diet to a conventional diabetes diet in individuals with type 2 diabetes. 99 participants were randomly assigned to either a vegan diet avoiding animal products and high-fat foods or a diet following American Diabetes Association guidelines. Both groups showed improvements in glycemic and lipid control, though the vegan diet produced greater reductions in A1c and body weight. The vegan group also significantly improved their diet quality scores compared to the conventional diet group.
The document discusses the Glycemic Index, which ranks foods based on how quickly they raise blood sugar levels after consumption. A high GI means blood sugar rises quickly, while a low GI means it rises slowly and stays steady. High GI foods break down rapidly, causing blood sugar fluctuations, while low GI foods break down slowly for stable blood sugar levels. However, a low GI food is not necessarily nutritious if it contains unhealthy ingredients like saturated fat or lacks nutrients. An overall balanced diet and exercise are most important for health.
Medical Nutrition Therapy for Cardiovascular Diseases, Krause Book 14th editionBatoul Ghosn
Prepared from the chapter of MNT of CVD from Krause's book 14 the edition 2017 as well as some part from " Modern Nutrition in health and disease" 11th edition.
What Should I Eat includes information and answers to patient questions regarding diet, nutrition and scleroderma. It is presented by Bethany Doerfler, MS, RD, LDN
Dozens of diet plans on the market. everybody search for diets offering a way to reduce without accompanying cravings, hunger pangs, or need for heavy exertion.
Bethany Doerfler MS, RD, LDN discusses top nutrition concerns of scleroderma patients, as well as the results of a recent medical nutrition therapy study. She also discusses strategies for healthy eating, combating GI issues, maintaining muscle, a Mediterranean diet, supplements and more.
The document discusses nutrition recommendations for heart health, focusing on good and bad fats, providing evidence-based diet and lifestyle guidelines including limiting saturated and trans fats, increasing omega-3 fatty acids, fiber, and plant sterols/stanols to lower risk of heart disease, and addresses specific dietary goals and options for an individual with metabolic syndrome.
The ketogenic diet was initially developed in the 1920s to mimic the metabolic effects of fasting for treating epilepsy. It has since shown benefits for a variety of metabolic, oncologic, neurodegenerative, and psychiatric disorders through mechanisms like improving mitochondrial function and ATP production. Common indications for the ketogenic diet include epilepsy, Parkinson's disease, Alzheimer's disease, cancer, traumatic brain injury, autism, and depression. Side effects can include low-level acidosis, constipation, and nutrient deficiencies.
Medical Nutrition Therapy (MNT) involves a four-step approach of assessing an individual's metabolic and lifestyle parameters, identifying nutrition goals, designing interventions to achieve those goals, and evaluating therapeutic outcomes. The assessment identifies eating habits and goals for things like weight loss, blood glucose and lipid control. Individualized treatment goals and meal plans are created, focusing on education, appropriate macronutrient distribution, fiber intake, and exercise. Progress is monitored and the nutrition care plan is reviewed and revised as needed.
Brian MacAulay, Director of the Innovation Index at NESTA, gave this presentation at a workshop on 'innovating out of recession' held at the West Midlands Regional Observatory's Annual Conference, 20th October 2009.
This document outlines key aspects of innovation and strategic thinking for a company. It discusses 1) visualizing industry growth and the role of innovation in strategic thinking, 2) portfolio management metrics to track performance, 3) using research to build conceptual models, and 4) ideation through a "sandbox" approach. It then provides details on the innovation process, including insight, targeting, prototyping, and market development. Lastly, it discusses innovation types and notes several factors for innovation success, such as customer focus, technology leverage, process discipline, and an risk-embracing culture.
CloudConf2011 Introduction to Google App Engineadesso AG
The document provides an introduction and agenda for a presentation on Google App Engine. It discusses the speaker's background in Java development. The agenda covers Google App Engine, persistence in GAE using JDO and JPA, limits of GAE/J, quotas and performance, build tools, and hands-on examples. It summarizes the features and restrictions of GAE/J, how to set up projects in Eclipse, deploy to the cloud, and view apps online.
This document provides information about prediabetes and strategies for preventing type 2 diabetes. It discusses that prediabetes affects 86 million Americans and puts them at risk for developing diabetes. Lifestyle changes like modest weight loss through diet and exercise can help delay the onset of diabetes by 58% for those with prediabetes. The document then outlines various dietary approaches like carbohydrate counting and meal planning to help manage blood glucose levels and prevent diabetes.
A Business-CriticalSharePoint SolutionFrom adesso AGadesso AG
The document discusses how adesso AG created a business-critical SharePoint solution for a public transportation system to aggregate information from multiple legacy systems and provide it through standard interfaces. This allowed information about delays and schedules to be accessed through multiple channels like mobile apps and social media. By making information more accessible and reliable, the solution increased customer satisfaction and modal share by 5%.
