A few facts...

• Dibetic management should always include nutrition management, exercise and medicine therapies.
• The main aims of the nutritional therapy are to reach almost-normal blood glucose and pressure, to reach optimum serum lipid level and to reach and maintain a normal weight. It is also important to prevent short- and long-term complications, reach the optimum nutrition and exercise while considering the patients lifestyle, cultural background and personal preferences.
• There is no such thing as the one and only diet receipt for patients with diabetes. For meal planning and diets there are different methods available, such as:: 1) the Plate Model, 2) the Food Guide Pyramid, 3) Exchange Lists, 4) Carbohydrate Counting.

Diabeties is number five on the list of deadly diseases in America and there is currently no cure to this disease. Using the most current research the American Diabetes Association created an updated recommendation in 2002, replacing the older recommendations dating from the mid nineties.

Diabetes can be connected with many different metabolic irregularities. The notion that there would be one and only one existing diet for patients with diabetes is no longer the norm. Instead, the current recommendation is that patients with diabetes should in cooperation with diabetes management group of specialists - such as a doctor, dietitian, nurse - together develop a diabetes meal plan that fits their own personal metabolism, nutritionan requirements and lifestyle.

Diabetes management - the goals

There are 3 important parts in diabetes management: diet, exercise and medication when required (normally the use of insulin and/or glucose-lowering medication). When eating, blood glucose level and blood fat level increases. Exercise and the use of proper medicine will lower both blood glucose level and the blood fat level.

Diabeties type 1

Diabetes is normally grouped as either type 1 or type 2. Which one will depend on the underlying physiological problem. Diabetes type 1 (with the older name: insulin-dependent diabetes mellitus),comes from the destruction of the pancreatic beta cells that are the insulin producers. As a result, there will be an insulin deficiency which requires insulin to be taken regularly as medication. Type 1 diabetes is most frequent in either children and young adults, although it is possible that it develops at other ages as well.

In the past, patients on insulin had to use a very strict eating pattern. This could under certain circumstances create noncompliance conflicts to some degree. The later recommendations allow for a higher level of flexibility as they mix insulin treatment into the patient ’s normal food and exercise patterns. These recommendations will also allow a patient to vary the specific timing and amount of insulin taken depending on the actual blood glucose level.

One of the most important goals of type 1 diabetes management is a tight blood glucose level control. It is recommended to monitor the blood glucose level often. With frequent blood glucose monitoring, it is possible to find out which specific foods, exercise activities etc affect the blood glucose level the most. By varying the dose of insulin accordingly, a patient can achieve almost-normal blood sugar levels and minimize the risk for complications such as neuropathy.

It is nevertheless very much a recommendation still that patients who are on insulin have their meals at consistent times and control the amount of carbohydrates to achieve a level of synchronization with the timing of the insulin taken. With the help of several daily insulin doses and frequent controls of blood glucose levels, diabetes patients may adapt to any changes in exercice or food habits.

Diabeties type 2

Type 2 diabetes, (with the old name: non-insulin dependent diabetes mellitus), with over 90% of the cases of diabetes is by far the most common of the diabetes types.

Type 2 diabetes is a combination of an insulin deficiency and an insulin resistance, where the body can not use the insulin in the normal way. Type 2 diabetes risk will increase with age, it is also connected to overweight. The typical patient with diabetes type 2 is above 40-50, has a family history with diabetes and may be overweight with high cholesterol and blood pressure levels. Female patients in this group may have had pregnancy diabetes. There is a new trend in the US, in which type 2 diabetes tends to develop in other ages as well.

The total amount of calories in the diet should be controlled so the right weight is achieved and there is no further increase in weight. The weight control has long been the major task for patients with diabetes type 2. Exercise is very important and should be planned on a regular basis. Control of the blood sugar level, blood lipid level and the blood pressure are three further goals of great importance. Controlling all these factors together will help in minimizing the risk of longer term complications, such as neuropathy.

As a part of the meal planning for type 2 diabetes, improving food choices towards the Dietary Guidelines for Americans and the Food Guide Pyramide should be considered. A reduction in saturated fat levels is also very important together with planning of the daily intake of nutrition into smaller and more frequent portions. Achieving even only a small reduction in weight has been proved to be very beneficial to patients of diabetes. Changing lifestyle towards a slightly higher exercise level and a slightly higher calory intake is also beneficial.

