Recently the incidence of type-2 diabetes mellitus has increased and almost one member of each household is a diabetic. Type 2 diabetes mellitus is a metabolic disorder, which is characterized by hyperglycemia or high plasma glucose levels. This results due to defects in insulin secretion or insulin action or both.
When a meal containing carbohydrate is consumed, it is broken down to glucose and absorbed. This causes rise in the plasma glucose level, which is then sensed by the pancreas and insulin is released. This release of insulin promotes uptake of glucose by the muscles, thus clearing the bloodstream. However, in case of diabetes mellitus, the action of insulin is affected, thus causing hyperglycemia.
Uncontrolled diabetes mellitus for a prolonged period of time may lead to devastating complications such as retinopathy (damage to eyes), neuropathy (damage to nerves), nephropathy (damage to kidneys) and cardiovascular diseases. Therefore, management of type 2 diabetes mellitus through diet and medication is very important.
Diagnosis of Diabetes and Pre-diabetes
|–||Fasting plasma glucose (mg/dL)||Oral glucose tolerance test (mg/dL)||A1C (percent)|
|Normal||99 or below||139 or below||About 5|
|Diabetes||126 or above||200 or above||6.5 or above|
Nutritional Management of Type 2 Diabetes Mellitus
Maintain a healthy body weight
Being overweight or obese increases insulin resistance, thus it becomes difficult to maintain plasma glucose levels within normal range. Therefore, a 5-7% weight loss is targeted initially by creating an energy deficit of 500 calories per week. A calorie-controlled diet with moderate carbohydrate and low fat is an effective strategy to promote weight loss. Once an overweight diabetic loses weight, insulin resistance decreases and insulin sensitivity improves. This also promotes better uptake of glucose by the muscles.
Selection of carbohydrates
Both the quality and quantity of carbohydrate plays an important role in the management of diabetes mellitus. Carbohydrate sources rich in dietary fiber are the best options and these have shown to improve the plasma glucose levels. Foods with low dietary fiber content have high glycemic index, which tends to raise the plasma glucose levels rapidly. Favoring low glycemic index foods will help in the management of diabetes.
Healthy carbohydrate options include.
- Bran cereals
- Whole wheat
- Brown rice
- Broken wheat
- Fruits and
High protein diets are controversial in diabetes. Therefore, it is best to stick to a moderate protein diet. Include low-fat protein sources in your daily diet such as.
- Low fat milk and milk products
- Cereal-pulse combination
- Beans and pulses
- Red meat – it contains protein, but is also high in unhealthy fat. Therefore, limit it to one to two serving per month.
People with diabetes need to lower or limit their fat intake in order to reduce their risk of developing cardiovascular diseases. Do not use more than 4 teaspoons of oil per day for cooking. Here are some healthy as well as unhealthy types of fat.
|Unhealthy fat||Healthy fat|
Sample Diet Plan
|Meal timing||Menu||Reason behind|
|On rising||5-6 soaked fenugreek seeds (Methi) with 1 glass of water.||Hypoglycemic effect|
|Breakfast||1 bowl oats/ broken wheat/ quinoa/ barley porridge without sugar, with low-fat milk and 1/4th teaspoon cinnamon powder. OR 1 bowl fiber rich cereal grain with vegetables+1 cup milk/tea/coffee/green tea||The basic idea is to combine a cereal with a protein source such as milk. If you do not drink milk daily, replace it with egg whites.|
|Mid-morning||1 fruit||Do not combine fruit with a meal.|
|Lunch||1 bowl salad/ soup/ vegetable stir-fry +1 serving of fiber rich cereal grain +1 serving pulses/beans/soy/ ½ serving chicken/fish/ 2-3 egg whites +1 serving yogurt/buttermilk||Combine a source of carbohydrate with a good source of protein, a low-fat dairy product and loads of vegetables. This will lower the glycemic load of the meal.|
|Evening||1 cup milk/tea/coffee/green tea +1 serving of fiber rich cereal grain||During this time chances of slipping into hypoglycemia are more. Therefore, eat a carbohydrate source.|
|Late-evening||1 fruit+ 4 almonds or 1 walnut|
|Dinner||1 bowl salad/ soup/ vegetable stir-fry +1 serving of fiber rich cereal grain +1 serving pulses/beans/soy/ ½ serving chicken/fish/ 2-3 egg whites +1 serving yogurt/buttermilk||Combine a source of carbohydrate with a good source of protein, a low-fat dairy product and loads of vegetables. This will lower the glycemic load of the meal.|
|Bedtime||1 cup of milk without sugar||This will prevent 3 a.m. hypoglycemia and will keep your morning fasting plasma glucose levels in normal range.|
Here are some important tips and ways to correct your mistakes and to manage plasma glucose levels wisely.
|Nutritional Mistakes||Healthy Corrections|
|Fasting for a long period, for example- eating only 3 big meals with a gap of 5-6 hours within each meal.||Eat small-frequent meals every 2-3 hours. Do not fast.|
|Drinking sugar-sweetened beverages, fruit juices, and aerated drinks||Replace the unhealthy drinks with healthy beverages such as buttermilk, green tea, infused water.|
|Eating chocolates and sweets||Replace chocolates and sweets with fruits (50-100 grams of fruit at a time).|
|Eating products made out of refined flour.||Eating products made out of whole wheat, wheat cracks, buckwheat, oats, barley, brown rice, quinoa and sorghum.|
|Skipping your breakfast||Eat a heavy breakfast daily.|
|Not including vegetables in your daily diet||Eat at least 3-5 servings of vegetables daily in form of salad, stir-fry, and unstrained vegetable soups (without adding thickening agents) and unstrained vegetable juices.|
|Drinking fruit juices (fruit juices lack dietary fiber).||Replace fruit juices with whole fruits (whole fruits contain dietary fiber).|