The document describes an exchange list system for meal planning that divides foods into 6 groups based on their nutrient content: milk, non-starchy vegetables, fruits, starches, meats and substitutes, and fats. Each group has a standard serving size or "choice" that contains a set amount of calories, carbohydrates, proteins, etc. The system allows users to balance their food intake over a day by tracking how many "choices" from each group they consume. Examples are provided to illustrate how to use the exchange lists to plan meals and snacks.
Carbohydrate counting is an effective meal planning method that was used in the Diabetes Control and Complications Trial. It involves assessing a patient's needs, developing an optimal carbohydrate intake pattern based on lifestyle and schedule, and teaching patients how to achieve euglycemia through various carbohydrate intake patterns. Summarizing key points from the document, carbohydrate counting decreases A1C by 1-2% in people with diabetes, achieves and maintains target blood glucose and lipid levels, and prevents or slows chronic diabetes complications by modifying nutrient intake and lifestyle.
Managing Diabetes Through a Healthy Dietrinki singh
Eating a healthy diet is important for managing type 2 diabetes as it can help control blood sugar and weight, prevent complications, and potentially reduce medication needs. Nutrition guidelines recommend consuming at least 130 grams of carbohydrates per day primarily from fruits, vegetables, whole grains and low-fat dairy, monitoring carbohydrate intake, limiting saturated and trans fats, and engaging in regular exercise. Individualized medical nutrition therapy is needed based on a person's health status and goals.
Carbohydrate counting is a meal planning approach for managing blood sugar levels in diabetes. It is based on counting the total amount of carbohydrates consumed rather than specific food sources. The amount of carbohydrates has the largest effect on post-meal blood sugar levels. Carbohydrate counting provides flexibility in meal planning and eating when desired without feeling restricted. It requires understanding how different foods affect blood sugar and investing time to accurately estimate portion sizes and carbohydrate amounts in foods.
Exchange Lists for Meal Planning splits foods into 6 groups based on their nutrients and calories:
1) The Dairy Group contains foods like milk and yogurt. 2) The Vegetables Group includes all non-starchy veggies. 3) The Fruit Group portions fruits by their carbohydrate content. 4) The Starch Group measures foods like bread, cereal and potatoes with similar carb amounts. 5) The Meat Group provides protein amounts. 6) The Fat Group specifies fat grams. Tracking the number of "choices" from each group helps create balanced meal plans.
Question # 1: How do we measure innovation input?
Question # 2: How do we measure an innovation process?
Question # 3: How do we measure innovation output?
Steve Jobs' LEAN STARTUP PROJECT MANAGEMENT: How Steve Jobs Planned, Organize...Rod King, Ph.D.
Steve Jobs' approach to creating extraordinarily successful products is shrouded in mystery. This presentation introduces a new framework, "Lean Startup Project Management", which can be used to explain Steve Jobs' innovation methodology which was largely intuitive. As the name implies, Lean Startup Project Management focuses on translating into reality ideas and principles from Eric Ries's bestselling book, "The Lean Startup." The core tool of Lean Startup Project Management is the One-Page Lean Startup which is a multilevel dashboard. Whereas existing approaches focus on using a tactical dashboard for Lean Startup Project Management, the One-Page Lean Startup uses 3 integrated dashboards: visionary, strategic, and tactical One-Page Lean Startup. Users end up saving time, money, energy, and lots of other resources. Experiment with the One-Page Lean Startup and provide us with your feedback.
Google, Apple, Microsoft bauen wesentliche Strategien auf den Einsatz von HTML5 auf. HTML5 beschäftigt heute die Webwelt und ist dabei viel mehr als die Weiterentwicklung von HTML 4.01 oder XHTML 1.0. Es bietet neue vielfältige Möglichkeiten, den Web-Browser als Plattform für interaktive Anwendungen zu nutzen - und das bei Bedarf uauch offline. Wir zeigen Ihnen anhand von Beispielseznarien, wie Sie von den neuen Möglichkeiten profitieren können.
10 Ways Your Boss Kills Employee MotivationOfficevibe
This document outlines 10 ways that bosses can kill employee motivation, including micromanaging employees, focusing only on mistakes, dismissing new ideas, holding useless meetings, making empty promises, telling inappropriate jokes, not keeping their word, measuring employee success in the wrong way, setting unrealistic deadlines, and playing favorites. The document encourages bosses to listen to employee concerns to better motivate them.