Nutrition recommendations

Carbohydrates and fat: One of the larger risks to diabetes patients is cardiovascular disease or stroke. These diseases tend to be much more common among diabeties patients than others. Any precautions that can be taken to prevent these complications is of importance so controlling the fat and carbohydrate intake is an important aim for any diabetes meal plan or diet.

Proteins: Around twenty percent of total daily calories normally consumed are derived from proteins. As long as renal functionality is normal, no research shows any need for changing this dietary proportion of protein. An increase of the protein above this normal level has been shown to have some positive effect on the risk of developing nephropathy.

For diabetes patients, there are two main targets for the intake of fat; The limitation of the total amount of saturated fat and cholesterol. The recommendation is that the amount of calories from saturated fats should be kept at less than 10% of the total. Patients with high cholesterol levels (more than 100 mg/dl) will notice an improvement if the saturated fat level can be kept even lower. For the purpose of lowering cholseterol, a recommendation is to reduce the calories from saturated fats if a weight loss is also required. Alternatively, replacing the saturated fat with carbohydrates or proteins will be equally beneficial but with no weight loss as a result.

It is recommended that the total level of fat is kept on approximately 15% of the gross calory intake, where the poly unsaturated fats are kept at max 10% and the mono unsaturated fats at no more thatn 20% of the gross calory level.

Cholesterol from the diet should ideally be controlled at a maximum of 275-300 mg per day. If the patient has a high cholesterol level, it may be better to aim at 200 mg per day. High triglyceride levels (above 150 milligrammes per day) can also be a trigger for cardiovascular disease. With more exercise, it is possible to decrease further.

The dietary intake of trans fatty acids should be controlled as they will increase cholesterol in a similar way as the saturated fats. This applies to the LDL cholesterol but the HDL cholesterol is actually decreased by trans fatty acids which is also not beneficial and another reason for controlling the level of trans fatty acids.

Fat replacing substances can be used in the reduction of the fat and cholesterol via diabetic receipts. There are a number of these approved by FDA. However, they may not be enough result from the replacement to achieve a weight loss.

Sugar: The old assumption was that simple sugars would digest and absorbe more rapidly than starches, with high blood sugar levels as a likely result. However, this idea has been shown wrong by modern scientific research. The guidelines now allow using sugar and foods that contain sugar, in modest levels to achieve a more balanced diabetic diet. It is still important though that these foods are substituted for other carbs, and not added to the diet as such. Of main importance is the total carbohydrate count and it is very important to handle this in moderation.

Non-nutritive sweeteners: Several of these have been FDA approved, such as saccharin, aspartame, acesulfame potassium (K) and sucralose. These can be used by diabetes patients including pregnant women with gestational diabetes, as long as the diabetes diet is balanced. Saccharin can actually cross the placenta, something that makes it less recommendable to pregnant patients who are recommended to use other sweeteners.

Fiber: There is no major difference in the recommendations for patients with diabetes as compared to any healthy individual. Somewhere between 20-30 grammes of fiber from several different sources daily is the general recommendation. Of this, 10-20 g should ideally originate from soluble fiber. There is a health benefit on glucose and serum lipids, from soluble source fiber to a diabetic patient. As sources of soluble fiber, fruits, vegetables and oat products are among the recommended.

Diabeties - Planning diets

Meal planning for diabetes should be aimed at supporting nutritional and health needs and not simply tailored towards control of the blood sugar level. The meal planning starts with an initial consideration of the normal eating habits of the patient, what foods he likes and dislikes, what his normal eating times are and the work hours. There are a few different diabetes receipt dietary planning systems available for meal planning for diabetics.

The Plate Method.

The plate method: This is a good and simple method to start with when understanding diabetic meal planning. A normal dinner plate can b seen as a pie chart showing the different food groups and proportions recommended. Vegetables should be incorporated to at least 50% level and the rest of the plate should be split between bread, potatoes and grain products plus one choice from the meat group.

Diabetic exchange diets: This system separates the food groups into six different categories depending on their content of macro nutrient - starch, meat, non-starchy vegs, fruit, fat and milk. The patient will use the Food Exchange method to plan the daily diet based on a certain specified amount of servings out of each of the categories. The advantage of this method is that the patient can measure his food, rather whan weighing, something that simplifies food and diet planning. In choosing, it is possible to exchange anything for something else as long as it is on the same food exchange list.

Carbohydrate Counting: This method is about counting the amount (of grammes) of carbohydrates in different foods, and vary the amount of carbohydrate taken in over the course of the day to control blood sugar. Dibetic diets, diabeties receipts summary for diabetes.