Nutrition and diabetes mellitus

Nutrition in diabetes mellitus is an important part of alongandhealthy life. The newest concept is the medical nutrition therapy

What is medical nutrition therapy (MNT)?

Medical nutrition therapy (MNT) is a term used to describe the optimal coordination of caloric intake with other aspects of diabetes therapy (insulin, exercise, weight loss). For example, MNT now includes foods with sucrose and seeks to modify other risk factors such as hyperlipidemia and hypertension rather than focusing exclusively on weight loss in individuals with type 2 DM. Like other aspects of DM therapy, MNT must be adjusted to meet the goals of the individual patient. Main aims of MNT are prevention of short term and long term complications.


Nutrition and Type1 Diabetes mellitus


The goal of MNT in the individual with type 1 DM is to coordinate and match the caloric intake, both temporally and quantitatively, with the appropriate amount of insulin. MNT in type 1 DM and self-monitoring of blood glucose must be integrated to define the optimal insulin regimen. MNT must be flexible enough to allow for exercise, and the insulin regimen must allow for deviations in caloric intake. An important component of MNT in type 1 DM is to minimize the weight gain often associated with intensive diabetes management.

Nutrition and Type2 Diabetes mellitus

The goals of MNT in type 2 DM are slightly different and address the greatly increased prevalence of cardiovascular risk factors (hypertension, dyslipidemia, obesity) and disease in this population. The majority of these individuals are obese, and weight loss is strongly encouraged and should remain an important goal. Hypocaloric diets and modest weight loss often result in rapid and dramatic glucose lowering in individuals with new-onset type 2 DM. Current MNT for type 2 DM should emphasize modest caloric reduction, reduced fat intake, increased physical activity, and reduction of hyperlipidemia and hypertension. Increased consumption of soluble, dietary fiber may improve glycemic control in individuals with type 2 DM.

Dietary constituents and Diabetes mellitus

1. Carbohydrates

• 50-55% of calorie should be provided by carbohydrates
• consume unrefined carbohydrates (parboiled rice) rather than simple sugars (glucose)
• foods with low glycemic index aids the metabolic control
• high fiber diets are considered as foods with low glycemic index

2. Protein

• 10-20% of calorie should come from protein
• protein should be cut down if nephropathy is present

3. Fat

• Fat should provide 30% of the caloric need

10% unsaturated fat
10% poly saturated fat
10% monosaturated fat

• if the patient is hyperlipedimic, fat should be cut down

4. Alcohol

• Alcohol consumption is same as for the general public

2drinks/day for male
1drink/day for female

• Patients on insulin therapy should avoid alcohol as it can precipitate hypoglycemic attacks.