This document discusses dietary recommendations for managing diabetes. It recommends that diet should provide 60% of calories from carbohydrates, 15-20% from proteins, and 15-25% from fats. Carbohydrates should come from whole grains, fruits and vegetables. Protein can come from plant sources like legumes and soy. Fats intake should emphasize unsaturated rather than saturated fats. Meals should be frequent and balanced to control blood sugar levels. Regular physical activity and maintaining a healthy body weight are also emphasized.
Diabetes is a condition where there is too much sugar in the blood due to lack of or insufficient insulin produced by the pancreas. Proper management of diabetes through diet, exercise, medication and monitoring of blood sugar levels is important to prevent serious complications such as blindness, nerve damage, heart disease and amputation. The document provides guidance on diabetes self-management including healthy eating through use of food exchanges and groups, monitoring blood sugar levels, treating hypoglycemia and ketoacidosis, and balancing food, exercise and medication.
The document discusses diabetes, which occurs when the body does not properly produce or use insulin. It describes the roles of insulin in regulating carbohydrate, protein, and fat metabolism. Two main types of diabetes are described: type 1 diabetes results from little to no endogenous insulin production and requires lifelong exogenous insulin, while type 2 diabetes involves insulin resistance and impaired insulin secretion. Screening methods and treatment options like carbohydrate counting are also summarized.
This document provides information on dietary education tools for people with diabetes. It discusses the goals of dietary advice, which are to maintain health through appropriate food choices and achieve optimal health outcomes. The role of the dietician is described, which includes assessing individuals' specific needs and beliefs to develop a realistic eating plan. Dietary education tools are separated into two stages - stage one focuses on basic concepts like the food pyramid and plate model, while stage two covers more advanced topics such as food exchanges and carbohydrate counting. Carbohydrate counting is explained in detail as a key method for meal planning and insulin dosing.
Functional Dairy Foods for Combating Metabolic Disorder Kaushik Khamrui
Metabolic disorders result from genetic abnormalities that affect enzyme function in metabolism. This can lead to an inability to break down or produce essential substances. The document discusses how certain dairy foods and components can help manage metabolic disorders and related conditions like metabolic syndrome. It provides examples of how dairy foods with low glycemic indexes, soluble fibers, bioactive peptides, and reduced lactose can help lower blood glucose, dyslipidemia, hypertension, microalbuminuria, and manage lactose intolerance. Functional dairy foods developed through fortification or composition manipulation may help address the growing epidemic of metabolic disorders.
This document provides dietary recommendations for managing diabetes through healthy eating. It discusses controlling blood glucose, cholesterol, weight and blood pressure by eating a diet low in saturated fat and cholesterol, moderate in carbohydrates, and high in fiber. Specific foods and nutrients are identified that can help or harm blood sugar and heart health. Portion sizes, meal timing, and consistency are important aspects of a diabetes meal plan. Regular physical activity and modest weight loss also benefit diabetes control.
This document provides guidelines for the management of diabetes through diet and nutrition. It outlines the main goals of treatment as making patients symptom-free and preventing complications. Target blood glucose and lipid levels are listed. A balanced diet with appropriate proportions of carbohydrates, proteins, fats, and fibers is recommended. Factors like age, gender, diabetes type, weight, and medical conditions determine an individual's diet. Meal planning considers calorie needs and glycemic index values of foods. Dietary education tools like food groups, exchanges, and carbohydrate counting are discussed to help patients understand healthy eating.
The document provides guidelines for diet and nutrition in managing diabetes mellitus (DM). It recommends a balanced diet with regular meals that includes carbohydrates, proteins, fats, and fibers in appropriate amounts based on an individual's needs and goals. Dietary education tools like food groups, food exchanges, carbohydrate counting and the glycemic index help patients understand healthy eating habits and self-manage their blood glucose levels. The overall goals are to maintain a healthy weight and lifestyle to prevent complications and symptoms of DM through nutritional modifications.
Diabetes Patient Presentation Dr Vivek BaligaDr Vivek Baliga
This presentation on diabetes is meant to inform patients about diabetes and what it is all about. Presentation by Dr Vivek Baliga, Internal Medicine Consultant.
Diabetes Mellitus for Nursing Students. PPTAnandh Perera
This document discusses diabetes mellitus, including its history, types, symptoms, diagnosis, management, and prevention. It notes that diabetes is a chronic condition caused by either insufficient insulin production or decreased sensitivity to insulin, resulting in high blood glucose levels. The two main types are type 1, characterized by lack of insulin production, and more common type 2, associated with insulin resistance. Management involves lifestyle changes like diet and exercise as well as medication like oral hypoglycemics or insulin. Lifestyle interventions and some medications have been shown to prevent or delay the onset of type 2 diabetes in those at high risk.
