This document discusses diabetes mellitus, including the four main types, symptoms, relationship to insulin, and nutritional management. There are four types of diabetes defined by differences in insulin production or use. Symptoms include excessive urination, thirst, appetite and fatigue due to high blood glucose levels. Insulin controls glucose levels by allowing cells to absorb blood glucose for energy. Treatment focuses on controlling blood glucose through diet, medication, exercise and monitoring to prevent complications and maintain health. The exchange list method is commonly used to plan diabetic diets that meet calorie and nutrient needs.

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2. Objectives
- Describe diabetes mellitus and identify
the types.
- Describe the symptoms of diabetes
mellitus.
- Explain the relationship of insulin to
diabetes mellitus.
- Discuss appropriate nutritional
management of diabetes mellitus.
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3. Diabetes Mellitus
There are 4 types:
- Type 1 diabetes (insulin-dependent
diabetes)
- Type 2 diabetes (noninsulin-dependent
diabetes)
- Gestation diabetes mellitus
- Impaired glucose tolerance (prediabetes)
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4. Diabetes Mellitus
Define as a group of serious and chronic
disorders affecting the metabolism of
carbohydrates.
- Glucose is the primary source of energy
for the body.
- Glucose is transported by the blood, and
its entry into the cells is controlled by
insulin.
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5. Insulin
- Secreted by the beta cells of pancreas
gland
- When there is inadequate production of
insulin, or the body is unable to use the
insulin, glucose cannot enter the cells and it
accumulates in the blood, creating
hyperglycemia.
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6. How Insulin Works
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7. Symptoms
- Glycosuria: glucose in the urine
- Polyuria: excessive urination
- Polydipsia: excessive thirst
- Polyphagia: excessive appetite
- Loss of weight, weakness, and fatigue
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8. Unrecognized symptoms:
- Poor wound healing
- Blurred vision
- Skin irritation or infection
- Recurrent gum or bladder infections
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9. Etiology
- The cause of diabetes is unclear, but it is
believed to be hereditary.
- Environmental factors may also play a
role in the development of diabetes.
- Viruses and obesity may precipitate the
disease.
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10. Treatment
Goals
- Control blood glucose levels
- Provide optimal nourishment for the
client
- Prevent symptoms and thus delay
complications
Normal blood glucose levels are 70 to 110
mg/dL
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11. Treatment Regimes
- Diet alone
- Diet combined with glucose-lowering
medication
- Diet combined with insulin
- Exercise combined with any of the above
- Regularly monitor blood glucose levels in
addition to any of the above.
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12. Nutritional Management
Goals of nutrition management of diabetes:
- Maintain desirable blood glucose and
blood lipid (fat) levels.
- Maintain optimal nutritional status.
- Reach and maintain a healthy weight.
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13. Diets Exchange Lists
- Most commonly used method of diet
therapy is based on exchange lists.
- These lists were developed by the
American Diabetes Association in
conjunction with the American Dietetic
Association.
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14. - The exchange lists is grouped the foods
together because they are alike.
- Foods on each list have about the same
amount of carbohydrate, protein, fat and
calories.
- In the amounts given, all choices on each
list are equal.
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15. - Any food on the list can be exchanged for
any other food on the list.
- The lists are grouped into three main
groups: carbohydrate group; meat and meat
substitute group; and fat group.
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16. Client’s calorie needs will depend on:
- Age
- Activities
- Muscle mass
- Size and resting energy expenditure.
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17. Dietary Recommendation
- 50% to 60% of the calories should be from
carbohydrates (40% to 50% from complex
carbohydrates and 10% to 20% from simple
sugars)
- Fats should be limited to 30% of total
calories.
- Proteins should provide from 15% to 20%
of total calories.
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18. Fiber
- High-fiber intake appears to reduce the
amount of insulin needed because it lowers
blood glucose.
- It also appears to lower blood cholesterol
and triglyceride levels.
- High fiber may mean 25–35 g of dietary
fiber a day.
- Increase water when increasing fiber.
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19. High Fiber Foods
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20. Alternative Sweeteners
- Saccharin: It has been shown to produce
bladder cancer in rats when used in large
quantities.
- Aspartame: made from amino acids; does
not require insulin for metabolism
- Sucralose: sweetener made from sugar
molecules
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21. Exercise
- Type 1: exercise can complicate glucose
control. If done, should be on a regular
basis, and considered carefully as meals are
planned to avoid hypoglycemia.
- Type 2: exercise helps improve weight
control, glucose levels, and the
cardiovascular system
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22. Considerations for the Health Care
Professional:
- If diet is followed, medication is taken,
and time is allowed for sufficient exercise
and rest, one can live a near-normal life.
- Emphasize the importance of eating all of
the prescribed food.
- Meals should be eaten at regular times,
and clients should read labels.
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23. Conclusion
- The diabetic diet is used in treating
diabetes mellitus, a metabolic disease
caused by the improper functioning of the
pancreas.
- Serious complications, including death,
can occur if the condition is left untreated.
- Treatment includes diet, medication, and
exercise.
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24. Thank
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