Type II diabetes and gestational diabetes can be treated through nutritional management. Obese individuals have the highest risk of developing type II diabetes due to insulin resistance and metabolic alterations caused by excess fat accumulation. Nutritional therapy focuses on controlling blood glucose levels through moderate calorie, low-fat, high-fiber diets with balanced macronutrients. For gestational diabetes, nutritional management is similar but carb intake is slightly lower to prevent ketosis in both mother and baby. The goal is to support a healthy pregnancy and delivery for both.
Diabetes is a chronic disease characterized by high blood sugar levels due to a problem with insulin production or effectiveness. There are three main types of diabetes: type 1 caused by the body's failure to produce insulin; type 2 often related to obesity and lack of exercise; and gestational diabetes during pregnancy. Diet and lifestyle changes are important for managing diabetes, focusing on eating foods low in carbohydrates and sugar, limiting fat intake, and consuming adequate fiber, protein, vitamins and minerals. A balanced diet along with exercise can help control blood sugar levels and reduce health complications of diabetes.
This note covers the following topics: medical nutrition therapy for diabetes, basic dietary guidelines, hypoglycemia, more information specifically for treating the patient with type2 diabetes, managing lipid abnormalities, managing blood pressure, type2 diabetes in childhood, pregnancy with preexisting diabetes, gestational diabetes, medical nutrition therapy for diabetes
Diet for diabetes ....in World diabetic day at Apollo Hospital Ranchinutritionistrepublic
Medical Nutrition Management and proper dietary management are the cornerstones for managing diabetes, as diet plays a major role in regulating carbohydrates, fat, and protein. The goals of diabetes nutrition management are to achieve normal blood glucose and lipid levels to reduce vascular disease risks, prevent chronic diabetes complications by modifying nutrient intake and lifestyle, address individual nutrition needs, and maintain the pleasure of eating. Key recommendations include calculating calorie needs based on age and activity level, obtaining 50-60% of calories from carbohydrates focusing on high fiber sources with a low glycemic index, and limiting fat intake to 30% of calories. Lifestyle changes such as controlling weight, increasing physical activity, choosing whole grains over processed carbohydrates,
This document discusses carbohydrate, lipid, and protein macronutrients. It provides details on carbohydrate types including monosaccharides, disaccharides, and polysaccharides. It also discusses glycogen storage and the role of carbohydrates in exercise. For lipids, it describes fatty acid types and lipoprotein transport. It discusses cholesterol and the roles of lipids in the body. Finally, it summarizes carbohydrate and lipid use during different intensities of exercise.
This document provides guidelines for eating and managing diabetes, including recommendations around carbohydrate, protein, fat, and alcohol intake. The key points are:
- Carbohydrate intake affects blood glucose levels the most, so it's important to consistently consume carbohydrates and match insulin doses to carbohydrate amounts.
- Fiber intake of 20-35 grams per day from whole grains, fruits, and vegetables is encouraged.
- Saturated and trans fats should be limited to lower LDL cholesterol and risk of heart disease. Monounsaturated fats are recommended instead.
- Small amounts of weight loss through a structured program including reduced calories and regular physical activity can improve diabetes management and health outcomes.
- L
Learning how to control diabetes is the aim for all of us with diabetes.
This can be done for both type 1 and type 2 diabetes with food, diet and regular blood testing.
Being armed with information will help you to control your diabetes and this guide includes specific information for controlling type 1 and type 2 diabetes
For more information, visit https://www.timberlandmedical.com
This presentation is by Dr LO SIAW PING, a visiting dietician at Timberland Medical Centre
Timberland Medical Centre is a private hospital that has been in operation since 1994. We are strategically located at the 3rd Mile roundabout on Jalan Rock, Kuching, Sarawak, East Malaysia. Our hospital is 10 minutes from the Kuching International Airport and 15 minutes from the Central Bus Terminal. We continually seek to improve and upgrade our services and facilities, as we strive to provide the best medical care for our patients and customers.
1. The document discusses the glycemic index (GI) and glycemic load (GL), which are measures of how foods affect blood glucose levels. The GI ranks carbohydrates based on their effect on blood glucose, while GL considers both the quality and quantity of carbs.
2. Eating low GI and GL foods is associated with health benefits like lower blood glucose, cholesterol, weight, and risk of heart disease and diabetes. Factors like fiber, fat, and cooking method influence a food's GI ranking.
3. The document provides examples of low and high GI meals and snacks and recommends focusing on a balanced, well-portioned diet including low GI carbs.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
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8. Action of Insulin on Carbohydrate, Protein
and Fat Metabolism
Carbohydrate
Facilitates the transport of glucose
into muscle and adipose cells
Facilitates the conversion of glucose
to glycogen for storage in the liver
and muscle.
Decreases the breakdown and
release of glucose from glycogen by
the liver
9. Action of Insulin on Carbohydrate, Protein
and Fat Metabolism
Protein
Stimulates protein synthesis
Inhibits protein breakdown;
diminishes gluconeogenesis
10. Action of Insulin on Carbohydrate, Protein
and Fat Metabolism
Fat
Stimulates lipogenesis- the
transport of triglycerides to adipose
tissue
Inhibits lipolysis – prevents
excessive production of ketones or
ketoacidosis
11. Type I Diabetes
Low or absent endogenous insulin
Dependent on exogenous insulin for
life
Onset generally < 30 years
5-10% of cases of diabetes
Onset sudden
Symptoms: 3 P’s: polyuria, polydypsia,
polyphagia
14. Type II Diabetes
Insulin levels may be normal, elevated or
depressed
Characterized by insulin resistance,
diminished tissue sensitivity to insulin,
and impaired beta cell function (delayed or
inadequate insulin release)
Often occurs >40 years
16. Type II Diabetes
Risk factors: family history,
sedentary lifestyle, obesity and
aging
Controlled by weight loss, oral
hypoglycemic agents and or insulin
17.
18. Screening for Diabetes
Fasting Significance Action
Blood
Glucose
< 110 Normal Retest in 3
years
>110 & IGT 1. Additional
<126 testing
2. Check risk
factors
3. MNT
> 126 Diabetes 1. Confirm
Likely by 2nd FBG
2. Treat DM
21. Medical Nutrition Therapy
Maintain short and long term body
weight
Reach and maintain normal growth
and development
Prevent or treat complications
Improve and maintain nutritional
status
Provide optimal nutrition for
pregnancy
22. Nutritional Management for Type I
Diabetes
Consistency and timing
of meals
Timing of insulin
Monitor blood glucose
regularly
23. Nutritional Management for Type II
Diabetes
Weight loss
Smaller meals and snacks
Physical activity
Monitor blood glucose and
medications
24. Diabetes Control and
Complications Trial
10 year randomized, controlled,
clinical trial
Determine the effects of glucose
control on the development of long
term microvascular and neurologic
complications in persons with type I
diabetes.
1441 participants, ages 13 to 39
25. Diabetes Control and
Complications Trial
Conventional therapy:
1 - 2 insulin injections,
self monitoring B.G
routine contact with MD and case manager 4X/year.
Intensive therapy:
3 or more insulin injections, with adjustments in dose
according to B.G monitoring,
planned dietary intake and anticipated exercise.
26. Diabetes Control and
Complications Trial
Results:
76% reduction in retinopathy
60% reduction in neuropathy
54% reduction in albuminuria
39% reduction in microalbuminuria
Implication: Improved blood
glucose control also applies to
person with type II diabetes.
27. Nutrition Recommendations
Carbohydrate
60-70% calories from carbohydrates
and monounsaturated fats
Protein
10-20% total calories
28. Nutrition Recommendations
Fat
<10% calories from saturated fat
10% calories from PUFA
<300 mg cholesterol
Fiber
20-35 grams/day
Alcohol
Type I – limit to 2 drinks/day, with meals
Type II – substitute for fat calories
29. 2003Diabetic Exchange Lists
Food Group CHO Protein Fat Calories
(grams) (grams) (grams)
Starch 15 3 0-1 80
Fruit 15 60
Milk
Skim 12 8 0-3 90
Low-Fat 12 8 5 120
Whole 12 8 8 150
Other 15 varies varies Varies
Carbohydrate
Nonstarchy 5 2 0 25
Vegetables
31. 2003 Diabetic Exchange Lists
Carbohydrate Exchanges – 3 g. protein,
0-1 g. fat and 80 calories
Bread: bagel, bread, English muffin, tortilla
Cereal: cold and hot cereal, pasta, rice
Starchy vegetables: corn, peas, potato,
squash
Crackers and snacks
Dried beans
Starch prepared foods with fat: biscuits,
muffins
32. 2003 Diabetic Exchange Lists
Fruit Exchanges
15 grams carbohydrate and 60 calories
Fruit and fruit juice
Vegetables
5 g. carbohydrate, 2. G protein and 25
calories
34. 2003 Diabetic Exchange Lists
Milk – 12 g. carbohydrate, 8 g.
protein and 0-8 g. fat
Meat and Meat Substitutes
Very Lean Meat (7 g protein, 0-1 g.
fat and 35 calories)
Chicken, turkey – white meat
Shellfish (clams, crab, lobster, shrimp)
35. 2003 Diabetic Exchange Lists
Lean Meat (7 g protein, 3 g. fat and
55 calories)
Select or choice beef, trimmed of fat
Lean pork
Poultry, turkey –dark meat
36. 2003 Diabetic Exchange Lists
Medium Fat Meat (7 g protein, 5 g. fat
and 75 calories)
Most beef products – corned beef, ribs, prime
grades
Ground turkey
Chicken – dark meat with skin
High Fat Meat (7 g protein, 8 g. fat and
75 calories)
All cheeses
Processed meats, hot dogs
37. Daily Meal Plan
Time Exchanges Menus
8 AM ___Fruit exchanges
___Starch exchanges
___ Meat exchanges
___ Milk exchanges
___ Fat exchanges
10 AM
12:30 PM ___ Fruit exchanges
___Starch exchanges
___ Meat exchanges
___ Milk exchanges
___ Fat exchanges
6:30 PM ___ Fruit exchanges
___Starch exchanges
___ Meat exchanges
___ Milk exchanges
___ Fat exchanges
8 PM
38. Carbohydrate Counting
A serving of carbohydrate is
considered 15 grams
A serving of fruit or starch or 3
servings of vegetable is = to 1
carbohydrate
One milk serving is considered
equal to one carbohydrate
39. Carbohydrate Counting
Example: Meal plan = 9
carbohydrate servings
4 fruit and 5 starches or
3 fruit + 4 starches + 3 vegetables
and 1 milk or
2 fruit + 4 starches + 3 vegetables
and 2 milk
40. Daily Meal Plan
Time Grams of Carbohydrate Menus
8 AM ___Carbohydrate choices
___ Meat exchanges
___ Fat exchanges
10 AM ___ Carbohydrate Choices
12:30 PM ___Carbohydrate choices
___ Meat exchanges
___ Fat exchanges
6:30 PM ___Carbohydrate choices
___ Meat exchanges
___ Fat exchanges
8 PM ____ Carbohydrate Choices
Editor's Notes
In the writings of Aretaios (Aretaeus) of Cappadocia, a Greek physicianswho lived during the period 120-200 A.D., there is a reference, probably to Diabetes. Amongst the disease described, he mentioned a condition associated with unquenchable thirst, excessive drinking of water and excessive passing of urine. The word "Diabetes" is perhaps derived from a Greek word signifying a siphon, appropriately describing how in the disease the fluid cannot be retained in the body. Greek physicians, like ancient Hindu physicians, used to taste the patient's urine to detect abnormal constituents. This unpleasant practice perhaps enabled them to detect diabetic patients. Thomas Willis, in 1764, observed that the urine of a diabetic patient was sweet and he surmised that it contained either sugar or honey. Diabetes mellitus comes from the Greek word "diabainein" meaning "to pass through," and the Latin word "mellitus" meaning "sweetened with honey." Put the two words together and you have "to pass through sweetened with honey."
The digestion of carbohydrate. The complex polysaccharide starch is broken down into glucose by the enzymes amylase and maltase (secreted by the small intestine).
Panel 2. Insulin secretion - Insulin secretion in beta cells is triggered by rising blood glucose levels. Starting with the uptake of glucose by the GLUT2 transporter, the glycolytic phosphorylation of glucose causes a rise in the ATP:ADP ratio. This rise inactivates the potassium channel that depolarizes the membrane, causing the calcium channel to open up allowing calcium ions to flow inward. The ensuing rise in levels of calcium leads to the exocytotic release of insulin from their storage granule. The process by which insulin is released from beta cells, in response to changes in blood glucose concentration, is a complex and interesting mechanism that illustrates the intricate nature of insulin regulation. Type 2 glucose transporters (GLUT2) mediate the entry of glucose into beta cells (see panel 2). As the raw fuel for glycolysis, the universal energy-producing pathway, glucose is phosphorylated by the rate-limiting enzyme glucokinase. This modified glucose becomes effectively trapped within the beta cells and is further metabolized to create ATP, the central energy molecule. The increased ATP:ADP ratio causes the ATP-gated potassium channels in the cellular membrane to close up, preventing potassium ions from being shunted across the cell membrane. The ensuing rise in positive charge inside the cell, due to the increased concentration of potassium ions, leads to depolarization of the cell. The net effect is the activation of voltage-gated calcium channels, which transport calcium ions into the cell. The brisk increase in intracellular calcium concentrations triggers export of the insulin-storing granules by a process known as exocytosis. The ultimate result is the export of insulin from beta cells and its diffusion into nearby blood vessels. Extensive vascular capacity of surrounding pancreatic islets ensures the prompt diffusion of insulin (and glucose) between beta cells and blood vessels. Insulin release is a biphasic process. The initial amount of insulin released upon glucose absorption is dependent on the amounts available in storage. Once depleted, a second phase of insulin release is initiated. This latter release is prolonged since insulin has to be synthesized, processed, and secreted for the duration of the increase of blood glucose. Furthermore, beta cells also have to regenerate the stores of insulin initially depleted in the fast response phase
How insulin works Panel 3. Insulin binding to the insulin receptor induces a signal transduction cascade which allows the glucose transporter (GLUT4) to transport glucose into the cell. [ magnify ] Insulin molecules circulate throughout the blood stream until they bind to their associated (insulin) receptors. The insulin receptors promote the uptake of glucose into various tissues that contain type 4 glucose transporters (GLUT4). Such tissues include skeletal muscles (which burn glucose for energy) and fat tissues (which convert glucose to triglycerides for storage). The initial binding of insulin to its receptor initiates a signal transduction cascade that communicates the message delivered by insulin: remove glucose from blood plasma (see panel 3). Among the wide array of cellular responses resulting from insulin ‘activation,’ the key step in glucose metabolism is the immediate activation and increased levels of GLUT4 glucose transporters. By the facilitative transport of glucose into the cells, the glucose transporters effectively remove glucose from the blood stream. Insulin binding results in changes in the activities and concentrations of intracellular enzymes such as GLUT4. These changes can last from minutes to hours. Panel 3. Insulin-mediated glucose uptake - Insulin binding to the insulin receptor induces a signal transduction cascade which allows the glucose transporter (GLUT4) to transport glucose into the cell. As important as insulin is to preventing too high of a blood glucose level, it is just as important that there not be too much insulin and hypoglycemia. As one step in monitoring insulin levels, the enzyme insulinase (found in the liver and kidneys) breaks down blood-circulating insulin resulting in a half-life of about six minutes for the hormone. This degradative process ensures that levels of circulating insulin are modulated and that blood glucose levels do not get dangerously low
What goes wrong in diabetes? The body’s response to blood sugar requires the coordination of an array of mechanisms. Failure of any one component involved in insulin regulation, secretion, uptake or breakdown can lead to the build-up of glucose in the blood. Likewise, any damage to the beta cells, which produce insulin, will lead to increased levels of blood glucose. Diabetes mellitus, commonly known as diabetes, is a metabolic disease that is characterized by abnormally high levels of glucose in the blood. Whereas non-diabetics produce insulin to reduce elevated blood glucose levels (i.e. after a meal), the blood glucose levels of diabetics remain high. This can be due to insulin not being produced at all, or not in quantities sufficient to be able to reduce the blood glucose level. The most common forms of diabetes are Type 1 diabetes (juvenile onset, 5-10% of cases), which is an autoimmune disease that destroys beta cells, and Type 2 diabetes (adult onset, 90-95% of cases), which is associated with insufficient insulin. In either case, diabetes complications are severe and the disease can be fatal if left untreated. Insulin is the foundation for the management of insulin-dependent diabetes. Unfortunately, the use of insulin is not a cure nor without side effects. In certain parts of the world, it is not even available. Insulin is also not completely effective in preventing complications of the disease such as blindness, heart disease, kidney failure, etc. While millions of men, women, and children await a life without diabetes, let us hope that policy makers and the scientific community can converge on strategies that promote discovery for a cure.
Insulin is a polypeptide hormone that travels around the bloodstream. Most of the cells in the body carry receptors for the molecule in their cell membranes. Once the hormone has become bound to one of these receptors, the receptor gives a signal to the cell's interior. This signal leads to many enzyme controlled reactions which, in turn lead to changes in the metabolism of the cell. Many of the effects of insulin depend on the particular cell type in which it stimulates. However, in nearly all of the cells that have insulin receptors in their cell membrane, the binding of insulin to the receptors leads to increased glucose uptake of the cell. The two types of cells that are the main exceptions are the brain and the liver. However, this is only due to the fact that these cells are readily permeable to glucose, even in the absence of insulin. Liver cell membranes do contain insulin and glucagon receptors, but binding of the hormone to them affects cellular processes other than glucose permeability. The animation below illustrates the way insulin brings about the increase in glucose uptake Glucose enters the cells of the body through glucose transporter (GLUT) proteins which are embedded within the cell membrane. This is a process called facilitated diffusion. When insulin binds to it's receptor, the intracellular domain of the receptor changes shape slightly . This sets off a chain of reactions. These reactions serve to activate certain enzymes. As a result, more glucose transporter proteins are released from intracellular stores and move to the plasma membrane and become embedded within it.
In general we can say that insulin favors anabolic reactions; glucagon, catabolic reactions. Put more simply, insulin favors storing energy and production of proteins while glucagon activates release of stored energy in the form of glucose or fatty acids. The actions of these two hormones on individual metabolic processes are summarized in the following table.
A protein-rich meal leads to release of both insulin and glucagon. The latter stimulates gluconeogenesis and release of the newly formed glucose from the liver to the blood stream. The very moderate rise in insulin associated with the protein meal stimulates uptake of the sugar formed in the liver by muscle and fat tissue.
One of the primary actions of insulin is to control movement of fatty acids in and out of adipocytes. It does this through two mechanisms; regulation of hormone-sensitive lipase and activation of glucose transport into the fat cell via recruitment of GLUT4. Storage of triglycerides after a meal is dependent upon insulin-stimulated glucose uptake and glycolysis. Fat cells take up both fatty acids and glucose simultaneously. The fatty acids come from the action of lipoprotein lipase at the capillary wall. Glucose uptake is stimulated by insulin and occurs through the insulin-sensitive glucose transport protein GLUT4. Thus insulin increases glucose uptake and glycolysis in fat cells, inhibits hormone-sensitive lipase and thereby increases storage of lipids as triglycerides in adipocytes.
The total lack of insulin leads to two metabolic crises; a marked increase in the rate of lipolysis in adipose tissue and activation of hepatic gluconeogenesis in spite of high plasma glucose levels. The dramatically increased rate of lipolysis in adipose tissue follows the lack of insulin inhibition of hormone-sensitive lipase. The increase in fatty acids that results leads to a massive synthesis of ketone bodies in the liver. These then exceed the buffer capacity of the blood, leading to ketoacidosis. Excess acid is a potent poison for the brain. Coma and death follow ketoacidosis. Blood glucose levels
Type 1 and type 2 diabetes have different causes. Yet two factors are important in both. First, you must inherit a predisposition to the disease. Second, something in your environment must trigger diabetes. Genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease at most only half the time. When one twin has type 2 diabetes, the other's risk is at most 3 in 4. In most cases of type 1 diabetes, people need to inherit risk factors from both parents. We think these factors must be more common in whites because whites have the highest rate of type 1 diabetes. Because most people who are at risk do not get diabetes, researchers want to find out what the environmental triggers are. One trigger might be related to cold weather. Type 1 diabetes develops more often in winter than summer and is more common in places with cold climates. Another trigger might be viruses. Perhaps a virus that has only mild effects on most people triggers type 1 diabetes in others. Early diet may also play a role. Type 1 diabetes is less common in people who were breastfed and in those who first ate solid foods at later ages. In many people, the development of type 1 diabetes seems to take many years. In experiments that followed relatives of people with type 1 diabetes, researchers found that most of those who later got diabetes had certain autoantibodies in their blood for years before. (Antibodies are proteins that destroy bacteria or viruses. Autoantibodies are antibodies 'gone bad,' which attack the body's own tissues.)
Blood sugar levels are dependent upon glucose uptake after meals and hepatic release of glucose between meals. The sugar released from the liver comes either from stored glycogen or production of glucose from lactate and amino acids. This production of glucose is largely responsible for stabilization of postprandial blood sugar levels. The hyperglycemia noted in type 2 diabetes partially results from lack of control over hepatic glucose formation due to resistance to insulin. It has recently become clear that part of this insulin effect occurs indirectly through insulin-sensitive receptors in the brain (more precisely, in the hypothalamus).
Type 2 diabetes has a stronger genetic basis than type 1, yet it also depends more on environmental factors. Sound confusing? What happens is that a family history of type 2 diabetes is one of the strongest risk factors for getting the disease but it only seems to matter in people living a Western lifestyle. Americans and Europeans eat too much fat and too little carbohydrate and fiber, and they get too little exercise. Type 2 diabetes is common in people with these habits. The ethnic groups in the United States with the highest risk are African Americans, Mexican Americans, and Pima Indians. In contrast, people who live in areas that have not become Westernized tend not to get type 2 diabetes, no matter how high their genetic risk. Obesity is a strong risk factor for type 2 diabetes. Obesity is most risky for young people and for people who have been obese for a long time.
Note that this figure applies both to uncontrolled diabetes type I and severe uncontrolled diabetes type II
Balance food intake with insulin (or oral agents) and activity to achieve blood glucose levels as near normal as possible. Achieve and maintain normal lipid (cholesterol) levels
Provide energy to reach and maintain short and long term body weight Reach and maintain normal growth and development in children and adolescents Prevent or treat complications Improve and maintain nutritional status Provide optimal nutrition for pregnancy
Consistency and timing of meals Timing of meals and administration of insulin Insulin plans should be designed to match the person’s eating pattern Monitor blood glucose regularly
Weight loss: 10-20# is sufficient Smaller meals and snacks Physical activity Monitor blood glucose and medications
Sucrose and sucrose foods may be substituted for other carbohydrates; not added to male plan